“You don’t know how it affects your baby”: Women’s beliefs and decision-making about physical activity during pregnancy and postpartum

While the benefits to both mother and baby of appropriate physical activity in pregnancy are well-studied, the reasons that women do or don’t meet those recommendations are less well-investigated. In this blog post, the lead author of a new qualitative study of women’s experiences and beliefs about physical activity during and after pregnancy, published in BMC Pregnancy and Childbirth, discusses the findings and their implications for practice.

It is well known that physical activity during pregnancy can have positive benefits for both the mother and unborn baby. During pregnancy, women often reduce time spent being physically active, change to lighter physical activities such as yoga or swimming, or completely stop being physically active. However, there is a lack of research investigating the decision-making processes behind this behavior change. Understanding women’s experiences, beliefs, and decision-making about physical activity can help shape and improve healthcare practice. Our new study, published today in BMC Pregnancy and Childbirth, sheds light on women’s beliefs and decision-making about engaging in physical activity during pregnancy and following birth.

Study findings

Our research, which involved interviews with 16 women who were either currently pregnant or had recently given birth to their first child, provides some context around women’s beliefs about physical activity during pregnancy. The research found two key themes: Ownership of body and Unknown territory.

The findings emphasize the important role of healthcare providers and trainers to provide women with information about physical activity during pregnancy.

Theme 1:  Ownership of body The participants in the study described feeling a lack of ownership of their own body during pregnancy, which originated from experiencing unfamiliar bodily sensations from common pregnancy symptoms e.g. sickness, tiredness, discomfort:

 “A little bit kind of unsure of what’s going to happen, and that lack of kind of control over the situation because I, you think you know your asthma, I think I know my asthma, but I don’t know my asthma when being pregnant. I think it means that I don’t necessarily know my body and my health in relation to pregnancy as I did pre-pregnancy so, it’s something that I’ve never experienced before so I don’t know, I don’t know how it’s going to affect my ability to do things.” (Jane)

Women also spoke about how others often offered unsolicited, but good intentioned, advice to try and ‘protect’ the women from coming to harm. This advice, however, inadvertently created a level of pressure to behave in a certain way that limited their physical activity levels:

“I was at work and we was really busy and they said oh this patient wants sitting up the bed, quite a large man, and I said oh I’ll come, like because I’m more than happy to but it’s other people I think, I think it’s the guilt of letting me, and if something happens they would blame their self, so I’m like I’ll come, and they were like no no no, and I’m like what is the problem like are you using like the appropriate equipment that I’m supposed to, they’re like no no it’s fine we’ll get somebody else” (Sally)

Theme 2:  Unknown territory Women experienced a conflict between wanting to be physically active but also wanting to be completely self-assured that their unborn baby was safe. With medical scans few and far between, some women felt a lack of certainty of their baby’s health and saw physical activity as a potential ongoing risk:

“there’s no way to check how it affects your baby, you do know that at the scan the baby’s fine, we cannot tell if what your doing, say if you was to go for a run or go to the gym you don’t know how it affects your baby, because that scan its only so many weeks apart you don’t know the immediate impact of activity on the baby” (Charlotte)

Women sought advice on what constitutes safe physical activity during pregnancy from a number of places, but the most trusted advice was from medical professionals, such as midwives or doctors, and sports trainers who were professionally trained to work with pregnant women. Some women received vague advice from health professionals and often felt like the advice was not tailored to their situation:

“I’ve read and spoken  to my midwife and GP about it sort of it was all quite, almost quite vague advice saying if your used to exercise then you should carry on but not really specific about the level of activity and how long a period of activity, so I found it quite difficult to sort of make that decision” (Michelle)

Implications for practice

Women in our study showed an enthusiasm to maintain fitness throughout pregnancy for physical and psychological benefit. The findings from this research emphasize the important role of healthcare providers and sports/physical activity trainers to provide women with the information they need about physical activity during pregnancy. The advice they provide would be best received by the women if individually-tailored and specific to their situation in terms of: (a) how active the woman was pre-pregnancy; and (b) any specific health requirements.

More support and information about the types of bodily experiences that are normal to feel during pregnancy could help reduce the anxiety that women experience when their bodies feel unfamiliar. This may help them to feel assured that the physical activity they are engaging in is safe for themselves and their baby.

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