J Korean Matern Child Health .  2024 Jul;28(3):88-94. 10.21896/jkmch.2024.28.3.88.

A Review of Factors for Successful Childbirth and Return to Sport for Female Elite Athletes

• Yun HG

• KMID: 2558200
• DOI: http://doi.org/10.21896/jkmch.2024.28.3.88

Abstract

An increasing number of elite athletes who experience pregnancy and childbirth during their careers and subsequently return to competitive sports is steadily increasing. While general guidelines for physical activity during and after pregnancy exist for the nonathletes and recreational athletes, there is a lack of evidence-based guidelines for high level competitive athletes. As a result, athletes often return to training without adequate support, and some may even choose to give up pregnancy and parenthood. This review aims to examine the factors that influence the healthy pregnancy and successful return to elite sport among female athletes, based on the experiences of those who have navigated this transition successfully and the research in this area. The studies included in this review emphasize the need for an inclusive sports environment, open and supportive systems, and institutional changes and academic research to enable informed decision-making for pregnant and parenting elite athletes. To ensure sufficient recovery time for elite athletes after childbirth and to develop evidence-based return-to-sport programs, as well as provide clear policies and practices for financial and social support, including childcare, collaboration and support from national governments, sports organizations, and associations is crucial.

Keyword

Female athletes, Competitive athletes, Pregnant female elite athlete

Reference

American College of Obstetricians and Gynecologists. ACOG Committee Opinion number 313, September 2005. The importance of preconception care in the continuum of women's health care. Obstet Gynecol. 2005. 106:665–6.

Bø K., Artal R., Barakat R., Brown W., Davies GA., Dooley M, et al. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 1—exercise in women planning pregnancy and those who are pregnant. Br J Sports Med. 2016a. 50:571–89.

Bø K., Artal R., Barakat R., Brown WJ., Davies GAL., Dooley M, et al. Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 3—exercise in the postpartum period. Br J Sports Med. 2017. 51:1516–25.

Bø K., Artal R., Barakat R., Brown WJ., Davies GAL., Dooley M, et al. Exercise and pregnancy in recreational and elite athletes: 2016/2017 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 5. Recommendations for health professionals and active women. Br J Sports Med. 2018. 52:1080–5.

Bø K., Artal R., Barakat R., Brown W., Dooley M., Evenson KR, et al. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 2—the effect of exercise on the fetus, labour and birth. Br J Sports Med. 2016b. 50:1297–305.

Bø K., Backe‐Hansen KL. Do elite athletes experience low back, pelvic girdle and pelvic floor complaints during and after pregnancy? Scand J Med Sci Sports. 2007. 17:480–7.

Bung P., Huch R., Huch A. Maternal and fetal heart rate patterns: a pregnant athlete during training and laboratory exercise tests; a case report. Eur J Obstet Gynecol Reprod Biol. 1991. 39:59–62.

Ceydeli A., Rucinski J., Wise L. Finding the best abdominal closure: an evidence-based review of the literature. Curr Surg. 2005. 62:220–5.

Coll CV., Domingues MR., Gonçalves H., Bertoldi AD. Perceived barriers to leisure-time physical activity during pregnancy: a literature review of quantitative and qualitative evidence. J Sci Med Sport. 2017. 20:17–25.

Culvin A., Bowes A. The incompatibility of motherhood and professional women's football in England. Front Sports Act Living. 2021. 3:730151.

Currie A. Sport and eating disorders-understanding and managing the risks. Asian J sports Med. 2010. 1:63–8.

Darroch FE., Giles AR., Hillsburg H., McGettigan-Dumas R. Running from responsibility: athletic governing bodies, corporate sponsors, and the failure to support pregnant and postpartum elite female distance runners. Sport Soc. 2019. 22:2141–60.

Davenport MH., Nesdoly A., Ray L., Thornton JS., Khurana R., McHugh TF. Pushing for change: a qualitative study of the experiences of elite athletes during pregnancy. Br J Sports Med. 2022. 56:452–7.

Davenport MH., Ray L., Nesdoly A., Thornton J., Khurana R., McHugh TF. We're not superhuman, we're human: a qualitative description of elite athletes’ experiences of return to sport after childbirth. Sports Med. 2023. 53:269–79.

Davies GA., Wolfe LA., Mottola MF., MacKinnon C; Society of Obstetricians and Gynecologists of Canada, SOGC Clinical Practice Obstetrics Committee. Joint SOGC/CSEP clinical practice guideline: exercise in pregnancy and the postpartum period. Can J Appl Physiol. 2003. 28:330–41.

Hong YH., Chung S. Small for gestational age and obesity related comorbidities. Ann Pediatr Endocrinol Metab. 2018. 23:4–8.

Kardel KR. Effects of intense training during and after pregnancy in top‐level athletes. Scand J Med Sci Sports. 2005. 15:79–86.

Korean Society of Obstetrics and Gynecology. Obstetrics. 6th ed.Seoul (Korea): Korean Society of Obstetrics and Gynecology;2019.

Kovacs CS., Ralston SH. Presentation and management of osteoporosis presenting in association with pregnancy or lactation. Osteoporos Int. 2015. 26:2223–41.

Lang U., Baker RS., Braems G., Zygmunt M., Künzel W., Clark K. Uterine blood flow—a determinant of fetal growth. Eur J Obstet Gynecol Reprod Biol. 2003. 110(Suppl 1):S55–61.

Lovelady CA., Lonnerdal B., Dewey KG. Lactation performance of exercising women. Am J Clin Nutr. 1990. 52:103–9.

Martinez-Pascual B., Alvarez-Harris S., Fernández-De-Las-Peñas C., Palacios-Ceña D. Maternity in Spanish elite sportswomen: a qualitative study. Women Health. 2014. 54:262–79.

Massey KL., Whitehead AE. Pregnancy and motherhood in elite sport: The longitudinal experiences of two elite athletes. Psychol Sport Exerc. 2022. 60:102139.

McGannon KR., McMahon J., Gonsalves CA. Juggling motherhood and sport: A qualitative study of the negotiation of competitive recreational athlete mother identities. Psychol Sport Exerc. 2018. 36:41–9.

Moon GB., Lee MH., Min DS., Im BS., Cho EJ. A survey on the human rights situation of women professional sports, 2020. Seoul (Korea): National Human Rights Commission of the Republic of Korea;2021.

Mottola MF. Exercise in the postpartum period: practical applications. Curr Sports Med Rep. 2002. 1:362–8.

Mountjoy M., Sundgot-Borgen J., Burke L., Carter S., Constantini N., Lebrun C, et al. The IOC consensus statement: beyond the female athlete triad-relative energy deficiency in sport (RED-S). Br J Sports Med. 2014. 48:491–7.

Salvesen KÅ., Hem E., Sundgot-Borgen J. Fetal wellbeing may be compromised during strenuous exercise among pregnant elite athletes. Br J Sports Med. 2012. 46:279–83.

Scharfen HE., Memmert D. Measurement of cognitive functions in ex perts and elite athletes: a meta‐analytic review. Appl Cogn Psychol. 2019. 33:843–60.

Solli GS., Sandbakk ø. Training characteristics during pregnancy and postpartum in the world's most successful cross country skier. Front Physiol. 2018. 9:595.

Sundgot-Borgen J., Sundgot-Borgen C., Myklebust G., Sølvberg N., Torstveit MK. Elite athletes get pregnant, have healthy babies and return to sport early postpartum. BMJ Open Sport Exerc Med. 2019. 5:e000652.

Tenforde AS., Toth KE., Langen E., Fredericson M., Sainani KL. Running habits of competitive runners during pregnancy and breast-feeding. Sports Health. 2015. 7:172–6.

Weaving C. Prenatal paranoia: an analysis of the bumpy landscape for the pregnant athlete. Sport Ethics and Philosophy. 2020. 14:176–91.

Weina SU. Effects of pregnancy on the army physical fitness test. Mil Med. 2006. 171:534–7.

Wieloch N., Klostermann A., Kimmich N., Spörri J., Scherr J. Sport and exercise recommendations for pregnant athletes: a systematic scoping review. BMJ Open Sport Exerc Med. 2022. 8:e001395.

Wowdzia JB., McHugh TL., Thornton J., Sivak A., Mottola MF., Davenport MH. Elite athletes and pregnancy outcomes: a systematic review and meta-analysis. Med Sci Sports Exerc. 2021. 53:534–42.