There was a look of mild shock on the face of Elina Svitolina in the moments after her Wimbledon quarter-final opponent, the top seed, Iga Swiatek hit one final forehand into the net.
That shot sent Svitolina through to her first Grand Slam semi-final since 2019.
“I don’t really know what is happening right now in my head,” she told the ` moments after her victory. “It’s just really unbelievable… At the beginning of the tournament, if someone had told me and my team that we would be in the semi-final and beaten the world No 1, I would have just said that they are crazy.”
Why the shock? Well, since her last appearance in a grand slam at last year’s Australian Open (where she was swept aside with ease by Victoria Azarenka in the third round), the 28-year-old has not only been dealing with the mental and emotional impact of her country Ukraine being invaded by Russia but she has become a parent to daughter Skai, born in October 2022.
It was once a rare occurrence to see a female athlete return to the top of their sport after giving birth. For a variety of reasons, both physical and practical, the majority felt that they had to make a choice between their sport and their desire to start a family.
In tennis, Margaret Court and Evonne Goolagong Cawley bucked that trend by returning to win major titles after becoming mothers (Court became the first mother to win a grand slam in the Open era at the 1973 Australian Open, while Goolagong Cawley became the first — and so far only — mother to win Wimbledon in the Open Era, claiming the title in 1980). The Belgian Kim Clijsters added her name to an exclusive list when she returned from having daughter Jada in 2008 to win three Grand Slam titles (US Open in 2009 and 2010 and the 2011 Australian Open).
More recently, Serena Williams reached four Grand Slam finals after giving birth to daughter Olympia in September 2017 (Wimbledon 2018, 2019 and US Open 2018, 2019) while Victoria Azarenka reached one (2020 US Open, where she was defeated by Naomi Osaka, who announced the birth of her first child this week).
Outside of tennis, Christie Pearce (formerly Rampone) combined being a mother of two with winning two Olympic gold medals (2008, 2012) and a World Cup (2015) with the US women’s national team, while Alex Morgan will be looking to follow suit at this summer’s tournament, after giving birth to daughter Charlie in May 2020.
Alex Morgan with her daughter (Photo: Tim Nwachukwu/Getty Images)
At the same competition, American-born Haitian footballer Dani Etienne will be one of the players looking to take down the Lionesses in her team’s opening game. In February, she helped Haiti qualify for their first-ever World Cup, having her first child the previous December.
Together with stories like US swimmer Dara Torres returning from having her first child to win three silver medals at the 2008 Olympics, Paula Radcliffe being first over the line in the New York City marathon 10 months after having her first child, and British heptathlete Jessica Ennis-Hill winning gold at the 2015 World Championships, just nine months after returning to training following the birth of her son Reggie, it’s easy to overlook the extreme challenges these athletes have overcome.
“I went from a C-section to a second pulmonary embolism to a Grand Slam final,” wrote Serena Williams in her essay for Vogue, announcing her “evolution” away from tennis. “I played while breastfeeding. I played through postpartum depression.”
Serena Williams (Photo: Julian Finney/Getty Images)
Williams developed breathing problems after delivering daughter, Alexis Olympia Ohanian Jr by emergency caesarean section. Doctors discovered multiple blood clots, including one on her lungs meaning she required surgery. She was put on blood thinners and bedridden for six weeks while she recovered.
Thankfully, not every woman goes through as traumatic a birth experience as Williams. But even so, there is a huge range of factors that athletes have to consider when returning to elite sport after giving birth.
“Some people may have a very straightforward delivery but, in many cases, birth — not just physically but mentally — traumatises the body. It’s a huge, huge event,” says women’s health and fitness coach and former GB rower Baz Moffat.
“Because at the end of it, there’s hopefully a beautiful, happy baby and you’re both alive, we kind of forget what the event of birth is like, and it takes a long time for our body to heal and recover from that experience. Athletes often like to have quite a fixed mindset with regards to, ‘I’m having my baby then I’m going to get back on the team here, or I’m going to this World Cup or tournament here.’
“What we don’t do a really good job of is saying, ‘Where am I at?’ Let’s follow a process and follow where my body is at as opposed to telling it what it needs to do and when. Because we don’t have the research and the evidence (to give us that timeline).”
Only six per cent of sports science research is done exclusively on females, with very, very little research done on those who are pre- and post-natal. And in terms of those who are qualified to help guide women back to fitness postnatally, there aren’t a huge number around.
“Only eight per cent of personal trainers in the UK have a pre- and post-natal qualification,” says Moffat. “In the world of sport, it doesn’t exist; there is no pre- and post-natal qualification. And it’s such a new concept, having a baby within your sporting career, that actually these sports doctors and physios, through no fault of their own, don’t know what to do.”
In January this year, the Chelsea midfielder Melanie Leupolz made her first start for the club since having her first child the previous October. She praised the club for the support she had received through pregnancy and beyond. Leupolz had fortnightly catch-ups with the Chelsea manager Emma Hayes to discuss her training programme, was offered a contract extension and received support from a pelvic floor coach.
But that is still the exception as opposed to the norm in elite sport. Moffat says that FIFA (world football’s governing body) has been putting together a research study on how to return players safely to play post-natally, with the aim of producing clear protocols as to what players need to achieve and when, just as there are for ACL injuries, sprained ankles or concussion.
The challenge is that pregnancy and giving birth affect every woman so differently, making it hard to make blanket recommendations.
Helen Keeble is a pelvic health physiotherapist who has worked with female athletes across all levels, including professionals in powerlifting, running, tennis, football, rugby, CrossFit (a multidisciplinary sport that takes in weightlifting, gymnastics and cardiovascular elements like skipping and running), athletics and Olympic weightlifting.
She tells The Athletic that the road to recovery depends partly on the delivery of the baby. “A C-section recovery will differ slightly from a vaginal delivery. And then a straightforward vaginal delivery will differ from a more complicated vaginal delivery. That will really dictate the first few weeks especially.
“It takes about six weeks for any wounds to heal. Whether that’s a C-section wound, stitches, or any tearing at all, it takes about six weeks to heal in everybody.”
As Williams’ experience showed, elite athletes are not immune from anything that can happen through pregnancy or birth. In fact, says Keeble, they are actually a bit more at risk of suffering from pelvic floor problems.
That’s because they are putting more pressure and strain on their core cylinder, she explains. “That’s the abdominal wall, the pelvic floor muscles and the diaphragm.
“The diaphragm is the lid to the core cylinder, the tummy muscles are the walls and the pelvic floor is the bottom. The core cylinder is where the baby grows, so all these things get stretched and weakened and a lot of pressure is put down on the pelvic floor.”
Even female athletes who have never been pregnant can struggle with pelvic floor symptoms like urinary leakage, especially those partaking in higher-impact sports or those with heavier lifting. Keeble says that the statistics do vary but points to a research paper that was published a few years ago on CrossFit and showed that of the 452 female CrossFit athletes completing the survey, over 50 per cent suffered from urinary incontinence.
Unlike muscles elsewhere in the body, those of the pelvic floor are the only ones that have caused debate over whether or not exercise is good for them.
“The consensus is that it is good,” says Keeble, “but things that have high impact or high loads, such as weightlifting, or situations where people get fatigued will put more pressure and force through the pelvic floor.
“It doesn’t ever mean the exercise is actually bad for the pelvic floor but it means that you have to have an incredible pelvic floor to never have any symptoms.”
For any female looking to return to sport or exercise at any level, Keeble says the first piece of the puzzle has to be that core cylinder. Part of that is making sure the abdominal wall is recovering.
“You can get a diastasis, which is where the tummy muscles kind of stretch in the middle so it looks and feels a bit like a gap but it’s really where the ligament stretches. And that can be quite problematic, especially for a sport such as tennis, because you need to have that rotational force and power. So the abdominal wall rehab has to be really good. But then the pelvic floor has to match up to that as well.”
After birth, hormones take on average three to six months to return to normal. “That’s either from the time you give birth if you’re not breastfeeding or from the time you stop breastfeeding,” says Keeble. “It’s a rough guide as everyone’s different but a good gauge is when your periods come back.
“If you’re breastfeeding, you’re still in a bit of a post-natal mix. And it just means that you’re at a slightly increased risk of injury in terms of proprioception, balance and coordination. You can train to mitigate those risks though.”
Given how much is going on within the body in those early months, how is it possible for an athlete to get back to competing in as little as two to three months, as with Haiti footballer Etienne?
“In theory, it is possible if everything was in your favour,” says Keeble. “For example, if you had a vaginal birth and it wasn’t very complicated.”
Until recently, the only real guidance practitioners had on post-natal return to exercise came from guidelines published in 2019 on returning to running. That advised no return to impact sport before three months, but Keeble says that advice has changed.
“Actually, there’s brand new expert consensus coming out about postnatal return to exercise. And the consensus is, definitely not before three weeks, because within that very acute period after having the baby there’s obviously bleeding and things like that still going on. And that goes for everybody: C-section or vaginal delivery.
“But now you see elite sportswomen getting back quicker and sooner. I think with the right team, the right circumstances and everything else, it’s definitely possible to do that safely, to get back quickly.”
That “everything else” is doing a lot of heavy lifting. Breastfeeding and the implications of that on hormones, sleep deprivation and psycho-social support; all of these factors come into play when talking about elite athletes returning postnatally.
Svitolina during her run to the semi-finals at Wimbledon (Photo: Robert Prange/Getty Images)
For Moffat, there’s an important part of the conversation that often gets overlooked when headlines are written celebrating a female athlete returning to their sport within months, and that’s the ‘how’ of their return.
“You have to say, ‘How have you done that?’ And really get underneath the bonnet of how they’ve made that happen” says Moffat.
“It’s a real bugbear of mine: this celebration of mums that bounce and the narrative around becoming an Olympic champion or Wimbledon champion and the athlete saying in a cute, kind of way, ‘Oh, my goodness, I just decided I wanted to do it and look, here I am.’
“Because, for the majority of women at this stage post-natally, this is not the reality. I don’t want to dismiss or be derogative of what they have achieved, but I don’t want to celebrate this narrative of, ‘If you just put your mind to something and are positive, you can get back to work, you can be incredible, you can be better than you were before.’ That’s the bit that I really struggle with — because everyone is very different.
“Athletic women are freaks. They are genetic freaks in terms of the normal distribution of physicality, and that also carries over after having a baby. So it’s not just because they were super determined or super positive; there are a lot of factors that go into this, including their genetics but also the fact that they have money, they have nannies, they have people to support them with their childcare. And they most likely have a pretty advanced and supportive team around them that enables them to return to elite sport quickly.
“You’ve got to think of that woman on the sofa that has her baby and had post-natal depression, a husband or a partner at work, has money troubles, no time to go to the gym. Seeing these elite athletes winning is not motivational. She’s like, ‘F*** off. That is not my life.’ That’s the bit that has really frustrated me over the last couple of years with all the stories coming out about these mum athletes. It’s like, ‘Oh my God, look what you can do if you put your mind to it.’ No, we can’t do that and we shouldn’t be expected to.
“I think it’d be really great if we started having these conversations about how these people are doing it: What childcare do you have? How much money have you got? What kind of sacrifices are you making?”
Among all the talk of sacrifice and physical challenges, there is another aspect to consider: that coming out of the other side of pregnancy and birth, some female athletes can actually feel stronger than ever before.
“Our blood volume increases by 50 per cent during pregnancy,” says Keeble. “That’s a lot more blood carrying oxygen and improving energy availability. If you’ve managed to escape all of the side effects and symptoms that can happen in pregnancy — and you’re actually able to get up and train to the same level — then there are massive benefits to gain.
“You can definitely improve your endurance capacity or strength. There’s also the fact that your body’s already under strain because it’s creating a baby so you’re already kind of working out, and then you’re working out on top of that, putting your body under really big strain. That’s the whole point of training, isn’t it? To then get the benefits from putting the body under the controlled strain.”
If athletes are able to train throughout pregnancy then, it can mitigate any fitness they might lose in those first few weeks after giving birth.
And new research is giving them the confidence to do that.
“There was a study out this year looking at exercise intensity during pregnancy. So over 20 minutes it looked at doing one minute of hard exercise, as hard as you can, so over 90 per cent of their heart rate, and then have a minute rest and do that 10 times. And they compared that to moderate-intensity exercise in pregnancy. And basically, they were both as safe as each other.
“I guess the research is beginning to catch up a bit with what we’re seeing because, beforehand, the research would be very conservative. It would say things like, ‘The most you can lift in pregnancy is 20 pounds or nine kilograms’. I just think that is so far behind where we’re at.
“There are so many more women now competing in sport and interested in sport. It’s a really exciting part of women’s health.”
Svitolina didn’t reach the Wimbledon final, losing out to Marketa Vondrousova in the semi-finals, leaving Goolagong Cawley’s record intact.
The path back is not an easy one but it’s one that more women than ever before are choosing to take.
(Photos: Getty Images/Design: Ray Orr)
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