Elite athletes have reported uncertainty about training through pregnancy. They exercise well above the 150 minutes per week, often at a vigorous intensity, causing some to question the relevance of these recommendations to them.
For instance, a study conducted on 42 elite-level runners during pregnancy found that while their training volume decreased from the first to the third trimester, it was still two to four times higher than current guidelines.
Another study demonstrated that high-intensity interval training, which takes place at above 90 per cent of maximum heart rate, was well-tolerated by both medically screened mothers and fetuses for acute sessions and short periods of time.
More research is needed to provide better guidance on exercise frequency, intensity and duration for pregnant athletes, as the current guidelines may be relatively conservative for elite athletes.
OTHER CONSIDERATIONS
Over the past few Olympic Games, mother-athlete advocates have highlighted the difficult decisions athletes feel they must make when training during pregnancy.
For example, some athletes struggle with the societal pressure to choose between becoming pregnant or being an athlete – a choice male athletes never have to make. Athletes also expressed concerns around pregnancy planning, fertility, pregnancy disclosure, discrimination, safety while training, and funding support.
A follow-up study conducted with coaches and health-care professionals working with pregnant and postpartum athletes revealed similar themes. This included a lack of female-athlete reproductive research, a need for evidence-informed education and training, open communication to support athlete-centred care, and better essential supports and policy changes to support pregnant or postpartum athletes.
With the right supports in place, athletes can continue to train during pregnancy with medical support, and excel after birth. However, as with pregnancy and postpartum care, there is still work to be done to improve athlete care and support.
We need more high-quality evidence to inform evidence-based guidelines for elite sport participation and training through pregnancy and return to sport postpartum, with improved sport policy. This will, in turn, promote longevity in sport.
Jenna Schulz is Physiotherapist and Postdoctoral Fellow, Fowler Kennedy Sport Medicine Clinic, Western University. Jane Thornton is a Sport Medicine Physician at Western University and a former Canadian Olympic rower. Michelle F Mottola is Professor in Kinesiology, Faculty of Health Sciences and Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University. This commentary first appeared in The Conversation.
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