After six days of labour in an Austrian hospital, Canadian skeleton racer Elisabeth Maier lay on the operating table for an emergency C-section and doctors immediately knew it was the right decision.
"The doctor could see my muscles had not opened up enough, my hips stayed closed," Maier told CBC Sports. "My body didn't cooperate. Well, it cooperated as an athlete [since] my muscles stayed engaged, but not for the child-birthing side.
"Had there not been an opportunity for a C-section and modern medicine, I would have been someone that probably would've succumbed to childbirth death."
Delivering her son Hendrix wasn't how Maier expected her quadrennial to Beijing 2022 to begin, but the 26-year-old from Calgary quickly learned to embrace the moments her dual roles as athlete and mother collided.
They started early in her pregnancy, like when her coach put a premature stop to sprint training because she'd get physically sick. And they continued after Hendrix was born, like when he got meningitis at three months old and she would do squats while comforting him in her arms.
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No doubt Maier's "comeback" from pregnancy — in the midst of a pandemic no less — will be a major storyline for her in China. Similar to how Jamaican sprinter Shelly-Ann Fraser-Pryce was celebrated for winning 100-metre gold at the world championships a year after having her son, or when Serena Williams was lauded after winning the Australian Open while eight-weeks pregnant.
And while coming back from pregnancy should be celebrated, physiotherapist Sara Tanza, who does pelvic floor work with pregnant and postpartum athletes, insists it should be through a more realistic, long-term lens.
"I don't even use the term comeback because I think we'll never bounce back," Tanza said, arguing women become different people both physically and mentally. "I really want us to change the narrative coming back really soon as something to be celebrated.
"I've seen so many athletes start too much too soon and six months down the line they have a stress fracture, or they start having incontinence after three months. So I think the biggest thing in the comeback of the pregnant athlete is we should respect it as a longer process than we might have thought originally."
Tanza works with both amateur and professional athletes before, during and after their pregnancies. She's treated patients with pregnancy-related issues up to eight years after childbirth. She focuses on preventing pregnancy-related injuries like pelvic organ prolapse and back, knee and hip injuries, as well as keeping athletes as strong and flexible as possible, especially in sport specific movements.
"You have this big weight, like a big bowling ball, sitting on your pelvis," Tanza said. "So what is that doing? It's putting weight downwards, loading your pelvic floor muscles and they're getting more stretched out. But it's also widening the whole structure of your pelvis.
"And we know how important your hips are for supporting you as you move and stabilize on one leg, and for athletes walking or running or playing a sport that involves arm movement, they're shifting their weight a lot, so those muscles have to be there to support them."
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And then there's rehabbing after childbirth, regardless of the type. In Maier's case, doctors cut through seven layers of her abdomen to get Hendrix out.
"If there was a hockey player that had an ACL tear, no one is expecting that player to be themselves six months later, yet we are expecting our pregnant athletes to do that," said Tanza. "And that's what a C-section is right? You're literally cutting through muscle."
Despite hearing some people being cleared by doctors to work out six to eight weeks after childbirth, Tanza says based on knowledge of tissue healing, athletes shouldn't be running or jumping until after three months.
Returning better than before
So that's why Marier started back slow, working with a postpartum physiotherapist and keeping movements simple.
"I'd have a three-hour work out where I was walking up stairs forward, backwards, sideways," she said.
That and the fact she maintained her fitness over her pregnancy with at-home weights got her to a point where she could begin dryland training with her team once their season was over. Her physical and push coach Ivan De Bruin, another sliding athlete, needed to do some research to learn how to train a pregnant athlete.
"After two-and-a-half months of slow and steady progression, she really got the hang of it and we were moving faster through the program than I was expecting," he said. "She got back to full gym and sprint workouts before we knew it.
"Physically and mentally she is stronger and more determined and confident than ever before."
And that's showing in her progress. Despite getting less than four hours of sleep per night, dealing with hormonal boosts from breastfeeding and learning to "keep this little human alive", Maier is now physically at the same spot she was a year out from Pyeongchang 2018. It's something Tanza sees often.
"I've seen a lot of athletes actually come back stronger, set personal records, have a better performance postpartum than they did before, so I don't think they'll necessarily go back to their old body ever," she said. "I've found with some of my patients that when they've learned to utilize their pelvic floor, they're actually stronger in other parts of their bodies."
Sliding like a mother
But it was a big surprise to Maier.
"To be at a pre-Olympic spot two years out from the Games and just having a sunroof baby eight months ago, it's amazing," she said. "I almost have a lot more body awareness ... I'm more intentional with the time I'm using.
"It's learning to take the hats on and off: the athlete hat, mom hat, wife hat. Where am I at in my life right at this moment?"
Maier plans to better her ninth place finish from Pyeongchang in Beijing. Trials to make the World Cup team are in October and she's planning a Sep. 26 fundraiser in her hometown of Calgary to help raise funds to get her and baby Hendrix to China.
"The fire is definitely re-lit and my purpose has completely changed, because leading into the last Olympics or into my competitions, I was never really clear on what my purpose in sport was," she said. "But now, I want to inspire my son to chase after his dreams and moms all over the world to chase after their goals, because I think a lot of the time they get put on the backburner: "Oh, I'll do that when my kids are in school or something." No.
"I'll do everything in my capabilities to grow and honour that purpose and honour my son and the moms worldwide."