The extensive benefits of physical activity (PA) are well known. However, PA participation among pregnant women remains low. This study evaluated PA levels and associated factors, including barriers and facilitators in pregnant women in Harare, Zimbabwe. This cross-sectional study recruited 517 pregnant women receiving antenatal care across ten primary healthcare clinics. Data were collected using the Pregnancy Physical Activity Questionnaire (PPAQ), Exercise Benefits and Barriers Scale (EBBS) and EQ-5D-5L. We used descriptive statistics and binary logistic regression for analyses. The mean age of the study participants was 26.1 (±5.9) years. 89% of the pregnant women did not meet the WHO recommendations of 150 minutes of moderate-intensity PA. For women who were active, most engaged in moderate intensity (41.9%) PA and household activity (51.1%). The most perceived barriers and facilitators to PA were reported as exercise environment and life enhancement, respectively. Lower education (AOR 5.24 [1.69: 16.19]), multigravida (AOR .47 [.31: .42]), not exercising pre-pregnancy (AOR 2.02 [1.30: 3.13]), perceived decreased current PA level (AOR 2.04 [1.22: 3.43]) and not being advised by a doctor on exercise (AOR 2.05 [1.04: 4.04]) were associated with physical inactivity. Physical inactivity is endemic among Zimbabwean pregnant women, there is a need for bespoke and contextualized interventions. Implementing supervised and group-based antenatal exercise classes must be considered.
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