To Climb or Not to Climb: A Cross-Sectional Investigation of Risks and Benefits During Pregnancy and Postpartum

Current physical activity guidelines for pregnancy recommend avoiding climbing owing to the increased risk of falling, which are based on opinion owing to limited empirical data. This cross-sectional study examined climbers' perceptions of climbing during pregnancy, safety, falls, exposure of climbing during the pregnancy and postpartum period, and the impact of participation in climbing during pregnancy has on maternal and fetal health outcomes.

Climbers aged ≥ 18 years completed an online questionnaire between May and October 2024 based on the pregnancy where they had the highest engagement in climbing. Questions related to maternal demographics, training and competition patterns, health outcomes during and following pregnancy, and returning to climbing postpartum. Hard falls were subjectively defined as falls or catches that were hard enough to remember/cause concern.

Overall, 692 participants (34.7 ± 3.8 years) completed the survey. Respondents were primarily located in the USA (34.2%), Germany (14.1%), and the UK (13.3%). The cumulative total of falls between participants was 155 across 63,972 h of climbing. Rates of adverse events was 0.03 per 1000 h of exposure. While most participants had concerns about climbing during their pregnancy, 96% felt "happy" or "very happy" that they continued to climb. Mental and emotional health outcomes were improved or unchanged by those who continued to participate. There was no significant difference in pregnancy health outcomes between groups who stopped climbing ≤ 27 weeks gestation and those who continued to climb. Participants returned to climbing at 2.7 months postpartum.

Continued participation in climbing into the third trimester was not associated with increased odds of self-reported pregnancy complications.