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How frequently and intensely can you train during pregnancy? How soon can you return to sport after childbirth? Female Athlete Program and Wu Tsai Human Performance Alliance collaborating researcher Kirsty Elliott-Sale led a review of the existing literature for the answers to such questions and pinpoints research gaps that need to be addressed to improve care for elite athletes and women in arduous occupations during and post-pregnancy. 

We don’t have many comprehensive guidelines for female athletes, especially pregnant athletes. The situation reflects the science – there hasn’t been much research about these populations. So the article reviews piecemeal suggestions from gynecology and sport-related resources, including the American College of Obstetricians and Gynecologists and the International Olympic Committee, respectively. One piece of advice: elite athletes should adjust the type and volume of training between trimesters, and omit high-impact activities in the weeks right after giving birth if they have a history of muscle or tendon-related injury.

These imprecise guidelines open the door to further questions, like, how much should an athlete adjust the type and volume of training for a specific trimester? Elliot-Sale and her co-authors suggest recruiting a multidisciplinary team with a range of expertise to help the mother achieve her health and performance goals. Such a team could implement preventative measures before birth, for instance through pelvic floor muscle training and reducing activities like prolonged standing. The team could also support the mother through a phased training plan to recover and return to sport after delivery.

The authors also suggest ten research gaps to improve care for elite athletes and women in arduous occupations during and post-pregnancy. They want to see answers to questions such as what are the most effective exercise-based interventions for recovering in the weeks after pregnancy and when can you safely start such an intervention. 

Elliot-Sale, among other researchers in the Female Athlete Program, will continue their work to advance our knowledge, understanding, and quality of care for female athletes and all women throughout their life stages. 

Read the full perspective article from Exercise and Sport Sciences Reviews