Knowledge and practices of pregnant women regarding exercise during pregnancy : a comparison between private and public sector

Abstract

Introduction: Evidence suggests that pregnant women who lead sedentary lifestyles and have a poor knowledge of exercise during pregnancy are at risk of developing diseases like gestational diabetes, pre-eclampsia and low back pain along with many other chronic conditions. An exercise program during pregnancy has benefits for both the mother and the child. No studies have ascertained the knowledge and practices of exercise in pregnant women in South Africa, furthermore, there was a need to conduct research regarding exercise amongst South African pregnant women, particularly to determine whether any barriers to physical activity exist.

Aim: To compare the knowledge and practices of pregnant women regarding exercise during pregnancy between a selected private practice and public clinic.

Methodology: A quantitative, descriptive, cross sectional survey was used in this research study. The population consisted of pregnant women (n = 400) attending both public and private sector antenatal care in the Ethekwini municipal area of KwaZulu-Natal, South Africa. Public sector participants were drawn from the Addington Hospital public antenatal clinic and private sector participants were drawn from the gynaecological practice of Dr D Sankar. Purposive, stratified sampling was used. Following the signing of an informed consent form, data was collected by means of a self-administered questionnaire. A minimum sample size of 324 patients was calculated by the statistician. Descriptive statistics, such as frequencies and percentages were used to describe the demographic profile of respondents and their physical activities. Inferential statistics, including Chi-Square tests of association and student t-tests were used to determine differences in proportions and means respectively between the two categories of participants. Odds ratios (OR) were calculated to ascertain the measure of association between a risk factor and an outcome.

Results: There were 198 (57.6%) participants from the private gynaecological practice and 146 (42.4%) from the public clinic at Addington Hospital. The mean age of the study population was 27.65 ± 5.3 years. Almost half of the study population were Indians (46.2%). Blacks made up the second largest proportion of the study population (39.2%). More than half of the study participants were involved in exercise during their pregnancy (57.1%). However, only 37% of the study population met the international criteria of physical activity, which is 30 minutes of moderate -intensity aerobic exercise, per day, for 5 days a week, during pregnancy as set out by the American College of Obstetrics and Gynecologists (2002).

However, there was evidence of unstructured physical activity which increased the level of acceptable physical activity in the majority of participants 82.1%. Walking was the most common activity that the women engaged in from both the private sector (88.8%) and public clinic (89.3%). The average time spent on walking was more than 30 minutes a day. Household chores and climbing stairs also increased the levels of physical activity within the participants.

Only a minority of participants (35.4%) stated that they were diagnosed with an adverse health condition, which prevented them from exercising. Some participants who did not exercise reported that fatigue was the reason for not being physically active (51.6%).

Conclusion: Interventions need to be implemented to increase the knowledge of physical activity amongst pregnant women and the benefits that are associated with it. An attempt needs to be made by health practitioners to try and increase the level of physical activity among pregnant women, so that they may benefit from its effects.