Authors: Chloë Williamson, Graham Baker, Marlize De Vivo, Hayley Mills, Linda Bauld, Rebecca M. Reynolds, Anna Boath, and Paul Kelly.
A new scoping review aimed to understand what is known about how healthcare professionals communicate about physical activity during pregnancy in the UK. Despite well-established guidelines and compelling evidence for physical activity benefits during pregnancy, the research reveals a troubling disconnect between what pregnant women need and what they’re receiving in terms of physical activity communication from healthcare professionals. This blog summarises the review’s key findings and implications for practice.
Healthcare professionals’ perspective
Healthcare professionals face multiple barriers to providing physical activity advice. They lack knowledge about what guidance to give, lack confidence in delivering it, and report insufficient time during appointments to discuss physical activity alongside other priorities. Stigma around weight prevents many midwives from initiating conversations about physical activity and exercise, fearing they might cause offense or embarrassment. Compounding this, many healthcare professionals don’t view physical activity advice as part of their role, with less than half of midwives in one study believing weight management advice (including physical activity) was their responsibility.
Pregnant women’s experience
The perception that physical activity during pregnancy is dangerous remains pervasive, e.g., 68% of women in one study viewing their pre-pregnancy activities as risky once pregnant. Knowledge of physical activity guidelines is low, with many overestimating recommended amounts. When women do receive advice, they describe it as minimal, contradictory, confusing, inconsistent, and restriction-focused (being told what NOT to do without guidance on what they COULD do). This leaves women relying on “common sense” to make decisions without adequate expertise.
Barriers beyond communication
Women face multiple barriers: physical (fatigue, morning sickness, discomfort), social (childcare, work pressures, opinions of friends and family), psychological (safety fears, lack of motivation, guilt), and environmental (cost, lack of appropriate facilities, weather). Awareness of physical activity benefits is limited. However, when women did describe their experiences of benefits of physical activity, they described the mental health benefits like feeling relaxed, energised, and socially connected. These findings should be considered in communications with pregnant women where possible.
Implications for practice
The review provides evidence-based recommendations: healthcare professionals must address the perception that physical activity is dangerous by discussing guidelines and offering examples of suitable activities. Communication should emphasise wide-ranging benefits (particularly mental and social health benefits) and should be delivered non-judgmentally using tailored approaches where possible, and should remain clear and consistent across all healthcare professionals. Critically, healthcare professionals need training, dedicated time in appointments, and recognition that providing physical activity advice is part of their role. Pregnant women view healthcare professionals as important messengers, making this system-level change essential for closing the guideline-practice gap.
