A theory-based approach to explain the correlates of safe physical activity in pregnant and postpartum individuals

Introduction: Physical activity (PA) during pregnancy has benefits for mother and child. Engaging in PA during pregnancy helps prevent excessive weight gain, decrease the risk of gestational diabetes and preeclampsia, and lower maternal anxiety and depression. Barriers to PA during pregnancy and postpartum are multifaceted, a lack of knowledge on safe PA practices for this phase of life is an established concern. Even amongst women who are regularly physically active, pregnancy can create a decline or cessation of activity. Women report difficulties in finding evidence-based materials, rely on Internet information, and receive ambiguous messaging about pregnancy and postpartum PA from healthcare providers. During pregnancy, women could also adopt healthy lifestyle choices, but without resources to empower women through educated healthy choices in PA, this period of desired lifestyle improvements could become a missed opportunity. The project aimed to analyze the level of PA behavior in pregnant and postpartum–two years following birth, individuals living in a southwestern state in USA. It is also to examine safe PA efforts to support and increase the likelihood of adherence to behavior in this unique population. Methods: In order to understand the factors that contribute to health behavior change for safe PA in pregnancy and postpartum, this cross-sectional study employed the fourth-generation multi-theory model (MTM) in individuals ages 18 years and older. An MTM-based 37-item pre-defined instrument for 150 minutes of safe PA was administered electronically to a local representative sample of pregnant and postpartum women in A southwestern state in USA (n = 110). Results: The study found that in women who have been engaged in ≥ 150 minutes of PA in the last week as per recommendations, the construct of MTM, namely behavioral confidence (β = 0.175, 95% CI [-1.21, 8.12], p < 0.001) was statistically significant and important to initiate ≥ 150 minutes of PA, while attributing to a significant 62.9% of the variance in the likelihood to achieve ≥ 150 minutes of PA. The study also explained that two other constructs of MTM namely, emotional transformation (β = 0.097, 95% CI [-7.19, 12.36], p < 0.001) and changes in the social environment (β = 0.048, 95% CI [- 6.97, 9.19], p < 0.001), respectively, accounted for a significant for maintenance of the repeated behavior of continuing ≥ 150 minutes of PA. These two constructs accounted for 39.0% of the variance. Discussion: This evidence-based study verifies the use of MTM in facilitating PA interventions in pregnant and postpartum women aged 18 and over. Furthermore, outcomes from these activities can be evaluated using both quantitative and qualitative methodology. This provides future physicians with the knowledge of safe PA and allows them to develop their skill set in patient education on healthy living. While findings from the MTM survey will provide guidance on areas of need to increase PA in pregnant and postpartum individuals, identifying areas for future interventions and educational resources can be developed to address these needs.