How to reconcile high-level sport and motherhood

Serena Williams during the US Open, September 2, 2022, a few months before her second pregnancy.

Ten thousand steps and more. Control weight gain, reduce lower back and pelvic pain, prevent urinary incontinence… The benefits of physical activity for pregnant women have been amply demonstrated. Moving appropriately during pregnancy also helps reduce the risk of certain complications such as gestational diabetes or hypertension. Studies even suggest positive effects for the future baby, including a boost in the development of their language and cognitive abilities.

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What about elite athletes, who practice intensively for dozens of hours per week? Is the benefit/risk ratio as positive as in the general population? How to adapt training and manage the return to competition? Reconciling a sporting career and motherhood is a subject that is less and less taboo, but which often remains complicated in practice, despite the existence of recommendations.

A qualitative survey, conducted among 16 professionals in the field, and published online October 25 in the British Journal of Sports Medicine, deplores the lack of specific research in this area. This deficiency hampers their ability to adapt training and advise high-level athletes during their pregnancy and postpartum, deplore the doctors, physiotherapists and coaches interviewed, most of whom practice in North America. Thus, write Margie Davenport (University of Alberta, Canada), first author of the article, and her colleagues, several professionals consider the current recommendations too general, sometimes inappropriate for this specific audience. Some admit to not knowing what clinical warning signs to look for or what parameters to monitor to verify that training is being done in safe conditions. These field specialists also emphasize that athletes themselves are not sufficiently informed about the physiological consequences of pregnancy, for example in terms of the pelvic floor.

Adapted training

“It is true that there is a lack of scientific studies of pregnancy in high-level sport, but the gap has been closing in recent years, and I find the conclusions of this study a little pessimistic”, reacts Carole Maître, gynecologist at the National Institute of Sport, Expertise and Performance (Insep). According to this specialist, current documents, including the recent guide “High-level sport and motherhood, it’s possible”led by the Ministry of Sports (and in which she participated) are precise and concrete.

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