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Impact of Antenatal Exercise Education on Physical Activity Practices among Pregnant Women in Nigeria

Abstract

Physical activity during pregnancy is an important component of maternal health and may support physical wellbeing, functional capacity, mental health, healthy weight management, and preparation for childbirth when appropriately recommended and performed. However, pregnant women in Nigeria may have limited knowledge of appropriate antenatal exercise practices and may avoid physical activity because of fear of harming the pregnancy, cultural beliefs, misconceptions, previous experiences, limited professional guidance, or concerns about pregnancy-related complications. Inadequate knowledge may also result in inappropriate exercise practices, excessive inactivity, or participation in activities that may not be suitable for individual pregnancy conditions. Antenatal exercise education provides an opportunity to improve pregnant women's understanding of appropriate physical activity, safety precautions, exercise intensity, suitable activities, warning signs, and situations requiring professional advice. Against this background, this study investigates the impact of antenatal exercise education on physical activity practices among pregnant women in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Theory of Planned Behavior. The Health Belief Model explains how pregnant women's perceptions of the benefits and risks of physical activity during pregnancy, perceived barriers, self-efficacy, and cues to action may influence their exercise practices. Social Cognitive Theory emphasizes observational learning, behavioural modelling, self-efficacy, reinforcement, social support, and environmental factors in shaping physical activity behaviours. The Theory of Planned Behavior emphasizes attitudes toward antenatal exercise, subjective norms, perceived behavioural control, and behavioural intentions as determinants of physical activity practices during pregnancy. Collectively, these theoretical perspectives provide a suitable framework for explaining how antenatal exercise education may influence physical activity practices among pregnant women in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise pregnant women aged 18 years and above attending selected public and private antenatal clinics across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, healthcare facilities, antenatal clinics, and eligible pregnant women. Antenatal exercise education will be assessed using indicators such as exposure to exercise education sessions, frequency and duration of education, information on the benefits of physical activity during pregnancy, appropriate types of exercise, exercise frequency and duration, appropriate exercise intensity, warm-up and cool-down practices, hydration, suitable clothing and environment, pelvic-floor exercises, walking and other appropriate activities, activities to avoid, contraindications or precautions, warning signs requiring cessation of exercise and medical assessment, and the importance of individualized professional advice. Physical activity practices will be assessed using indicators such as frequency of physical activity, duration and intensity of activity, participation in recommended exercises, walking, pelvic-floor exercises, stretching, routine daily physical activity, sedentary behaviour, adherence to recommended precautions, and appropriate response to warning signs. Data will be collected using structured questionnaires, standardized antenatal exercise and physical-activity assessment tools, activity logs where appropriate, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize participants' demographic and obstetric characteristics, gestational age, previous exercise experience, sources of pregnancy-health information, antenatal exercise education exposure, and physical activity practices. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of antenatal exercise education on physical activity practices. Where a quasi-experimental design is adopted, physical activity practice scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that antenatal exercise education has a significant positive impact on physical activity practices among pregnant women in Nigeria. Pregnant women exposed to structured, evidence-based, practical, and individualized exercise education are expected to demonstrate better physical activity practices than women without comparable education. Education may improve women's understanding of the benefits of appropriate physical activity, suitable exercises, exercise intensity, safety precautions, hydration, pelvic-floor exercises, and warning signs requiring cessation of activity and professional assessment. Practical demonstrations may improve women's confidence and ability to perform appropriate exercises safely. Education may also reduce misconceptions that all physical activity is harmful during pregnancy and encourage women to discuss their individual exercise needs and restrictions with qualified healthcare professionals. However, pregnancy-related complications, fear of miscarriage or fetal harm, cultural beliefs, fatigue, financial constraints, limited access to safe exercise environments, inadequate professional guidance, and insufficient antenatal exercise programmes may reduce the effectiveness of education alone. The study therefore expects accessible, practical, culturally appropriate, and individualized antenatal exercise education, supported by appropriate clinical assessment and professional guidance, to contribute significantly to improved physical activity practices among pregnant women in Nigeria. The study is expected to contribute to the literature on antenatal exercise, physical activity during pregnancy, maternal health education, prenatal care, maternal wellbeing, health promotion, pregnancy health, women's health, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, primary healthcare centres, antenatal clinics, midwives, nurses, obstetricians, physiotherapists, public health practitioners, maternal-health organizations, development partners, and policymakers regarding strategies for strengthening antenatal health education. The study will also provide evidence-based recommendations for integrating safe physical-activity education into antenatal care, strengthening healthcare-provider counselling, developing practical exercise education materials, improving access to appropriate prenatal exercise guidance, addressing misconceptions about physical activity during pregnancy, and developing sustainable interventions that promote safe and appropriate physical activity among pregnant women across Nigeria.

Keywords: Antenatal exercise education, physical activity practices, pregnant women, antenatal care, maternal health education, prenatal exercise, maternal wellbeing, health promotion, pregnancy health, women's health, Nigeria, public health.