Pregnant and Postpartum Women's Perceptions of Barriers to and Enablers of Physical Activity During Pregnancy: A Qualitative Systematic Review

Abstract

Introduction Physical activity throughout pregnancy has been shown to have health benefits for the pregnant person, including reductions in the risk of preeclampsia and gestational weight gain and improvements in blood pressure regulation. Despite the benefits, many pregnant women do not meet the guidelines for physical activity throughout pregnancy. Therefore, it is important to determine what influences women's activity levels during pregnancy. This systematic review of the qualitative literature aimed to determine pregnant and postpartum women's perceptions of barriers to and enablers of physical activity, specifically during pregnancy. Methods MEDLINE, PsycINFO, CINAHL, and Embase were searched systematically to identify qualitative studies investigating pregnant or postpartum women's perceptions of barriers to and enablers of physical activity during pregnancy. Included studies were limited to populations of pregnant or postpartum women, the majority of whom were aged 18 to 40 years, and studies published from 1985 onward. Data quality was assessed using the Critical Appraisal Skills Programme Qualitative Studies Checklist. Data were extracted using NVivo software and subsequently mapped on the COM‐B framework. Results Twenty‐five qualitative studies were included in this systematic review. Sixteen themes were identified that mapped onto 6 components of the COM‐B framework. Commonly reported barriers to physical activity during pregnancy included pregnancy symptoms, lack of knowledge of what constitutes safe activity, and the opinions of women's social circles. Commonly reported enablers of physical activity during pregnancy were social support and the experienced benefits, including physiologic, psychological, and social benefits. Discussion The results of this systematic review have clinical implications for perinatal care providers, as the overall benefits of physical activity during pregnancy have been well documented in previous studies. The authors recommend clinicians aim to explore pregnant women's perspectives on physical activity during pregnancy in order to be able to address their perceived barriers to and enablers of physical activity during pregnancy.

Effectiveness of interventions to prevent perinatal depression: An umbrella review of systematic reviews and meta-analysis

“…We found a trend towards greater effectiveness when physical activity targeted at-risk women with a history of depression or elevated depression symptoms during the perinatal period [ 46 ]. However, women may be less likely to undertake exercise due to the symptoms of depression (e.g., less energy, fatigue), which can be an added barrier for women to exercise during pregnancy [ 61 ]. Regarding the type of the exercise activity, our study cannot recommend any intervention in favour of others, but most trials were aerobic in nature [ 46 , 51 ].…”

Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial

“…In support of this speculation, Teede et al 's [14] recent review of interventions to promote healthy gestational weight gain found that diet only interventions led to more favorable (i.e., less) gestational weight than PA interventions, diet with PA interventions, or mixed interventions. Indeed, the challenges related to increasing PA are substantial [49] and often requiring adding in a new behavior that may be challenging and time-consuming versus making modifications to existing behaviors, as is the case for diet. Behavioral intervention participants in our study improved their diet quality, vegetable intake, and % of grains that were whole grains, suggesting they were able to make small but meaningful changes to their diet.…”

Assisted reproductive technology and physical activity among Chinese pregnant women at high risk for gestational diabetes mellitus in early pregnancy: A cross‐sectional study

“…According to Green (1991), the minimum required sample size for multiple linear regression can be estimated using the formula n > 50 + 8 m , where m is the number of predictors. Based on the literature review, the predictors of physical activity were assumed to be self‐efficacy (Yu et al, 2023), knowledge (McKeough et al, 2022), social support (Grenier et al, 2021), age (Jones et al, 2021), education (Jones et al, 2021), occupation (Jones et al, 2021), monthly household income (Janakiraman et al, 2021), attendance at antenatal physical activity classes (Ahmadi et al, 2021), pre‐pregnancy physical activity habits (Janakiraman et al, 2021), and parity (Alaglan et al, 2020). Thus, in the present study, m is 10.…”

“…According to Bandura (1977), physical activity is related to physical activity self-efficacy, which refers to individuals' confidence in their ability to learn or engage in physical activities. Apart from physical activity self-efficacy, insufficient knowledge is commonly reported as a barrier preventing pregnant women from engaging in physical activity (McKeough et al, 2022). Social support for physical activity refers to providing instrumental, informational, emotional, and peer support during physical activity (Xiang et al, 2022).…”