PERCEIVED IMPORTANCE OF EXERCISE AMONG PREGNANT WOMEN

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PERCEIVED IMPORTANCE OF EXERCISE AMONG PREGNANT WOMEN

CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

In recent years, there has been a great increase of knowledge derived from scientific studies regarding physical exercise during pregnancy (Mason et al, 2010). This reflects the need to clarify their effects for mother and fetus, as some women of childbearing age report exercising and may continue their exercise practice during pregnancy, whereas other sedentary women may start this practice only during pregnancy.

As the effects of healthy lifestyle are well known and supported by studies that show it is safe for both mother and fetus, physical exercise is recommended activity for pregnant women. The American College of Obstetricians and Gynecologists recommends that all healthy pregnant women follow the American College of Sports Medicine-Centers for Disease Control and Preventions general guidelines for physical exercise by engaging in 30 min or more of moderate physical activity per day in the majority or preferably all days of the week. Women who were active before pregnancy may continue their activities, but change intensity and frequency over the course of pregnancy. Other guidelines for physical exercise during pregnancy and the postpartum period have been published, such as the Canadian guidelines for exercise during pregnancy in 2003, and the recommendations of the Royal College of Obstetricians and Gynaecologists in 2006. Some researchers argue for the necessity of incorporating strength training and muscle conditioning, revising the definition of moderate exercise, and increasing the amount of vigorous intensity exercises and weekly physical activity expenditure.

Aerobic exercise is recommended to maintain cardiovascular fitness and to help prevent chronic diseases, apart from avoiding excessive weight gain (Valim et al, 2011). They should involve large muscle groups in activities such as when walking or jogging, using stationary bicycle, treadmill, swimming, water aerobics exercises, aerobic dance, or low-impact aerobics. Regardless of the choice of activity, it is important that women find a modality of exercise to which they will adhere over the long term. Those exercises that increase the risk of falling, abdominal traumas and contacts sports should be contraindicated (Valim et al, 2011).

Recent recommendations add strength training to the routine exercise of pregnant women. They suggest that light strength training during second and third trimesters does not affect newborn size or overall health. These effects have been rarely studied, although many women looking for muscle conditioning during pregnancy think that practices such as Pilates and yoga, circuit-type resistance training, and weight training could be beneficial (Artal & O’Tolle, 2003). The possible benefits of increasing strength and stretching training are improvement in overall body strength, good posture and body core strengthening that may contribute in labor, birth, and prevent musculoskeletal discomforts. In addition, pelvic floor muscle strengthening is also an important component in pregnant women’s exercise. Routine exercise is required to reduce the prevalence of urinary incontinence. Nevertheless, there is little evidence-based literature concerning these practices, so it should be recommended to be careful when women plan to be engaged in these activities, mainly when starting only during pregnancy. Attention should also be paid in avoiding exercise in supine position during the second half of pregnancy in order to prevent hypotension and avoid the Valsalva maneuver throughout the pregnancy.

Previously, sedentary women should start with 15 min of exercise three times a week and gradually increase to 30 min four times a week at low-to moderate intensity. Active women may keep their routine exercise or perform at least moderate-to vigorous exercise four times a week in sessions of 30 min or more. Athletes or women who have higher fitness status should be evaluated individually. Some high-impact activities or sports with fall or trauma risks should be avoided, and the intensity of exercise like running should be reduced. For all, brief warm-up and cool-down periods should be incorporated to each session of exercise.

Universally, and in contemporary societies like Nigeria pregnancy being an important phase in the life of women has been found from previous studies to be a risk factor associated with decreased physical activity. Nevertheless, women also wish to be physically active during pregnancy as it is expected of every healthy pregnant women to do 30 minutes or more of light or moderate physical activities or exercise on most days of the week if it is impossible to do it in all days of the week (American College of Obstetricians and Gynecologists (ACOG), 2012). This also shows that pregnant mothers need exercises because of its importance to increased blood circulation in the body system of a pregnant mother.

Physical activity and exercise are important components of a healthy lifestyle. According to the World Confederation for Physical Therapy (WCPT, 2011) exercise in pregnancy enables pregnant women to develop, maintain and restore maximum movement and functional ability throughout their pregnancy. Exercise is defined as a planned, structured, and repetitive subset of physical activity that improves or maintains physical fitness, overall health or well-being as an intended intermediate or final objective (WCPT, 2011). Exercise during pregnancy is associated with reduced back pain improved sleep and improved health perception as shown by results from few randomized controlled trials which examined the efficacy and safety of exercise during pregnancy.

Historically, pregnancy was regarded as a state of confinement. More recently, however, results from researches demonstrated many potential health benefits of aerobic and strength-conditioning exercise in pregnancy and the postpartum period. It is now considered safe, and even advisable, for otherwise healthy pregnant women to initiate or continue an active lifestyle during pregnancy. Lack of exercise during pregnancy might result in loss of muscular and cardiovascular fitness, excessive maternal weight gain with a raised risk of GDM, varicose veins, dyspnea, lower-back pain and poor psychological adjustment. Previous studies have reported that exercise during the second half of pregnancy could reduce the severity of lower back pain. A study was carried out to evaluate a population of pregnant women and results suggest that the practice of waterbased physical activity is beneficial to pregnant women, although it was not associated with any increase in quality of life.

Although exercise programs during pregnancy after childbirth is designed to minimize impairment and helps the woman maintain or regain function while she is preparing for the arrival of the baby and then caring for the infant, it is submitted that pregnant women are not meeting the exercise recommendations of previous studies (De-Barros, Lopes, Francisco, Sapienza & Zugaib, 2010). This is linked to numerous factors such as the beliefs and attitudes of pregnant women with respect to exercise in pregnancy, level of knowledge, level of education, safety concern of the pregnant woman especially a precious pregnanacy and her physician, race/ethnicity, and previous involvement in regular exercise (Mbada, Adebayo, Adeyemi, Arije & Dada, 2014). Studies have also shown that pregnant women’s perception and attitude towards exercise in pregnancy was influenced mostly by tiredness, lack of feeling to exercise, and insufficient information on exercise. Similar findings have been reported by other authors (Cioffi, Schmied, Dahlen, Mills& Thornton, 2014).

Furthermore, knowledge about benefit and contraindication to antenatal exercise significantly influences the perception and attitude of the women towards exercise in pregnancy. There is ample and consistent evidence that physical activity and exercises in women of reproductive age may be a promising approach for the prevention of excessive weight gain, gestational diabetes mellitus and subsequent complication suffered by children born from pregnancies (Ferraro, Rutherford, Keely, Dubois & Adamo, 2015). This finding of previous studies revealed that there is significant association between adequate knowledge of antenatal exercises and perceived benefits of exercise during pregnancy among women of reproductive age (Abedzadeh, Saberi & Sadat, 2015).

Since pregnancy is an ideal time for behaviour modification and for adopting a healthy lifestyle because of increased motivation and frequent access to medical supervision. Patients are more likely to control weight, increase physical activity, and improve their diet physician recommends that they do so. Therefore, motivation counseling tools have been used successfully for diet and exercise counseling. Therefore, pregnancy is a good time to develop healthy lifestyle habits including regular exercise and good nutrition. Besides, based on the mentioned benefits of pregnant women’s exercise, the objective of the present study was to assess the perceived benefits of exercise among pregnant mothers in University of Calabar Teaching Hospital (UCTH), Calabar, and Cross River State, Nigeria.

STATEMENT OF THE PROBLEM

In Nigeria, there has been increased awareness about the benefits of exercise among pregnant women. Some clinical trials have been conducted to evaluate the effect of exercise on maternal outcome such as low back/pelvic pain, depression during pregnancy and postpartum, gestational weight gain and excessive weight gain, gestational diabetes and insulin resistance, urinary incontinence symptoms, cardiovascular fitness, and the impact of exercise on quality of life and health status perception. Musculoskeletal discomforts such as lower back, pelvic, and/or joint pain are common complaints during pregnancy associated with the anatomical adaptations during pregnancy and previous risks factors. However, active women were able to better handle the condition. Musculoskeletal pain can also be attenuated with physical activity in some women who present mild pelvic and lumbar discomfort. So, this study is coming at the right time to assess the perception of pregnant women in Ikwo Local Government Area of Ebonyi State on the benefits of exercise during pregnancy.

OBJECTIVES OF THE STUDY

The following are the objectives of this study:

To examine the perception of pregnant women in Ikwo Local Government Area of Ebonyi State on the benefits of exercise during pregnancy.

To examine the importance and benefits of exercise among pregnant women.

To identify the outcome of exercise among pregnant women.

1.4 RESEARCH QUESTIONS

What is the perception of pregnant women in Ikwo Local Government Area of Ebonyi State on the benefits of exercise during pregnancy?

What is the importance and benefits of exercise among pregnant women?

What is the outcome of exercise among pregnant women?

1.6 SIGNIFICANCE OF THE STUDY The following are the significance of this study:

The result from this study will reveal the perception of pregnant women on exercise. The outcome of this study will also educate on the benefits and outcome of regular exercise by pregnant women.

This research will be a contribution to the body of literature in the area of the effect of personality trait on student’s academic performance, thereby constituting the empirical literature for future research in the subject area.

1.7 SCOPE/LIMITATIONS OF THE STUDY

This study will cover the views of the women of Ikwo Local Government Area of Ebonyi State on exercise among pregnant women.

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