Drawn from IOC, FIFA but still uniquely cricket-specific: Doctor behind ICC's post-pregnancy guidelines

The ICC's first-ever 'post-pregnancy return to play' guidelines draw from the existing advisories of IOC and FIFA but remain uniquely cricket-specific in addressing psychological and logistical challenges, says Dr Philippa Inge, the body's Medical Advisory Committee member who led the drafting of the document.

In an interview with PTI, the Melbourne-based Sport and Exercise Medicine Physician also spoke about the process that went into creating the guidelines, its potential impact, and the challenges flagged by the cricketers.

Dr Inge is also the team doctor of the Australian women's squad and is currently with the side in England for the ongoing ICC T20 World Cup.

"There are obviously some guidelines that the IOC (International Olympic Committee) have put together. Other organisations, such as FIFA (the football world body), have a really comprehensive document as well. We've certainly used those documents to help shape what we've done here," she said.

"Probably the unique piece that we've tried to put on this one is the practical lens that actually reflects the cricket-specific issues. What does it look like in terms of training during that time? What sort of skills need to be integrated and when?" she explained.

"We certainly haven't reinvented the wheel here. We've obviously used many other resources from other sporting nations as well. We tried to pull together what we hope is a really tangible and practical set of guidelines."

The guidelines, unveiled on Monday, outline a six 'R's framework: Ready, Review, Restore, Recondition, Return and Refine.

They are similar to FIFA's stepwise return-to-play programme, which also covers managers as well as players.

The IOC has not developed a specific policy, but some years ago, it outlined the medical clearances needed for return to play in a consensus statement, which forms the basis of postpartum policies for national bodies worldwide.

Dr Inge said the ICC was nudged by member nations to develop the guidelines, and that it took one year of deliberations to frame them.

"So essentially these sort of came to life after a number of member nations came to the ICC requesting some advice around return to play postpartum. I think we did our first draft of the guidelines probably close to 12 months ago. We then sought feedback from all member nations within their medical teams as well," she said.

"These are guidelines that member nations can use to adapt in their own environment. Ideally, they provide a platform for athletes to see that they can have a baby. There is a process in which they can return to playing cricket as well," she added.

Among the prominent women cricketers who attempted comebacks after becoming mothers is former Pakistan captain Bismah Mahroof, who eventually quit the game in 2024.

West Indies' Afy Fletcher, however, is competing at the ongoing World Cup after giving birth to her son in 2021.

Regarding the biggest challenges identified during the guidelines' formulation, Dr Inge said, "I think the biggest one that came to light was the logistics behind it and how to actually go about that return."

She said that during her interactions with cricketers, she found them highly driven and keen to pursue careers after motherhood.

"It's how to actually start some of those conversations. That is particularly important if they're within an organisation that hasn't necessarily done it before. The other one is the logistics behind it," he said.

"How do I, if I want to breastfeed, practically do that on the ground? How do I make sure I've got enough energy to do that? What are the dietary considerations behind it? What would it look like for travel?" she revealed some of the questions that came her way.

"The physical stuff -- I think every athlete has been through issues where there are physical limitations. But it's the practicalities and psychological overlay which I think certainly needed to be considered with these guidelines," she explained.

Dr Inge acknowledged that not every country would have the resources to implement the guidelines at full scale. The appointment of a Care Manager, as suggested, for individual cases could itself be a task. But she said they are flexible enough for everybody to gain from them.

"The really key thing we wanted to do here was not to provide stringent advice," she said.

"It's a framework in which athletes and their team medical staff and conditioning staff can use and adapt for their unique environments," she added.

Throwing some light on the psychological battles that a pregnancy break can bring with it, Dr Inge said it can feel like a very long way back.

"The confidence to know that your body can get back and do that again can be really challenging. The other one is obviously performance.

"It's about rebuilding them into that environment. Ideally, sports psychologists, if they're available within the member nations' coaching staff, can help with that process," she said.

"I think we want athletes to return to play. But equally importantly is return to performance."

Dr Inge hoped that the guidelines would have some impact in reducing the dropout rate within about a decade, although she admitted it is hard to know for sure at this point.

"The two things I'd like to hope from these guidelines are, number one, women coming into the game, whether they're 16, 18 or 35, can see that they have the capacity to play cricket and have a family. They're not mutually exclusive," she said.

"Realistically, probably in eight to 10 years, we'll see if there's been much shift. I think it's a bit of a 'watch this space'," she concluded.

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