7 August 2023



Female athletes returning to action after having a baby is a commonly spoken topic world-wide. Traumatic deliveries are another one. Now, does high performance training connect to the latter? Ventures around the fact that elite athletes are more likely to have obstetric interventions during labour and delivery are continuous. Afterall, Serena Williams almost died following the birth of her child. Yet, there are little studies to establish the connection, and even less when it comes to judo. Former junior European Champion and Grand Prix gold medallist, Anna KUCZERA studied the case, particularly for judoka. The title of her study as follow: Comparison of First Childbirth Characteristics between Elite Judo Athletes and Non-Athletes: The Preliminary Retrospective Case–Control Study. 

Serena Williams: ‘I Almost Died After Giving Birth to My Daughter, Olympia.’

The Queen of Tennis, Serena Williams in action. © Wikimedia Commons

Kuczera’s master’s study became extremely popular and with that, her supervisor sought to obtain funds to publish her article outside of the university. Once again, they have succeeded. 

I chose to write about this topic because I heard some stories from my judo friends about their hard and traumatic deliveries.

She begins to explain her journey…

That made me think why they had this troubles giving birth. I was sure that being an elite athlete will help me in the future to have an easy delivery, because I will have the strength and endurance to do it. However, their stories made me think and I started to research this topic, recognising there was small number of articles and studies. Up on realisation, I talked to my master’s thesis supervisor, and she was happy to help me do some research.

Anna married Tokyo 2020 Olympian and European silver medallist, Piotr Kuczera and together, they were excited to welcome their newborn baby in November 2022. During their journey, Anna herself became very cautious around her parturition. She further reveals her personal bumps on the road.

First of all, I was careful and wanted be prepared much as possible. I focused on releasing tension. I gave up running and jumping, although it is not necessary and I started swimming even though I don’t like it very much. In addition to swimming, I did home workouts two or three times a week – mainly pilates, yoga and cardio. When I was in the 32nd week of pregnancy, I went to a urogynecological physiotherapist, where the main emphasis we had on relaxing and reducing pain and childbirth education. Even with such a mindful preparation, we had a few complications but it’s hard to determine their cause. The midwife noticed the increased blood supply and the volume of the pelvic floor muscles. However, this is was her singular observation.

Kuczera’s preliminary retrospective case–control study aimed to determine whether the first labours of elite judo competitors required obstetric interventions more frequently and were longer than those of non-athletes. It was presumed that years of judo training at an elite level could potentially lead to higher risk at childbirth. What was the most important message you learned from your studies? 

AK: I think it is important to have knowledge about pelvic floor muscles and how they work. We need more research that focuses on the impact of daily sports training and on their performance. High intensity of exercise, especially a large number of jumps and exercises that increase the abdominal pressure, may cause excessive tension of the pelvic floor muscles. These muscles work at a low level all the time, and when they are additionally stimulated to work more during training units, it can cause a disturbance in their function and lead, for example, to stress urinary incontinence or problems during natural childbirth. So many women are professional athletes these days, we are doing equal work as men, and we are not sure what impact it has on our health. So that’s why I think this topic is important to explore. Most of the research around the impact of physical activity on pregnancy and childbirth outcomes has focused on regular recreational-level exercise during pregnancy. This type of physical activity has a positive effect on the course of childbirth. However, there is still a need to investigate childbirth characteristics in women who have long-term sports practice with higher training loads. The evidence summary produced by experts of the International Olympic Committee leaves many unanswered questions concerning perinatal outcomes in elite athletes.

Olympic Sprinter, Bowie was eight months pregnant at the time of her death and was in active labour when she suffered complications that led to her death.


The preliminary results of the research, based on 32 women, indicated that elite judo athletes and non-athletes had similar childbirth outcomes, suggesting that competitive sports training does not increase the risk of perinatal complications. It was also acknowledged that the existing evidence was limited and of very low certainty due to the observational nature of the studies. Are you satisfied with the outcome of your research? 

AK: This preliminary study indicates no negative effect of elite judo practice before first pregnancy on childbirth. Outcomes such as the rates of labour induction and augmentation, mode of delivery, the total duration of labour and its second stage, the rates of perineal tear, episiotomy, and the neonate’s Apgar score. This preliminary study is limited by its small sample size and indirect retrospective nature of obstetric data collection. Therefore, all conclusions should be considered with caution. Further research should be based on direct access to participants data from the obstetric units. Our findings are promising, but there are so many factors that impact childbirth and that’s why it’s so important to investigate bigger group of athletes.

Knowledge is power so they say. Kuczera’s research is certainly creating awareness for female athletes, especially judoka, planning to embark into motherhood by birth following their elite career. Message to your fellow elite athletes? 

AK: I would recommend every woman who trained professionally to prepare her body for childbirth with the help of a urogynaecology physiotherapist. Such a visit gives a lot of knowledge about the condition of the pelvic floor muscles and what to implement and usually it will be learning to relax the muscles, not to strengthen them.

Read more about Kuczera’s research: https://www.mdpi.com/1660-4601/19/20/13218/htm

Former and current elite judoka on the mat and right after birth. Photos: EJU & IJF © Szandra Szogedi


Author: Szandra Szogedi