Why do exercise and pregnancy seem to be incompatible?
Studies that have examined factors associated with LTPA have mainly focused on sociodemographics and identified lower education and/or income, belonging to a minority ethnic group, being single/divorced and smoking5,6 to be associated with physical inactivity during pregnancy. Other frequently reported LTPA barriers include lack of time, childcare difficulties, fatigue, experiencing pregnancy-related discomfort, lack of social support and low self-efficacy for overcoming exercise barriers.5–7 Women may also have misconceptions about the benefits of LTPA as the information they receive is from multiple sources – including healthcare providers, printed materials, family, friends and the Internet – which may vary in consistency and accuracy.
Pregnancy has been described as a “teachable moment” for promoting a healthy lifestyle, as women are concerned about the health of their unborn baby and are motivated to return to their pre-pregnancy weight. Yet, as many as one in two women report that their doctor did not discuss exercise during their pregnancy. Women view health care providers as credible sources for obtaining prenatal information. As part of comprehensive prenatal care and wellness promotion, health professionals need to routinely provide pregnant women with accurate and sufficient information related to the benefits of LTPA. An individualized approach is preferred by women and has been shown to be more effective in maintaining behaviour change.8 In current practice, exercise is not routinely discussed during prenatal care and, when it is, it does not often go beyond simple advice. Prenatal health care providers acknowledge the importance of regular LTPA during pregnancy, but many report a lack of knowledge and confidence on how to motivate women to uptake or maintain LTPA during pregnancy, highlighting the need to address this knowledge gap.
Pregnant women have reported the Internet as an important and frequently accessed source for pregnancy-related information, including exercise.8 These findings suggest the need and feasibility of providing evidence-based information to promote healthy behaviors during the perinatal period via the web as part of routine prenatal care. Obtaining endorsement and support from healthcare providers for such web-based initiatives may enhance the credibility, uptake, and usability of Internet-delivered information. Web-based resources can serve as a powerful low-cost educational tool to support and reinforce the health promotion advice received from healthcare providers.
While knowledge is considered to be an important precursor for behavior change, it may be insufficient for uptake and maintenance. A number of interventions have been designed and evaluated to increase LTPA during pregnancy, but few have been effective, largely due to methodological limitations and lack of theory-driven strategies to guide intervention development.9 Behaviour change theory-driven strategies such as individualized goal setting and planning with feedback have been shown to be more effective at enhancing LTPA throughout pregnancy.9 Training prenatal health care providers in the implementation of these techniques and their incorporation into other modes of physical activity promotion for pregnant women (i.e., websites, pamphlets, prenatal classes) are needed to enhance the health messages women receive during pregnancy.