Providing physical activity education and counseling during pregnancy: A qualitative study of midwives' perspectives

Background: Midwives have a strategic role to inform, educate, and encourage pregnant women to maintain an active lifestyle during pregnancy. Aim: This study explored a cohort of midwives' perspectives on providing prenatal physical activity education and counseling during pregnancy. Subjects and Methods: Seventeen midwives participated in semistructured interviews which were audio-recorded and transcribed verbatim. A thematic analysis approach was applied to the transcribed qualitative data. Results: Midwives rarely provide physical activity education and counseling to pregnant women, citing lack of knowledge on which physical activity to recommend, and the duration and intensity of the physical activity as reasons. Walking is the only physical activity recommended during antenatal sessions. Barriers to providing physical activity education and counseling include shortage of midwives, busy work responsibilities, nonavailability of exercise equipment, and nonprioritization of antenatal physical activity. The midwives also cited overwhelming work responsibilities resulting in extreme fatigue rendering them hardly able to counsel the women. They advocated for the introduction of exercise classes in antenatal health care and the training of midwives on exercises to improve the uptake of midwives' knowledge regarding prenatal exercise and their engagement with pregnant women during antenatal consultations. Conclusions: The midwives lacked knowledge of physical activity during pregnancy and rarely provided such education and counseling. They advocated the need for training and workshops on maternal physical activity. Our findings suggest that physical activity should be integrated into the midwifery/nursing curriculum to empower midwives and other health providers to offer evidence-based physical activity education and counseling to women during antenatal health care as part of the primary health-care service.