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      Perceived barriers and enablers of physical activity in postpartum women: a qualitative approach

      research-article
      , ,
      BMC Pregnancy and Childbirth
      BioMed Central
      Postnatal women, Exercise, Barriers, Enablers

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          Abstract

          Background

          Postpartum women’s recovery from birth can be assisted through increased physical activity (PA). However, women face substantial barriers to participating in exercise and require support to enable them to benefit from increased PA.

          Methods

          This study sought to explore women’s beliefs about and experiences of PA and exercise during the 6 weeks to 12 months postpartum period. A cohort of 14 postpartum women from a survey study of the barriers and enablers to exercise participation agreed to take part in interview sessions to provide an in-depth understanding of the women’s perceptions of the postpartum period and their physical activity during this time.

          Results

          Findings are presented with reference to the social ecological framework and indicate postpartum women face substantial personal and environmental barriers to PA and exercise participation: fatigue, a lack of motivation and confidence, substantial time constraints, lack of access to affordable and appropriate activities and poor access to public transport. In contrast, enablers such as possessing greater social support, in particular partner support, improved PA and exercise participation.

          Conclusions

          The findings encourage facilitation of exercise through mothers’ groups, mothers’ exercise clubs or postnatal classes suggesting behavioral and social change is needed. Interaction between individuals, community, organizations and policy makers is required. In addition, the provision of specifically tailored and appropriate exercise programs could potentially enable increased PA in postpartum women, thereby improving their health.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12884-016-0908-x) contains supplementary material, which is available to authorized users.

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          Most cited references41

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          Toward a comprehensive model of physical activity

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            The problem of rigor in qualitative research.

            There are few explicit discussions in nursing literature of how qualitative research can be made as rigorous as it is relevant to the perspective and goals of nursing. Four factors complicate the debate about the scientific merits of qualitative research: the varieties of qualitative methods, the lack of clear boundaries between quantitative and qualitative research, the tendency to evaluate qualitative research against conventional scientific criteria of rigor, and the artistic features of qualitative inquiry. A framework for understanding the similarities and differences in research approaches and a summary of strategies to achieve rigor in qualitative research are presented.
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              Waging war on modern chronic diseases: primary prevention through exercise biology.

              In this review, we develop a blueprint for exercise biology research in the new millennium. The first part of our plan provides statistics to support the contention that there has been an epidemic emergence of modern chronic diseases in the latter part of the 20th century. The health care costs of these conditions were almost two-thirds of a trillion dollars and affected 90 million Americans in 1990. We estimate that these costs are now approaching $1 trillion and stand to further dramatically increase as the baby boom generation ages. We discuss the reaction of the biomedical establishment to this epidemic, which has primarily been to apply modern technologies to stabilize overt clinical problems (e.g., secondary and tertiary prevention). Because this approach has been largely unsuccessful in reversing the epidemic, we argue that more emphasis must be placed on novel approaches such as primary prevention, which requires attacking the environmental roots of these conditions. In this respect, a strong association exists between the increase in physical inactivity and the emergence of modern chronic diseases in 20th century industrialized societies. Approximately 250,000 deaths per year in the United States are premature due to physical inactivity. Epidemiological data have established that physical inactivity increases the incidence of at least 17 unhealthy conditions, almost all of which are chronic diseases or considered risk factors for chronic diseases. Therefore, as part of this review, we present the concept that the human genome evolved within an environment of high physical activity. Accordingly, we propose that exercise biologists do not study "the effect of physical activity" but in reality study the effect of reintroducing exercise into an unhealthy sedentary population that is genetically programmed to expect physical activity. On the basis of healthy gene function, exercise research should thus be viewed from a nontraditional perspective in that the "control" group should actually be taken from a physically active population and not from a sedentary population with its predisposition to modern chronic diseases. We provide exciting examples of exercise biology research that is elucidating the underlying mechanisms by which physical inactivity may predispose individuals to chronic disease conditions, such as mechanisms contributing to insulin resistance and decreased skeletal muscle lipoprotein lipase activity. Some findings have been surprising and remarkable in that novel signaling mechanisms have been discovered that vary with the type and level of physical activity/inactivity at multiple levels of gene expression. Because this area of research is underfunded despite its high impact, the final part of our blueprint for the next millennium calls for the National Institutes of Health (NIH) to establish a major initiative devoted to the study of the biology of the primary prevention of modern chronic diseases. We justify this in several ways, including the following estimate: if the percentage of all US morbidity and mortality statistics attributed to the combination of physical inactivity and inappropriate diet were applied as a percentage of the NIH's total operating budget, the resulting funds would equal the budgets of two full institutes at the NIH! Furthermore, the fiscal support of studies elucidating the scientific foundation(s) targeted by primary prevention strategies in other public health efforts has resulted in an increased efficacy of the overall prevention effort. We estimate that physical inactivity impacts 80-90% of the 24 integrated review group (IRG) topics proposed by the NIH's Panel on Scientific Boundaries for Review, which is currently directing a major restructuring of the NIH's scientific funding system. Unfortunately, the primary prevention of chronic disease and the investigation of physical activity/inactivity and/or exercise are not mentioned in the almost 200 total subtopics comprising t
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                Author and article information

                Contributors
                +61 413 066 311 , maryam.saligheh@sydney.edu.au
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                2 June 2016
                2 June 2016
                2016
                : 16
                : 131
                Affiliations
                [ ]School of Occupational Therapy and Social Work, Faculty of Health Sciences, Bentley Campus, Curtin University, Perth, WA Australia
                [ ]School of Psychology and Speech Pathology, Faculty of Health Sciences, Bentley Campus, Curtin University, Perth, WA Australia
                [ ]Discipline of Exercise and Sport Science, Faculty of Health Sciences, Cumberland Campus, University of Sydney, 75 East St, Lidcombe, NSW Australia
                Article
                908
                10.1186/s12884-016-0908-x
                4890285
                27256279
                bb470f24-9876-4bb7-b7f5-331f12a97b6b
                © Saligheh et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 19 October 2015
                : 13 May 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Obstetrics & Gynecology
                postnatal women,exercise,barriers,enablers
                Obstetrics & Gynecology
                postnatal women, exercise, barriers, enablers

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