Factors that influence physical activity for pregnant and postpartum women and implications for primary care

Abstract

Many pregnant women and women of child-bearing age do not engage in the recommended levels of physical activity despite the well known benefits. Pregnancy and the postpartum period can be a time when inactivity actually increases. Women who experience gestational diabetes mellitus (GDM) during their pregnancy are often advised to become more active in order to ameliorate their increased risk of developing type 2 diabetes. Health professionals have an influential role in promoting physical activity, which would be enhanced with an understanding of the factors that positively and negatively influence women's participation in physical activity during pregnancy and in the postpartum period. This research sought to explore these factors with pregnant and postpartum women including those who had experienced GDM and the attention given to physical activity during pregnancy. A survey was developed after a critical review of factors identified from previous studies. Women were recruited from the antenatal clinic, community health centres and the local media. Results from 72 women are reported from a predominately well educated, Caucasian population. Overall, the results were confirmatory of factors previously identified. Lack of child care, time constraints, no time and feeling unwell during pregnancy hindered activity and factors that facilitated activity included family support, enjoyment of activity and to prevent later health problems. It was also found that non-GDM women are given minimal advice about exercise during pregnancy. A checklist has been developed for health professionals, in partnership with women, to direct attention to the factors that enable and hinder participation in physical activity during and after pregnancy.

Mothers with young children: Caring for the self through the physical activity space

“…Women themselves have identified that LTPA is an important aspect of postnatal well-being (Currie, 2009;Daley, MacArthur, & Winter, 2007). They also, however, report difficulties continuing with formal exercise in the postnatal period for various reasons including high stress levels (Lox & Treasure, 2000), lack of energy, feeling unwell, and lack of time and space for LTPA (Doran & Davis, 2011). Further, for some women, the expectations to achieve specified levels of LTPA in relation to frequency, intensity, and time can place an additional burden (e.g., feelings of mother guilt and inadequacy) on those who are already vulnerable and deemed "at risk, " including new mothers who are at particular risk of inactivity (Albright, Maddock, & Nigg, 2006).…”

Reasons for participation and non-participation in a diabetes prevention trial among women with prior gestational diabetes mellitus (GDM)

“…As ours and other studies suggest (see [30,33]), awareness of GDM as a risk factor for type 2 diabetes may not be sufficient to increase personal risk perception and motivate women to change their lifestyle and health behaviours. Other factors such as emotional stress and fear of diagnosis have been shown to present significant barriers to participation in follow-up health care programmes.…”

“…For example, Kim et al . [30] and Doran and Davis [33] found that women with prior GDM who perceived themselves to be at high risk of developing type 2 diabetes and planned to modify their future health behaviour were also associated with the lowest fruit and vegetable consumption, and self-reported no physical activity (or any other recent modifications to their health or lifestyle behaviours). A small number of studies have used qualitative methodologies to explore the barriers to and facilitators of post-partum follow-up care in a cohort of women with recent GDM.…”

Development and design of an intervention to improve physical activity in pregnant women using Text4baby

“…Specifically, the intervention designed from the formative research reported here can be used to inform how physical activity messaging is incorporated into Text4-baby in the future. The current Text4baby curriculum has limited SMS about physical activity, and because the evidence supporting participation in physical activity as part of a healthy pregnancy is ample [1][2][3][4][5][6][7][8][9][10][11][12], there is a need to modify standard Text4baby physical activity SMS in light of these findings.…”

“…For the mother, benefits may include weight control [4] and reduced risk of early delivery and gestational diabetes [2,3,[5][6][7], and for the fetus, benefits may include improved stress tolerance and a decrease in resting fetal heart rate [8][9][10][11][12]. Despite these benefits, only 15.8 % of pregnant women (as compared to 26 % of non-pregnant women) achieve recommendations for physical activity [6,13,14] (i.e., meeting physical activity recommendations of 150 min of moderate intensity activity per week) [15][16][17].…”