From trimester-specific mental training to legal rights: evidence-based strategies for practitioners and athletes navigating pregnancy in sport.
What happens when a professional athlete tells her club she's pregnant? For Swedish footballer Maja Göthberg, it meant Lazio Women ended contract negotiations, a decision the Court of Arbitration for Sport ruled unlawful in June 2026, ordering the club to pay more than 70,000 euros in compensation. The landmark ruling also set a precedent for medical confidentiality, confirming that pregnancy cannot justify walking away from an employment relationship.
Yet even as legal guardrails strengthen, sport psychology rarely equips athletes for the psychological ripple effects: anxiety over disclosure, fractured athletic identity, and performance-related body image stress. Most mental training resources ignore pregnancy entirely, treating it as a hiatus rather than a phase demanding its own psychological playbook. The importance of sports psychology for athletes becomes especially clear when those athletes face a transition as profound as pregnancy.
The mental health toll of athletic pregnancy is not a private struggle, it is a professional reality that sport psychology is only beginning to address.
Pregnant athletes occupy a liminal space. On one side, the demands of elite sport: performance metrics, training schedules, team roles. On the other, the bodily and psychological transformations of pregnancy. Unlike non-athlete pregnant individuals, these athletes face a collision of two all-consuming identities. Public scrutiny intensifies when a visible baby bump meets a starting lineup. Coaches and sponsors may question commitment. Contractual vulnerability, as highlighted by the landmark Göthberg case, can turn a pregnancy announcement into a career threat. Training disruption isn't merely a physical setback; it strips away the daily rituals that anchor an athlete's sense of self. Without specialized support, this perfect storm of stressors can overwhelm even the most resilient competitors.
While robust data on pregnant athletes specifically remains limited, the mental health disparities in elite female sport provide a stark warning. A 2026 systematic review found that 19.4% of elite female athletes struggle with anxiety and 18.7% with depression, rates more than double those of the general female population (7.3% and 7.8%, respectively).1 Disordered eating affects 18.6% of elite female athletes, compared to 5.7% in the general population.1 Among pregnant women generally, body image concerns are pervasive: 40.2% report significant weight-related anxiety, and up to 15% have a lifetime eating disorder.2 When the athlete's hyperfocus on leanness and performance intersects with pregnancy's natural weight gain and body changes, the psychological toll can be magnified. The gap in tailored athlete mental health support leaves many pregnant athletes navigating these dual pressures in silence.
For many athletes, sport is more than an activity; it's their primary identity. Pregnancy forces a dramatic pause or permanent shift in training, competition, and team belonging. This loss of routine, goals, and social connection often triggers a grief response similar to what practitioners observe in athlete identity crisis after career-ending injury. Athletes may feel they are losing themselves, mourning the competitor they were while struggling to embrace a maternal identity they haven't yet fully inhabited. This identity disruption can fuel anxiety, depression, and a sense of isolation that general prenatal care rarely addresses. Sports psychologists recognize this as a critical window where targeted interventions can validate the loss, foster a new integrated identity, and prevent long-term mental health consequences.
The question "Can female athletes play while pregnant?" has no universal yes or no. Medically, many athletes continue training and even competing with proper clearance and monitoring. But the psychological dimension remains dangerously underserved. The decision to play often comes with fear of judgment, anxiety about fetal health, and pressure to prove that pregnancy hasn't diminished an athlete's value. Even when physically safe, the mental load of competing while pregnant, managing public perceptions, and protecting contractual rights can exact a heavy toll. Specialized sports psychology support can help athletes weigh these factors, set realistic goals, and maintain psychological well-being regardless of their competitive status. Without such guidance, athletes risk navigating this life transition without the playbook they need.
Each stage of pregnancy brings distinct psychological demands. This trimester specific guide helps athletes adapt mental training techniques to maintain well-being and performance readiness, from early secrecy stress to late stage identity transitions.
| Trimester | Key Psychological Challenge | Mental Training Technique | Practical Exercise |
|---|---|---|---|
| First Trimester | Managing secrecy stress, performance anxiety about declining output, and fear of miscarriage. | Process-focused goal reframing: Shift emphasis from outcomes (wins, times) to controllable execution cues. | Daily process journal: Replace "I must win" with "I will focus on smooth breathing during my first three strokes." |
| Second Trimester | Body image acceptance, adapting competitive identity, and strengthening social support systems. | Values-based goal setting: Connect training adjustments to deeply held personal values beyond sport. | Values alignment exercise: List your top three values (e.g., resilience, connection). Plan one daily action that honors each, even if modified. |
| Third Trimester | Preparing psychologically for training cessation and developing a postpartum mental readiness plan. | Narrative reframing: Adopt an "athlete in transition" identity rather than viewing yourself as retired. | Letter to future self: Write about your athletic identity, strengths gained from pregnancy, and intentions for returning to sport. |
Performance anxiety during pregnancy is not a sign of weakness. It's a predictable psychological response to the collision of athletic expectations and profound physiological change. When an athlete announces a pregnancy, a cascade of worries often follows: fear of judgment from coaches and teammates, anxiety about losing sponsorships or roster spots, and catastrophic thoughts about never returning to pre-pregnancy form. Left unaddressed, these mental patterns can erode confidence, disrupt sleep, and even lead to avoidance of training altogether.
Many pregnant athletes describe a constant internal monologue questioning every dip in performance. "Is this just a bad day, or am I losing my edge forever?" becomes a recurring rumination. The unpredictability of energy levels, nausea, and physical limitations feeds a loop of self-criticism. Sports psychologists can help by normalizing these fears and introducing cognitive restructuring: challenging catastrophic predictions with evidence and focusing on controllable factors like nutrition, recovery, and communication. It's crucial to remind athletes that temporary performance fluctuations are medical, not moral failures.
Body image disruption during pregnancy hits athletes especially hard because their bodies are their instruments. Structured cognitive-behavioral tools can make a significant difference. A body neutrality exercise shifts the focus from appearance to functionality: rather than judging the belly, acknowledge its role in nurturing new life. Functional body appreciation journaling, writing down three things your body accomplished that day like carrying groceries or completing a modified workout, gradually rebuilds a positive connection. A media consumption audit is equally powerful: unfollowing accounts that idealize a narrow athletic physique reduces the constant comparison trap. These small, consistent practices help athletes see their changing body as capable, not compromised.
Athletes who define themselves solely through sport, a state called identity foreclosure, experience heightened distress when pregnancy pauses or alters their career. The mental shift from "athlete" to "nothing" is jarring, and the psychological pattern closely mirrors what sports psychologists observe when working on rebuilding identity after career-ending injury. Sports psychology encourages identity expansion: embracing an "athlete AND parent" self-concept. This isn't about diminishing athletic drive but adding layers. Values-based motivation mapping is a practical exercise: list core values (e.g., perseverance, health, family), then connect daily actions to those values. When an athlete sees that a prenatal swim aligns with both maternal wellness and personal strength, motivation becomes intrinsic and resilient. It's about rediscovering purpose beyond the podium, without abandoning ambition.
Several evidence-based techniques offer immediate relief. Mental toughness in sports research supports acceptance and commitment therapy (ACT) defusion exercises, which teach athletes to observe anxious thoughts without fusing with them: for example, silently noting, "I'm having the thought that I'll never compete again," instead of believing it as fact. This creates breathing room between stimulus and reaction. Progressive muscle relaxation, adapted for pregnancy, involves lying on the left side and gently tensing then releasing muscle groups from toes to head, paired with slow diaphragmatic breathing; it reduces physical tension and quiets the mind. Finally, values-based motivation mapping anchors training to lasting priorities rather than fleeting fears. Combined, these tools help pregnant athletes navigate the mental marathon of pregnancy with clarity and composure.
Mental health screening during pregnancy and the postpartum period is essential for all women, but athletes face unique pressures that can mask or intensify symptoms. Regular, structured screening helps identify depression, anxiety, and other perinatal mood disorders early, enabling timely support that keeps both the athlete and her pregnancy safe.
While no screening instrument has been specifically validated for athletic populations during pregnancy,1 several evidence-based tools are recommended for perinatal women. The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used, validated for detecting depression during pregnancy and postpartum, and endorsed by the American College of Obstetricians and Gynecologists (ACOG) and Postpartum Support International (PSI).2 The Patient Health Questionnaire (PHQ-9) is also validated for perinatal depression.3 For anxiety, the Generalized Anxiety Disorder scale (GAD-7) is commonly used, though it may not capture all nuances of perinatal anxiety.4 The Perinatal Anxiety Screening Scale (PASS) was developed specifically for this purpose and demonstrates a detection rate of about 68%.5 Combining the EPDS with the PASS or GAD-7 can provide a more complete picture.
Elite and competitive athletes often develop coping mechanisms that inadvertently conceal distress. Overtraining, strict dietary rituals, and a tendency to downplay physical discomfort can normalize symptoms like exhaustion, sleep disruption, and appetite changes, all of which overlap with depression and anxiety. Athletes may also avoid disclosing emotional struggles because they fear being removed from training or losing their spot on the team. A sports psychologist must look beyond the screening score and recognize when an athlete's relentless drive is actually a mask for underlying distress. Questions about training loads, recovery patterns, and how the athlete feels about her changing body can reveal what a questionnaire alone might miss.
The minimum recommendation is at least one screen during pregnancy and one postpartum.1 However, for athletes under high physical and psychological demands, more frequent check-ins are clinically wise. A practical schedule includes screening at least once per trimester (first, second, and third) and again at six weeks and six months after delivery. These assessments can be woven into existing sports medicine visits, preseason physicals, or wellness checks with the team physician or athletic trainer. Integrating mental health screening into routine care normalizes the process and reduces stigma.
Who administers the screening and who has access to the results are critical questions in a team setting. The screen should be given by a licensed mental health professional (such as a clinical sport psychologist) who is not in a position to make roster or playing-time decisions. Results must be stored separately from the athlete's general medical record and shared only with the athlete's explicit consent. If a positive screen requires coordination with a coach or trainer for adjustments to training, the information divulged should be the minimum necessary, for example, stating that the athlete needs a temporary reduction in intensity without revealing the diagnosis. Clear confidentiality policies, established before screening begins, protect trust and encourage honest reporting.
Some athletes tell their coach as soon as they see two lines on a pregnancy test; others wait until it's impossible to hide. The first instinct is often fear, but a strategic approach turns a vulnerable disclosure into a professional conversation that protects both your mental health and your career.
You are not legally required to disclose a pregnancy at any specific point. Timing is a personal decision, but early, planned conversations often build trust and give you more control over the narrative. Identify the key person who needs to know first, usually your head coach or direct supervisor, and keep the circle small initially. Athletes are not obligated to share medical details, conception stories, or due dates. The conversation should focus on your plan to continue training or competing, not on private health information.
A structured approach can reduce anxiety and prevent misunderstandings. Consider this four-part framework:
Before disclosing to sponsors or media, review any contract clauses about endorsement obligations or reporting changes in athlete status. Some contracts have vague "morals" clauses or fitness requirements; knowing these in advance helps you craft a message that asserts agency. Dual-career athletes sports psychology research highlights how athletes managing competing life roles benefit from rehearsing key talking points before high-stakes conversations. Prepare a brief statement that centers your ongoing capability, not a setback. For example: "I am continuing to train and compete while pregnant, and I look forward to this next chapter of my athletic career." This frames the pregnancy as part of your journey, not a limitation.
The landmark 2026 Court of Arbitration for Sport ruling in favor of soccer player Maja Göthberg hinged on WhatsApp messages that proved the club knew of her pregnancy and then ended contract talks. For any athlete, this is a powerful warning: verbal assurances can be forgotten or denied. After any conversation about your pregnancy, send a brief follow-up email or message summarizing key points and any agreements. Even a simple note like "Thanks for our talk today. I appreciate your support on the modified training plan through the first trimester" creates a paper trail. This not only protects your legal standing but also eases the mental load of having to remember every detail during a time of heightened stress.
Legal rights for pregnant athletes took a significant step forward on June 24, 2026, when the Court of Arbitration for Sport (CAS) ruled that Lazio Women violated the rights of Swedish footballer Maja Göthberg after the club ended contract negotiations upon learning of her pregnancy. The ruling, published by the global players' union FIFPRO, ordered Lazio to pay Göthberg more than 70,000 euros (about $79,000 US) in salary compensation and damages for infringement of personality rights, plus 5 percent interest.1 This verdict establishes that clubs cannot walk away from an employment relationship simply because a player is pregnant.
The CAS decision clarifies that when essential contract terms are agreed upon and both parties behave as though a contract exists, the player is protected, even without a signed document. In Göthberg's case, WhatsApp messages showed that Lazio was aware of the pregnancy, and the CAS deemed this evidence of an established working relationship.1 Alexandra Gomez Bruinewoud, FIFPRO's Legal Director, emphasized that "clubs cannot walk away from an employment relationship when they learn a player is pregnant." This precedent strengthens legal frameworks for athletes worldwide, underscoring that pregnancy-based discrimination has no place in sport.
While the Göthberg ruling is a milestone, existing policies from major sports organizations provide varying levels of protection. In the NCAA, student-athletes are safeguarded by rules that prevent scholarship termination or reduction during the award year if they remain enrolled.2 Pregnancy is not grounds for withdrawal from sport; instead, it is treated as a temporary medical condition, with return-to-play determined by the head team physician.2 Financial aid cannot be revoked, and athletes must be granted as much medical leave as medically necessary.3 Since 2024, the NCAA athlete physical health resources framework has also been reinforced by a rule offering an additional year of eligibility for those whose athletic careers are interrupted by pregnancy.4
FIFA's regulations for professional women's football include mandatory maternity leave, job security, and the right to return to play after pregnancy. However, enforcement gaps remain, as Göthberg's case illustrates. The International Olympic Committee encourages national federations to adopt supportive policies but does not enforce a binding universal standard. Despite these protections, surveys indicate many athletes are unaware of their rights, and fear of losing scholarships or contracts persists. This makes it essential for sport psychologists and athlete advocates to educate clients on the existing safeguards and the avenues for legal recourse.
Göthberg's case also set a vital precedent regarding the confidentiality of pregnancy-related medical information. The CAS ruling affirmed that athletes are not required to disclose their pregnancy and that clubs cannot use such information against them.1 For team physicians and sport psychologists, this means handling medical disclosures with strict confidentiality unless the athlete explicitly consents to share. It also reinforces that psychological support must be free from pressure or retaliation, encouraging athletes to seek help early without fear of career consequences.
For sports psychologists working with pregnant athletes, this legal landscape provides a backdrop for advocacy and education. Understanding these rulings helps practitioners guide athletes through disclosure decisions, interface with coaching staff, and ensure mental health remains prioritized. The Göthberg verdict is a reminder that psychological well-being and legal rights are intertwined, and that a supportive environment starts with informed, confident practitioners.
Legal protections for pregnant athletes differ between U.S. collegiate sport and international professional contexts. The NCAA provides comprehensive scholarship and anti-discrimination safeguards, while the landmark CAS ruling in the Göthberg case established critical precedents around contract rights and medical confidentiality.
A medical provider clearing you for sport at the six-week postnatal visit is not a signal that you are mentally ready to compete. Physical healing is only one component of the return-to-sport puzzle. Psychological readiness involves rebuilding confidence, managing anxiety, and reintegrating your identity as both an athlete and a mother. The concept of the "fourth trimester" (the first 12 weeks postpartum) underscores the need for a gradual, compassionate timeline rather than an immediate return to pre-pregnancy intensity.1 Without a parallel psychological readiness assessment, athletes risk returning with unresolved fear, guilt, or unrealistic expectations that can derail long-term performance and well-being.
Establishing psychological readiness can be guided by the 6Rs framework for postpartum sport, which emphasizes a sport-specific, individualized, and biopsychosocial process.2 Core domains to evaluate include:
Even a physically smooth pregnancy can produce psychological hurdles. Many athletes experience guilt about time spent training instead of with their infant. Comparing current performance to pre-pregnancy benchmarks often fuels frustration. Fear of re-injury, particularly for those who had a cesarean or pelvic floor issues, can create hesitation. Rebuilding identity after a career-ending injury follows a similar pattern, and imposter syndrome may surface as athletes question whether they still belong in competitive sport. Additionally, poor sleep and fatigue can magnify depressive symptoms, which research shows can be reduced by roughly 45% through moderate-to-vigorous physical activity.1 Recognizing these barriers is the first step toward managing them with a sport psychologist.
A symptom-led, individualized plan helps bridge the gap from clearance to confident return.1 Consider these phases:
The landmark Court of Arbitration for Sport ruling awarding Swedish footballer Maja Göthberg more than 70,000 euros in compensation underscores a hard truth: without systemic safeguards, pregnant athletes face profound psychological and professional risks. Sports psychologists are uniquely positioned to move beyond individual counseling and drive organizational change that protects athlete well-being.
Advocacy starts inside the locker room but must extend to the boardroom. Sports psychologists can push for explicit pregnancy clauses in athlete contracts that guarantee salary continuation, medical privacy, and a clear return-to-sport pathway. They should also champion mandatory perinatal mental health screening protocols integrated into pre-season physicals, normalizing early identification of anxiety, depression, or identity distress. Presenting aggregated, de-identified data to athletic directors can make a compelling case: when athletes feel psychologically safe through pregnancy, retention rates and long-term performance outcomes improve.
Coach education is a frontline intervention. Training modules should address unconscious bias about a pregnant athlete's capabilities, legal obligations under evolving case law, and communication best practices that transform disclosure from a high-stakes confrontation into a collaborative planning conversation. Role-playing scenarios help coaches practice empathic, non-retaliatory responses. Sports psychologists can also train athletic trainers and team physicians to recognize warning signs of perinatal distress and refer appropriately, creating a wraparound support network.
Practitioners often walk a thin line between athlete confidentiality and a team's "need to know." The CAS ruling reinforces that pregnancy-related medical information is private unless the athlete explicitly consents to share. Sports psychologists must document disclosures meticulously, obtain signed releases before communicating with coaches, and clarify their role boundaries upfront. When serving both the athlete and the organization (e.g., a university counseling center), dual relationships demand transparent contracting: who is the client, how will information flow, and what happens if the athlete's wishes conflict with the institution's interests? Understanding what sports psychologists do on a daily basis helps clarify why these boundary-setting conversations are foundational to ethical practice.
For aspiring practitioners, this niche represents a significant career opportunity. Key steps include: - Specialized Training: Pursue continuing education in perinatal mental health through organizations like Postpartum Support International or the Association for Applied Sport Psychology. - Supervised Hours: Seek mentorship from experienced professionals who have navigated pregnancy cases in collegiate or elite sport settings. - Networking: Connect with women's health physical therapists, OB-GYNs, and Title IX coordinators to build referral pipelines. - Business Acumen: Develop workshops and policy consultation services for athletic departments, teams, and governing bodies, positioning yourself as the go-to expert on mental health through the athlete's reproductive lifespan. Sport psychology resources can help you identify professional organizations, certification pathways, and peer networks to support this specialty.
Pregnancy adds unique layers to an athlete's mental game, from identity shifts to performance concerns. These answers address common questions about psychological well-being, legal rights, and practical communication strategies for athletes navigating sport and pregnancy.
