Navigating preconception and pregnancy in elite athletes: insights from Australian elite female athletes, athlete support staff and sport organisational staff

Objectives The primary objective of this study was to explore the experiences and beliefs of elite female athletes, athlete support staff and sport organisational staff regarding preconception and pregnancy in Australian elite athletes. Secondary objectives were to identify barriers and enablers encountered by elite athletes during preconception and pregnancy, and to use the study findings to develop recommendations to inform future pregnancy policies within sporting organisations. Methods 58 participants comprising 27 elite athletes, 20 support staff (eg, coaches, physicians, physiotherapists) and 11 sport organisational staff (eg, general managers, athlete well-being officers) from 25 sports participated in either a focus group (n=45) or semi-structured interview (n=13) conducted between 14 August 2023 and 21 November 2023. Focus groups and interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results The vast majority of athletes felt that organisational support for preconception and pregnancy was inadequate. Their feedback was categorised into four distinct themes: (1) planning, fertility and disclosure; (2) mindset; (3) training during preconception and pregnancy and (4) access to support and information. Within these themes, participants highlighted barriers (eg, lack of knowledge, impaired fertility, pregnancy symptoms) and opportunities for organisations to improve the current level of support provided (eg, education, fertility treatments, training flexibility). Overall, 22 recommendations were developed to guide Australian sporting organisations in future pregnancy policies. Conclusion Australian elite female athletes continue to face numerous barriers during preconception and pregnancy. Sporting organisations can use the findings and recommendations within this study to develop pregnancy policies, which better support female athletes.