Physical activity (PA) is important for a woman’s health particularly before pregnancy, yet many remain inactive during this time despite its benefits for themselves and their child. This qualitative descriptive study explored pregnant women’s experiences with pre-pregnancy PA and the factors influencing their engagement. Using convenience sampling, data were collected from women across Nebraska between December 2023 and February 2024 via Zoom interviews. Thematic analysis, guided by the Theory of Planned Behavior (TPB), identified three key themes: (1) Behavioral attitudes - women recognized the benefits of PA but lacked awareness of guidelines; (2) Subjective norms - support from partners, family, and friends encouraged participation; and (3) Perceived behavioral control-barriers such as low motivation, time constraints, and environmental factors influenced engagement. Findings highlight the need for tailored interventions, social support, and education to enhance PA before pregnancy. Addressing barriers and leveraging enablers may improve maternal and infant health outcomes.
AdamsGDoblesIGómezLH, et al. (2015) Decolonizing psychological science: Introduction to the special thematic section. Journal of Social and Political Psychology3(1): 213–38.
2.
AlbertFACroweMJMalau-AduliAE, et al. (2020) Physical activity promotion: a systematic review of the perceptions of healthcare professionals. International Journal of Environmental Research and Public Health17(12): 4358
3.
AjzenI (1991) The theory of planned behavior. Organizational Behavior and Human Decision Processes50(2): 179–211.
4.
BatalhaAPDBMarcalIRMainE, et al. (2025) Barriers to physical activity in women from ethnic minority groups: A systematic review. BMC Women’ s Health25(1): 330.
5.
BearakJPopinchalkAAlkemaL, et al. (2018) Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: Estimates from a Bayesian hierarchical model. Lancet Global Health6(4): e380–e389.
6.
BennettGGWolinKYPuleoEM, et al. (2009) Awareness of national physical activity recommendations for health promotion among US adults. Medicine and Science in Sports and Exercise41(10): 1849–1855.
7.
BradshawCAtkinsonSDoodyO (2017) Employing a qualitative description approach in health care research. Global Qualitative Nursing Research4: 2333393617742282.
8.
BraunVClarkeV (2006) Using thematic analysis in psychology. Qualitative Research in Psychology3(2): 77–101.
9.
BurtonNWBarberBLKhanA (2021) A qualitative study of barriers and enablers of physical activity among female Emirati university students. International Journal of Environmental Research and Public Health18(7): 3380.
10.
ChanCWHAu YeungELawBMH (2019) Effectiveness of physical activity interventions on pregnancy-related outcomes among pregnant women: A systematic review. International Journal of Environmental Research and Public Health16(10): 1840.
11.
CharlesworthSFouldsHJBurrJF, et al. (2011) Evidence-based risk assessment and recommendations for physical activity clearance: Pregnancy. Applied Physiology Nutrition and Metabolism36 (S1): S33–S48.
12.
ChaudharyPRechJPKumarG, et al. (2025) Role of doulas across the pregnancy care continuum on maternal and child health: A scoping review. NPJ Women's Health3(1): 63.
13.
Cilar BudlerLBudlerM (2022) Physical activity during pregnancy: A systematic review for the assessment of current evidence with future recommendations. BMC Sports Science Medicine and Rehabilitation14(1): 133.
14.
CollCVNDominguesMRGonçalvesH, et al. (2017) Perceived barriers to leisure-time physical activity during pregnancy: A literature review of quantitative and qualitative evidence. Journal of Science and Medicine in Sport20(1): 17–25.
15.
CreswellJWMillerDL (2000) Determining validity in qualitative inquiry. Theory Into Practice39(3): 124–130.
16.
CurrieSGrayCShepherdA, et al. (2016) Antenatal physical activity: A qualitative study exploring women's experiences and the acceptability of antenatal walking groups. BMC Pregnancy and Childbirth16(1): 182.
17.
DeliensTDeforcheBDe BourdeaudhuijI, et al. (2015) Determinants of physical activity and sedentary behaviour in university students: A qualitative study using focus group discussions. BMC Public Health15(1): 201.
18.
Di FabioDRBlommeCKSmithKM, et al. (2015) Adherence to physical activity guidelines in mid-pregnancy does not reduce sedentary time: An observational study. International Journal of Behavioral Nutrition and Physical Activity12(1): 27.
19.
DonahueSMZimmermanFJStarrJR, et al. (2010) Correlates of pre-pregnancy physical inactivity: Results from the pregnancy risk assessment monitoring system. Maternal and Child Health Journal14(2): 235–244.
20.
DzauVJMcClellanMBMcGinnisJM, et al. (2017) Vital directions for health and health care: Priorities from a National Academy of Medicine initiative. Journal of the American Medical Association317(14): 1461–1470.
21.
ElkayamUGolandSPieperPG, et al. (2016) High-risk cardiac disease in pregnancy: Part II. Journal of the American College of Cardiology68(5): 502–516.
22.
FindleyASmithDMHeskethK, et al. (2020) Exploring women’s experiences and decision making about physical activity during pregnancy and following birth: A qualitative study. BMC Pregnancy and Childbirth20: 54.
23.
GaoZLeeJE (2019) Emerging technology in promoting physical activity and health: challenges and opportunities. Journal of Clinical Medicine8(11): 1830.
24.
GarlandM (2017) Physical activity during pregnancy: A prescription for improved perinatal outcomes. Journal for Nurse Practitioners13(1): 54–58.
25.
GuestGNameyEChenM (2020) A simple method to assess and report thematic saturation in qualitative research. PLoS One15(5): e0232076.
26.
HarrisonCLBrownWJHaymanM, et al. (2016) The role of physical activity in preconception, pregnancy, and postpartum health. Seminars in Reproductive Medicine34(2): e28–e37.
27.
HayesLMcparlinCKinnunenTI, et al. (2015) Change in level of physical activity during pregnancy in obese women: Findings from the UPBEAT pilot trial. BMC Pregnancy and Childbirth15(1): 52.
28.
HeklerETiroJAHunterCM, et al. (2020) Precision health: The role of the social and behavioral sciences in advancing the vision. Annals of Behavioral Medicine54(11): 805–826.
29.
HenninkMMKaiserBNMarconiVC (2017) Code saturation versus meaning saturation: How many interviews are enough?Qualitative Health Research27(4): 591–608.
30.
HillemeierMMDownsDSFeinbergME, et al. (2008) Improving women’s preconceptional health: Findings from a randomized trial of the strong healthy women intervention in the Central Pennsylvania women’s health study. Women’s Health Issues18(6): S87–S96.
31.
KandelPLimSDeverM, et al. (2023) Enablers and barriers related to preconception physical activity: Insights from women of reproductive age using mixed methods. Nutrients15(23): 4939.
32.
KayMCCarrollDDCarlsonSA, et al. (2014) Awareness and knowledge of the 2008 physical activity guidelines for Americans. Journal of Physical Activity and Health11(4): 693–698.
33.
KoletzkoBCremerMFlothkötterM, et al. (2018) Diet and lifestyle before and during pregnancy – practical recommendations of the Germany-wide healthy start – young family network. Geburtshilfe Und Frauenheilkunde78(12): 1262–1282.
34.
KorstjensIMoserA (2018) Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. European Journal of General Practice24(1): 120–124.
35.
LiuYZhaiXZhangY, et al. (2023) The promoting effect of exercise motivation on physical fitness in college students: A mediation effect model. BMC Public Health23(1): 2244.
36.
LubV (2015) Validity in qualitative evaluation: Linking purposes, paradigms, and perspectives. International Journal of Qualitative Methods14(5): 1609406915621406.
37.
MalmCJakobssonJIsakssonA (2019) Physical activity and sports—real health benefits: A review with insight into the public health of Sweden. Sports7(5): 127.
38.
MarshallESBlandHMeltonB (2013) Perceived barriers to physical activity among pregnant women living in a rural community. Public Health Nursing30(4): 361–369.
39.
MenaGPMielkeGIBrownWJ (2019) The effect of physical activity on reproductive health outcomes in young women: A systematic review and meta-analysis. Human Reproduction Update25(5): 542–564.
40.
MerkxAAusemsMBudéL, et al. (2017) Factors affecting perceived change in physical activity in pregnancy. Midwifery51: 16–23.
41.
MoustakasC (1994) Phenomenological Research Methods. Thousand Oaks.
42.
MusgraveLHomerCGordonA (2023) Knowledge, attitudes and behaviours surrounding preconception and pregnancy health: An Australian cross-sectional survey. BMJ Open13(1): e065055.
43.
NarasimhuluDMKarakashSWeedonJ, et al. (2016) Patterns of internet use by pregnant women, and reliability of pregnancy-related searches. Maternal and Child Health Journal20(12): 2502–2509.
NowellLSNorrisJMWhiteDE, et al. (2017) Thematic analysis: Striving to meet the trustworthiness criteria. International Journal of Qualitative Methods16(1): 1609406917733847.
47.
O'BrienBCHarrisIBBeckmanTJ, et al. (2014) Standards for reporting qualitative research: A synthesis of recommendations. Academic Medicine89(9): 1245-1251.
48.
OkaforUBGoonDT (2021) Physical activity advice and counselling by healthcare providers: A scoping review. Healthcare9(5): 609.
49.
OthmanMSMat LudinAFChenLL, et al. (2022) Motivations, barriers and exercise preferences among female undergraduates: A need assessment analysis. PLoS One17(2): e0264158.
50.
ParikhNIGonzalezJMAndersonCAM, et al. (2012) Adverse pregnancy outcomes and cardiovascular disease risk: Unique opportunities for cardiovascular disease prevention in women: A scientific statement from the American Heart Association. Circulation143(18): e902–e916.
51.
PengBNgJYYHaAS (2023) Barriers and facilitators to physical activity for young adult women: A systematic review and thematic synthesis of qualitative literature. International Journal of Behavioral Nutrition and Physical Activity20(1): 23.
52.
PiercyKLTroianoRPBallardRM, et al. (2018) The physical activity guidelines for Americans. Journal of the American Medical Association320(19): 2020–2028.
53.
RethornZDCovingtonJKCookCE, et al. (2022) Physical therapists’ knowledge, skills, beliefs, and organizations impact physical activity promotion: A systematic review and meta-analysis. Physical Therapy102(3): ab291.
54.
RichardsEAFranksMMMcDonoughMH, et al. (2018) ‘Let’s move:’ A systematic review of spouse-involved interventions to promote physical activity. International Journal of Health Promotion and Education56: 51–67.
55.
RitchieJOrmstonRMcNaughton NichollsC, et al. (2013) Qualitative Research Practice: A Guide for Social Science Students and Researchers. Thousand Oaks, CA: Sage, pp.1–456.
56.
RoseG (1997) Situating knowledges: Positionality, reflexivities, and other tactics. Progress in Human Geography21(3): 305–320.
57.
SantoECForbesPWOkenE, et al. (2017) Determinants of physical activity frequency and provider advice during pregnancy. BMC Pregnancy and Childbirth17(1): 286.
58.
SayakhotPCarolan-OlahM (2016) Internet use by pregnant women seeking pregnancy-related information: A systematic review. BMC Pregnancy and Childbirth16: 65.
59.
ShumKWAngMQShoreyS (2022) Perceptions of physical activity during pregnancy among women: A descriptive qualitative study. Midwifery107: 103264.
60.
SobierajskiFMPurdyGMUsselmanCW, et al. (2018) Maternal physical activity is associated with improved blood pressure regulation during late pregnancy. Canadian Journal of Cardiology34(4): 485–491.
61.
SparksJRFlanaganEWKebbeM, et al. (2023) Understanding barriers and facilitators to physical activity engagement to inform a precision prescription approach during pregnancy. American Journal of Lifestyle Medicine17(1): 108–122.
62.
TiniusREdensKLinkK, et al. (2020) Effect of evidence-based materials and access to local resources on physical activity levels, beliefs, and motivation during pregnancy in a rural setting. Journal of Physical Activity and Health17(10): 947–957.
63.
WagnerALKeuschFYanT, et al. (2019) The impact of weather on summer and winter exercise behaviors. Journal of Sport and Health Science8(1): 39–45.
64.
WarburtonDEBredinSS (2016) Reflections on physical activity and health: What should we recommend?Canadian Journal of Cardiology32(4): 495–504.
65.
WatsonEDNorrisSADraperCE, et al. (2016) “Just because you’re pregnant, doesn’t mean you’re sick!” A qualitative study of beliefs regarding physical activity in black South African women. BMC Pregnancy and Childbirth16(1): 174.
66.
WehbiNKWaniRYangY, et al. (2018) A needs assessment for simulation-based training of emergency medical providers in Nebraska, USA. Advances in Simulation3: 22.
67.
World Health Organization (2019) Global Action Plan on Physical Activity 2018-2030: More Active People for a Healthier World. World Health Organization. Available at: https://www.who.int/publications/i/item/9789241514187
