Perceived Barriers And Motivators For Physical Activity In Women With Perinatal Depression

Abstract

Physical activity (PA) may help reduce severity of depressive symptoms in women with perinatal depression (depression during pregnancy or postpartum). However, less than one third of pregnant and postpartum women meet national PA recommendations, and PA is likely even lower in women with perinatal depression. Barriers and motivators for PA among women with perinatal depression are not well understood. PURPOSE: The aim of this study was to identify barriers and motivators for PA among women with perinatal depression. METHODS: Pregnant and postpartum women with perinatal depression were identified using Kaiser Permanente Northern California’s universal perinatal depression screening program. We conducted 8 focus groups totaling 35 women with prenatal (n=15) and postpartum depression (n=20). Focus groups were analyzed using an inductive approach. RESULTS: Pregnant women were, on average, 27 weeks gestation (range: 11-37) with mild to moderately severe depressive symptoms (Patient Health Questionnaire (PHQ)-8 mean: 10; range: 4-19). Postpartum women were, on average, 12.5 months postpartum (range: 8.5-16.5) with no to moderately severe depressive symptoms (PHQ-8 mean: 7; range: 0-16). Perceived barriers to PA identified by pregnant and postpartum women included low energy and mood, limited time due to other priorities, feeling discouraged when comparing to pre-pregnancy self, and limited geographic accessibility and high cost of group exercise classes. Unique barriers identified by pregnant women were physical discomfort and fear of judgement from others. Postpartum women identified lack of childcare as an additional barrier. Motivators for PA identified by pregnant and postpartum women included self-care (“me time”), improved mood after PA, making progress toward goals, being strong and fit to keep up with their children, and having a social support system. CONCLUSIONS: Interventions to increase PA in pregnant and postpartum women with perinatal depression should include components addressing motivation, time, geographic accessibility, and cost barriers. Interventions can also increase PA by promoting potential mood benefits, fostering a sense of accomplishment, and leveraging social support as motivators in pregnant and postpartum women with perinatal depression.