Promoting Prenatal Exercise From a Sociocultural and Life-Course Perspective: An “Embodied” Conceptual Framework

ABSTRACT

Purpose: Prenatal exercise is a health behavior that is receiving growing attention amid concern that women in Western societies are gaining excess weight during pregnancy and contributing to future obesity in both the mother and child. In this article, we draw on insights from the fields of social epidemiology and social theory of the body to examine existing prenatal exercise interventions and to propose a multidimensional framework intended to guide future theorizing and intervention design. Method: A scoping review of existing prenatal exercise programs and interventions focused on controlling gestational weight gain was conducted. Articles published prior to January 2017 were obtained from PubMed and CINAHL, and relevant articles were identified (n = 62) using specified inclusion and exclusion criteria. Identified articles were further analyzed to classify the level(s) of the socioecological model targeted in the intervention or program. Results: The majority of existing interventions target intrapersonal factors during pregnancy and do not attend to the role that cumulative exposure of social and structural disadvantage over the lifetime—not just during the prenatal period—plays in shaping health outcomes. In response, a multidimensional framework is proposed that includes key concepts that facilitate a life-course perspective, as well as attention to the integration of biological and social factors as they relate to health and health-related behaviors. Conclusion: Efforts to promote prenatal exercise and to improve maternal and infant health should attend to how systemic inequality impacts women’s health.

KEYWORDS:

• Gestational weight gain
• health equity
• obesity
• scoping review

Acknowledgment

Thank you to the anonymous reviewers for their insightful comments.

Supplemental material

Supplemental data for this article can be accessed on the publisher’s website.

Notes

¹ To be coded as interpersonal, there needed to be a focus on the creation of social support in the form of other women and/or family members. We did not count support from the researchers or health practitioners as these interactions typically focused on educating women by changing knowledge, beliefs, or motivation, which we classified as intrapersonal, although we acknowledge that an element of social support was provided through these interactions. To be coded as community level, the intervention had to include a component that facilitated access to community resources (e.g., fitness facilities) in a sustainable manner (i.e., not just having participants come to the lab or clinic where the intervention was being conducted). A code of environmental level required the intervention alter an aspect of the participants’ environment such as providing an exercise bike in their home or a workout DVD to facilitate workouts in the home.