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PT postpartum: An added stress for new moms

Oct. 2, 2013 - 05:27PM   |  
An airman conditions during the 90in90 fitness program. Postpartum Air Force women have used the program to get back in shape before an upcoming PT test.
An airman conditions during the 90in90 fitness program. Postpartum Air Force women have used the program to get back in shape before an upcoming PT test. (John Walters via YouTube)
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Staff Sgt. Alison Mona wanted out of her physical training test. She’d already failed twice. One more failure would mean an end to her Air Force career.

Adding to her stress was her recent pregnancy, which left her feeling out of shape.

As the Feb. 28 PT test loomed, Mona concocted a plan and enlisted a roommate to help her carry it out. The roommate would stab Mona in the stomach with a steak knife. They’d tell authorities she was attacked by a stranger. Hospitalized, she would be unable to take the test.

“I gave birth to my child after 6 weeks of being on maternity leave,” Mona wrote in an official statement after she was charged with misleading authorities. “Realizing I had a PT test due in 6 months, I was nervous I would not be physically fit ... and pass.”

Airmen have used drastic measures to pass the abdominal circumference component of the PT test — from slathering on heat rub or hemorrhoid cream, cocooning themselves in plastic wrap, to dehydrating themselves with saunas or steam baths. Some have even had surgical procedures, according to Air Force fitness experts.

But Mona’s desperate actions — while caring for a new baby and dreading her PT test — may be the most drastic yet.

“I was not ready for my test, and I knew I wouldn’t pass if I had taken it,” Mona told military judge Lt. Col. Jill Thomas. “I intentionally inflicted injury upon myself ... nobody forced me to do this.”

PT and pregnancy

About 4,800 female airmen each year face the challenge of passing a PT test six months after giving birth. Between January 2001 and December 2010, 47,816 babies were born to women serving in the Air Force,according to the Armed Forces Health Surveillance Center.

Women get six months postpartum to get back in shape for their next PT test, under Air Force Instruction 36-2905. The Air Force Fitness Advisory Board, supported by the Air Force Surgeon General’s obstetrics and gynecology consultant, concluded last year that six months is the appropriate recovery time.

But in a recent study, “Changes in Air Force Fitness Measurements Pre- and Post- Childbirth,” researcher Lt. Col. NicoleArmitage found that one in four of the women in her test group did not pass the PT test after having a baby. Armitage is the chief of clinical research at the Clinical Investigation Facility, 60th Medical Group, at Travis Air Force Base, Calif.

Armitage created a database from PT records between Jan. 1, 2008, and Oct. 31, 2011. She analyzed data from 107 active-duty women, ages 20 to 41 and in varying ranks, from both Travis and Fairchild Air Force Base, Wash. The preliminary study found these women had larger abdominal circumferences, fewer pushup repetitions, and longer run times at six months postpartum than in their prepregnancy assessments. No significant difference was found in situp measurements.

“We were trying to show that women physiologically — there are many reasons, that once a woman is pregnant and has a baby — may not be able to pass the PT test,” said retired Lt. Col. Denise Smart, co-author to the study and Armitage’s supervisor. Smart was the chief of public health and chief nurse with the 141st Medical Group at Fairchild.

“It takes your body six months to a year to totally heal up internally with cellular rejuvenation. Externally, the scars and the tissue may be healed, but internally, it takes a while,” Smart said of postpartum women.

Armitage said that most women in her study had prepregnancy assessments using an older PT scoring system and postpartum assessments using a newer scoring system.

Capt. Rose Richeson, an Air Force spokeswoman, also pointed out the difference in scoring: “The increased failure rate after pregnancy is not just because of deconditioning but can also be attributed to [the 2010] changes in the Air Force scoring system that made the fitness test tougher to pass for all airmen.”

But Armitage recently completed a second study, not yet published, for which she interviewed 17 women at Travis and Fairchild — again, from varying ranks, but ages 21 to 36 — about the experiences they had as they prepared for their fitness assessments six months postpartum.

“They spoke of the struggle of trying to adjust to training after having a baby,” Armitage said.

Most of them were concerned with the physical changes — how much conditioning they had lost, challenges of doing situps after having Caesarean sections, and how to schedule training around breastfeeding.

“Not all women are struggling [post-pregnancy], but — from a health care perspective, as health care provider — following up with women more closely with referrals, nutritional counseling, would be helpful,” Armitage said.

“What we were trying to show is that supervisors, commanders and physicians and nurse practitioners need to know that perhaps these women have had problems either during the pregnancy or right after pregnancy,” Smart said. “We’re trying to get folks to realize, to [make] practitioners and providers more sensitive and try to educate these women about the options they have,” she said.

Richeson said that the Air Force has no plans to change its criteria for new mothers.

“Placing a priority on fitness by educating airmen and commanders of its importance after pregnancy promotes health and mission performance, which are essential to meeting all Air Force standards,” she said.

A different case

Mona’s stabbing wound was only superficial, but she spent the day of her PT test in the hospital.

A military judge in June sentenced Mona,a content management technician with the 61st Communications Squadron, Los Angeles Air Force Base, to 90 days in jail and busted her three ranks, to an E-2, after she pleaded guilty in a special court-martial to filing a false police report and making two false official statements.

She also was found guilty of inflicting self injury for the purpose of avoiding work and bringing discredit upon the armed forces, violations of Article 115 and 134 of the Uniform Code of Military Justice.

Air Force Times was first to report the sentencing in July. More details of the case are included in a partially redacted record of trial provided Sept. 9 at Air Force Times’ request.

“My fear of failing the PT test stemmed from a story of which a member failed 3 times and was kicked out of the Air Force,” Mona said in a written statement. “If I failed this most recent PT test, I was sure that I was going to be kicked out of the military.”

Friends, relatives and colleagues wrote character statements on Mona’s behalf, praising her devotion to her family, her work and the Air Force.

Mona’s roommate — asked to do the stabbing and identified as her husband’s cousin — said “she looked at [Mona] as a mother who was trying to keep her job.”

Mona was a “go-getter in their unit,” Staff Sgt. Melvin Batangan testified.

When asked if Mona should stay in the Air Force, he replied yes, because “everybody deserves a second chance.”

Senior Airman Ivory Salazar, also a witness for the defense, said she and Mona PTed together for about four months — sometimes with the squadron, plus on their own three times a week. They also did pushups and situps for an hour every day for two months before work in the morning.

“I do believe I have rehabilitative potential,” Mona told the judge. “I do believe that people make mistakes. It’s exactly that; it’s a mistake.”

Bouncing back

One airman who failed her PT test after having twins in 2011 described in an email to Air Force Times the challenge she and women like Mona face.

“Even though I still had a score of 89 [out of 100], it was considered a failure due to missing the situp minimum by 3 situps,” Anna Mejia wrote. “Three kids in two years by C-section will do a number on your core. I work very hard at PT, but my ab muscles will never be the same and I am terrified of that portion of the test every time.”

Another airman wrote on the Air Force Times Facebook page in praise of a program run by the Dover Air Force Base, Del., Health and Wellness Center called 90in90. “I joined this program to get ready for my first test after giving birth and it definitely helped,” Chelli Smithwrote.

John Walters, Dover Air Force Base exercise physiologist, created the “90in90” program in January 2012.

“The goal is to take someone that’s not reaching a 90 [score] ... and get them to a 90 in that 12-week, almost 90-day period,” Walters said. Airmen must score at least a 75 to pass the PT test, but a 90 allows them to take the test just once a year, instead of every six months.

Walters breaks the 90in90 classes into three days a week: speed on Mondays, circuit training on Wednesdays, and a 5-kilometer runon Fridays.

“If people do not want to participate in certain components [modeled after the PT test], it’s not mandatory,” he said. “It’s what they can do but use[s] the same premise — getting that heart rate up and then down again — to condition themselves to be ready. The Air Force is asking for a 1 mile run test. If you can’t run it, then I want you to walk two.”

Senior Airman Brittany Bailey, vehicle mechanic with the 436th Readiness Squadron at Dover, started the class as a new mom 1½ months before her PT test.

During her pregnancy, she said she had gained almost 70 pounds and had complications after having had a C-section. She had no motivation or support to help her get back into shape — until her primary care physician told her to go see Walters.

“Mr. Walters really works with you as an individual,” Bailey said. “The way he has the program set up, it’s not only meant for success in PT but also for a healthy lifestyle. It is definitely something the Air Force, even the entire military, should look into doing for everyone.”

Before her PT test, Bailey lost 40 pounds. She scored 82. She continued with 90in90 and three months later scored 96. After that, she scored 98.

“Every pregnancy is different, especially with complications,” Bailey said. “I think, in the Air Force, it needs to be taken case by case and that women should be reviewed by their [primary care managers] every few weeks, and extensions should be allowed.”

'No option' mentality

Ultimately, the extreme measures Mona took to avoid being kicked out of the Air Force ruined her career.

She was released from jail Aug. 26, after serving her 90-day sentence. But with six years of service and a reduction in rank to E-2, she is unlikely to be allowed to stay in the Air Force because of limits on tenure and rank.

Due to some actions still pending in her case, Mona was not available for an interview, her attorney, Capt. John Capps, said. He declined to speak on her behalf. The prosecution and Mona’s commanding officer couldn’t be reached.

“I want to apologize to my family for letting them down, disappointing them, and most importantly, I want to apologize to my colleagues, director, supervisor, and the Air Force, to the uniform I wear and [that] I brought shame upon [with] these charges against me; it was an act of desperation,” Mona said to the judge before sentencing. “I lost the one thing that I love the most, my Air Force career.”

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