Knowledge, attitude, and practice of antenatal exercises among pregnant women in Ethiopia: A cross-sectional study

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Abstract

Background

“Is pregnancy opportunity or a barrier for engaging in exercise”. Maternal health still is a top priority in sub-Saharan Africa including Ethiopia. Participation in exercises during pregnancy in low-middle income countries is constrained. The objective of this study was to evaluate the knowledge, attitude, and practice of antenatal exercises among Ethiopian women during pregnancy, and also to examine the barriers to prenatal physical activity.

Methods

A descriptive hospital-based cross-sectional study was conducted and 349 pregnant women receiving prenatal care at the ante-natal care clinic, University of Gondar comprehensive specialized hospital were recruited. Data were obtained on maternal characteristics, knowledge, attitude, practice, and barriers towards antenatal exercise (ANEx) by interview method.

Results

Among 349 pregnant women, 138 (39.5%) and 193 (55.3%) had adequate knowledge, a positive attitude, and good practice respectively. Overall, 108 (30.9) of the respondents practiced antenatal exercise, while only 41 (37.9%) of those pregnant women had a good practice. Brisk walking (90.7%), relaxation (38.9%), and breathing exercise (36.1%) were most practice ANEx, while pelvic floor 6 (5.6%) and 3 (2.8%) yoga were the least practiced. Enhancing post-natal recovery (71%) and vaginal bleeding (64.5) were perceived as benefits and contraindication of ANEx. More than half of the pregnant women (53.6) reported that ANEx is not appropriate for Ethiopian culture. Knowledge, attitude, and practice of ANEx among pregnant women are significantly associated with higher education, government employees, pre-pregnancy exercise, and being advised on ANEx before. Women with adequate knowledge are more likely to have a good practice (AOR 4.53, 95%CI: 1.64, 15.3).

Conclusion

The findings of this study suggest that knowledge concerning antenatal exercise is low and their attitude is reasonably favorable. However, very few Ethiopian pregnant practices ANEx according to recommended guidelines during pregnancy.

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Most cited references 33

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ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period.

(2015)

Physical activity in all stages of life maintains and improves cardiorespiratory fitness, reduces the risk of obesity and associated comorbidities, and results in greater longevity. Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise routines may be necessary because of normal anatomic and physiologic changes and fetal requirements. Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy. Obstetrician-gynecologists and other obstetric care providers should carefully evaluate women with medical or obstetric complications before making recommendations on physical activity participation during pregnancy. Although frequently prescribed, bed rest is only rarely indicated and, in most cases, allowing ambulation should be considered. Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychologic well-being. An exercise program that leads to an eventual goal of moderate-intensity exercise for at least 20-30 minutes per day on most or all days of the week should be developed with the patient and adjusted as medically indicated. Additional research is needed to study the effects of exercise on pregnancy-specific outcomes and to clarify the most effective behavioral counseling methods, and the optimal intensity and frequency of exercise. Similar work is needed to create an improved evidence base concerning the effects of occupational physical activity on maternal-fetal health.

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WHO recommendations on antenatal care for a positive pregnancy experience-going beyond survival.

Ӧ Tunçalp, J Pena-Rosas, T Lawrie … (2017)

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Antenatal and postnatal care service utilization in southern Ethiopia: a population-based study.

N Regassa (2011)

Access to antenatal care (ANC) and postnatal care (PNC) services has a great deal of impacts on major causes of infant death and significantly affects trends of mortality in a population. Antenatal care may play an indirect role in reducing maternal mortality by encouraging women to deliver with assistance of a skilled birth attendant or in a health facility. In most rural settings of Ethiopia, there are challenges in increasing such health care service utilization mainly due to the fact that the decisions that lead women to use the services seem to occur within the context of their marriage , household and family setting. Examining the prevalence and factors associated with antenatal Care (ANC) and Postnatal Care (PNC) service utilizations. This was a cross-sectional population based study undertaken in 10 rural villages of the Sidama zone, southern Ethiopia. The data were collected from a representative sample of 1,094 households drawn from the study population using a combination of simple random and multistage sampling techniques. Two dependent variables were used in the analysis: The ANC, measured by whether a woman got the service (at least once) from a health professional or not during her last pregnancy and PNC which was approximated by whether the last born child completed the required immunization or not. Household and women's characteristics were used as explanatory variables for both dependent variables. The study revealed that the level of ANC and PNC service utilizations is 77.4 % and 37.2% respectively. The predicted probabilities, using logistic regression, showed that women who are literate, have exposure to media, and women with low parity are more likely to use both ANC and PNC services. Antenatal care service utilization was generally good while the postnatal care given to new born children was very low compared to other population groups in the region. Promoting women's education and behavioral change communication at grass root level, provision of the services at both home and health facilities, and improving the quality and capacity of the health providers are some of the recommendations forwarded.

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Author and article information

Contributors

Balamurugan Janakiraman:

ORCID: https://orcid.org/0000-0003-3866-9351

Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: SupervisionRole: Writing – review & editing

Tsiwaye Gebreyesus: Role: ConceptualizationRole: Writing – review & editing

Mulualem Yihunie: Role: Data curationRole: Writing – review & editing

Moges Gashaw Genet:

ORCID: https://orcid.org/0000-0002-4532-1786

Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: ResourcesRole: SupervisionRole: Writing – original draftRole: Writing – review & editing

Frank T. Spradley: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS One

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 19 February 2021

Publication date Collection: 2021

Volume: 16

Issue: 2

Electronic Location Identifier: e0247533

Affiliations

[1 ] Department of Physiotherapy, School of Medicine, College of Health Sciences and Ayder Comprehensive Specialized Hospital, Mekelle University, Mekelle, Ethiopia

[2 ] Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar comprehensive specialized hospital, Gondar, Ethiopia

University of Mississippi Medical Center, UNITED STATES

Author notes

Competing Interests: The authors have declared that no competing interests exist.

* E-mail: bala77physio@ 123456gmail.com

Author information

Balamurugan Janakiraman https://orcid.org/0000-0003-3866-9351

Moges Gashaw Genet https://orcid.org/0000-0002-4532-1786

Article

Publisher ID: PONE-D-20-30016

DOI: 10.1371/journal.pone.0247533

PMC ID: 7895387

PubMed ID: 33606844

SO-VID: 8d194398-7da0-4fa2-9813-ab1bf54c44bb

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 23 September 2020

Date accepted : 8 February 2021

Page count

Figures: 0, Tables: 5, Pages: 15

Funding

Funded by: funder-id http://dx.doi.org/10.13039/501100007866, College of Medicine and Health Sciences, University of Gondar;

Award ID: 112/7/2019

Award Recipient :

ORCID: https://orcid.org/0000-0003-3866-9351

Balamurugan Janakiraman

This study was fully resourced and partly funded by the University of Gondar (Grant no: SOM112/7/2019). The views presented in the article are the authors and not necessarily express the views of the funding organization. University of Gondar did not involve in the design of the study, data collection, analysis, and interpretation. There was no additional external funding received for this study.

Custom metadata

Data Availability All data relevant to our findings are contained within the manuscript. The full dataset contains sensitive participant information. Requests for further details on the dataset and queries concerning data sharing should be directed to the Head of the Department, Dept of Physiotherapy, University of Gondar at getachewazeze43@ 123456gmail.com .

Knowledge, attitude, and practice of antenatal exercises among pregnant women in Ethiopia: A cross-sectional study

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Most cited references 33

ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period.

WHO recommendations on antenatal care for a positive pregnancy experience-going beyond survival.

Antenatal and postnatal care service utilization in southern Ethiopia: a population-based study.

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