Are contact and collision sports safe during pregnancy?

What does the evidence say about contact and collision sports during pregnancy?

1. A comparison of guidelines across multiple countries found ACOG names basketball, ice hockey, downhill skiing, soccer, and volleyball among the activities to avoid during pregnancy, with sport safety judged by the movements the sport actually requires, and every guideline reviewed ruled out sports carrying a risk of falls, trauma, or collisions. 1
2. Beyond ACOG, other national guidelines name rugby, floor or roller hockey, and combat sports like boxing and karate as activities to avoid, reasoning that pregnancy hormones relax ligaments and make joints more prone to injury, on top of the direct collision risk these sports carry. 1
3. Placental abruption, the leading cause of fetal death not linked to maternal death, is estimated to complicate 1% to 6% of minor injuries and up to 50% of major injuries in pregnancy, according to StatPearls, which also notes trauma of some kind is sustained in about 8% of all pregnancies. 2
4. For elite football, one sports-medicine review frames continued contact participation as an individualized decision made with a full medical team's support, describing contact as reasonable to continue until about 12 weeks of pregnancy or until the top of the uterus reaches the pelvic brim, while noting there is currently no empirical evidence of negative outcomes from continuing match-play that early, alongside limited overall research either way. 3
5. The same review is direct about a practical reality: governing bodies generally place responsibility for any pregnancy-related injury on the player, and specialist obstetric support is not available on site during recreational or amateur play the way it may be for a supported elite athlete, which is part of why the individualized exception described for elite competitors doesn't translate cleanly to a weekend rec league. 3
6. A broader scoping review of elite and sub-elite athletes across sports found most competitors stopped competing after the first trimester by personal choice, citing physical changes and risk aversion, and that high-intensity or contact activities like judo or netball were often stopped specifically for safety reasons, even though the review separately found no consistent evidence of adverse pregnancy outcomes from high general training loads, a finding about exercise intensity overall rather than about collision safety specifically. 4

Is contact and collision sports safe in each trimester?

• First trimester. Early pregnancy is when the most detailed guidance on continued elite play exists: one sports-medicine review notes match-play can continue until about 12 weeks, or until the top of the uterus reaches the pelvic brim, for elite athletes with dedicated medical support, adding there's no empirical evidence yet of negative outcomes from continuing this early. That level of individualized monitoring isn't realistic for most recreational leagues.
• Second trimester. By the second trimester, the uterus is no longer protected within the pelvis, and this is the point every major guideline reviewed across multiple countries agrees contact or collision play should stop. Growing ligament laxity from pregnancy hormones also raises the injury risk of any fall or awkward landing, contact sport or not.
• Third trimester. Third trimester makes the case even clearer: balance changes and a larger belly increase both fall risk and the consequences of any impact. This is not the trimester to make an exception for a rec league final or a casual pickup game.

Contact sports during pregnancy: what the guidelines say