The Mum-Alete: An Observational Survey-Based Study of Australian Athletes Returning to High-Performance Sport After Pregnancy.

backgroundAs more female athletes extend their careers and resume high-performance sport following childbirth, there is an increasing need to understand factors influencing this transition. The return-to-high-performance sport process for postpartum athletes remains complex, with limited evidence available to guide sporting organisations and practitioners. This study aimed to identify the experiences, facilitators, challenges, and barriers for athletes returning to high-performance sport postpartum.

designAn exploratory cross-sectional survey study.

methodsParticipants included postpartum elite and sub-elite Australian athletes who maintained training 6 months prior to conception and gave birth between July 2016 and February 2022. The online Mum-Alete survey included various types of closed-ended questions as well as open-ended questions to gather deeper insights related to demographic/pregnancy information, training and performance, physical health (e.g., sport-related injuries), and social factors impacting return to high-performance sport. Descriptive statistics were used to summarise data, while a hybrid thematic analysis was used for qualitative analyses.

resultsDescriptive analyses for the 64 athletes who participated showed most resumed exercise within 6-week postpartum, with pelvic floor exercises initiated earliest. Endurance and strength training followed, though 59% of respondents reported performance declines and 43% reported sport-related injuries. Key challenges in returning to high-performance sport included time management, sleep, breastfeeding, and pelvic floor dysfunction. Among facilitators in returning to high-performance sport, support from family, coaches, and medical staff was generally rated positively, with many athletes reporting a lack of (or non-awareness of) organisational policies and support provisions (e.g., well-being officer, maternity leave, status protections, including stipends, caregiver allowance to attend training) as well as facility-related challenges (e.g., dedicated spaces for childcare and breastfeeding). Eight qualitative themes were identified, including time/time management, training 'new' bodies, safe return to high-performance sport, breastfeeding while participating, critical support, navigating motherhood and sport, discrimination, and education/expertise.

conclusionsThis study showed that while athletes returned to high-performance training relatively early following childbirth, they regularly perceived reductions in performance and reported sport-related injuries. Various factors were also shown to facilitate and challenge the return-to-high-performance sport process. These outcomes highlight the need for athlete-informed, multidisciplinary, and flexible support strategies, and underscore critical gaps in organisational practice.