Abstract

Low levels of physical activity (PA) are of a health concern among high body mass index (BMI) women living a sedentary lifestyle and being overweight or obese during pregnancy is associated with increased risks of maternal and fetal health complications. Obstetricians often provide advice regarding recommended PA levels, yet this has not been easily achieved in this group to prevent adverse birth-related outcomes. The purpose of this study is to explore motivators/enablers and perceived barriers through in-depth qualitative inquiry, guided by a behavioral change model, for understanding of pregnant women’s decisions to engage, or refrain from PA practice. Thirteen overweight and obese pregnant women aged 28 to 45 years with an inactive, sedentary lifestyle in urban areas of northern Taiwan were recruited to participate in six focus group sessions for their intent and readiness for PA engagement in pregnancy. A thematic content analysis was performed with a constant comparison method to categorize interview data and generate themes. The findings illustrate the extent to which obese and overweight pregnant women’s readiness for PA is affected by multiple factors, including personal beliefs, perceived societal norms, peer support, and the competing priorities in the environment. PA interventions are to be effective by focusing on overcoming barriers, increasing motivations, and enhancing self-management. Strategies shared by participants shed lights for program developers to design preferable behavioral interventions for this group of women who are low self-esteem with low self-efficacy to increase PA and meet recommended levels. There is considerable potential for health care providers to provide accessible information, facilitate PA, and promote an active lifestyle during and after pregnancy.

Highlights

  • While obesity is found as a significant contributor to chronic diseases [1], women with their body mass index (BMI) above 25 kg/m2 [2] at their first antenatal visit are likely to have more clinical implications than their counterparts with normal BMIs during pregnancy and childbirth [3,4]

  • The clinically diagnosed obese and overweight participants included those: (1) who were aged over 20 years, (2) who were able to speak and write Mandarin Chinese, (3) who had their BMI ≥ 25 kg/m2 at antenatal booking and for at least 24 gestational weeks, and (4) who had never participated in any physical activity (PA) intervention program before this study

  • Low levels of PA are a health concern among women with a sedentary lifestyle, and being overweight or obese during pregnancy is associated with increased risks of maternal and fetal health complications

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Summary

Introduction

While obesity is found as a significant contributor to chronic diseases [1], women with their body mass index (BMI) above 25 kg/m2 [2] at their first antenatal visit are likely to have more clinical implications than their counterparts with normal BMIs during pregnancy and childbirth [3,4]. According to the Report of Nutrition and Health Survey in 2020 [7], more than 81% of the adult women in Taiwan have their waist circumference, a predictor of metabolic syndrome, larger than 30 cm; Taiwanese women residing in urban areas are either overweight (31.5%) or obese (25.5%). This prevalence of maternal obesity escalates to pose a serious public health concern in Taiwan.

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