Returning to sport after pregnancy: A qualitative study of elite female athletes in the UK

Returning to sport after pregnancy: A qualitative study of elite female athletes in the UK | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Returning to sport after pregnancy: A qualitative study of elite female athletes in the UK Noreen O'Leary, Catherine Caro, Storm Trow, Zoe Bell, Elana Payne, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4318196/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Returning to sport postpartum is becoming increasingly common for elite athletes. While policies to support women during this period are emerging, this remains an area of limited research. To date the lived postpartum experience of UK elite athletes as they returned to sport has not been explored. Methods: This qualitative study collated the experiences of 11 women via online interviews. Data was analysed using thematic analysis. Results: Three key themes were generated from the data: 1) navigating the mother-athlete identity 2) personal support and inspiration and 3) systemic supports. Athletes must navigate their return to sport, both in terms of their changed identity and practical challenges associated with having a child. Seeing other women navigate this journey provided encouragement to athletes that they could do this. Findings also illustrated the role of the athletes’ own sports community and wider organisations. Access to specific supports such as timelines for return to sport and nutritional advice positively impacted the athlete’s postpartum return to sport, as did access to maternity leave policies which protected funding during the pregnancy and postpartum period. Conclusions: Moving forward, carrying out high-quality research to inform guidelines for elite athletes return to sport and developing national level maternity leave polices need to be seen as urgent priorities. This is to ensure that elite athletes are properly supported during the postpartum period and can resume their careers. athlete pregnancy postpartum return to sport Background Motherhood is a period of major transition, and is associated with significant physical, psychological and social changes. Adapting to motherhood can be a complex process, due to changing priorities, competing demands, and changing identity ( 1 , 2 ). Although research on motherhood and the transition to motherhood is well documented in the general population ( 3 ), there is limited research describing the experiences of elite athletes as they navigate the dual role of mother and athlete . However, understanding the specific issues facing postpartum athletes is necessary to ensure optimal health and performance outcomes ( 4 ) and will make an important contribution to United Nations Sustainable Development Goal 5 of Gender Equality and Empowerment ( 5 ). A recent review reported elite athletes’ experiences during and after pregnancy and described biomedical and sociological factors. Biomedical factors described included physical changes, injury risk and performance outcomes while social factors focused on support systems, childcare and access to maternity leave ( 6 ). However, there is a paucity of studies exploring factors athletes consider to be supportive or inhibitive in adjusting to motherhood and returning to high performance sport. Recent research from North America explored the experiences of elite athletes who returned to sport post-childbirth and described time pressures and expectations for returning to sport, physical, mental, and emotional health changes, practical challenges and the importance of supportive networks ( 7 ). In New Zealand, a study which explored the multiple identities of elite athletes and mothers, described how sport was a large part of an athletes’ sense of self, and while the impact of motherhood on the athletes’ identity was positive, feelings of guilt, lack of time, and limited organisational support were identified as major challenges ( 8 ). Additionally, a study in Slovenian elite athletes who became mothers during their competitive career described motherhood and elite sport having a reciprocal effect on each other with three distinct transition phases identified including pre-pregnancy and pregnancy, returning to sport, and living the life of a mother-athlete ( 9 ). In the UK, an increasing number of elite athletes are returning to sport post-pregnancy. In 2023, UK Sport developed guidelines for high-performance sports during and after pregnancy. These guidelines advise Sports Governing Bodies (SGBs) and athletes on how best to support an athlete’s return to sport including advice on level of training/return to fitness, post-childbirth rehabilitation, nutritional wellbeing, and practicalities around training schedules, breastfeeding and return to competition ( 10 ). Such guidelines must continue to be updated and informed by research that is grounded in the experiences of elite athletes who combine motherhood and high-performance sport. Currently, there is a knowledge gap in understanding the post-pregnancy experiences of UK elite athletes. This study aimed to explore UK elite athletes' experiences post-pregnancy as they navigate motherhood and return to high performance sport. Methods Study Design This qualitative analysis forms part of a wider study with the primary aim of understanding the preconception, pregnancy, and post-pregnancy experiences of elite athletes in the UK (11). This analysis pertains to post-pregnancy experiences of elite athletes. This research used a qualitative descriptive study design (12), and adopted a relativist ontology and constructivist epistemology (13). Data was collected using semi-structured interviews. The COnsolidated criteria for REporting Qualitative research (COREQ) reporting guidelines have been followed (14) and the COREQ checklist completed (Additional file 1) . Ethical approval This study was reviewed and approved by King’s College London (Reference: LRS/DP-22/23-34763) and the protocol registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/BU5H4). The participants provided written consent prior to commencing all interviews. Recruitment and participants Participants were recruited using social media platforms (Twitter, Instagram, Facebook, and LinkedIn), researcher networks, sports organisations (King’s Sport), and word of mouth via purposeful and snowball sampling (15). Inclusion criteria were: i) athletes aged 18 years or older, ii) resident in the UK, and iii) athletes who competed at an elite level pre-pregnancy and/or during pregnancy in the last 10 years. Tier 4 (elite/international level) and Tier 5 (world class) of the Participant Classification Framework (16) was used to defined elite athletes. Interested participants received a participant information sheet and a consent form to be completed prior to data collection. Participants had a minimum of 24 hours between receiving this information and providing consent. Data Collection The interviews were scheduled at a time convenient for the participants and were conducted online via Microsoft Teams between March and June 2023. Two authors (ST, CC) conducted individual semi-structured interviews, which followed a standardised structure, while allowing flexibility in exploring topics in more depth. The interview schedule was developed in consultation with multidisciplinary academics and informed by literature on pregnancy health and elite sport and was piloted by two elite athletes who were not included in the study (Additional file 2) . Each interview lasted between 23 and 64 minutes (M Time = 43 minutes). Prior to the interview, the athletes completed a short questionnaire to collect social and demographic data (age, ethnicity), and data on the type of sport the athlete participated in (type of sport, highest level of competition achieved, and current status: active or retired). Data analysis The interviews were audio recorded, transcribed verbatim, and imported into NVivo v.14 for data management. To ensure anonymity, participants names and specific sport were removed and replaced with pseudonyms and type of sport, respectively. Data were analysed using inductive thematic analysis, following a six-phase process. (17). In brief, this entails familiarisation with the data through reading and re-reading the transcripts, generating an initial list of codes, crosschecking codes, grouping codes into themes, refining and naming themes. The data was coded by two authors (ST and CC); provisional themes were discussed and refined by all authors. Further analytical work was carried out by two authors (EP and SAS) to derive the final thematic structure. Theory can support conceptually deeper data analysis, however, can also bias findings in the direction of the theoretical concepts (18). For this study, data collection and analysis were initially completed inductively. Following development of initial themes potentially suitable theories were explored, to frame findings and recommendations. The socioecological framework was chosen as the most suitable for this study, as it considers phenomena through multiple levels of influence the impact of different contexts(19). This framework has also been used in research relating to physical activity in pregnancy (20). Sample size sufficiency was determined based on information power. Using this approach sample adequacy is informed by considering the specificity of participant experience relevant to the research question, whether the study has a narrow or broad aim, the quality of the interview dialogue and the analytical strategies (21). As this study included individual interviews with participants with first-hand experience of the phenomenon of interest, the final number of participants (n=11) was deemed adequate. Results Participant characteristics Eleven elite athletes participated in the study. The mean (SD) age of the athletes was 31(3) years and duration participating in elite sport 10(5) years (Table 1). Two participants were pregnant at the time of interviewing and prospectively described their return plans, while nine had returned to sport post-pregnancy. Participants were involved in nine different sports, including team ball sports (n= 3), sprint and endurance sports (n= 5), power sports (n= 2), and combat sports (n= 1). Four athletes were 1-2 years postpartum, two were three years postpartum and four years postpartum respectively and one was five years postpartum (Table 2) . Table 1. Participant characteristics Mean (SD) Age (years) 31 (3) Ethnicity White British 8 (73) White Other 1 (9) Black Caribbean 2 (18) Duration in sport (years) 10 (5) Retired 0 (0) Currently pregnant 2 (18) 1-5 years post pregnancy 9 (81) Type of sport N (%) Sprint and Endurance sport, e.g. rowing 5 (45) Team ball sport e.g. football 3 (27) Power sport e.g. powerlifting 1 (9) Precision and Technical e.g. shotput 1 (9) Combat sport e.g. judo 1 (9) Highest level of competition Olympic games or world championships (Tier 5) 8 (73) Paralympic games or world championships (Tier 5) 1 (8) Elite/international competition (Tier 4) 2 (18) Table 2. Themes and sub-themes Navigating the Mother-Athlete Identity Changing priorities and shifting identities Athletes described a shift in their mentality from sport being their principal focus to having a new perspective where personal and professional experiences were more balanced. “It's given me a bit more of a well-rounded perspective and approach on success and happiness and stuff. And I guess I'm doing my sport because I still feel I'm good at it and I enjoy it. But ultimately, it's not the be all and the end all now to me.” Victoria, combat sport “The couple hours that I would get to be able to train each day or three times a week was actually just quite a nice break from motherhood and more feeling like myself. Victoria, combat sport “And it was nice to do things that I used to do and go back to, like being old me” Beatrice, technical sport However, changing priorities and the shift from having control of factors such as time and sleep to focusing on the baby first was considered challenging. “I think. It's just quite hard when you're an athlete and you're used to. I guess yeah, one being able to be like really selfish with your time and then suddenly I couldn't and I wasn't in control of it. And also looking after yourself really well. And then suddenly I wasn't getting to sleep for an hour, wasn't able to eat at regular times or what I needed to. Because you look after the baby first and then yourself”. Elizabeth, endurance sport Breastfeeding and the return to sport was an issue spoken about by many athletes. Breastfeeding was in part discontinued for an athlete who participated in contact sport due to it being painful. While another athlete described the challenges of breastfeeding and milk supply in the postpartum period and concerns around pumping and leaking breasts while training. “I stopped breastfeeding at seven months post part, and that was partly due to coming back to [sport] and it being painful to do [sport] with one while breastfeeding. Like every time someone hit into my chest, it really hurt.” Victoria, combat sport “if I were to carry on breastfeeding when I went to things like training [I’d have to] to worry about, you know leaking and also pumping. When I pumped I didn't produce enough milk and when I breastfed she wasn't getting what she needed. You know luckily, she had the most important part of the colostrum so that was great, but there was a lot of pressure on it and I just couldn't produce what I needed to so that obviously made me feel bad that I couldn't breastfeed. But I actually think that it was a blessing in disguise really, because from you know, weeks six, she slept through the night and, you know she wouldn't. She didn't become too dependent on me.” Jane, team ball sport Impact of having a changed body Athletes described the physical impact of childbirth on the return to sport, in particular pelvic floor health and how it impacted the type of exercise an athlete could engage in. “ I've never had bad pelvic floor or anything, but when I was well, I don't know how old she would have been. Maybe about 3-4 months. I was doing these jumps [and wetting myself]. I have a male coach and we’ve never thought about jumps before and I was doing these jumps up. Ohh. I don't think I'm fully ready for quite so many jumps”. Beatrice, technical sport “if I need to go for like a wee, I need to go for a wee. I can't hold it anymore. I feel like definitely around pelvic floor like. It's so crucial for a woman, and it is especially when they had a baby and then want to go [do sport]” Miranda, sprint sport Some participants acquired multiple injuries post-pregnancy as a result of a lack of information regarding the body’s ability to return to pre-pregnancy health and fitness. “I got a rib stress fracture and I've never had one of those before, and looking at, I think you know, I was breastfeeding…for over a year and lots of things that I still have not had actually anything investigated…I've had more niggles and more injuries than I used to get, but nothing that's taking me out of the [sport] so there's not quite kind of been that emphasis to look for answers.” Jemima, endurance sport Several of the participants referred to new injuries post-pregnancy, as a direct consequence of the pregnancy or from a prolonged period not exercising. Athletes spoke about not investigating any niggles post-pregnancy further as they were not perceived as serious enough to miss sport, but also there was a perception that injuries post-pregnancy were normal due to the physical demands of being an elite athlete. “No, just the shin splints, and that you know that probably could have been as a result of not exercising for so long, and then all of a sudden go back into to full training. I didn't really have, like, a reduced training plan. It was just kind of do what you can.” Jane, team ball sport “I had a really bad hip issue. I think that was brought on because of pregnancy and I had it in the past, but somehow it got better, but then it got worse and then it got really, really bad. But learning how to manage that and do the right exercises and like pushing your body every day, you are always going to have some sort of niggles.” Miranda, sprint sport Mental Preparedness The athletes also reported mental health benefits of returning to sport as it allowed them time and space for themselves. So, I think if anything coming back to training really helped me mentally. It helped me to, I don't know, feel good, it was my feel-good factor.” Victoria, combat sport Some athletes reported that their pregnancy had provided them with a shift in perspective which improved their psychological well-being when competing. “I think it's been good and I'm in a way better mental place. A growing one as well. Like when I compare my stress levels, my anxiety and my worries about things like [previous Olympics], where I just thought [sport] was life and like my mood was determined by how well a session had gone. Now I think my perspective is much wider, much broader. I'm just kind of generally much more balanced around both areas of my life” Jemima, endurance sport Overall, there was a reported increased mental load associated with returning to sport post-partum. Athletes expressed that tasks that were considered simple before were now more difficult, particularly because of the lack of guidance from managers. Responsibility was largely on the athlete in terms of gauging how the return to sport was going. “I couldn't turn like I used to. Or even the mental part, so even the decision-making processes and, you know, looking where to pass the ball and just simple things like that checking your shoulder [were difficult]. I'd forgot how to do [it]” Chloe, team ball sport Athletes spoke about the struggle of having to start from the bottom again and not being as physically fit as they were pre-pregnancy. Some athletes described how their postpartum body impacted their return to sport. “I'd put on a bit of weight from having baby, and I'm actually personally like I didn't feel comfortable in the kit and stuff, so I was really, really not feeling good about playing.” Jane, team ball sport “…”physically it was hard because it was like a fatter version of myself. And I've never not been able to lose weight before.”. Beatrice, technical sport “One of the biggest stresses I had was, like, not knowing what support I would have postpartum. As in financially, I didn't know whether how long I'd stay on funding for and it was kind of like a or. We'll let you kind of know when you get to that point. So there was never like that, that real ability to like plan ahead and be like, OK, I know I'm gonna be supported for X amount of time”. Victoria, combat sport Personal Support and Inspiration Peer and family support Family members were spoken about as being critical to facilitate returning to sport. “… I've got a very supportive family around me and my husband's very supportive. He played [sport] himself, so he knows and they want me to go back to [sport] and they want me to try and go to the Olympics and everyone says, don't worry, we'll help. We'll help you. We'll make it work. Isabel, team ball sport The athlete’s team or peer group were also seen as very important. “also the fact that all my teammates love having him around and they I mean this I think is like above and beyond … I can see why this really wouldn't work in a lot of situations, but yeah, my son gets to come to load all training camp. Quite a lot of races and stay with the team. It's a really, really nice.” Lily endurance sport Athletes spoke about the importance of their support network when returning to sport. The support from teams and teammates was spoken about in terms of a lack of pressure to return, access to medical staff and the overall environment that facilitated bringing children to training camps and competitions. “And the team was really supportive of me as a professional [sport] and I had absolutely no pressure from them, it was kind of a case of return when you want to …I think they didn't think that I would but I could see the physio and the doctor and I got a lot of support from them in terms of private healthcare” Lily endurance sport Role modelling In figuring out a way back to sport postpartum, athletes highlighted how important it was to see how other athletes had navigated the postpartum return to sport. “I think if you're reading stories of other athletes who have done it and who have been through it… how the postpartum journey went, I think that would be great support for other women considering doing the same thing.” Victoria, combat sport “it does snowball like you've seen it in [sport]… one person comes back after baby, then another, then they start winning and then 3,4,5 people come back…as soon as you see those people being successful, it just kind of squashes any questions” Lily, endurance sport Systemic Support Structural flexibility The return to sport was managed differently across different sports and thus had a different impact on athletes. Flexibility was described by the athletes as being a key factor in supporting a return to sport. This included flexibility around training and being able to adapt as necessary. “They were really flexible with me. And I think initially I only started at three days a week and then I moved from three to four [days], and then it wasn't really until, like, I don't know, eight months or so postpartum, really, that I kind of went to, like, a full program. And so maybe even later than that, actually, because it was kind of just before comp that went before program.” Victoria, combat sport Not all sports had the same focus on flexibility. Athletes spoke about the challenges associated with the lack of flexibility and how it impacted managing the demands of motherhood and her sporting career. I just say like for me like there's so little flexibility, so like. I've had an issue with. If I go in and [sport] first thing and don't make it back for [name] nap time, he doesn't nap and then it means he's up all night, but the coaches won't take me out at a different time, so I literally do a session then I get straight back in my car … it could be an hour, hour and a half before I get any food because I'll get through the front door I have to deal with [name]. And then once I've dealt with him, then I'd like deal with myself. And I think the coaches aren't always willing to engage with that side of it.” Sarah, endurance sport Athletes who felt supported and safe during the returning to sport were able to get specific advice from team trainers and health professionals. “I think that was kind of a conversation that we had quite openly and we talked a lot about breastfeeding as well with the physio and the gym coach … I think because breastfeeding causes you to keep quite a bit of relaxin maybe, so the same thing as when you're when you're pregnant, you need to be a bit cautious around gym training because of all the relaxin in your muscles and tendons. Lily, endurance sport One athlete who was pregnant and intended to breastfeed spoke about future concerns, in particular how mixed feeding would work, pumping, and how it would fit into their routine. Exclusive breastfeeding and participation in sport as an elite athlete was perceived as not being achievable. “The biggest issue is gonna be breastfeeding logistics… and working out how that will work and… you need to stop to like pump. In transition and things… But my intention is to…try and get like the dual feeding thing going on quite early. So he can take both breast and bottle because I can't obviously do any kind of sport if he's exclusively breastfeeding” Georgina, endurance Sport Maternity policies and advice Athletes described how they were given very little, or no nutrition advice. Advice provided was often generic, not tailored to being an elite athlete post-pregnancy. “No. Do you know this is making [Sport Organisation] [look] really bad. Because I did, I have actually asked the nutritionist and I asked for any information on whether I should be taking calcium or iron or anything like that and that hasn't come back to me” Jemima, endurance sport There were also instances of athletes receiving incorrect, and potentially harmful, advice. In the absence of specific information athletes may approach weight restoration in less healthy ways. “No, I think like I think nutrition like I didn't have much guidance … For me, I got told that if I did lose weight postpartum too quickly and my milk would become toxic and it's things like actually normalizing weight gain and weight loss and not crash losing it postpartum, which I think you could be tempted to do as an athlete.” Sarah, endurance sport Funding and the financial impacts of combining sport and motherhood was discussed among the athletes. Athletes described the challenges associated with losing funding due to motherhood, which impacted performance. The stress related to uncertainty around funding support post-pregnancy and the lack of clarity from their sport was highlighted. “A lot of things changed… I lost like my sponsorship with [brand sponsor]…I lost my funding because I didn't [perform in specific sport related activity] in 2021, but I just had a baby the last year. Like it just didn't make sense. And yeah, I lost my access to the team physio then. And it was, yeah, it was tough. It's been tough like since 2021. It's been tough because it you just feel like, oh, not supported like that. You're not like I just had a baby” Miranda, sprint sport The financial impact of childcare costs was also highlighted. This included the lack of childcare provision for sporting events and how maternity policies which include childcare provision are not universal across sports. “Let's say I go to this trip…who looks after the baby?… me and my husband have discussed it and he would actually come out to [Country]… But that's a financial cost that we would have to pay for… I read the women's rugby RFU maternity policy and they pay for their babies to come on tours, which is amazing. So that kind of level of funding doesn't exist… we will have to look for some paid childcare as well… So that's another barrier… that does come down to money again, because if you're paying for childcare… you might not be able to afford it.” Isabel, team ball sport Introducing maternity policies was referred to as a ‘game-changer’ to ensure funding is secure, however, there was also a frustration that maternity policies were not universal leading to differences in support available. “I think having the maternity policy makes a huge difference. Like without the maternity policy, like you can't fund it and or certainly you wouldn't want to risk having your funding cut whilst being pregnant and like you're not eligible for statutory or anything like that because we don't pay tax. So if you don't have the funding, you literally lose your entire income. So I think that's been like quite a big game changer. The only thing I'd say is like I know rugby have written a full policy and [sport governing body] are yet to write any policy and for me, that's quite frustrating because I'm aware like there's another person I know it's his wife having the baby, but already what they're allowing him to do is very different to what I was allowed… [sport governing body] won't be consistent with how they treat new parents and which just means like I can't pass that advice because what I say. Will be different, potentially to what someone else will be eligible for, so there's not really the security from that side.” Sarah, endurance sport Discussion This research illustrates the nuanced experience of elite athletes returning to sport postpartum. These UK-based findings are comparable to findings from a North American-based study (7). Research in this area is limited but growing (6). To integrate these findings with existing scholarship and to generate research-based recommendations, the socio-ecological framework will be applied (Figure 1) . Intrapersonal: The individual athlete Becoming a mother represents a significant life event, which brings with it an identity shift. For some women this can be perceived as a positive, e.g. identity not solely defined by athletic performance. For others it can be a challenging transition, with athletes grappling to merge their largely self-focused athletic identity with their new mother identity which involves prioritisation of another. Within the general population there are limited supports available for new mothers to navigate this transition, with most inputs being focused on the infant or physical recovery from childbirth and limited wellbeing supports focused on the identity transition (22). Additionally, elite athletes may also require sports specific support to develop strategies for motivation and time management around the return to sport (23) and the increased psychosocial stressors they are managing (24). Providing appropriate supports can help athletes successfully fuse their athlete and mother identities (25). Interpersonal Athletes reported a greater reliance on family members postpartum as they needed support for things like childcare. Participant data indicated availability of such support was impacted by partner and family member understanding of the sports world. This reliance on informal arrangements highlights the need for structured supports relating to childcare and feeding within sports organisations. Within the athlete’s immediate team, the opportunity for open conversations about the return to sport was a supportive factor. Conversely other athletes felt that they needed to navigate this transition themselves without guidance. Access to specific and accurate nutritional guidance was limited for postpartum athletes. This is an issue of significant concern as postpartum athletes will have particular nutritional requirements as they return to sport postpartum, especially if also breastfeeding (4). Postpartum elite athletes are significantly influenced by their access to informed support and medical professionals (6). This lack of a standardized approach to managing postpartum athletes contributes to the challenge of providing appropriate guidance. For example, typical postpartum advice is to avoid exercise during the first six weeks postpartum (26). However, there are reports of between 40-70% of athletes returning to training within six weeks post-partum (27). It is not clear if the general population-based six-week timeline is applicable to elite athletes (28). However, in the absence of athlete-adapted evidence-based guidelines for healthcare professionals, a conservative approach is adopted (29). Therefore, high-quality studies are urgently needed that are specific to elite athletes to inform individualized return-to-sport protocols to enhance training, reduce injury, and create a less-stressful or uncertain training environment (30, 31). Furthermore, Donnelly and colleagues propose a holistic framework to guide athletes postpartum return to sport (32). This framework requires proactive multidisciplinary supports, considering the athlete’s physical and psychological recovery as well as adapting training protocols and environments (32). Fallon et al have created a template which could be used by sports governing bodies to develop sports-specific pregnancy and post-partum athlete supports (33). Organisational Organisational level support was highly variable across sports. UK Sports is the umbrella organisation representing high-performance athletes and published specific pregnancy and postpartum guidelines in 2023 (10). These guidelines provide top level advice and recommendations which is a positive development. However, these need to be supported by more detailed and specific guidance, further illustrating the need for research in the area. Currently the vast majority of sporting bodies lack evidence-based, athlete-centred policies supporting athlete mothers. Sport policy that enables mothers to successfully return to elite sport is paramount and urgently needs to be developed by sporting organizations around the world (7). Initial actions could include funding development of postpartum nutritional to address the identified deficits. This may be a particularly pressing issue. In the absence of specific guidance and supports, elite athletes may be at risk of nutritional deficiency or development of disorder eating behaviours, which elite athletes are already at increased risk of (34). Environmental Participants reported that seeing other women return to sport postpartum made this feel more achievable. This reflects the fact elite athletes returning to sport postpartum has not been a cultural norm (35). Female athletes have described needing to fight against societal expectations of the mothering role and the need to make a binary choice between being a mother or an elite athlete (6). Media representation of elite athletes is a contributing factor to this narrative. Traditional narratives have often portrayed sports and motherhood as incompatible or that motherhood was an individual choice and thus it was the athlete’s sole responsibility to manage both. (25). It is also worth noting the impact of language. Elite athletes returning to sport postpartum are in effect returning to the workplace. As such they need to be afforded the same accommodations that have made it feasible for women in other sectors to return to work (36). While the term ‘return to sport’ is accurate it may dilute the perception of sport as a career and sports organisations as workplaces for elite athletes. Athletes may be better served by this being framed as ‘return to work’. Policy Sponsors are a key source of income for elite athletes and as was the experience of one participant in this study pregnancy and postpartum cost them this source of income. Most athletes are not categorised as employees and as such are not eligible for benefits such as maternity leave (37). High profile athlete reporting on situations where sponsorship was lost or reduced due to pregnancy has crated social pressure for brand sponsors to create maternity protections for athletes (38). While such policies are beginning to emerge, progress is halting at best and the situation remains precarious for many female athletes. When they existed, specific maternity policies were described a game changing. However, these remain limited and many athletes have no guarantee of protected maternity leave. National level policies are needed to ensure all athletes within a jurisdiction have access to the same baseline maternity supports. For example, in 2019, Sports Ireland introduced an overarching maternity policy which guarantees 12 months funding for all athletes who become pregnant (39). Recommendations Specific postpartum mental well-being supports to help athletes navigate the transition to motherhood and integrate this with their athlete identity. Access to specialist nutrition advice which can account for postpartum needs such as breastfeeding and intake requirements prior to and following the return to sport. This could involve the development of specialist continuing professional development courses for nutrition and dietetic professionals. High quality research focused on the postpartum return to sport, especially during the first six weeks where the general recommendation to not exercise may need to be tailored for elite athletes. Greater reporting by sports and mainstream media of the challenges facing elite athletes postpartum and creating avenues to amplify how women navigate these challenges. National level maternity leave policies for all elite athletes, creating a comparable situation for elite athletes as other pregnant women in terms of access to maternity supports. Strengths, Limitations, and Future Directions While the sample size here is comparatively small, the participants had high information power for the topic of interest. As such they were able to provide rich accounts of the return to sport postpartum. The range of sports represented also adds credibility to the research. The research team comprises a range of disciplinary and research expertise, which brought a range of perspectives to the study and more comprehensive data analysis and reporting. A broad definition of postpartum was adopted as elite athletes who have given birth are a special population with limited numbers. Five years was the longest time from birth to participating in the research. There were no notable differences in reported experience between this participant and those who had given birth more recently. A multi-national survey of the top priorities and requirements of female athletes with regards to pregnancy and maternity leave would be advisable to have a broader understanding of the needs and expectations of these women during this time. Future research might entail a comparative study after either local (i.e. at an individual Sport’s club), national (i.e. Sport England), and/or International (i.e. International Olympic Committee) policies are changed. If more positive experiences were found, recommended policy changes should be implemented widely. Intervention studies using health education may also be a viable line of empirical enquiry. Conclusions Elite athletes returning to sport postpartum face specific challenges and require tailored support to maintain their own physical and mental well-being and perform optimally within their fields. Key priorities are carrying out high-quality research which can provide evidence-based guidelines for elite athletes return to sport and providing holistic support addressing mental and physical well-being during the return to sport. There is also an urgent need for the development of national level policies stipulating maternity leave rights for elite athletes. Adopting these recommendations would represent significant improvements for individual women. Abbreviations Sports Governing Bodies (SGBs) Declarations Ethics Approval and Consent to Participate This study was reviewed and approved by King’s College London (Reference: LRS/DP-22/23-34763) and the protocol registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/BU5H4). The participants provided written consent prior to commencing all interviews. Consent for Publication Not applicable Availability of data and materials The datasets used and/or analysed during the current study are not available as participants did not provide consent for the data to be used in further research Competing interests The authors declare no competing interests. Funding The authors received no specific funding for this work. Authors’ contribution ACF and CC conceptualised and designed the study. FL and ZB supervised the research. CC, ST, FL, and ZB recruited, and CC and ST conducted the interviews. CC, ST, FL and ZB analysed the data. NOL wrote the first draft of the manuscript with input from ACF, FL, CC, ZB, EP, SAS. All authors saw successive drafts of the paper and provided input. All authors approved the final version of the manuscript. Acknowledgements We gratefully acknowledge the contribution of all the athletes who took part in this study. References Laney EK, Hall MEL, Anderson TL, Willingham MM. Becoming a Mother: The Influence of Motherhood on Women's Identity Development. Identity. 2015;15(2):126-45. Choi P, Henshaw C, Baker S, Tree J. Supermum, superwife, supereverything: performing femininity in the transition to motherhood. Journal of Reproductive and Infant Psychology. 2005;23(2):167-80. McCarthy M, Houghton C, Matvienko-Sikar K. Women’s experiences and perceptions of anxiety and stress during the perinatal period: a systematic review and qualitative evidence synthesis. BMC Pregnancy and Childbirth. 2021;21(1):811. Afifi T, Barrack MT, Casey E, Huddle M, Kliethermes SA, Kraus E, et al. Infographic. Head to toe considerations for the postpartum endurance athlete. British Journal of Sports Medicine. 2024:bjsports-2023-107624. Santos-Rocha R, Szumilewicz A. Fostering the social and physical challenges of female recreational or professional athletes in pregnancy and postpartum. BMC Pregnancy and Childbirth. 2024;24(1):128. McGregor B, McGrath R, Young J, Nottle C. A scoping review of the experiences of elite female athletes concerning pregnancy and motherhood. Sport in Society.1-33. Davenport MH, Ray L, Nesdoly A, Thornton J, Khurana R, McHugh T-LF. We’re not Superhuman, We’re Human: A Qualitative Description of Elite Athletes’ Experiences of Return to Sport After Childbirth. Sports Medicine. 2023;53(1):269-79. Palmer FR, Leberman SI. Elite athletes as mothers: Managing multiple identities. Sport Management Review. 2009;12(4):241-54. Tekavc J, Wylleman P, Cecić Erpič S. Becoming a mother-athlete: female athletes’ transition to motherhood in Slovenia. Sport in Society. 2020;23(4):734-50. UK Sport. UK Sport Pregnancy guidance and support for UK Sport funded athletes. 2023. Caro CV, Trow S, Bell Z, Flynn AF, Lavelle FE. Empowering Women in Sport: A Qualitative Analysis of Elite Athletes Perceptions of Pregnancy in the United Kingdom. Qualitative Research in Sport, Exercise and Health. Under Review. Doyle L, McCabe C, Keogh B, Brady A, McCann M. An overview of the qualitative descriptive design within nursing research. J Res Nurs. 2020;25(5):443-55. Palermo C, Reidlinger DP, Rees CE. Internal coherence matters: Lessons for nutrition and dietetics research. Nutr Diet. 2021;78(3):252-67. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007;19(6):349-57. Naderifar M, Goli H, Ghaljaie F. Snowball Sampling: A Purposeful Method of Sampling in Qualitative Research. Strides in Development of Medical Education. 2017;14(3):-. McKay AKA, Stellingwerff T, Smith ES, Martin DT, Mujika I, Goosey-Tolfrey VL, et al. Defining Training and Performance Caliber: A Participant Classification Framework. Int J Sports Physiol Perform. 2022;17(2):317-31. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77-101. Garvey CM, Jones R. Is There a Place for Theoretical Frameworks in Qualitative Research? International Journal of Qualitative Methods. 2021;20:1609406920987959. Scarneo SE, Kerr ZY, Kroshus E, Register-Mihalik JK, Hosokawa Y, Stearns RL, et al. The Socioecological Framework: A Multifaceted Approach to Preventing Sport-Related Deaths in High School Sports. J Athl Train. 2019;54(4):356-60. Sun J, Piernicka M, Worska A, Szumilewicz A. A socio-ecological model of factors influencing physical activity in pregnant women: a systematic review. Frontiers in public health. 2023;11:1232625. Malterud K, Siersma VD, Guassora AD. Sample Size in Qualitative Interview Studies:Guided by Information Power. Qualitative Health Research. 2016;26(13):1753-60. Van den Branden L, Van de Craen N, Van Leugenhaege L, Bleijenbergh R, Mestdagh E, Timmermans O, et al. On cloud nine? Maternal emotional wellbeing six weeks up to one year postpartum – A cross-sectional study. Sexual & Reproductive Healthcare. 2023;36:100856. 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(4):e001395. Pascoe M, Pankowiak A, Woessner M, Brockett CL, Hanlon C, Spaaij R, et al. Gender-specific psychosocial stressors influencing mental health among women elite and semielite athletes: a narrative review. British Journal of Sports Medicine. 2022;56(23):1381-7. Kulkarni S, McGannon KR, Pegoraro A. Expanding understanding of elite athlete parenthood in socio-cultural context: a meta-synthesis of qualitative media research findings on motherhood and sport. Sport in Society.1-20. Mullins E, Sharma S, McGregor AH. Postnatal exercise interventions: a systematic review of adherence and effect. BMJ Open. 2021;11(9):e044567. Diggles A. The "Mother Load" and Return to Sport: A Case Report of Returning to Professional Netball Following Cesarean Section. Int J Sports Phys Ther. 2023;18(1):228-39. 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. 2016;50(10):571-89. L’Heveder A, Chan M, Mitra A, Kasaven L, Saso S, Prior T, et al. Sports Obstetrics: Implications of Pregnancy in Elite Sportswomen, a Narrative Review. Journal of Clinical Medicine. 2022;11(17):4977. Kimber ML, Meyer S, McHugh TL, Thornton J, Khurana R, Sivak A, Davenport MH. Health Outcomes after Pregnancy in Elite Athletes: A Systematic Review and Meta-analysis. Med Sci Sports Exerc. 2021;53(8):1739-47. Deering RE, Christopher SM, Heiderscheit BC. From Childbirth to the Starting Blocks: Are We Providing the Best Care to Our Postpartum Athletes? Journal of Orthopaedic & Sports Physical Therapy. 2020;50(6):281-4. Donnelly GM, Moore IS, Brockwell E, Rankin A, Cooke R. Reframing return-to-sport postpartum: the 6 Rs framework. British Journal of Sports Medicine. 2022;56(5):244-5. Fallon T, Heron N, Moore IS, Donnelly GM. What should be included in an Olympic Sports International Federations’ pregnancy and postpartum policy and guidance? British Journal of Sports Medicine. 2024:bjsports-2023-107778. Downes Gastrich M, Quick V, Bachmann G, McDonald Moriarty A. Nutritional Risks Among Female Athletes. Journal of Women's Health. 2020;29(5):693-702. Tighe BJ, Williams SL, Porter C, Hayman M. Barriers and enablers influencing female athlete return-to-sport postpartum: a scoping review. British Journal of Sports Medicine. 2023;57(22):1450-6. Lucia-Casademunt AM, García-Cabrera AM, Padilla-Angulo L, Cuéllar-Molina D. Returning to Work after Childbirth in Europe: Well-Being, Work-Life Balance, and the Interplay of Supervisor Support. Front Psychol. 2018;9:68. 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 in Society. 2019;22(12):2141-60. Scott T, Smith SVM, Darroch FE, Giles AR. Selling vs. Supporting Motherhood: How Corporate Sponsors Frame the Parenting Experiences of Elite and Olympic Athletes. Commun Sport. 2023;11(6):1181-202. Sport Ireland. Sport Ireland Maternity Policy: International Carding Scheme. Sport Ireland; 2019. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4318196","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":295956071,"identity":"774d5f98-79ba-4217-9d3e-0d967b36f3df","order_by":0,"name":"Noreen O'Leary","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2ElEQVRIiWNgGAWjYBADGTD5AYjZiNXCAyIYZ5CshZmHGKXm7L0PH3zcYcPDz372mbTtHjt7Pgbmh49u4NFi2XPc2HDmmTQeyZ50M+mcZ8mJbQxsxsY5eLQY3Ehjk+ZtO8xjcADIyDlwIIGNgQfIwK+F/fdfoBb788/YpC0OHLAnRgsbMyPIFgmgLQwHDjC2EdRy5hizZG9bGo/EjWfMlj0HgH5hJuSX422MH3622cjx96cx3vhxwM5evr354WN8WpABiwSYYiZSOVjtBxIUj4JRMApGwQgCAFW3QZr+Z00RAAAAAElFTkSuQmCC","orcid":"","institution":"Royal College of Surgeons in Ireland","correspondingAuthor":true,"prefix":"","firstName":"Noreen","middleName":"","lastName":"O'Leary","suffix":""},{"id":295956074,"identity":"b7ec64e0-75f5-4f0f-8717-be2d2b99e31d","order_by":1,"name":"Catherine Caro","email":"","orcid":"","institution":"Royal College of Surgeons in Ireland","correspondingAuthor":false,"prefix":"","firstName":"Catherine","middleName":"","lastName":"Caro","suffix":""},{"id":295956077,"identity":"63a3bcc8-5144-40c7-8e6f-b1b87527f48a","order_by":2,"name":"Storm Trow","email":"","orcid":"","institution":"King’s College London","correspondingAuthor":false,"prefix":"","firstName":"Storm","middleName":"","lastName":"Trow","suffix":""},{"id":295956080,"identity":"76319932-03ae-44ae-8852-7e65dcf6c9f5","order_by":3,"name":"Zoe Bell","email":"","orcid":"","institution":"King’s College London","correspondingAuthor":false,"prefix":"","firstName":"Zoe","middleName":"","lastName":"Bell","suffix":""},{"id":295956082,"identity":"b5cea0f6-85bf-4efc-b2ca-168f39b1456c","order_by":4,"name":"Elana Payne","email":"","orcid":"","institution":"King’s College London","correspondingAuthor":false,"prefix":"","firstName":"Elana","middleName":"","lastName":"Payne","suffix":""},{"id":295956084,"identity":"1c6ce736-b3c8-44d9-b72b-f1fd4916f055","order_by":5,"name":"Sergio A. Silverio","email":"","orcid":"","institution":"King’s College London","correspondingAuthor":false,"prefix":"","firstName":"Sergio","middleName":"A.","lastName":"Silverio","suffix":""},{"id":295956086,"identity":"8df9ac8d-cefc-4bde-88dd-785f446a36f9","order_by":6,"name":"Fiona Lavelle","email":"","orcid":"","institution":"King’s College London","correspondingAuthor":false,"prefix":"","firstName":"Fiona","middleName":"","lastName":"Lavelle","suffix":""},{"id":295956087,"identity":"63bc483e-9a07-4395-ade7-e3e548b2ce48","order_by":7,"name":"Angela C Flynn","email":"","orcid":"","institution":"Royal College of Surgeons in Ireland","correspondingAuthor":false,"prefix":"","firstName":"Angela","middleName":"C","lastName":"Flynn","suffix":""}],"badges":[],"createdAt":"2024-04-24 12:22:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4318196/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4318196/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":82236910,"identity":"95643c56-13f9-46d0-acd1-c9fc612a8f87","added_by":"auto","created_at":"2025-05-08 07:17:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":673603,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4318196/v1/0adcb058-d197-4ac9-8edd-dd311eed7317.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Returning to sport after pregnancy: A qualitative study of elite female athletes in the UK","fulltext":[{"header":"Background","content":"\u003cp\u003eMotherhood is a period of major transition, and is associated with significant physical, psychological and social changes. Adapting to motherhood can be a complex process, due to changing priorities, competing demands, and changing identity (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Although research on motherhood and the transition to motherhood is well documented in the general population (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e), there is limited research describing the experiences of elite athletes as they navigate the dual role of \u003cem\u003emother\u003c/em\u003e and \u003cem\u003eathlete\u003c/em\u003e. However, understanding the specific issues facing postpartum athletes is necessary to ensure optimal health and performance outcomes (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) and will make an important contribution to United Nations Sustainable Development Goal 5 of Gender Equality and Empowerment (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA recent review reported elite athletes\u0026rsquo; experiences during and after pregnancy and described biomedical and sociological factors. Biomedical factors described included physical changes, injury risk and performance outcomes while social factors focused on support systems, childcare and access to maternity leave (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). However, there is a paucity of studies exploring factors athletes consider to be supportive or inhibitive in adjusting to motherhood and returning to high performance sport. Recent research from North America explored the experiences of elite athletes who returned to sport post-childbirth and described time pressures and expectations for returning to sport, physical, mental, and emotional health changes, practical challenges and the importance of supportive networks (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). In New Zealand, a study which explored the multiple identities of elite athletes and mothers, described how sport was a large part of an athletes\u0026rsquo; sense of self, and while the impact of motherhood on the athletes\u0026rsquo; identity was positive, feelings of guilt, lack of time, and limited organisational support were identified as major challenges (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Additionally, a study in Slovenian elite athletes who became mothers during their competitive career described motherhood and elite sport having a reciprocal effect on each other with three distinct transition phases identified including pre-pregnancy and pregnancy, returning to sport, and living the life of a mother-athlete (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the UK, an increasing number of elite athletes are returning to sport post-pregnancy. In 2023, UK Sport developed guidelines for high-performance sports during and after pregnancy. These guidelines advise Sports Governing Bodies (SGBs) and athletes on how best to support an athlete\u0026rsquo;s return to sport including advice on level of training/return to fitness, post-childbirth rehabilitation, nutritional wellbeing, and practicalities around training schedules, breastfeeding and return to competition (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Such guidelines must continue to be updated and informed by research that is grounded in the experiences of elite athletes who combine motherhood and high-performance sport. Currently, there is a knowledge gap in understanding the post-pregnancy experiences of UK elite athletes. This study aimed to explore UK elite athletes' experiences post-pregnancy as they navigate motherhood and return to high performance sport.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis qualitative analysis forms part of a wider study with the primary aim of understanding the preconception, pregnancy, and post-pregnancy experiences of elite athletes in the UK (11). This analysis pertains to post-pregnancy experiences of elite athletes. This research used a qualitative descriptive study design (12), and adopted a relativist ontology and constructivist epistemology (13). Data was collected using semi-structured interviews. The COnsolidated criteria for REporting Qualitative research (COREQ) reporting guidelines have been followed (14) and the COREQ checklist completed \u003cstrong\u003e(Additional file 1)\u003c/strong\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis study was reviewed and approved by King\u0026rsquo;s College London (Reference: LRS/DP-22/23-34763) and the protocol registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/BU5H4). The participants provided written consent prior to commencing all interviews.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eRecruitment and participants\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants were recruited using social media platforms (Twitter, Instagram, Facebook, and LinkedIn), researcher networks, sports organisations (King\u0026rsquo;s Sport), and word of mouth via purposeful and snowball sampling (15). Inclusion criteria were: i) athletes aged 18 years or older, ii) resident in the UK, and iii) athletes who competed at an elite level pre-pregnancy and/or during pregnancy in the last 10 years. Tier 4 (elite/international level) and Tier 5 (world class) of the Participant Classification Framework (16) was used to defined elite athletes. Interested participants received a participant information sheet and a consent form to be completed prior to data collection. \u0026nbsp;Participants had a minimum of 24 hours between receiving this information and providing consent.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eData Collection\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe interviews were scheduled at a time convenient for the participants and were conducted online via Microsoft Teams between March and June 2023. Two authors (ST, CC) conducted individual semi-structured interviews, which followed a standardised structure, while allowing flexibility in exploring topics in more depth. The interview schedule was developed in consultation with multidisciplinary academics and informed by literature on pregnancy health and elite sport and was piloted by two elite athletes who were not included in the study \u003cstrong\u003e(Additional file 2)\u003c/strong\u003e. Each interview lasted between 23 and 64 minutes (M\u003csub\u003eTime\u003c/sub\u003e= 43 minutes). Prior to the interview, the athletes completed a short questionnaire to collect social and demographic data (age, ethnicity), and data on the type of sport the athlete participated in (type of sport, highest level of competition achieved, and current status: active or retired).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eData analysis\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe interviews were audio recorded, transcribed verbatim, and imported into NVivo v.14 for data management. To ensure anonymity, participants names and specific sport were removed and replaced with pseudonyms and type of sport, respectively. \u0026nbsp;Data were analysed using inductive thematic analysis, following a six-phase process. (17). In brief, this entails familiarisation with the data through reading and re-reading the transcripts, generating an initial list of codes, crosschecking codes, grouping codes into themes, refining and naming themes. The data was coded by two authors (ST and CC); provisional themes were discussed and refined by all authors. \u0026nbsp;Further analytical work was carried out by two authors (EP and SAS) to derive the final thematic structure. \u0026nbsp;Theory can support conceptually deeper data analysis, however, can also bias findings in the direction of the theoretical concepts (18). For this study, data collection and analysis were initially completed inductively. Following development of initial themes potentially suitable theories were explored, to frame findings and recommendations. The socioecological framework was chosen as the most suitable for this study, as it considers phenomena through multiple levels of influence the impact of different contexts(19). This framework has also been used in research relating to physical activity in pregnancy (20).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSample size sufficiency was determined based on information power. Using this approach sample adequacy is informed by considering the specificity of participant experience relevant to the research question, whether the study has a narrow or broad aim, the quality of the interview dialogue and the analytical strategies (21). As this study included individual interviews with participants with first-hand experience of the phenomenon of interest, the final number of participants (n=11) was deemed adequate.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003eParticipant characteristics\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eEleven elite athletes participated in the study. The mean (SD) age of the athletes was \u0026nbsp;31(3) years and duration participating in elite sport \u0026nbsp;10(5) years (Table 1). Two participants were pregnant at the time of interviewing and prospectively described their return plans, while nine had returned to sport post-pregnancy. Participants were involved in nine different sports, including team ball sports (n= 3), sprint and endurance sports (n= 5), power sports (n= 2), and combat sports (n= 1). Four athletes were 1-2 years postpartum, two were three years postpartum and four years postpartum respectively and one was five years postpartum \u003cstrong\u003e(Table 2)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1. Participant characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"586\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003eMean (SD)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e31 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eEthnicity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eWhite British\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e8 (73)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eWhite Other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e1 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eBlack Caribbean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e2 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eDuration in sport (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e10 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eRetired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eCurrently pregnant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e2 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003e1-5 years post pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e9 (81)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eType of sport\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eSprint and Endurance sport, e.g. rowing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e5 (45)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eTeam ball sport e.g. football\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e3 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003ePower sport e.g. powerlifting\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e1 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003ePrecision and Technical e.g. shotput\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e1 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eCombat sport e.g. judo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e1 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eHighest level of competition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eOlympic games or world championships (Tier 5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e8 (73)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eParalympic games or world championships (Tier 5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e1 (8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"55.2901023890785%\" valign=\"top\"\u003e\n \u003cp\u003eElite/international competition (Tier 4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.7098976109215%\" valign=\"top\"\u003e\n \u003cp\u003e2 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Themes and sub-themes\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cimg src=\"data:image/png;base64,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\" style=\"width: 613px; height: 453.28px;\" width=\"613\" height=\"453.28\"\u003e\u003c/strong\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNavigating the Mother-Athlete Identity\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eChanging priorities and shifting identities\u003c/p\u003e\n\u003cp\u003eAthletes described a shift in their mentality from sport being their principal focus to having a new perspective where personal and professional experiences were more balanced.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;It\u0026apos;s given me a bit more of a well-rounded perspective and approach on success and happiness and stuff. And I guess I\u0026apos;m doing my sport because I still feel I\u0026apos;m good at it and I enjoy it. But ultimately, it\u0026apos;s not the be all and the end all now to me.\u0026rdquo; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eVictoria, combat sport\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;The couple hours that I would get to be able to train each day or three times a week was actually just quite a nice break from motherhood and more feeling like myself.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eVictoria, combat sport\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;And it was nice to do things that I used to do and go back to, like being old me\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eBeatrice, technical sport\u003c/p\u003e\n\u003cp\u003eHowever, changing priorities and the shift from having control of factors such as time and sleep to focusing on the baby first was considered challenging.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I think. It\u0026apos;s just quite hard when you\u0026apos;re an athlete and you\u0026apos;re used to. I guess yeah, one\u0026nbsp;\u003c/em\u003e \u003cem\u003ebeing able to be like really selfish with your time and then suddenly I couldn\u0026apos;t and I wasn\u0026apos;t in\u0026nbsp;\u003c/em\u003e\u003cem\u003econtrol of it. And also looking after yourself really well. And then suddenly I wasn\u0026apos;t getting to\u0026nbsp;\u003c/em\u003e\u003cem\u003esleep for an hour, wasn\u0026apos;t able to eat at regular times or what I needed to. Because you look\u0026nbsp;\u003c/em\u003e\u003cem\u003eafter the baby first and then yourself\u0026rdquo;.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eElizabeth, endurance sport\u003c/p\u003e\n\u003cp\u003eBreastfeeding and the return to sport was an issue spoken about by many athletes. Breastfeeding was in part discontinued for an athlete who participated in contact sport due to it being painful. While another athlete described the challenges of breastfeeding and milk supply in the postpartum period and concerns around pumping and leaking breasts while training.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I stopped breastfeeding at seven months post part, and that was partly due to coming back to [sport] and it being painful to do [sport] with one while breastfeeding. Like every time someone hit into my chest, it really hurt.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Victoria, combat sport\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;if I were to carry on breastfeeding when I went to things like training [I\u0026rsquo;d have to] to worry about, you know leaking and also pumping. When I pumped I didn\u0026apos;t produce enough milk and when I breastfed she wasn\u0026apos;t getting what she needed. You know luckily, she had the most important part of the colostrum so that was great, but there was a lot of pressure on it and I just couldn\u0026apos;t produce what I needed to so that obviously made me feel bad that I couldn\u0026apos;t breastfeed. But I actually think that it was a blessing in disguise really, because from you know, weeks six, she slept through the night and, you know she wouldn\u0026apos;t. She didn\u0026apos;t become too dependent on me.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eJane, team ball sport\u003c/p\u003e\n\u003cp\u003eImpact of having\u0026nbsp;a changed body\u003c/p\u003e\n\u003cp\u003eAthletes described the physical impact of childbirth on the return to sport, in particular pelvic floor health and how it impacted the type of exercise an athlete could engage in.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo; I\u0026apos;ve never had bad pelvic floor or anything, but when I was well, I don\u0026apos;t know how old she would have been. Maybe about 3-4 months. I was doing these jumps [and wetting myself]. I have a male coach and we\u0026rsquo;ve never thought about jumps before and I was doing these jumps up. Ohh. I don\u0026apos;t think I\u0026apos;m fully ready for quite so many jumps\u0026rdquo;.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eBeatrice, technical sport\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;if I need to go for like a wee, I need to go for a wee. I can\u0026apos;t hold it anymore. I feel like definitely around pelvic floor like. It\u0026apos;s so crucial for a woman, and it is especially when they had a baby and then want to go [do sport]\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMiranda, sprint sport\u003c/p\u003e\n\u003cp\u003eSome participants acquired multiple injuries post-pregnancy as a result of a lack of information regarding the body\u0026rsquo;s ability to return to pre-pregnancy health and fitness.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I got a rib stress fracture and I\u0026apos;ve never had one of those before, and looking at, I think you know, I was breastfeeding\u0026hellip;for over a year and lots of things that I still have not had actually anything investigated\u0026hellip;I\u0026apos;ve had more niggles and more injuries than I used to get, but nothing that\u0026apos;s taking me out of the [sport] so there\u0026apos;s not quite kind of been that emphasis to look for answers.\u0026rdquo;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eJemima, endurance sport\u003c/p\u003e\n\u003cp\u003eSeveral of the participants referred to new injuries post-pregnancy, as a direct consequence of the pregnancy or from a prolonged period not exercising. Athletes spoke about not investigating any niggles post-pregnancy further as they were not perceived as serious enough to miss sport, but also there was a perception that injuries post-pregnancy were normal due to the physical demands of being an elite athlete.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;No, just the shin splints, and that you know that probably could have been as a result of not exercising for so long, and then all of a sudden go back into to full training. I didn\u0026apos;t really have, like, a reduced training plan. It was just kind of do what you can.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eJane, team ball sport\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I had a really bad hip issue. I think that was brought on because of pregnancy and I had it in the past, but somehow it got better, but then it got worse and then it got really, really bad. But learning how to manage that and do the right exercises and like pushing your body every day, you are always going to have some sort of niggles.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMiranda, sprint sport\u003c/p\u003e\n\u003cp\u003eMental Preparedness\u003c/p\u003e\n\u003cp\u003eThe athletes also reported mental health benefits of returning to sport as it allowed them time and space for themselves.\u003c/p\u003e\n\u003cp\u003eSo, I think if anything coming back to training really helped me mentally. It helped me to, I don\u0026apos;t know, feel good, it was my feel-good factor.\u0026rdquo;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eVictoria, combat sport\u003c/p\u003e\n\u003cp\u003eSome athletes reported that their pregnancy had provided them with a shift in perspective which improved their psychological well-being when competing.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;I think it\u0026apos;s been good and I\u0026apos;m in a way better mental place. A growing one as well. Like when I compare my stress levels, my anxiety and my worries about things like [previous Olympics], where I just thought [sport] was life and like my mood was determined by how well a session had gone. Now I think my perspective is much wider, much broader. I\u0026apos;m just kind of generally much more balanced around both areas of my life\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eJemima, endurance sport\u003c/p\u003e\n\u003cp\u003eOverall, there was a reported increased mental load associated with returning to sport post-partum. Athletes expressed that tasks that were considered simple before were now more difficult, particularly because of the lack of guidance from managers. Responsibility was largely on the athlete in terms of gauging how the return to sport was going.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;I couldn\u0026apos;t turn like I used to. Or even the mental part, so even the decision-making processes and, you know, looking where to pass the ball and just simple things like that checking your shoulder [were difficult]. I\u0026apos;d forgot how to do [it]\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eChloe, team ball sport\u003c/p\u003e\n\u003cp\u003eAthletes spoke about the struggle of having to start from the bottom again and not being as physically fit as they were pre-pregnancy. Some athletes described how their postpartum body impacted their return to sport.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;I\u0026apos;d put on a bit of weight from having baby, and I\u0026apos;m actually personally like I didn\u0026apos;t feel comfortable in the kit and stuff, so I was really, really not feeling good about playing.\u0026rdquo;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eJane, team ball sport\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;\u0026hellip;\u0026rdquo;physically it was hard because it was like a fatter version of myself. And I\u0026apos;ve never not been able to lose weight before.\u0026rdquo;.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBeatrice, technical sport\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;One of the biggest stresses I had was, like, not knowing what support I would have postpartum. As in financially, I didn\u0026apos;t know whether how long I\u0026apos;d stay on funding for and it was kind of like a or. We\u0026apos;ll let you kind of know when you get to that point. So there was never like that, that real ability to like plan ahead and be like, OK, I know I\u0026apos;m gonna be supported for X amount of time\u0026rdquo;.\u003c/p\u003e\n\u003cp\u003eVictoria, combat sport\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePersonal Support and Inspiration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePeer and family support\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFamily members were spoken about as being critical to facilitate returning to sport.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;\u0026hellip; I\u0026apos;ve got a very supportive family around me and my husband\u0026apos;s very supportive. He played [sport] himself, so he knows and they want me to go back to [sport] and they want me to try and go to the Olympics and everyone says, don\u0026apos;t worry, we\u0026apos;ll help. We\u0026apos;ll help you. We\u0026apos;ll make it work.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIsabel, team ball sport\u003c/p\u003e\n\u003cp\u003eThe athlete\u0026rsquo;s team or peer group were also seen as very important.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;also the fact that all my teammates love having him around and they I mean this I think is like above and beyond \u0026hellip; I can see why this really wouldn\u0026apos;t work in a lot of situations, but yeah, my son gets to come to load all training camp. Quite a lot of races and stay with the team. It\u0026apos;s a really, really nice.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eLily endurance sport\u003c/p\u003e\n\u003cp\u003eAthletes spoke about the importance of their support network when returning to sport. The support from teams and teammates was spoken about in terms of a lack of pressure to return, access to medical staff and the overall environment that facilitated bringing children to training camps and competitions.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;And the team was really supportive of me as a professional [sport] and I had absolutely no pressure from them, it was kind of a case of return when you want to \u0026hellip;I think they didn\u0026apos;t think that I would but I could see the physio and the doctor and I got a lot of support from them in terms of private healthcare\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eLily endurance sport\u003c/p\u003e\n\u003cp\u003eRole modelling\u003c/p\u003e\n\u003cp\u003eIn figuring out a way back to sport postpartum, athletes highlighted how important it was to see how other athletes had navigated the postpartum return to sport.\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;I think if you\u0026apos;re reading stories of other athletes who have done it and who have been through it\u0026hellip; how the postpartum journey went, I think that would be great support for other women considering doing the same thing.\u0026rdquo; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eVictoria, combat sport\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;it does snowball like you\u0026apos;ve seen it in [sport]\u0026hellip; one person comes back after baby, then another, then they start winning and then 3,4,5 people come back\u0026hellip;as soon as you see those people being successful, it just kind of squashes any questions\u0026rdquo;\u003c/p\u003e\n\u003cp\u003eLily, endurance sport\u003c/p\u003e\n\u003cp\u003eSystemic Support\u003c/p\u003e\n\u003cp\u003eStructural flexibility\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe return to sport was managed differently across different sports and thus had a different impact on athletes. Flexibility was described by the athletes as being a key factor in supporting a return to sport. This included flexibility around training and being able to adapt as necessary.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;They were really flexible with me. And I think initially I only started at three days a week and then I moved from three to four [days], and then it wasn\u0026apos;t really until, like, I don\u0026apos;t know, eight months or so postpartum, really, that I kind of went to, like, a full program. And so maybe even later than that, actually, because it was kind of just before comp that went before program.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eVictoria, combat sport\u003c/p\u003e\n\u003cp\u003eNot all sports had the same focus on flexibility. Athletes spoke about the challenges associated with the lack of flexibility and how it impacted managing the demands of motherhood and her sporting career.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eI just say like for me like there\u0026apos;s so little flexibility, so like. I\u0026apos;ve had an issue with. If I go in and [sport] first thing and don\u0026apos;t make it back for [name] nap time, he doesn\u0026apos;t nap and then it means he\u0026apos;s up all night, but the coaches won\u0026apos;t take me out at a different time, so I literally do a session then I get straight back in my car \u0026hellip; it could be an hour, hour and a half before I get any food because I\u0026apos;ll get through the front door I have to deal with [name]. And then once I\u0026apos;ve dealt with him, then I\u0026apos;d like deal with myself. And I think the coaches aren\u0026apos;t always willing to engage with that side of it.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSarah, endurance sport\u003c/p\u003e\n\u003cp\u003eAthletes who felt supported and safe during the returning to sport were able to get specific advice from team trainers and health professionals.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I think that was kind of a conversation that we had quite openly and we talked a lot about breastfeeding as well with the physio and the gym coach \u0026hellip; I think because breastfeeding causes you to keep quite a bit of relaxin maybe, so the same thing as when you\u0026apos;re when you\u0026apos;re pregnant, you need to be a bit cautious around gym training because of all the relaxin in your muscles and tendons.\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eLily, endurance sport\u003c/p\u003e\n\u003cp\u003eOne athlete who was pregnant and intended to breastfeed spoke about future concerns, in particular how mixed feeding would work, pumping, and how it would fit into their routine. Exclusive breastfeeding and participation in sport as an elite athlete was perceived as not being achievable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;The biggest issue is gonna be breastfeeding logistics\u0026hellip; and working out how that will work and\u0026hellip; you need to stop to like pump. In transition and things\u0026hellip; But my intention is to\u0026hellip;try and get like the dual feeding thing going on quite early. So he can take both breast and bottle because I can\u0026apos;t obviously do any kind of sport if he\u0026apos;s exclusively breastfeeding\u0026rdquo;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eGeorgina, endurance Sport\u003c/p\u003e\n\u003cp\u003eMaternity policies and advice\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAthletes described how they were given very little, or no nutrition advice. Advice provided was often generic, not tailored to being an elite athlete post-pregnancy.\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;No. Do you know this is making [Sport Organisation] [look] really bad. Because I did, I have actually asked the nutritionist and I asked for any information on whether I should be taking calcium or iron or anything like that and that hasn\u0026apos;t come back to me\u0026rdquo;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eJemima, endurance sport\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eThere were also instances of athletes receiving incorrect, and potentially harmful, advice. In the absence of specific information athletes may approach weight restoration in less healthy ways.\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;No, I think like I think nutrition like I didn\u0026apos;t have much guidance \u0026hellip; For me, I got told that if I did lose weight postpartum too quickly and my milk would become toxic and it\u0026apos;s things like actually normalizing weight gain and weight loss and not crash losing it postpartum, which I think you could be tempted to do as an athlete.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSarah, endurance sport\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFunding and the financial impacts of combining sport and motherhood was discussed among the athletes. Athletes described the challenges associated with losing funding due to motherhood, which impacted performance. The stress related to uncertainty around funding support post-pregnancy and the lack of clarity from their sport was highlighted.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;A lot of things changed\u0026hellip; I lost like my sponsorship with [brand sponsor]\u0026hellip;I lost my funding because I didn\u0026apos;t [perform in specific sport related activity] in 2021, but I just had a baby the last year. Like it just didn\u0026apos;t make sense. And yeah, I lost my access to the team physio then. And it was, yeah, it was tough. It\u0026apos;s been tough like since 2021. It\u0026apos;s been tough because it you just feel like, oh, not supported like that. You\u0026apos;re not like I just had a baby\u0026rdquo;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMiranda, sprint sport\u003c/p\u003e\n\u003cp\u003eThe financial impact of childcare costs was also highlighted. This included the lack of childcare provision for sporting events and how maternity policies which include childcare provision are not universal across sports.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;Let\u0026apos;s say I go to this trip\u0026hellip;who looks after the baby?\u0026hellip; me and my husband have discussed it and he would actually come out to [Country]\u0026hellip; But that\u0026apos;s a financial cost that we would have to pay for\u0026hellip; I read the women\u0026apos;s rugby RFU maternity policy and they pay for their babies to come on tours, which is amazing. So that kind of level of funding doesn\u0026apos;t exist\u0026hellip; we will have to look for some paid childcare as well\u0026hellip; So that\u0026apos;s another barrier\u0026hellip; that does come down to money again, because if you\u0026apos;re paying for childcare\u0026hellip; you might not be able to afford it.\u0026rdquo;\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIsabel, team ball sport\u003c/p\u003e\n\u003cp\u003eIntroducing maternity policies was referred to as a \u0026lsquo;game-changer\u0026rsquo; to ensure funding is secure, however, there was also a frustration that maternity policies were not universal leading to differences in support available.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026ldquo;I think having the maternity policy makes a huge difference. Like without the maternity policy, like you can\u0026apos;t fund it and or certainly you wouldn\u0026apos;t want to risk having your funding cut whilst being pregnant and like you\u0026apos;re not eligible for statutory or anything like that because we don\u0026apos;t pay tax. So if you don\u0026apos;t have the funding, you literally lose your entire income. So I think that\u0026apos;s been like quite a big game changer. The only thing I\u0026apos;d say is like I know rugby have written a full policy and [sport governing body] are yet to write any policy and for me, that\u0026apos;s quite frustrating because I\u0026apos;m aware like there\u0026apos;s another person I know it\u0026apos;s his wife having the baby, but already what they\u0026apos;re allowing him to do is very different to what I was allowed\u0026hellip; [sport governing body] won\u0026apos;t be consistent with how they treat new parents and which just means like I can\u0026apos;t pass that advice because what I say. Will be different, potentially to what someone else will be eligible for, so there\u0026apos;s not really the security from that side.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSarah, endurance sport\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis research illustrates the nuanced experience of elite athletes returning to sport postpartum. These UK-based findings are comparable to findings from a North American-based study (7). Research in this area is limited but growing (6). To integrate these findings with existing scholarship and to generate research-based recommendations, the socio-ecological framework will be applied \u003cstrong\u003e(Figure 1)\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIntrapersonal: The individual athlete\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eBecoming a mother represents a significant life event, which brings with it an identity shift. For some women this can be perceived as a positive, e.g. identity not solely defined by athletic performance. For others it can be a challenging transition, with athletes grappling to merge their largely self-focused athletic identity with their new mother identity which involves prioritisation of another.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWithin the general population there are limited supports available for new mothers to navigate this transition, with most inputs being focused on the infant or physical recovery from childbirth and limited wellbeing supports focused on the identity transition (22). Additionally, elite athletes may also require sports specific support to develop strategies for motivation and time management around the return to sport (23) and the increased psychosocial stressors they are managing (24). Providing appropriate supports can help athletes successfully fuse their athlete and mother identities (25).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eInterpersonal\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAthletes reported a greater reliance on family members postpartum as they needed support for things like childcare. Participant data indicated availability of such support was impacted by partner and family member understanding of the sports world. This reliance on informal arrangements highlights the need for structured supports relating to childcare and feeding within sports organisations.\u003c/p\u003e\n\u003cp\u003eWithin the athlete\u0026rsquo;s immediate team, the opportunity for open conversations about the return to sport was a supportive factor. Conversely other athletes felt that they needed to navigate this transition themselves without guidance. Access to specific and accurate nutritional guidance was limited for postpartum athletes. This is an issue of significant concern as postpartum athletes will have particular nutritional requirements as they return to sport postpartum, especially if also breastfeeding (4). Postpartum elite athletes are significantly influenced by their access to informed support and medical professionals (6). This lack of a standardized approach to managing postpartum athletes contributes to the challenge of providing appropriate guidance. For example, typical postpartum advice is to avoid exercise during the first six weeks postpartum (26). \u0026nbsp;However, there are reports of between 40-70% of athletes returning to training within six weeks post-partum (27). It is not clear if the general population-based six-week timeline is applicable to elite athletes (28). However, in the absence of athlete-adapted evidence-based guidelines for healthcare professionals, a conservative approach is adopted (29). Therefore, high-quality studies are urgently needed that are specific to elite athletes to inform individualized return-to-sport protocols to enhance training, reduce injury, and create a less-stressful or uncertain training environment (30, 31). Furthermore, Donnelly and colleagues propose a holistic framework to guide athletes postpartum return to sport (32). This framework requires proactive multidisciplinary supports, considering the athlete\u0026rsquo;s physical and psychological recovery as well as adapting training protocols and environments (32). Fallon et al have created a template which could be used by sports governing bodies to develop sports-specific pregnancy and post-partum athlete supports (33).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOrganisational\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOrganisational level support was highly variable across sports. UK Sports is the umbrella organisation representing high-performance athletes and published specific pregnancy and postpartum guidelines in 2023 (10). These guidelines provide top level advice and recommendations which is a positive development. However, these need to be supported by more detailed and specific guidance, further illustrating the need for research in the area. Currently the vast majority of sporting bodies lack evidence-based, athlete-centred policies supporting athlete mothers. Sport policy that enables mothers to successfully return to elite sport is paramount and urgently needs to be developed by sporting organizations around the world (7). Initial actions could include funding development of postpartum nutritional to address the identified deficits. This may be a particularly pressing issue. In the absence of specific guidance and supports, elite athletes may be at risk of nutritional deficiency or development of disorder eating behaviours, which elite athletes are already at increased risk of (34).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eEnvironmental\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants reported that seeing other women return to sport postpartum made this feel more achievable. This reflects the fact elite athletes returning to sport postpartum has not been a cultural norm (35). Female athletes have described needing to fight against societal expectations of the mothering role and the need to make a binary choice between being a mother or an elite athlete (6). Media representation of elite athletes is a contributing factor to this narrative. Traditional narratives have often portrayed sports and motherhood as incompatible or that motherhood was an individual choice and thus it was the athlete\u0026rsquo;s sole responsibility to manage both. (25). It is also worth noting the impact of language. Elite athletes returning to sport postpartum are in effect returning to the workplace. As such they need to be afforded the same accommodations that have made it feasible for women in other sectors to return to work (36). While the term \u0026lsquo;return to sport\u0026rsquo; is accurate it may dilute the perception of sport as a career and sports organisations as workplaces for elite athletes. Athletes may be better served by this being framed as \u0026lsquo;return to work\u0026rsquo;.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePolicy\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSponsors are a key source of income for elite athletes and as was the experience of one participant in this study pregnancy and postpartum cost them this source of income. Most athletes are not categorised as employees and as such are not eligible for benefits such as maternity leave (37). High profile athlete reporting on situations where sponsorship was lost or reduced due to pregnancy has crated social pressure for brand sponsors to create maternity protections for athletes (38). While such policies are beginning to emerge, progress is halting at best and the situation remains precarious for many female athletes.\u003c/p\u003e\n\u003cp\u003eWhen they existed, specific maternity policies were described a game changing. However, these remain limited and many athletes have no guarantee of protected maternity leave. National level policies are needed to ensure all athletes within a jurisdiction have access to the same baseline maternity supports. \u0026nbsp;For example, in 2019, Sports Ireland introduced an overarching maternity policy which guarantees 12 months funding for all athletes who become pregnant (39).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendations\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eSpecific postpartum mental well-being supports to help athletes navigate the transition to motherhood and integrate this with their athlete identity.\u003c/li\u003e\n \u003cli\u003eAccess to specialist nutrition advice which can account for postpartum needs such as breastfeeding and intake requirements prior to and following the return to sport. This could involve the development of specialist continuing professional development courses for nutrition and dietetic professionals.\u003c/li\u003e\n \u003cli\u003eHigh quality research focused on the postpartum return to sport, especially during the first six weeks where the general recommendation to not exercise may need to be tailored for elite athletes.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eGreater reporting by sports and mainstream media of the challenges facing elite athletes postpartum and creating avenues to amplify how women navigate these challenges.\u003c/li\u003e\n \u003cli\u003eNational level maternity leave policies for all elite athletes, creating a comparable situation for elite athletes as other pregnant women in terms of access to maternity supports.\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths, Limitations, and Future Directions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhile the sample size here is comparatively small, the participants had high information power for the topic of interest. As such they were able to provide rich accounts of the return to sport postpartum. The range of sports represented also adds credibility to the research. The research team comprises a range of disciplinary and research expertise, which brought a range of perspectives to the study and more comprehensive data analysis and reporting. A broad definition of postpartum was adopted as elite athletes who have given birth are a special population with limited numbers. Five years was the longest time from birth to participating in the research. There were no notable differences in reported experience between this participant and those who had given birth more recently.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA multi-national survey of the top priorities and requirements of female athletes with regards to pregnancy and maternity leave would be advisable to have a broader understanding of the needs and expectations of these women during this time. Future research might entail a comparative study after either local (i.e. at an individual Sport\u0026rsquo;s club), national (i.e. Sport England), and/or International (i.e. International Olympic Committee) policies are changed. If more positive experiences were found, recommended policy changes should be implemented widely. Intervention studies using health education may also be a viable line of empirical enquiry.\u003c/p\u003e"},{"header":"Conclusions ","content":"\u003cp\u003eElite athletes returning to sport postpartum face specific challenges and require tailored support to maintain their own physical and mental well-being and perform optimally within their fields. Key priorities are carrying out high-quality research which can provide evidence-based guidelines for elite athletes return to sport and providing holistic support addressing mental and physical well-being during the return to sport. There is also an urgent need for the development of national level policies stipulating maternity leave rights for elite athletes. Adopting these recommendations would represent significant improvements for individual women.\u0026nbsp;\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eSports Governing Bodies (SGBs)\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was reviewed and approved by King’s College London (Reference: LRS/DP-22/23-34763) and the protocol registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/BU5H4). The participants provided written consent prior to commencing all interviews.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are not available as participants did not provide consent for the data to be used in further research\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors received no specific funding for this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contribution\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eACF and CC conceptualised and designed the study. FL and ZB supervised the research. CC, ST, FL, and ZB recruited, and CC and ST conducted the interviews. CC, ST, FL and ZB analysed the data. NOL wrote the first draft of the manuscript with input from ACF, FL, CC, ZB, EP, SAS. All authors saw successive drafts of the paper and provided input. All authors approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe gratefully acknowledge the contribution of all the athletes who took part in this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLaney EK, Hall MEL, Anderson TL, Willingham MM. Becoming a Mother: The Influence of Motherhood on Women\u0026apos;s Identity Development. Identity. 2015;15(2):126-45.\u003c/li\u003e\n\u003cli\u003eChoi P, Henshaw C, Baker S, Tree J. Supermum, superwife, supereverything: performing femininity in the transition to motherhood. Journal of Reproductive and Infant Psychology. 2005;23(2):167-80.\u003c/li\u003e\n\u003cli\u003eMcCarthy M, Houghton C, Matvienko-Sikar K. Women\u0026rsquo;s experiences and perceptions of anxiety and stress during the perinatal period: a systematic review and qualitative evidence synthesis. BMC Pregnancy and Childbirth. 2021;21(1):811.\u003c/li\u003e\n\u003cli\u003eAfifi T, Barrack MT, Casey E, Huddle M, Kliethermes SA, Kraus E, et al. Infographic. Head to toe considerations for the postpartum endurance athlete. British Journal of Sports Medicine. 2024:bjsports-2023-107624.\u003c/li\u003e\n\u003cli\u003eSantos-Rocha R, Szumilewicz A. Fostering the social and physical challenges of female recreational or professional athletes in pregnancy and postpartum. BMC Pregnancy and Childbirth. 2024;24(1):128.\u003c/li\u003e\n\u003cli\u003eMcGregor B, McGrath R, Young J, Nottle C. A scoping review of the experiences of elite female athletes concerning pregnancy and motherhood. Sport in Society.1-33.\u003c/li\u003e\n\u003cli\u003eDavenport MH, Ray L, Nesdoly A, Thornton J, Khurana R, McHugh T-LF. We\u0026rsquo;re not Superhuman, We\u0026rsquo;re Human: A Qualitative Description of Elite Athletes\u0026rsquo; Experiences of Return to Sport After Childbirth. Sports Medicine. 2023;53(1):269-79.\u003c/li\u003e\n\u003cli\u003ePalmer FR, Leberman SI. Elite athletes as mothers: Managing multiple identities. Sport Management Review. 2009;12(4):241-54.\u003c/li\u003e\n\u003cli\u003eTekavc J, Wylleman P, Cecić Erpič S. Becoming a mother-athlete: female athletes\u0026rsquo; transition to motherhood in Slovenia. Sport in Society. 2020;23(4):734-50.\u003c/li\u003e\n\u003cli\u003eUK Sport. UK Sport Pregnancy guidance and support for UK Sport funded athletes. 2023.\u003c/li\u003e\n\u003cli\u003eCaro CV, Trow S, Bell Z, Flynn AF, Lavelle FE. Empowering Women in Sport: A Qualitative Analysis of Elite Athletes Perceptions of Pregnancy in the United Kingdom. Qualitative Research in Sport, Exercise and Health. Under Review.\u003c/li\u003e\n\u003cli\u003eDoyle L, McCabe C, Keogh B, Brady A, McCann M. An overview of the qualitative descriptive design within nursing research. J Res Nurs. 2020;25(5):443-55.\u003c/li\u003e\n\u003cli\u003ePalermo C, Reidlinger DP, Rees CE. Internal coherence matters: Lessons for nutrition and dietetics research. Nutr Diet. 2021;78(3):252-67.\u003c/li\u003e\n\u003cli\u003eTong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007;19(6):349-57.\u003c/li\u003e\n\u003cli\u003eNaderifar M, Goli H, Ghaljaie F. Snowball Sampling: A Purposeful Method of Sampling in Qualitative Research. Strides in Development of Medical Education. 2017;14(3):-.\u003c/li\u003e\n\u003cli\u003eMcKay AKA, Stellingwerff T, Smith ES, Martin DT, Mujika I, Goosey-Tolfrey VL, et al. Defining Training and Performance Caliber: A Participant Classification Framework. Int J Sports Physiol Perform. 2022;17(2):317-31.\u003c/li\u003e\n\u003cli\u003eBraun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006;3(2):77-101.\u003c/li\u003e\n\u003cli\u003eGarvey CM, Jones R. Is There a Place for Theoretical Frameworks in Qualitative Research? International Journal of Qualitative Methods. 2021;20:1609406920987959.\u003c/li\u003e\n\u003cli\u003eScarneo SE, Kerr ZY, Kroshus E, Register-Mihalik JK, Hosokawa Y, Stearns RL, et al. The Socioecological Framework: A Multifaceted Approach to Preventing Sport-Related Deaths in High School Sports. J Athl Train. 2019;54(4):356-60.\u003c/li\u003e\n\u003cli\u003eSun J, Piernicka M, Worska A, Szumilewicz A. A socio-ecological model of factors influencing physical activity in pregnant women: a systematic review. Frontiers in public health. 2023;11:1232625.\u003c/li\u003e\n\u003cli\u003eMalterud K, Siersma VD, Guassora AD. Sample Size in Qualitative Interview Studies:Guided by Information Power. Qualitative Health Research. 2016;26(13):1753-60.\u003c/li\u003e\n\u003cli\u003eVan den Branden L, Van de Craen N, Van Leugenhaege L, Bleijenbergh R, Mestdagh E, Timmermans O, et al. On cloud nine? Maternal emotional wellbeing six weeks up to one year postpartum \u0026ndash; A cross-sectional study. Sexual \u0026amp; Reproductive Healthcare. 2023;36:100856.\u003c/li\u003e\n\u003cli\u003eWieloch N, Klostermann A, Kimmich N, Sp\u0026ouml;rri J, Scherr J. Sport and exercise recommendations for pregnant athletes: a systematic scoping review. BMJ Open Sport Exerc Med. 2022;8(4):e001395.\u003c/li\u003e\n\u003cli\u003ePascoe M, Pankowiak A, Woessner M, Brockett CL, Hanlon C, Spaaij R, et al. Gender-specific psychosocial stressors influencing mental health among women elite and semielite athletes: a narrative review. British Journal of Sports Medicine. 2022;56(23):1381-7.\u003c/li\u003e\n\u003cli\u003eKulkarni S, McGannon KR, Pegoraro A. Expanding understanding of elite athlete parenthood in socio-cultural context: a meta-synthesis of qualitative media research findings on motherhood and sport. Sport in Society.1-20.\u003c/li\u003e\n\u003cli\u003eMullins E, Sharma S, McGregor AH. Postnatal exercise interventions: a systematic review of adherence and effect. BMJ Open. 2021;11(9):e044567.\u003c/li\u003e\n\u003cli\u003eDiggles A. The \u0026quot;Mother Load\u0026quot; and Return to Sport: A Case Report of Returning to Professional Netball Following Cesarean Section. Int J Sports Phys Ther. 2023;18(1):228-39.\u003c/li\u003e\n\u003cli\u003eB\u0026oslash; 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. 2016;50(10):571-89.\u003c/li\u003e\n\u003cli\u003eL\u0026rsquo;Heveder A, Chan M, Mitra A, Kasaven L, Saso S, Prior T, et al. Sports Obstetrics: Implications of Pregnancy in Elite Sportswomen, a Narrative Review. Journal of Clinical Medicine. 2022;11(17):4977.\u003c/li\u003e\n\u003cli\u003eKimber ML, Meyer S, McHugh TL, Thornton J, Khurana R, Sivak A, Davenport MH. Health Outcomes after Pregnancy in Elite Athletes: A Systematic Review and Meta-analysis. Med Sci Sports Exerc. 2021;53(8):1739-47.\u003c/li\u003e\n\u003cli\u003eDeering RE, Christopher SM, Heiderscheit BC. From Childbirth to the Starting Blocks: Are We Providing the Best Care to Our Postpartum Athletes? Journal of Orthopaedic \u0026amp; Sports Physical Therapy. 2020;50(6):281-4.\u003c/li\u003e\n\u003cli\u003eDonnelly GM, Moore IS, Brockwell E, Rankin A, Cooke R. Reframing return-to-sport postpartum: the 6 Rs framework. British Journal of Sports Medicine. 2022;56(5):244-5.\u003c/li\u003e\n\u003cli\u003eFallon T, Heron N, Moore IS, Donnelly GM. What should be included in an Olympic Sports International Federations\u0026rsquo; pregnancy and postpartum policy and guidance? British Journal of Sports Medicine. 2024:bjsports-2023-107778.\u003c/li\u003e\n\u003cli\u003eDownes Gastrich M, Quick V, Bachmann G, McDonald Moriarty A. Nutritional Risks Among Female Athletes. Journal of Women\u0026apos;s Health. 2020;29(5):693-702.\u003c/li\u003e\n\u003cli\u003eTighe BJ, Williams SL, Porter C, Hayman M. Barriers and enablers influencing female athlete return-to-sport postpartum: a scoping review. British Journal of Sports Medicine. 2023;57(22):1450-6.\u003c/li\u003e\n\u003cli\u003eLucia-Casademunt AM, Garc\u0026iacute;a-Cabrera AM, Padilla-Angulo L, Cu\u0026eacute;llar-Molina D. Returning to Work after Childbirth in Europe: Well-Being, Work-Life Balance, and the Interplay of Supervisor Support. Front Psychol. 2018;9:68.\u003c/li\u003e\n\u003cli\u003eDarroch 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 in Society. 2019;22(12):2141-60.\u003c/li\u003e\n\u003cli\u003eScott T, Smith SVM, Darroch FE, Giles AR. Selling vs. Supporting Motherhood: How Corporate Sponsors Frame the Parenting Experiences of Elite and Olympic Athletes. Commun Sport. 2023;11(6):1181-202.\u003c/li\u003e\n\u003cli\u003eSport Ireland. Sport Ireland Maternity Policy: International Carding Scheme. Sport Ireland; 2019.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"athlete, pregnancy, postpartum, return to sport","lastPublishedDoi":"10.21203/rs.3.rs-4318196/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4318196/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Returning to sport postpartum is becoming increasingly common for elite athletes. While policies to support women during this period are emerging, this remains an area of limited research. To date the lived postpartum experience of UK elite athletes as they returned to sport has not been explored.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This qualitative study collated the experiences of 11 women via online interviews. Data was analysed using thematic analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Three key themes were generated from the data: 1) navigating the mother-athlete identity 2) personal support and inspiration and 3) systemic supports. Athletes must navigate their return to sport, both in terms of their changed identity and practical challenges associated with having a child. Seeing other women navigate this journey provided encouragement to athletes that they could do this. Findings also illustrated the role of the athletes’ own sports community and wider organisations. Access to specific supports such as timelines for return to sport and nutritional advice positively impacted the athlete’s postpartum return to sport, as did access to maternity leave policies which protected funding during the pregnancy and postpartum period.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eMoving forward, carrying out high-quality research to inform guidelines for elite athletes return to sport and developing national level maternity leave polices need to be seen as urgent priorities. This is to ensure that elite athletes are properly supported during the postpartum period and can resume their careers.\u003c/p\u003e","manuscriptTitle":"Returning to sport after pregnancy: A qualitative study of elite female athletes in the UK","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-05-02 21:01:39","doi":"10.21203/rs.3.rs-4318196/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"19a149bc-1d1e-46ed-9620-5be26a4e8f24","owner":[],"postedDate":"May 2nd, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-05-08T07:09:07+00:00","versionOfRecord":[],"versionCreatedAt":"2024-05-02 21:01:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4318196","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4318196","identity":"rs-4318196","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}