CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Pregnancy is a specific period that most women find it difficult to engage in some tasking activities as a result of hormonal changes. This often decreased their physical activity, thereby placing this special population at risk of several chronic diseases and sometimes premature mortality (Hausenblas, 2019). Pregnancy is an important phase in a woman’s life. Regular exercise is promoted for its overall health benefits. The American Congress of Obstetricians and Gynecologists ACOG (2015) recommended that pregnant women can exercise moderately for 30 minutes on most days of the week. This is promoted for its overall health benefits maintained ACOG. Pregnancy - related exercise may not be the same in Africa due to culture and non adherence to the recommendations for exercise during pregnancy (Uchenna & Daniel2020).Hoodbhoy, Qureshi, Iqba andMuhabat (2018) noted that 56.5% of pregnant women in Africa indicated that pregnancy was a time to rest and refrain from exercise which contradicts international guidelines on exercise. Studies shows that pregnant women had inadequate knowledge concerning antenatal exercises, the types and benefits of exercise participation during pregnancy (Sabiri, Olutunde, Issah & Vungwa 2018).
Thus, pregnancy - related exercise leads to healthy pregnancy delivery. Pregnancy depicts maturation by females. According to Chang and Streitman (2012) pregnancy is a physiological phenomenon that impose numerous changes on various organs and body systems of pregnant women, including their respiratory system. Thus, pregnant conditions need exercises for healthy growth and development. Exercise during pregnancy is safe and healthy. Pescoe, Bailey, Craike, Carter, Patten, Stepto et al (2020) defined exercise as a physical activity (PA) that is planned, structured and repetitive for conditioning the body. Liu (2011) suggestedthat exercises usually prescribed for pregnant women include water aerobics, running, brisk walking, yoga, kegel and breathing exercises. Exercises such as brisk walking, stationary cycling and swimming improve both cardiovascular and muscular systems, helps to lower risk of gestational diabetes, loss of weight, lowered risk of constipation etc and have been recommended for pregnant women. In this study, pregnancy - related exercises are those activities that are performed by pregnant women to maintain or improve physical fitness and enhance strength as well as the health of the feotus. The achievement of the types and benefits of pregnancy - related exercises are dependent on the level of knowledge and practiceofpregnant women,
Pre-natal exercise is described as physical effort performed by pregnant women in order to improve their health before delivery and is of great benefit to both the mother and the foetus (Clap and Rizzle, 2012; Jackson, 2005 and Clap, 2000). Engagement in prenatal exercise by pregnant women help to maintain and tone the muscle of the body, make them strong, agile and facilitates increase endurance needed during labour (Fraser and Cooper, 2014). Pre-natal exercises are physical activities that are performed by women during pregnancy (Smith, Foster and Campbell, 2011). It has the potential to reduce most of the risks associated with pregnancy including the onset of severe hypertension and gestational diabetes in pregnant women (Wadsworth, 2007). These benefits can only be achieved if pregnant mother perceive it as useful and are willing to engage in these exercises. Perception refers to how a person sees a situation or the feeling an individual has about a thing.
The exercises recommended for pregnant women include transverse exercises which the pregnant women should do sitting and breathing-in through the nose and exhale out through the mouth, pulling in the abdomen below the umbilicus keeping the spine at a place breathe normally holding the position for up to 10 seconds then gradually relax, repeating exercise up to 10 times. This exercise tones the transverse abdominal muscles which gives support to the spine, and also help to reduce back pain (Hodges and Richardson, 2016). Another exercise is foot and leg exercise. According to Fraser and Cooper (2014) the blood circulation during pregnancy is low because the venous return is sluggish and this can lead to problems such as cramp and varicose veins. The following simple exercises and advice is expected to improve the circulation and prevent the problem of sluggish venous return. The pregnant women should sit down or half lie with someone to support their legs, and then bend a little stretching the ankle up to 12 times, circling both the feet at the ankle for at least 20 times in each direction. Breast Support/Pectoral Toning exercise is another exercise which enlarged and increase in the breasts weight during pregnancy, the breast needs extra support. Exercise is needed to strengthen the muscles of the breast. The pregnant women should sit puts her hands together, as if she is praying, and raise the elbows to her shoulder, and slowly presses her hands together and is hold the position till a count of four then releases it slowly, and she can repeat the exercise as many times as possible (Shrock, 2008).
A lot of variations occur in a woman’s breathing rhythm during pregnancy. This is brought about by the developing uterus pushing up the diaphragm and thus compressing the thoracic cavity which makes breathing difficult especially during the last trimesters (Fraser and Cooper, 2014). There is need to make the pregnant women ready for the rhythmic and uniform breathing pattern during labour and ensure that there is a good intake of oxygen through. This they should do through exercises that relax their abdominals as well as their low chest and improves breathing techniques to ensure good intake of oxygen and relaxing during pregnancy and through labor (Bing, 2019). Walking is a very good activity for a pregnant woman; she should walk for 30 minutes, it is the cheapest form of exercise because it requires just a flat shoe or snickers and comfortable clothes. Walking is also an exercise that can help in improving the pregnant women aerobic fitness. There is need to use the modified walking form in other to derive a significant benefits, therefore the pregnant women should be advised to increase the walking speed, walk up and down the hill and to walk holding dumbbells as this can raise the heart to the level that can improve their fitness level (Shrock, 2008).
The perceived usefulness of prenatal exercise has been influence by several factors which according to Gaston and Cramp, (2017) include parity and location. Parity is a factor that can influence the pregnant women’s perception on the usefulness of prenatal exercise. Parity has to do with the number of deliveries or childbirths a woman has had. Gaston and Cramp (2017) concluded that pregnant women with previous children have less time to engage in prenatal exercise but they still have higher energy expenditure because of the increase daily activities as she tries to meet up with the needs of her older children. Fill, Joseph, Armson and Dodds (2019) showed that having previous children reduces their level of exercise participation. Mottola and Campbell (2003) stated that first time pregnant women were believed to have a higher level of fitness when compared with other women with previous children. Fill, Joseph, they further stated that pregnant women with high parity may not participate in physical exercise than women pregnant with their first issue. Gaston and Vamous (2012) maintained that there was significant difference in the perceived benefits of prenatal exercise based on parity among the population studied.
1.2 Statement of the problem
Literatures reviewed in the study have shown that during pregnancy most pregnant women experience discomfort that are associated with either hormonal changes or physical changes such as nausea and vomiting, backache, constipation, preeclampsia which affects over half of the pregnant women and might lead to death (Davis, 2019). It was reported that Nigerian woman have a 1-in-23 risk of death from any cause that is related to pregnancy and delivery in Nigeria which is higher than the general 1-in31 maternal death risk for pregnant women throughout the sub-Saharan Africa (/World Bank, 2008). Evidence from Ebonyi State Ministry of Health (2010) indicate that Ebonyi State records one death out of every 100 live birth in pregnancy related cases; this makes Ebonyi State to be among the communities with the highest maternal mortality rates in the world. Merson, Black and Mills (2016) listed the direct causes of maternal mortality which includes hypertensive disorders of pregnancy (preeclampsia), gestational diabetes, obstructed and prolonged labour. ACOG (2012) recommends that prenatal exercise can reduce the rates of these direct causes of high maternal morbidity and mortality. Despite the numerous benefits that are linked to the prenatal exercise, studies still show that many pregnant women in Nigeria do not engage in the exercise (Miller, Sales, Kopjar, 2015). In addition, prenatal exercise is not publicized and in some places it is termed a taboo. This has led to increased rate of maternal and foetal mortality in Nigeria.
1.3 Objectives of the Study
The main primary objectives of the study perceived benefit of exercise among pregnant women in Ikwere Local Government Area while the following specific objectives are to:
- Determine the various benefits associated with exercise for pregnant women in Ikwere Local Government Area.
- Ascertain the extent of exercise practice by pregnant women in Ikwere Local Government Area
- Discover the challenges mitigating the engagement of pregnant women in exercise in Ikwere Local Government Area
1.4 Research Objectives
- What is the various benefits associated with exercise for pregnant women in Ikwere Local Government Area?
- What is the extent of exercise practice by pregnant women in Ikwere Local Government Area?
- What are the challenges mitigating the engagement of pregnant women in exercise in Ikwere Local Government Area?
1.5 Research Hypotheses
H01 There is no significant What is the various benefits associated with exercise for pregnant women in Ikwere Local Government Area.
Ho2 There is no significant extent of exercise practice by pregnant women in Ikwere Local Government Area.
Ho3 There are no significant challenges mitigating the engagement of pregnant women in exercise in Ikwere Local Government Area.
1.6 Significance of the Study
The study will benefit women of child bearing age and academicians in the field of public health. Pregnancy is a critical period during which maternal health directly impacts fetal well-being. Studying the benefits of exercise among pregnant women is significant as it contributes to improving maternal health outcomes. Regular physical activity during pregnancy has been associated with reduced risk of gestational diabetes, hypertension, preeclampsia, and excessive weight gain, leading to healthier pregnancies and better maternal outcomes. The significance of this study extends to fetal development and long-term health outcomes. Maternal exercise has been linked to improved fetal growth and development, including lower rates of preterm birth and intrauterine growth restriction. Understanding the impact of exercise on fetal health can inform prenatal care strategies and interventions aimed at optimizing infant outcomes.
Pregnancy can be accompanied by physical discomfort, stress, and mood disturbances. Engaging in regular exercise has been shown to alleviate symptoms of depression, anxiety, and stress among pregnant women, promoting overall psychological well-being. By exploring the psychological benefits of exercise during pregnancy, this study contributes to improving mental health support for expectant mothers. Pregnancy-related conditions such as back pain, pelvic girdle pain, and urinary incontinence are common among expectant mothers. Exercise interventions tailored to address these conditions have been shown to reduce symptom severity and improve quality of life during pregnancy. Investigating the effectiveness of exercise in managing gestational conditions enhances our understanding of non-pharmacological approaches to prenatal care.
Pregnancy provides a unique opportunity to promote healthy lifestyle behaviors that can have lasting effects on maternal and child health. By highlighting the benefits of exercise among pregnant women, this study encourages the adoption of healthy behaviors that extend beyond the prenatal period. Empowering women with knowledge and resources to engage in safe and effective exercise during pregnancy promotes lifelong habits of physical activity and supports optimal health outcomes for both mother and child.
Academicians will benefit from this study because the study will form a reference material for future researchers who will want to expand the knowledge of this study to other aspect.
1.7 Scope of the Study
The scope of this study is based on three dimensions. The first is the contextual which covers the study of perceived benefits of exercise among pregnant women and the geographic scope is limited to Ikwere LGA of Rivers States and the periodic scope is limited to all pregnant women within the past one years (June, 2023 to May, 2024)
1.8 Definition of Terms
Pregnancy: Pregnancy is a natural biological process whereby a woman's body undergoes physiological changes to support the growth and development of a fetus inside the uterus. It begins with the fertilization of an egg by a sperm, leading to the formation of a zygote, which then implants itself into the lining of the uterus. Pregnancy typically lasts around 40 weeks, divided into three trimesters.
Exercise: Exercise is any physical activity that makes your body work and burn calories. There are many different types of exercise: Aerobic exercise, which gets your heart rate up and helps you breathe harder. This includes activities like running, swimming, biking, dancing, and brisk walking. Anaerobic exercise, which builds short bursts of strength and power. This includes activities like weightlifting, sprinting, and interval training
Pregnant Women: A pregnant woman is a woman who is carrying a developing baby (fetus) inside her womb (uterus). Pregnancy typically lasts about 40 weeks (just over 9 months) and is divided into three trimesters. During this time, the woman's body goes through many changes to support the growing baby.
