Pregnancy and Sport Participation

By Terry Zeigler, EdD, ATC

Although the benefits of exercising during pregnancy are well known, there is controversy over whether competitive athletes should continue to compete in their sport during pregnancy.

A number of pregnant athletes have continued to compete while pregnant including Olympic beach gold medalist volleyball player Kerry Walsh, WNBA athlete Candace Parker, and LPGA player Catriona Matthew who won the Brazil Cup when she was five months pregnant. However, the issue becomes more complicated when the athlete is under 18 and is competing in high school.

As the pregnancy progresses, the natural weight gain of the fetus coupled with the body weight and adaptations of the athlete will deter an athlete from competing. But should an athlete continue to compete during the first trimester when the body weight changes have not yet occurred?

The safety of both the pregnant woman and the fetus are the primary concerns. One guideline that was published in 1985 by Dr. Raul Artal, chairman of obstetrics, gynecology and women’s health at Saint Louis University in St. Louis, stated that a pregnant athlete should not have a heart rate of higher than 140 beats per minute to ensure that the fetus would not be deprived of oxygen.

Although this guideline is still quoted today, Dr. Artal now states that the 140 beats per minute guideline was calculated by an estimation and was not based on evidence (Lavigne, P., November 29, 2009). Although the original number of 140 beats per minutes was later tested in a lab setting and proved safe for both the pregnant athlete and the fetus, the standard still exists in the literature today.

Ultimately, the decision to continue to compete is up to the athlete and the athlete’s personal physician. However, not all physicians will agree on allowing a pregnant athlete to compete. With this in mind, a number of factors need to be taken into consideration including the age and fitness level of the athlete, competition level (high school versus collegiate team), physical demands of the sport, and risk factors of the sport (i.e., contact sport, sport implements).

Because pregnant athletes under 18 legally are under their parents care, parents need to be included in making the decisions for these athletes. Athletes 18 and older have the legal right to make decisions regarding their own health and medical care.

It is also well documented that women who regularly exercise before pregnancy may continue to do so during pregnancy. Because the body has already adapted to the physiological demands of the specific activity, the body will be able to handle the demands of exercising during pregnancy.

However, athletes who have not been regularly active prior to pregnancy should not begin a rigorous exercise program when they become pregnant. This can place both the fetus and the pregnant athlete at risk for medical complications.

Competition level is also an important factor to consider when making the decision on whether to compete or not. The demands of competing on a high school athletic team may not be as strenuous as the demands of competing on a club level or collegiate level team. More competitive teams tend to have more intense and longer practices. A less competitive program will require less physical demands from their athletes.

The physical demands of the sport may be the key factor in deciding whether to continue to compete during pregnancy. Sports such as volleyball that require an athlete to dive on to the floor may place the fetus at risk. Sports in which body to body contact is a regular occurrence (i.e., soccer and basketball) may also place the fetus at risk. However, noncontact sports such as cross-country running or swimming may be safer because the risk of injury due to the nature of the sport is significantly less.

With that being said, hypoglycemia (low blood sugar) during strenuous exercise is a potential problem for pregnant athletes along with overheating and dehydration. Competitive pregnant athletes need to consume extra calories and drink plenty of liquids to ensure that both the athlete and fetus have the nutrients needed during exercise.

Other risk factors that need to be considered include if the fetus may be at risk due to the nature of the sport. For example, a pregnant athlete who pitches on a fastpitch softball team may be placing her fetus at risk for injury while pitching due to high-speed projectiles (line drive up the middle). An athlete who is a catcher may place the fetus at risk for injury due to collisions likely to occur with a close play at the plate.

The physiological demands of the sport and the risk factors inherent in the sport need to be considered when making a decision whether to continue to compete in sports while pregnant. If the athlete should choose to continue to participate, the athlete should:

• Stay hydrated
• Increase caloric intake
• Be careful of her body’s center of gravity
• Compete at a pace that allows the athlete to breathe easily
• Be under the care of a physician. 

References

Anderson, M., Hall, S., & Martin. M. (2005). Foundations of Athletic Training: Prevention, Assessment, and Management. (3rd Ed.). Lippincott Williams and Wilkins: Philadelphia, PA.

Lavigne, P. (November 29, 2009). Pregnant Athletes Don’t Have to Sit Out. (ESPN.com).