Facilitators, Barriers, and Structural Determinants of Physical Activity in Nulliparous Pregnant Women: A Qualitative Study

Abstract

Aims & Backgrounds. Reduced physical activity in pregnant women is highly stemmed from their misconceptions and attitudes during pregnancy. This study is aimed at recognizing the facilitators, barriers, and structural factors that influence activity among pregnant women. Participants & Methods. This qualitative study was conducted from January to June 2020 in nulliparous pregnant women. Forty participants selected randomly from the Pounak Health Center of Tehran City, Iran, answered open-ended questions about the obstacles that deprived them of physical activity during pregnancy. Data were analyzed by MAXQDA 12 software. Findings. 620 primary codes, 42 secondary codes, 11 subthemes, and 6 themes were extracted. These themes were divided into the PEN-3 categories: facilitators, barriers, and structural factors. The nurture factors as facilitators had communication and support from others as subthemes. Barriers consisted of sociocultural (participate in pregnancy class with a companion, social beliefs, and culture of poverty), socioeconomic (financial problems), and individual factors (physical, psychoemotional, and spiritual dimensions), and structural factors consisted of environmental (equipment) and organizational (possibilities in health centers) factors. Conclusion. Lack of awareness and misinformation, accessibility obstacles, and economic problems are the worst physical activity barriers during pregnancy. Being among other pregnant women and the physicians’ recommendations are the best facilitators of physical activity during pregnancy.

Exploring Antenatal Exercise: Knowledge, Attitudes, Practices, and Influencing Factors among Pregnant Women in Libya

“…12,19,33 Several studies have highlighted barriers to antenatal exercise, including time constraints, lack of motivation, fear of exertion or harm to the baby, and lack of guidance or information. 13,15,19,34 These findings support the notion that knowledge and positive attitudes alone may not be sufficient to drive behavior change, and addressing barriers is crucial in promoting antenatal exercise practice.…”

“…33,38 Economic constraints and limited access to resources, such as sports facilities, gymnasiums, or exercise equipment, are additional barriers that prevent women from engaging in regular exercise. 34 Lack of time due to household responsibilities, caring for children, and engagement in income-generating activities further limits the opportunity for women to prioritize physical activity. 35 Addressing these barriers requires comprehensive strategies that consider cultural context, economic empowerment, infrastructure development, and social support systems to create an enabling environment for women to engage in regular exercise and improve their overall health and well-being.…”

A socio-ecological model of factors influencing physical activity in pregnant women: a systematic review

“…The publication period ranged from 2004 to 2022, with 20 (62.5%) published after 2019. We found results related to MVPA in pregnant women ( 30 , 31 , 38 , 40 , 45 , 50 , 55 ) in 7 papers. The sample sizes ranged from 22 to 9,345 participants, for a total of 37,920.…”

“…Relative studies contained different contents on a personal level. In addition, 28 papers included socio-demographic factors ( 24 , 25 , 27 , 28 , 30–43 , 45–51 , 53–55 ); 24 included biological factors ( 24–30 , 32 , 33 , 35 , 36 , 39 , 41–44 , 48–55 ); 21 included behavioral factors ( 25–30 , 32 , 33 , 35 , 36 , 39 , 41 , 44–46 , 48–51 , 53 , 55 ); and 19 included psychological factors ( 25 , 27–29 , 31–35 , 42–46 , 49 , 51–53 , 55 ), 32 in total, all of which involved the personal level. There were 24 articles analyzing the interpersonal level ( N = 24) ( 24–30 , 33–35 , 39 , 42–49 , 51–55 ); 18 analyzing the organization level ( N = 18) ( 25 , 27 , 29 , 32–39 , 42 , 44–46 , 51 , 53 , 55 ); 17 articles included factors related to the community level ( N = 17) ( 25 , 27 , 29 , 31–33 , 35 , 37–39 , 44–46 , 51–53 , 55 ); and only 3 articles included factors related the policy level ( N = 3) ( 25 , 33 , 51 ...…”

“…Some authors claim that heavy physical work can have negative impact on the progression of pregnancy. Nevertheless, it increases the amount of MVPA ( 36 , 40 , 45 , 50 ). However, since exercise was a small part of maternal activity, and work affected PA duration ( 45 ), a balance should be struck in future interventions focused on the implementation of PA programs in women who perform physical occupational work.…”