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Reframing return-to-sport postpartum: the 6 Rs framework
  1. Gráinne M Donnelly1,2,3,
  2. Isabel S Moore4,
  3. Emma Brockwell3,5,
  4. Alan Rankin6,7,
  5. Rosalyn Cooke8,9
  1. 1 School of Health Sciences, University of Ulster, Belfast, Newtownabbey, UK
  2. 2 Private Practice, Absolute Physio, Enniskillen, Co Fermanagh, N Ireland, UK
  3. 3 Perinatal Physical Activity Research Group, Canterbury Christ Church University, Canterbury, Kent, UK
  4. 4 Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
  5. 5 Private Practice, Physiomum, Oxted, Surrey, UK
  6. 6 Sports Medicine, Sport NI Sports Institute, Newtownabbey, N Ireland, UK
  7. 7 Sports Medicine, Sports Medicine NI, Belfast, N. Ireland, UK
  8. 8 Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
  9. 9 Bisham Abbey National Sports Centre, English Institute of Sport, London, Buckinghamshire, UK
  1. Correspondence to Gráinne M Donnelly, Private Practice, Absolute Physio, 7 Drumadagarve, Maguiresbridge, N. Ireland, BT94 4NX, UK; info{at}

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The need for change

Female participation and professionalisation within sport is growing, leading to greater investment, competition and publicity. Despite this, there is a lack of female-specific research and frameworks to guide organisations in supporting and optimising female athlete performance,1 particularly during the transition into motherhood. Recent developments in sporting regulations allow greater flexibility in team selections to support perinatal athletes who are pregnant or on maternity leave.2 However, provisions to assist these athletes returning to their sport are lacking and there is a need for greater recognition of perinatal health considerations, for example, pelvic health. Multidisciplinary teams managing athletes often include sports medicine clinicians (particularly physiotherapists and physicians), surgeons, physiologists and coaches.3 In the context of the perinatal athlete, we argue that it is crucial that specialist pelvic health physiotherapists, midwives and obstetric and gynaecological consultants are included in the multidisciplinary team supporting their return-to-sport. In this editorial we will outline considerations that are necessary for supporting athletes during and after pregnancy. In doing so we aim to provide a framework to guide multidisciplinary teams managing perinatal athletes and their return-to-sport postpartum.

Perinatal considerations

Several anthropometric and physiological factors have been argued to explain sex differences in performance and injury,1 yet sex-comparisons do not allow perinatal considerations to be explored. For example, female breasts lack intrinsic support and fluctuate in size during the perinatal period, …

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  • Correction notice This article has been corrected since it published Online First. Reference 5 has been updated.

  • Contributors GMD and RC conceptualised and devised the scope of the editorial. GMD, ISM and RC drafted the initial manuscript. GMD, ISM, EB, AR and RC all made substantial contributions to the revision of the manuscript prior to submission. AR produced the infographic based on the presented editorial. All authors consented to the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests ISM is an Associate Editor for British Journal of Sports Medicine.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.