Results based on a questionnaire by Melpomene Institute conducted in 2002 -Mary Healy Jonas, Research Director
Experience and anecdotal evidence seem to indicate that women of all ages and fitness levels receive a wide range of information regarding appropriate approaches to fitness during pregnancy. While some sources recommend maintaining one’s current level of physical activity within reason, others advise a more restrictive approach of prescribed heart rates and reducing or eliminating physical activity altogether during pregnancy.
The Melpomene Institute, in conjunction with Mothers in Motion® and Fit Pregnancy magazine, sought to determine if the anecdotal evidence proves true by surveying currently and recently pregnant women on their experiences with physical activity. The goal was to “map the field”: in essence, to ask a large sample of women about the range of advice they have received, the source of this information and how it affects their physical activity pursuits.
To accomplish this task, Melpomene prepared a 24-item questionnaire asking women a variety of questions about their exercise routines prior to pregnancy and during each trimester. Additionally, we asked women to rate the consistency of information they received on exercise and pregnancy and the sources they relied upon the most. After revisions and some suggested editing by the Fit Pregnancy staff, the new 16-item questionnaire appeared in the August/September 2002 edition of Fit Pregnancy Magazine.
We were impressed to receive a total of 3300 questionnaires back from all over the U.S., Canada, Puerto Rico and the Virgin Islands. From these we drew a random sample of 1132, according to the postdate on the envelope. This number gives us 99% confidence that the results we derived from the data are representative of the whole population of respondents.
When reading the results, keep in mind that despite random sampling, we were already dealing with a somewhat biased sample. In other words, most women who read Fit Pregnancy Magazine are those women who are interested in maintaining some level of fitness immediately before, during or immediately after their pregnancy. The numbers reflect this and therefore cannot be generalized to the wider population of all pregnant women in the U.S.
The sample included 1132 women between the ages of 16 and 46 years, with a mean and median age of 30 (SD = 5). The ages were concentrated between 28 and 34 years, with 53% of the sample falling in that range. Three and a half (3.5) percent of the respondents (n=40) were 40 years or older.
White women make up the majority of the sample (83%), 73 women (6%) identified as Hispanic/Latina, 35 (3%) as African-American and 33 (3%) as Asian. Ninety-three percent of the sample had attended at least some college, with 24% of the total having obtained a graduate degree of some type.
Most of the respondents were either in their second (30%) or third (37%) trimester. Seventeen percent were in their first trimester and another 17% had “just had a baby.” Of those women, 72% had delivered in 2002 and 23% in 2001.
To our surprise, the women responding to this questionnaire, for the most part, did not rate the information they had received about exercise and pregnancy as inconsistent. In fact, 3 out of 4 respondents (76%) indicated that the information they received was, indeed, consistent. Further, approximately half of the total sample (49%) indicated that the information they received advised continuing with their normal exercise routine; while the other half (49%) indicated that the advice was to continue with some modification (intensity, duration, frequency).
While we were anticipating that more of the respondents would report receiving inconsistent information on exercising while pregnant, and also report that the prevalent advice was to either seriously modify or discontinue, this is a case where unexpected findings are a positive outcome. It is good news to all of us who strive to encourage women to remain active during and after pregnancy that women are hearing this very message from those they trust most.
Below is a table indicating the percentage of women in the sample who indicated the pursuit of each activity listed below.
|
Type of activity |
Pre-pregnancy |
First trimester |
Second trimester |
Third trimester |
|
Aerobics |
36% |
19% |
18% |
14% |
|
Fitness walking |
61% |
76% |
79% |
72% |
|
Running |
42% |
19% |
10% |
4% |
|
Strength training |
50% |
38% |
37% |
27% |
|
Swimming |
16% |
17% |
22% |
18% |
|
Yoga |
24% |
23% |
25% |
22% |
Several themes are interesting to note above. It would appear that women who engaged in “high impact” activities prior to pregnancy decided to stop doing them altogether. Women who indicated doing aerobics (36%) or running (42%) before becoming pregnant, dropped off rather notably even in the first trimester. Almost half of aerobicizers and more than half of the runners eliminated this as a chosen exercise after they became pregnant.
It would be difficult to determine from the numbers if these changes in behavior were due to certain health concerns, discomforts specific to aerobics and running for pregnant women, or simply due to misinformation or assumptions about performing these activities during pregnancy.
On the other end of the activity spectrum, those women pursuing fitness walking increased from pre-pregnancy to the first trimester, and actually stayed higher than the pre-pregnancy rate throughout pregnancy. In other words, more women began walking after becoming pregnant than were walking before pregnancy, and they kept with it throughout the pregnancy.
Another interesting pattern existed for swimmers and yoga enthusiasts. The percentage of women who indicated swimming as their preferred exercise prior to becoming pregnant stays steady throughout pregnancy. Sixteen percent of women said they swam before pregnancy, and this number does not change much during the three trimesters of pregnancy, aside from a slight increase (from 17% to 22%) in the second trimester.
The same holds true for yoga. The percentage of women who did yoga before pregnancy stays perfectly steady throughout pregnancy, never changing more than one percentage point. Because both swimming and yoga are often promoted as great pregnancy exercises (safe, relatively comfortable, etc.), it is perhaps not surprising that the data shows women sticking with these forms of exercise and not feeling as though they should stop. A question for discussion, however, might be why the numbers of swimmers and yoga attendees did not rise in pregnancy as running and aerobics stopped. Did those women all turn to fitness walking, and why?
The table below highlights the patterns in exercise frequency among the 1132 respondents.
|
|
Pre-pregnancy |
First trimester |
Second trimester |
Third trimester |
|
Less than 1 day |
4% |
6% |
4% |
10% |
|
1-2 days per week |
11% |
16% |
17% |
26% |
|
3-4 days per week |
47% |
49% |
50% |
42% |
|
5-6 days per week |
33% |
25% |
25% |
18% |
|
Everyday |
5% |
4% |
4% |
4% |
While a small number of respondents either exercised very little (less than 1 day a week) or a great deal (everyday), most fell into the range of 3-6 days per week. This remains relatively constant throughout pregnancy for many women, which is encouraging. The only real change of note that occurs over time is that women exercising 5-6 days per week before pregnancy make changes immediately upon become pregnant by reducing the days per week that they exercise. Additionally, the number of women who make reductions in frequency at any significant level does not occur until the third trimester (see the 3-4 day and 5-6 day rows), indicating that most women are keeping up with their exercise routines throughout the majority of their pregnancies.
This same pattern exists in the amount of time respondents spend exercising. Table 3 below shows how women changed the duration of their exercise routines as their pregnancies progressed.
|
Duration |
Pre-pregnancy |
First trimester |
Second trimester |
Third trimester |
|
Less than 20 minutes |
5% |
11% |
9% |
20% |
|
20-40 minutes |
40% |
47% |
51% |
49% |
|
41-60 minutes |
41% |
35% |
33% |
25% |
|
More than 1 hour |
14% |
7% |
7% |
6% |
The changes in duration that occur are those that would be expected. Women exercising for an average of 41-60 minutes a session decrease their duration upon becoming pregnant, being absorbed mainly into the 20-40 minute category. Aside from this change, nothing of note changes for this women regarding the length of time they spend working out until the final trimester, which also would be expected.
As indicated above, we were surprised at the number of women who believed that the exercise information they received during pregnancy was consistent. Not surprising, however, was that the majority of women in the sample (75%) continued to exercise throughout pregnancy. While this is a high number, it still leaves one in four of the women in the sample who discontinued exercise during their pregnancies.
Of the 24% of women who discontinued exercising when they became pregnant, half of them (52%) identified discomfort as the main reason (too tired, out of breath easily, nausea, low energy, etc.). Aside from discomfort, health issues were the next most frequent reasons given (23%) for discontinuing exercise (high blood pressure, incompetent cervix, placenta previa, etc.) Other reasons identified were personal concerns about exercising while pregnant (e.g. worried about hurting the baby) and lack of time (9% and 3% respectively).
Of the 75% of women indicating that they kept exercising throughout pregnancy, the most common reason cited for doing so (42%) was that they were feeling good and saw no reason to stop. Other reasons given were to stay fit and in shape (28%), because they thought it would be good for mom and baby (12%), to help with labor and delivery (11%) and, our favorite, exercise is simply their way of life (6%).
Of the 155 women (14%) who felt the information they receive on exercise and pregnancy was inconsistent, the following are the sources they listed as those they relied on the most: magazines (61%), their female ob/gyn (41%), friends/acquaintances (40%), books (37%), and male ob/gyn (34%). These women said that they relied on these sources because they trusted in the person or sources (66%) and that the information provided by this/these source(s) was closely aligned with their own instincts (63%). Because the survey did not request this same information from those women who think the information they receive is consistent, comparison data is not available in this category.
As with more exploratory surveys of this nature, the results tell us what and how many, but they do not provide insight into the “whys.” Why do women feel the information they receive is consistent? What does consistent mean for a woman? Why do they stop certain activities when becoming pregnant but not stop others? Why do they ignore some advice and adhere to another?
If taken further, a study of this nature might conduct focus groups and case studies to further explore a smaller number of women on a more in-depth scale, to find answers to questions such as those raised above.