Exploring womens’ experiences and decision making about physical activity during pregnancy and following birth: a qualitative study

Abstract

Background: Physical activity (PA) tends to decline during pregnancy, and remains low in the early postpartum period, despite the known physical and psychological benefits. This study aimed to explore: (1) women's experiences of PA during pregnancy and following birth; and (2) decision-making processes related to PA during this time.Methods: Semi-structured telephone interviews were conducted with 16 women who were either pregnant or had recently given birth. Interviews were transcribed verbatim and analysed using thematic analysis.Results: There were two over-arching themes: (1) ownership of body, which consisted of the sub-themes: others try to take ownership, important to maintain fitness into pregnancy and motherhood, expectations of PA, and pressure to conform; and (2) unknown territory, which consisted of the sub-themes: engaging in PA with caution, and unclear advice. Decision-making about PA during pregnancy was influenced by: pressure from others who felt responsible to protect the woman from coming to harm; pressure from social media to lose weight postpartum; participant's beliefs about the benefits of maintaining fitness and participants expectations of how active they thought they would be able to be during pregnancy. Participants felt that pregnancy was an 'unknown territory' in terms of the unfamiliar feelings in their body and the inability to continually monitor their baby for reassurance of baby's health. Advice received from midwives was often lacking, or not tailored to the individual. Advice from friends and family was often regarded as incorrect, but still caused doubt and fear of PA during pregnancy.Conclusions: These findings contribute to the understanding of women's experiences of PA during pregnancy and post-partum, and their decision-making processes about PA during pregnancy. Developing accurate and tailored advice as part of midwifery care, that considers the physical and psychological aspects of engaging in PA during pregnancy, will help to ensure that women are supported to make informed decisions about their PA behaviour.

Physical Activity in Pregnancy: Beliefs, Benefits, and Information-Seeking Practices of Pregnant Women in South Africa

“…An overwhelming majority held the positive beliefs that regular exercise during pregnancy was permissible (87.4%), women not previously engaging in exercise could commence exercise during pregnancy (81.0%), and that it improved labor and delivery (93.1%) and the health of the baby (93.1%), and promoted energy (89.0%), and endorsed regular exercise at least three times weekly (85%). These positive beliefs about physical activity align with a previous study in South Africa 32 and others elsewhere, in which pregnant women have expressed the benefits of prenatal physical activity, 28 , 30 , 38 , 39 which serves as an enabling influencer to engage in prenatal activity during pregnancy. If women are informed about the importance of physical activity during pregnancy, this will invariably challenge their traditional beliefs about pregnancy-related risk.…”

“…Uunderstanding where women get advice on physical activity during pregnancy and what advice they act upon is necessary for improving the health-care support already in place. 30 Physical activity plays a significant role in maternal health; therefore, creating awareness of its benefits and contraindications may change women’s negative attitudes toward physical activity and promote it for better maternal outcomes, which might decrease the burden of preventable pregnancy-related conditions on the health-care system. 31 …”

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

“…Regardless of their previous experiences and number of children, the postpartum transition required study participants to revisit their capacities for desirable physical activities and their workability. Similarly, English women have described social pressure and physical and psychological changes during pregnancy and early postpartum affecting their thoughts about how to retain ownership of their bodies in making physical activity decisions, with limited trustworthy information [ 17 ]. In the current study, the processes involved in reconciling relationships with physical activity explained women’s postpartum reconfigurations of physical activity on personal, relational, and pragmatic levels.…”

“…Other participants recognized that they could have returned to physical activity earlier following birth. Women have described being cautious with physical activity engagement during pregnancy due to uncertainty about the effects of physical activity on their infant [ 17 ]. Our study findings suggest uncertainty about personal capacity postpartum can unduly contribute to cautious physical activity engagement for women.…”

“…Evidence suggests women’s postpartum physical activity trajectories vary; the largest percentage of women decrease physical activity but some women maintain previous activity and a small percentage increase their physical activity in the postpartum period [ 16 ]. Women have described incorporating social expectations and taking cues from their physical body and past exercise experiences to make physical activity decisions prenatally and in the early postpartum period [ 17 ]; however, previous work has not explicated complexity and variation in women’s physical activity choices at various points in the postpartum period. This qualitative study explains women’s postnatal physical activity decision-making processes.…”