Experiences regarding nutrition and exercise among women during early postpartum: a qualitative grounded theory study

Abstract

BackgroundExcess gestational weight gain has long- and short-term implications for women and children, and postpartum weight retention is associated with an increased risk of long-term obesity. Despite the existence of dietary and exercise guidelines, many women struggle to return to pre-pregnancy weight. Experiences of women in tackling postpartum weight loss are poorly understood. We undertook this study to explore experiences related to nutrition, exercise and weight in the postpartum in women in Ontario, Canada.MethodsThis was a nested qualitative study within The Be Healthy in Pregnancy Study, a randomized controlled trial. Women randomized to the control group were invited to participate. Semi-structured focus groups were conducted at 4–6 months postpartum. Focus groups were audio recorded, transcribed verbatim, coded and analyzed thematically using a constructivist grounded theory approach.ResultsWomen experienced a complex relationship with their body image, due to unrealistic expectations related to their postpartum body. Participants identified barriers and enablers to healthy habits during pregnancy and postpartum. Gestational weight gain guidelines were regarded as unhelpful and unrealistic. A lack of guidance and information about weight management, healthy eating, and exercise in the postpartum period was highlighted.ConclusionStrategies for weight management that target the unique characteristics of the postpartum period have been neglected in research and in patient counselling. Postpartum women may begin preparing for their next pregnancy and support during this period could improve their health for subsequent pregnancies.Trial registrationNCT01689961 registered September 21, 2012.

Reconciling relationships with physical activity: a qualitative study of women’s postnatal physical activity decision-making

“…Participants’ descriptions of difficulty accessing information about postpartum physical activity programming and recreation centres’ childcare aligns with previous work indicating women have perceived limited access to relevant physical activity resources and information for the postpartum period [ 12 , 13 ]. Our findings point to the importance of available information for postpartum physical activity decision-making, because study participants were less likely to pursue physical activity when they lacked confidence to navigate recreational programming information or access to social networks of people who could support their strategizing.…”

“…Variations in women’s physical activity desires and interpretations of workable and achievable physical activity suggest that postpartum physical activity interventions designed to address generalized barriers (e.g., free mother-infant classes) and facilitators (e.g., planned outdoor activities) may have limited capacity to contribute to women’s increased physical activity participation. Pursuing mother-infant fitness programming has been recommended to facilitate women’s postpartum physical activity [ 12 , 13 ] however, in the current study, some participants gauged themselves as emotionally vulnerable in such environments. Tailored and extended physical activity support that encourages women to identify and strategize to achieve desirable physical activities has more successfully supported sustained increased in physical activity than generalized support [ 25 ].…”

“…Consistent with built environment and sociological physical activity literature [ 20 ] study participants highlighted structural features (e.g., physical environment, recreation program availability) and resources (e.g., childcare, finances) in their decision-making about physical activity. Women in previous studies [ 12 , 13 ] have also reported a number of environmental barriers to physical activity following birth. The current study extends the literature because participants described unique postpartum environmental challenges, such as the safety of navigating the outdoor terrain with strollers, lack of recreation centre family-inclusive programming, and need for flexibility in program delivery and childcare options.…”

“…The majority of participants in large descriptive studies measuring women’s postpartum physical activity did not achieve physical activity recommendations [ 8 , 9 ]. Qualitative descriptive and survey research has illuminated personal, relational, and resource factors (e.g., facilitators, barriers) that women perceived as affecting their postnatal physical activity choices [ 10 – 12 ]. Women have identified lack of time/childcare, fatigue, and social support as significant factors affecting their postnatal physical activity levels [ 11 , 13 ].…”

Be Healthy in Pregnancy: Exploring factors that impact pregnant women's nutrition and exercise behaviours

“…Protocols for the primary study and the nested study are described in detail elsewhere (Murray-Davis et al, 2019;Perreault et al, 2018).…”