The raw data suggests that the consequences of pregnancy and playing elite football are fiendish to balance. Motherhood provokes physical, professional and financial uncertainty that, for most players, is seemingly too daunting.

The Women’s Super League has about 300 players (12 squads of up to 25), yet only two of them are known to be pregnant. The 2021 census found that the conception rate for women aged 15 to 44 in England and Wales was 71.5 per 1,000 women, so the WSL’s corresponding figure is about seven times lower than the national average.

Real-world examples reiterate the difficulties facing players who become pregnant. In January 2023 the Reading captain Emma Mukandi, having given birth 14 months earlier, claimed she had to use a breast pump in a cupboard after returning to the club. That same month, Fifa ordered Lyon to pay Sara Bjork Gunnarsdottir, their former player, more than £70,000 after a protracted maternity claim over withheld salary.

Even those who have good experiences face huge sacrifices. For instance Melanie Leupolz, who gave birth in October 2022, praised Chelsea for how they handled her situation but she still went 13 months without playing. “The support in the clubs isn’t where it should be right now,” she said in March 2023.

Minimising the struggles for footballers who choose to become pregnant appears a tricky conundrum but Fifpro, the global players’ union, is determined to crack it.

“Peak fertility years overlap with peak performance years,” Alex Culvin, Fifpro’s director of policy and strategic relations for women’s football, says. “We will keep pushing on behalf of players to ensure they have the best protections in this phase of their life, which should be something celebrated and exciting.”

Fifpro is not satisfied with the provisions for its members, as shown by the release of its postpartum return-to-play guide for players and clubs last month. The sheer detail of the 48-page dossier indicates the level of improvement Fifpro desires, as does the headline statistic that three in four players felt pregnancy-specific expert advice was not provided by their club.

“Everybody comes to the table with a view to protecting the players as much as they can, but also simultaneously protecting their interests,” Culvin, 40, says.

The guide, to which a taskforce of players including Gunnarsdottir contributed, covers topics such as nutrition, mental health, and pelvic coaching. It also cites stories of questionable treatment, such as a goalkeeper being advised to stop breastfeeding earlier than planned because she was unable to be hit in the chest.

It is understood that multiple WSL clubs are reviewing their postpartum policies after the guide’s release. This includes Everton, who announced in May that their forward Rikke Madsen was pregnant.

Another unsettling anecdote from the guide details a player being told that her salary was dependent on completing a stage of the return-to-play process. Indeed, financial reform is Fifpro’s next great pursuit.

“We want an automatic contract extension,” Culvin says. “We know that, on average, a women’s football contract is one year [long] so if you want to have a child, you’d have to sign your contract and get pregnant the next day to make sure you’re protected.”

In other words, Fifpro wants all clubs to do what AC Milan did last month. In a first for European football, the Italian club introduced automatic one-year contract renewals for players who become pregnant in the final year of their deals.

“Fifpro advised AC Milan on this process and I think it’s just brilliant to have an example of best practice,” Culvin, a former left back for Everton, Leeds United and Liverpool, says.

“If I was an AC Milan player, I would be like, ‘Bloody hell, this club’s so progressive and somewhere I want to play.’ It will attract players and hopefully it’s like the butterfly effect. You’ll hopefully see more clubs using AC Milan as an example to elevate their conditions for those players.”

For now, the contract question is a sticking point, with concerns of additional financial burden thought to have made some clubs hesitant about agreeing to automatic extensions.

Still, there’s nothing to stop individual clubs from emulating Milan. Recently, Manchester United announced Hannah Blundell, their defender, is pregnant and that the club will exercise an option to extend her contract, which was due to expire next summer, by a year. At West Ham United Dagny Brynjarsdottir, one of two mothers in their squad, also had her contract renewed shortly after she gave birth last February.

Yet there was no obligation for either club to extend those deals and no English club has committed to making such a renewal mandatory. Brighton & Hove Albion are weighing it up, though their position is non-committal. “This is a factor that is being considered,” a Brighton spokeswoman told The Times. “We have been reviewing our official club policies concerning our women’s players for a while now, which will be further supported by the Fifpro return-to-play guide.”

There is plenty that English clubs are doing. Arsenal, whose defender Amanda Ilestedt gave birth on August 30, work with pelvic health, gynaecology and nutrition experts. West Ham have adjusted training times to accommodate breastfeeding. Since the start of the 2022-23 season, WSL and Women’s Championship clubs have been mandated at league-wide level to pay players 100 per cent of their weekly wage for the first 14 weeks of pregnancy.

Last May, Fifa introduced new maternity policies, which included a minimum 14 weeks’ paid maternity leave for players and coaches. Uefa, since the 2021-22 season, has permitted clubs to alter their Champions League squads to account for pregnancy or maternity leave.

But Culvin and Fifpro, while emphasising co-operation rather than conflict, want more. “There is still work to be done,” Culvin says. “If you think about Uefa, Fifa or the ECA [European Club Association], their agendas are very, very different. Not everybody’s going to be at the same progressive point at the same stage.”

Her negotiating strategy is simple: better maternity policies lead to better results on the pitch.

“If you provide conditions that are suitable for high-performance athletes, you have happy players and that means good well-being and performance,” she says.

“What clubs need to understand is that if you provide high-performance facilities and players feel like they are centred, prioritised and cared for, you are going to have a perfect storm.”

Nadia Nadim: A Doctor's Perspective on Football and Motherhood

Nadia Nadim, the Milan forward who is also a qualified doctor, is an ardent supporter of AC Milan’s new maternity policy. She believes that the move to guarantee contract renewals for pregnant players is a significant step forward in the fight for equality in women’s football. Nadim also advocates for top clubs to provide female footballers with access to egg freezing services.

Nadim, who joined Milan this January, said: “For female athletes it’s sometimes hard to find the right balance between wanting to compete at the highest level, or to have a family. As athletes, we work hard, but we sacrifice even more. At a certain point it’s between choosing.”

“A lot of us might stop (our playing careers) at, say, 37 and for some of it gets really hard to get pregnant. And I know this as a doctor, it doesn’t become easier, it becomes harder. You have female players who reach the end of their careers and think, 'holy s**t, I really want to start a family, but right now, it seems really hard'. But AC Milan’s policy is a big thing.”

“Having this opportunity (of a guaranteed contract renewal) is brilliant, and I really hope that more clubs are going to follow.”

Nadim’s perspective is insightful because she understands both the demands of elite football and the complexities of female fertility. Her advocacy for egg freezing highlights the need for clubs to provide players with the resources and support they need to make informed decisions about their futures, both on and off the pitch.

The Road Ahead: More Than Just Contract Renewals

While AC Milan’s policy is a positive step, it is only one piece of the puzzle. Other clubs are making progress, but more comprehensive measures are needed to truly address the challenges faced by pregnant footballers.

Fifpro’s postpartum return-to-play guide provides valuable insights and recommendations for clubs. The guide stresses the importance of providing pregnancy-specific expert advice, comprehensive support for players’ physical and mental health, and financial security. It’s time for clubs to embrace these recommendations and work collaboratively with players’ unions to create a more equitable and supportive environment.

Ultimately, the goal is to create a future where women’s football celebrates motherhood and provides players with the resources and support they need to excel both on and off the pitch. This requires a collective effort from clubs, players’ unions, and governing bodies to ensure that pregnant footballers are not only protected, but also empowered to pursue their dreams.