By Vishwadha Chander
(Reuters Health) – Only one in two pregnant women in an Australian survey said their healthcare practitioner had advised them about exercising, and more than half of these women had to raise the topic themselves, researchers found.
Healthcare practitioners “are uniquely positioned” to advise women about exercise during pregnancy, the study team writes in the journal Women and Birth, but it’s possible that many doctors don’t bring it up because they are unsure about what to recommend.
Past research links exercise during pregnancy with both long- and short-term health benefits for women and their babies, the researchers note.
“Yet, we found pregnant women are not engaging in conversations about exercise with healthcare providers,” Dr. Melanie Hayman, a physical activity researcher at Central Queensland University in Rockhampton and lead author of the study, told Reuters Health in an email.
Hayman said healthcare professionals receive little formal training in exercise guidelines. In a 2017 survey of 50 Australian practitioners that she conducted, just two reported having received formal training in the guidelines. “They lack the confidence to advise pregnant women,” she said.
Exercise guidelines for healthy pregnant women without pregnancy complications are similar to those for other healthy adults, the authors note: a total of 150-300 minutes per week of moderate-to-vigorous physical activity. In addition, two sessions per week of resistance-based exercise is recommended.
Yet previous studies suggest only 35% of pregnant women in Australia meet these guidelines.
To assess whether healthcare providers are giving pregnant women guidance about exercise, Hayman and her colleagues recruited pregnant women attending appointments at any of 11 clinics, or public and private hospitals within Central Queensland’s Rockhampton region to fill out a survey.
Of the 142 women who completed and returned the survey, 49% said they had received exercise information from their doctors, and 56% of these women said they had to initiate the conversation.
Less than one third of the participants said they were counseled about how many times a week to exercise. And only two women got advice that matched the guidelines, having been told to “participate in exercise on most, if not all days of the week.”
About one in eight women said their doctors told them to do physical activity “as many times as they liked” – a recommendation the study authors called “vague and unclear.”
None of the women were advised to do resistance-based exercise and six of them said they were specifically advised against it.
These results highlight misconceptions still associated with exercising during pregnancy, the study authors write.
Hayman’s team also surveyed practitioners at the sites where they recruited pregnant women. The providers said they were willing to give exercise recommendations if they had the opportunity to learn about what exercises to recommend.
“We must support our medical professionals if we want them to engage in such conversations,” Hayman said.
Among the study’s limitations is that the authors had to rely on participants’ reports about what providers had told them. “There always is a chance for the findings to be affected by perception,” Hayman noted.
The study also doesn’t say whether any of the women had some health problem that restricted exercise. The participants were also primarily young (ages 25-35), married and employed, so they may not represent a broader population of pregnant women.
Studies in the U.S. and UK have found higher rates of familiarity with exercise guidelines and willingness to give advice among doctors and midwives.
“This study highlights that there may be a breakdown in communication,” said Dr. Sara Gould of the University of Alabama at Birmingham.
“Part of that breakdown may stem from lack of knowledge about recommendations, as well as lack of sound research to support the recommendations,” noted Gould, who wasn’t involved in the current research. “Therefore, any study that addresses this issue and seeks to better understand exercise during pregnancy, is very important from a clinical perspective.”
Women Birth 2019.