Breaking Boundaries: A Chronology with Future Directions of Women in Exercise Physiology Research, Centred on Pregnancy

Abstract

Historically, females were excluded from clinical research due to their reproductive roles, hindering medical understanding and healthcare quality. Despite guidelines promoting equal participation, females are underrepresented in exercise science, perpetuating misconceptions about female physiology. Even less attention has been given to exercise in the pregnant population. Research on pregnancy and exercise has evolved considerably from the initial bedrest prescriptions but concerns about exercise risks during pregnancy persisted for many decades. Recent guidelines endorse moderate-intensity physical activity during pregnancy, supported by considerable evidence of its safety and benefits. Mental health during pregnancy, often overlooked, is gaining traction, with exercise showing promise in reducing depression and anxiety. While pregnancy guidelines recommend moderate-intensity physical activity, there remains limited understanding of optimal frequency, intensity, type and time (duration) for extremes like elite athletes or those with complications. Female participation in elite sport and physically demanding jobs is rising, but research on their specific needs is lacking. Traditional practices like bed rest for high-risk pregnancies are being questioned, as evidence suggests it may not improve outcomes. Historical neglect of gestational parents in research perpetuated stereotypes of female frailty, but recent years have seen a shift towards recognizing the benefits of an active pregnancy. Closing knowledge gaps and inclusivity in research are crucial for ensuring guidelines reflect the diverse needs of gestational parents. Therefore, the purpose of this review is to summarize the evolution of exercise physiology and pregnancy research along with future directions for this novel field.