Debunking the Myth of Pregnancy Doping

Abstract

The notion that pregnancy and abortion are forms of doping has persisted for 20 years. Popular and scientific literature on pregnancy/abortion doping was critically analyzed to compare pregnancy/abortion doping with definitions of doping and blood doping and to compare pregnancy/abortion doping themes to current scientific knowledge. Main themes included oxygenation advantage and hormonal advantage. During pregnancy, maximal oxygen uptake may improve but not exercise performance. Human chorionic gonadotropin, the only pregnancy hormone on National Collegiate Athletic Association and United States Anti-Doping Agency banned substances lists, increases during pregnancy but there is no evidence that hCG enhances athletic performance in women. Recommendations include revising USADA and NNCAA policies into congruence with World Anti-Doping Agency policies which ban hCG for men only. During the past seven years of advocating for college student-athlete athletic department pregnancy and parenting policies, popular nonscientific literature (websites, blogs, and personal anecdotes) and scientific literature have been examined to detect barriers to student-athlete health and policy change. One barrier is a persistent belief in popular literature that athletes can use pregnancy and/or abortion to enhance competitive performance; i.e., as a form of prohibited blood doping. The scientific and nonscientific resources on pregnancy and abortion doping have considerably diverged over the past 20 years. The purposes of this paper were to examine the biophysical themes in popular and scientific definitions of doping, blood doping, and pregnancy/abortion doping, compare pregnancy/abortion doping to current scientific knowledge, and make recommendations to the stakeholders: student-athletes, coaches, athletic trainers, team physicians, athletic and university administrators, university faculty, the United States Anti-Doping Agency (USADA) and the National Collegiate Athletic Association (NCAA).

Effect of Pregnancy in 42 Elite to World-Class Runners on Training and Performance Outcomes

“…Indeed, all previous pregnancy performance research has only used general questionnaire-based self-report outcomes of performance (11,19,20) or indirect laboratory-based physiological markers of performance (e.g., lactate threshold or V̇O 2max ) (5–7). Media and coaching reports also sensationalize pregnancy as a potential performance enhancer (for reviews, see [32,33]), and there are examples of females being able to race at world-class levels within months to a few years postpregnancy (34,35). Indeed, there is rationale that some physiological aspects of pregnancy could positively affect performance, such as potential blood volume expansion and increased cardiac output (17,18).…”

Sport and exercise recommendations for pregnant athletes: a systematic scoping review

“…15 19 20 Although the current state of scientific evidence does not support the conclusion that the physiological changes described above increase peak performance during the first trimester of pregnancy, this topic is still controversial (especially in the lay press). [21][22][23][24] However, some studies indicate that the aforementioned physiological changes in the first trimester of pregnancy at least allow top performance during this period, even in elite athletes. 25 The evidence for pregnant athletes who also exercise at high intensity is sparse, and in current clinical practice, recommendations are usually based on best-practice knowledge and expert opinions.…”

“…In addition, increased ventilation, most likely triggered by escalating progesterone levels, results in up to 48% elevated minute ventilation during the first trimester 15 19 20. Although the current state of scientific evidence does not support the conclusion that the physiological changes described above increase peak performance during the first trimester of pregnancy, this topic is still controversial (especially in the lay press) 21–24. However, some studies indicate that the aforementioned physiological changes in the first trimester of pregnancy at least allow top performance during this period, even in elite athletes 25…”