A Mixed-Methods Exploration of the Role of Pregnancy Planning on Maternal Physical Activity Behaviors

Background: Pregnancy is a life event that is influenced by social, emotional, and cultural factors. Research has shown that pregnancy planning may be linked to decisions surrounding health behaviors in pregnant individuals. Specifically, there are differences in how categories of pregnancy planning may be associated with an individual's decision to either engage in or avoid risky behaviors such as alcohol consumption, smoking, and delaying prenatal care. Existing research has yielded ambiguous results and neglects to consider physical activity (PA) as a separate health behavior that may be linked to an individual’s pregnancy planning status. Therefore, this study aims to explore individuals in varying pregnancy planning stages—planned, unplanned, and ambivalent— and their PA behaviors.

Methods: Thirteen pregnant individuals (ages 18-40 years, ³16 weeks gestation), located in the southeastern region of the United States, participated in the study. Quantitative data were collected using a survey to provide data on participant demographics, pregnancy planning (London Measure of Unplanned Pregnancy [LMUP]), and maternal PA behaviors (Pregnancy Physical Activity Questionnaire [PPAQ]). Nonparametric tests (Mann-Whitney U and Spearman) were conducted due to the non-normal distribution of data (alpha level 0.05). Qualitative data were collected through semi-structured, one-on-one interviews and recorded via Zoom. Verbatim interview transcripts were analyzed by two investigators. Quantitative and qualitative data were analyzed separately and integrated using a convergent, parallel mixed-methods approach.

Results: The PPAQ estimated MET-hours/week and there were no differences by LMUP category (divided into planned, unplanned, and ambivalent) Six themes emerged from the qualitative participant interviews including: overall pregnancy experience, PA education received from providers, PA during pregnancy, pregnancy-related barriers to PA, advice to other pregnant individuals, and support needs and future directions. Collectively, the results revealed variations in pregnancy planning experiences, but findings did not identify differences in PA (MET-hours/week) by LMUP category.

Conclusion: This study provides additional information for future research into maternal PA behavior and pregnancy planning tools. Although quantitative results were not significant in this small sample, the qualitative and combined findings are valuable as they could inform and improve PA-related recommendations for prenatal health and fitness.