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Introduction Women who are pregnant in rural communities are disproportionally impacted by obesity and sedentary behavior, and this could be related to having negative beliefs about exercise during pregnancy, leading to inactivity. The purpose of this study was to identify self‐reported beliefs about exercise among pregnant women in a rural community. Methods Pregnant participants (N = 70) between 8 and 16 weeks’ gestation were recruited from an obstetric clinic serving a rural population. An open‐ended questionnaire addressing beliefs about exercise and based on the constructs of the theory of planned behavior was administered. Descriptive survey results were analyzed by calculating means and frequencies. Open‐ended responses were assessed by inductive content analysis. Results Commonly reported advantages of exercise during pregnancy included improved perinatal health outcomes and weight management. Commonly reported disadvantages included an increase in fatigue and concerns for maternal and fetal safety. Common facilitators of exercise included access to resources, free time or a decrease in demands from work, and support systems including family and friends. Common barriers to exercise included a lack of time, physical changes including feelings of nausea and fatigue, and lack of access to resources. Discussion This study was the first to report beliefs about exercise during pregnancy in a rural setting. Responses in the current study suggest potential gaps in knowledge of evidence‐based information regarding physical activity during pregnancy. Beliefs as well as reported barriers and facilitators of physical activity during pregnancy were similar those reported in other populations. In addition, access to resources (or lack of) appears to be an important facilitator (or barrier) among women in rural settings; thus, developing strategies designed to overcome this barrier, specifically in rural areas, is critically important. Future intervention strategies need to be tailored specifically to the needs of women living in rural areas.

Background Mobile health technology offers the opportunity for women to engage with physical activity promotion programs without many of the barriers commonly associated with exercise during and after pregnancy (eg, childcare concerns, rigid schedules, fear of doing harm to fetus or self, access to fitness facilities, uncomfortable with body in front of others) which may be particularly useful in under-resourced rural environments. We conducted the first known study on perspectives of pregnant women, postpartum women, and obstetric healthcare providers in a rural setting on needs related to the development of a mobile app designed to increase physical activity during pregnancy and postpartum. Methods Focus groups and in-depth face-to-face personal interviews were conducted with 14 pregnant women, 13 postpartum women, and 11 healthcare providers in a rural community. Semi-structured questions utilizing constructs of the Health Belief Model were used to identify barriers, facilitators, and other influences on physical activity during pregnancy and postpartum. Recordings of all in-depth interviews and focus groups were transcribed and standard content analyses for qualitative data were conducted. Results Rural women and healthcare providers expressed several key perspectives about and recommendations to promote physical activity during and after pregnancy. Broadly, these perspectives encapsulated two main themes: 1) physical activity as critical for weight control and 2) the need for evidence-based exercise information. Key desired features of this app identified include goal setting/progress tracking, evidence-based exercise guidance tailored to specific time points of pregnancy and postpartum, social support via community-based forum, symptom tracking, time-efficient workouts, and push notifications. Conclusion The perspectives identified by participants should be utilized when designing mobile health physical activity mobile apps for pregnant and postpartum women in rural areas.

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Background Metabolic dysfunction after pregnancy may have serious consequences for a new mother. The purpose of the study was to characterize basic changes that occur in metabolic profiles from late pregnancy through 4–6 months postpartum. A secondary purpose was to determine metabolic factors that may be contributing to postpartum weight retention. Methods Participants (n=25) came in for 2 visits: late pregnancy (~34 weeks gestation) and postpartum (4-6 months). Resting metabolic rate (RMR), respiratory quotient (RQ), and substrate oxidation values were assessed for 15 minutes during fasted conditions. Blood was drawn and skinfold anthropometry was performed to assess additional outcomes (inflammation, insulin resistance, lipid profiles, body composition). The participants completed a number of surveys that examined other lifestyle and demographic data of interest. At the postpartum visit, additional assessments regarding sleep and breastfeeding habits were administered. Results RMR was lower during postpartum (1517.2±225.1 kcal/day) compared to pregnancy (1867.9±302.6 kcal/day) (p<0.001), and remained lower when expressing RMR per kg body weight (postpartum: 22.3±2.7 vs pregnant: 23.7±3.4 kcal/kg, (p=0.034). Relative RMR (RMR per kg body weight) was negatively correlated to insulin resistance (HOMA-IR) during postpartum (r=−.463, p=0.034). Maternal HOMA-IR, inflammation (CRP), triglycerides (TAG), and carbohydrate oxidation were all positively correlated to postpartum weight retention (HOMA-IR: r=0.617, p=0.004; CRP: r=0.477, p=0.039, TAG: r=0.463, p=0.040; Carbohydrate Oxidation: (r=0.469, p=0.018). Conclusion Metabolic rate is lower during postpartum compared to pregnancy, and may be connected to insulin resistance. Maternal insulin resistance, inflammation, blood lipids, and substrate metabolism are all related to postpartum weight retention.