Pregnancy and postpartum experiences of elite para athletes: a cross-sectional survey

BackgroundPregnancy and the postpartum period present unique physiological, health, and sport-related challenges for female Para athletes, yet little is known about their experiences during these life stages. This study aimed to describe demographic, reproductive, health, and sport characteristics, and to examine training practices, access to guidance, and return-to-sport experiences among elite Para athletes who experienced pregnancy.

MethodsA cross-sectional survey was completed by 25 current or former elite Para athletes who had experienced pregnancy while participating in high-performance sport. Participants completed an anonymous online questionnaire assessing demographics, disability characteristics, pregnancy and postpartum health outcomes, delivery outcomes, sport participation, training modifications, and return-to-sport timelines. Descriptive statistics were used to summarize outcomes.

ResultsParticipants were 36 ± 6 years of age and represented a range of impairments and sport types. Commonly reported health conditions included urinary incontinence (20%), anxiety (16%), low back pain (16%), and depression (12%). Pregnancy and neonatal outcomes were generally favorable, with a median gestational age of 38 weeks (IQR: 2), mean birth weight of 7.1 ± 1.1 lbs, and a 4% neonatal intensive care unit admission rate. Less than half of participants (43%) reported receiving advice regarding physical activity during pregnancy, despite 57% modifying their training and 39% reporting exposure to higher-risk training conditions. Median return-to-exercise, training, and competition occurred at 6, 14, and 20 weeks postpartum, respectively.

ConclusionsFemale Para athletes generally reported favorable pregnancy and neonatal outcomes while maintaining sport participation. However, substantial gaps in pregnancy-specific and disability-informed guidance were identified. These findings highlight the need for tailored clinical recommendations, integrated support systems, and structured return-to-sport pathways to optimize health and performance during pregnancy and postpartum in Para sport.