The day before Caroline George went into labor with her first child, she was skiing to the top of a mountain with her mother. Three generations of women, her unborn daughter included, reached the summit together.

A few months later, she was back at work in the Mont Blanc range of the Alps, breast pump packed alongside her climbing gear. For George, a certified guide with the International Federation of Mountain Guides Association and an Eddie Bauer athlete located in Switzerland, it was a typical day in the office.

“It was kind of a cool mix of my two realities,” said George, 42. “You shouldn’t let pregnancy or motherhood hold you back from accomplishing your dreams.”

George and professional female athletes like her are challenging the understanding of what it means to compete professionally as an athlete and as a mother. In the past few years, women have pushed against the stereotype that pregnant women can’t do as much while expecting, or must minimize physical activity. Serena Williams triumphed at the 2017 Australian Open during her first trimester. Alysia Montaño ran the 2014 USA Track and Field Championships while eight months pregnant and again in 2017 while five months pregnant.

Still, it hasn’t always been easy. Montaño, alongside fellow runners Phoebe Wright and Kara Goucher, recently accused Nike of docking sponsorship pay to athletes who were new mothers in a New York Times opinion piece.

For Beth Rodden, a professional rock climber, the normal concerns around deciding to start a family were complicated by the worry over how her sponsors would react to the news. “I was preparing myself for the worst,” she said. “But they didn’t bat an eye. They just asked how I was feeling and doing.”

The 39-year-old Rodden became pregnant when she was 33, almost two decades into her climbing career. While she adjusted her workouts and took extra precautions, such as wearing a full-body harness, Rodden continued to climb into her seventh month of pregnancy.

“I was very open with my doctor and told her what I did and how it worked,” Rodden said. “She just said listen to your body and back off when you need to.”

A couple of times a week, Rodden and her husband would venture into Yosemite National Park to climb the same route which offered a view of the Valley. As her husband would lead climb, Rodden would follow. “Climbing for me has always felt like yoga, fun and good for my body,” she said. But when it stopped feeling good, Rodden backed off.

Recognizing when the normal level of physical activity becomes too much is the key to a healthy pregnancy while remaining active, according to Reshma Rathod, a physical therapist and founder of Restore Motion in Maryland. Rathod has also consulted with the Women’s Tennis Association since 2007.

“The idea is to continue with what you’ve been doing before pregnancy but keep the precautions in mind,” Rathod said. Halting physical activity during pregnancy is no longer a universal prescription but more of a precaution for some, she said.

While the average mother might not be ski touring through the Alps or climbing in Yosemite, there’s a growing body of research to support an active lifestyle for pregnant women.

A 2018 study published in the British Journal of Sports Medicine, conducted by University of Iceland researchers, looked at the health outcomes of 130 female athletes three years before their pregnancy and during. The results were compared with a control group of 118 non-active Icelandic mothers. The study found no significant difference in the length of delivery or pregnancy complications between the female athletes and the control group.

“There has been a lot of stigma around vigorous sports and pregnancy,” said Thorgerdur Sigurdardottir, one of the report’s researchers. “We have a lot of studies that haven’t been able to show that extreme exercise is harmful to the fetus or the exercising mother-to-be.”

Although Sigurdardottir said the study was too small in scope to make sweeping conclusions across populations, it could still lessen concerns over having a healthy childbirth while remaining physically active.

“Being pregnant doesn’t mean you stop moving,” Anna-Lee Markstedt said. Markstedt, a professional obstacle course racer based in Belgium, remained active until she gave birth. She cartwheeled into the delivery room.

Five months after giving birth to her second child, she took fourth place in a world championship obstacle course race in Europe. Markstedt credits her ability to compete so soon after childbirth with remaining physically active into her third trimester.

Yet, between 80 and 85 percent of pregnant women are not active enough to meet the guidelines for prenatal exercise, according to Margie Davenport, a University of Alberta professor specializing in pregnancy and postpartum health. One reason for this low exercise rate is because of the confusion on whether exercise is safe for the mother and baby, Davenport said.

“We need to start changing the conversation away from what are the risks of exercising during pregnancy to what are the risks of not exercising during pregnancy,” Davenport said

While it’s possible to maintain a healthy level of activity throughout pregnancy, women are encouraged to directly consult their primary care doctor.

“Women who are elite athletes are in a unique category. They can tolerate more exercise than a typical pregnant patient that is not an elite athlete,” said Jaqueline Worth, an OBGYN at Village Obstetrics in New York City and author of “The New Rules of Pregnancy.Worth recommends 30 minutes of mild exercise a day.

For George, who co-owns a mountain guiding company with her husband, deciding to continue skiing and working while pregnant came down to modeling the kind of life she wants for her seven-year-old daughter.

“I’m living my passions and hopefully she will learn from that and live her own passions," she said.

Read more: