Mount Sinai: Pregnancy and Tennis  

September 15, 2017

Welcome to the Mount Sinai Health Beat, a feature with the official medical provider of USTA Eastern, USTA, and the US Open. This month, Joanne Stone, MD, MS, Professor of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai, explains what to expect when you are expecting and playing tennis.


Serena Wiliams, the 23-time singles Grand Slam winner, surprised the tennis world by announcing her pregnancy three months after winning the Australian Open. Elite athlete moms are not as rare as players who have won all four majors of the Grand Slam. However, only three women have won a major after maternity leave. The last was Kim Clijsters, who retired from tennis in 2007, gave birth to a daughter the next year, and returned to win the US Open in 2009 and 2010.



But pregnancy has not hampered Ms. Williams, who continues training—showcasing her fitness on social media where she blisters tennis balls, smashes medicine balls, and conditions using sled push exercises.


Some of my patients have asked: Is tennis training while pregnant safe for the average mom? Absolutely. Women’s bodies are pretty good at telling them what they can handle. In general, people who exercise through pregnancy feel better and have fewer complaints. While I would not recommend downhill skiing at 28 weeks, playing tennis throughout pregnancy is generally safe, assuming your pregnancy is without complications. If you are not at risk for a pre-term delivery and do not have a bleeding issue—or any other medical issues—you can continue playing tennis. But there are a few things to keep in mind if you plan to hit the court when expecting.


Stay hydrated. Throughout pregnancy, there is a tremendous increase in blood and plasma in your body due to your baby’s blood circulation and amniotic fluid, and your own higher blood volume.  To accommodate these increases, you may need to drink more fluids. This is especially of concern during the first trimester, when some women may experience nausea. If you are unable to keep down sufficient food or fluids, your ability to play may be affected.


Be aware of dizziness. Progesterone—a hormone that creates a healthy environment for the developing fetus— tends to relax the smooth muscles and veins in the legs, causing blood to pool. When on your feet for extended periods, you may feel a bit of dizziness as there is less blood circulating to the heart and brain. To combat this, if on the court for a while, be sure to take breaks. If you begin to feel dizzy, stop. Get the blood flowing back to your heart and brain by sitting down and putting your head between your legs, below the level of your heart.


Mind your joints. Progesterone also relaxes the joints, allowing for the full-body expansion women will experience during pregnancy. If you do stretching exercises before your match, be especially careful not to hyperextend.


Stay balanced. As the uterus gets bigger, your center of gravity will shift. This will make maintaining balance—and the side-to-side movement during match play—more difficult. As your belly expands, remember to exercise caution to avoid falling.  


After giving birth, how quickly can you return to your normal tennis routine? Ms. Williams, who is due in early September, has her sights set on returning to the tennis court in January 2018. This summer, two-time Australian Open winner Victoria Azarenka returned to the tour after an 11-month maternity leave. She resumed training two months postpartum. Can the average mom match that? It depends on two things: your mode of delivery, your overall level of activity during pregnancy, and the resulting birthing experience.


If you had a vaginal birth, without heavy blood loss, you can return to the court whenever you feel comfortable. If you had a cesarean section, you should not return to training for at least six weeks to allow any scars to heal. If you were active only during the first half of pregnancy, you should slowly ease back into your routine. However, if you have been training throughout pregnancy and had an uncomplicated delivery, you can return to your former intensity almost immediately.


Keep in mind that taking care of a newborn is tiring. Even if you have the time, you may not have the stamina to hit the court. Fatigue is common and should be expected. Do not be discouraged if your energy level is not immediately the same.


We have moved past the time when women were relegated to bedrest during pregnancy but there are still misconceptions. They should not stand in the way of your keeping fit and enjoying tennis. It is important to know that you can keep doing what you were doing, within reason.


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