In total 19 women were interviewed. The four categories generated were: Physical activity as a lifestyle, Body awareness, Carefulness, and Sense of benefit.
Physical activity as a lifestyle
The sub-categories in this category were: Habit and Desire to continue. The majority of the women felt that their physically active lifestyle prior to pregnancy influenced their physical activity during pregnancy. Training at fitness centers, jogging, and cycling to and from work, as most did prior to pregnancy, are described by the majority of the women as activities, which were maintained as a matter of course during pregnancy. The retention of a physically active life in pregnancy was perceived by the women not as a deliberate but rather as an unconscious continuation of their habits and daily life. Most of the women found that their physically active lives continued at a pace lower than the pre-pregnancy level, although some exercised more.
"I felt it was just part of my daily routine and part of my life, so I simply went on with it (I:4)
Some of the women deliberately chose to carry on with their physical activity despite their pregnancy, and were of the opinion that physical activity should not be discontinued simply because they were pregnant. Pregnancy was not considered a disease by some of the women, who continued to be physically active. A number of the interviewed women had observed that other expecting mothers could exercise during their pregnancy and were themselves thus also motivated to continue exercising during their own pregnancies. The women related that they wished to continue to exercise in order not to give up the sense of well being that this afforded them - likewise, they wished to keep in shape during pregnancy. One expressed the view that it would be depressing to have to start from scratch upon resuming training after pregnancy. Several were aware that physical activity for a half hour each day was recommended, and that physical fitness contributed to an easier pregnancy and labour and helped avoid excessive weight gain during pregnancy.
"I was quite determined that my pregnancy should not stop me from being physically active... because I have always enjoyed exercising and I was sure that everything would go much better if I were physically active (I:5)
Several women felt that they could maintain their exercise patterns during pregnancy, while others found they were able to exercise less than expected or had to switch to new activities. The latter were described as yoga, prenatal gymnastics or swimming, all of which were seen to be activities that could be undertaken during pregnancy. The majority of the women described their observation that their routine of bicycling was something they could continue throughout their pregnancy.
"I bicycled as much as I could because it didn't bother me to cycle, I always could, meaning that I could right up to the very end (I:14)
The women who suffered psychologically challenging events such as the death of a parent or estrangement from the child's father perceived that they did not have the energy or desire for more physically intensive activities. They gave them up for a while or for the remainder of the pregnancy.
"and if I let myself become psychologically upset, then I lose the motivation to exercise, and that started with my daughter's father (I:16)
The issue of body awareness included the sub-categories: Pregnancy-related discomfort, Having a complicated pregnancy and A growing body. Bodily changes could affect physical activity both early and late in the pregnancy and are experienced as barriers to physical activity. Early pregnancy discomfort such as nausea or fatigue was seen by some women as grounds to give up the long bicycle rides to and from work and workouts in the fitness center. Nausea is seen as causing an aversion to being with other perspiring people at fitness training. Cycling or walks in the open air are, on the other hand, perceived to diminish nausea. One individual felt so poorly when training at a fitness center that she was forced to refrain from training even before the pregnancy was ascertained. She found this discouraging.
"just before I discovered that I was pregnant I was at a spinning class with my husband where at the end of the class I felt so awful, worse than I have ever experienced"... I simply couldn't go on" (I:1)
Physiological reactions such as pressure on the bladder while jogging or the frequent need to urinate during aerobics were perceived as unpleasant and reasons to switch to other forms of exercise. One woman's appetite when exercising was so great that she became unwell. She found however, that this could be avoided if she ate while doing prenatal gymnastics.
Pregnancy complications such as bleeding, emesis, after effects of fertility treatment or large uterine fibroids made some women to feel unable to be physically active during part of the pregnancy and one woman during the entire pregnancy. Several later resumed physical activity, taking up more gentle forms of exercise such as swimming, prenatal gymnastics, cycling or slow walks.
"Even though I was physically active before I became pregnant, and worked out, I would guess, 3-4 times a week... I hardly trained at all... I didn't have the energy or strength for it at all (I:1)
The fact that the body grows during pregnancy is perceived to affect both the intensity and preference of physical activity. Pregnant women who jogged felt that this became both heavier and harder even before their pregnancy became visible, and they had to reduce both pace and distance. Several could continue on stationary bicycles but not on spinning bicycles, as there was no space for the abdomen. These women also found that they could replace the spinning bicycle with the cross-trainer. The cross-trainer functioned well as there was space for the pregnant abdomen and it did not cause abrupt jolts of the body as did the treadmill or jogging in open terrain. Training in a fitness center was perceived as beneficial as the women could make individual modifications in their training program to adapt it to their changing bodies. Strength training became difficult however, towards the end of the pregnancy, as there was no space in the machines for the enlarging abdomen, but the women could then take up other activities.
"used the cross-trainer a lot, where you stand with your arms and legs, I mean, I think it's brilliant, because there is room for your stomach" (I:8)
"Well, I think two weeks before I gave birth I was of course working out a bit less, towards the end you can't sit at the machines with such a big stomach, but you can still do the Power Walker or stand on a stepper for 10 minutes or something, right?" (I:2)
Their large, fecund, growing bodies could psychologically discourage the pregnant women from training, as they felt fat and exposed in a fitness class with non-pregnant women. The growing body was perceived as demotivating, as exercise is normally taken to get fit and into better shape, while during pregnancy the opposite occurs, even with exercise.
"because you just get bigger even though you work out, so I think that can be a real demotivator or whatever you call it (I:19)
The growing stomach was perceived as problematic towards the end of the pregnancy if the women cycled on a racing or mountain bike, as their knees knocked against their abdomen. Pregnant women having bicycles with upright handlebars did not encounter these problems. Women did find, however, that they could continue to bicycle if they purchased or borrowed a bicycle with upright handlebars where there was room for their stomach. Some did not discover this and stopped bicycling. The pregnant women who continued to bicycle found cycling preferable to walking or transportation by bus.
"so I had problems because I had to lean forward so much on my bike, so at the end when I got other handlebars put on and later exchanged bikes with a friend who had one of these old-fashioned bikes, then I could sit upright so I could bike" (I:11)
Sub-categories were: Feelings of worry and Balancing worry and sense of security, the latter with the sub sub-categories Security from within and Security from without. All the pregnant women experienced a certain worry about being physically active during pregnancy; this influenced the level of activity to varying degrees and could be experienced as a barrier to continuing physical activity. Most concerned were those pregnant women who had received fertility treatment or had themselves previously miscarried or knew women who had miscarried. Women were afraid that physical activity might lead to miscarriage. For this reason they were cautious, one woman remaining inactive throughout her entire pregnancy.
"but before I had my son I had a miscarriage, so I had sort of a period where I didn't dare dance as wildly again while I was expecting my son, so I was especially careful (I:13)
"so it was that, really, now I was pregnant, like we were under treatment to get pregnant with IUI, so maybe it was sort of like, now finally we were successful so you didn't want to do too much, in case something went wrong, you know (I:17)
Anxiety and concern were also felt in relation to specific kinds of exercise. Several women refrained from strength training and jogging, considering these kinds of exercise too strenuous during pregnancy. Some women felt an unpleasant heaviness when jogging, a sensation that lead them to fear a miscarriage.
"I had been jogging and the next time I was supposed to go jogging, suddenly I had such an unpleasant heavy feeling, there was this feeling of pressure, and where I thought oh no, I wonder if I am having a miscarriage... but I just felt that heaviness every time I hit the ground with my legs, so I quit jogging" (I:15)
Although all women experienced worry about physical activity during pregnancy, most chose to continue to be active. The women opted to modify their physical activity or switch to a new form of exercise. They subsequently felt reassured with their choice, a reassurance that may be described as coming from within or as coming from without. The few pregnant women who maintained physical activity at a high level related that they believed they could sense what was right and not right for their bodies and thus felt a reassurance that came from within.
"no, well I did sort of feel that I would be able to sense from my body if something was wrong" (I:6)
The two pregnant women who had miscarried reduced their activity or switched to less intensive activities such as swimming, walking or yoga, and felt secure in their decision. One relates how her own inner sense of security was more important than what others told her.
"but I stayed away from jogging, and I stayed away from, I mean I did, I think I did some good things which I had good experiences with, I mean I went to pregnancy yoga, I swam and I cycled and I did some dance training" (I:10)
Expecting mothers also found that a sense of security in being physically active could come from without through professionals and other pregnant women. Those who continued to lift weights were all given special guidance. It is regarded as reassuring to be able to consult professionals and follow exercise programs where consideration is taken of the pregnancy. Some found that the trainer, due to the risk of miscarriage, wanted to postpone resumption of training until after week 12.
"I think we started by waiting the 12 weeks, and then I got a program that worked for me... not too strenuous" (I:2)
Others sensed insecurity in fitness, strength training or jogging and these women chose instead to join specific prenatal exercise classes. This was perceived as generating a sense of security, as the classes were led by professionals whom they considered capable of determining what a pregnant woman may do, and because other pregnant women performed the same physical activity.
"in the training center that had exercise sessions for pregnant women, it was as if it was within the pregnancy limits, there they knew how much you could take...I mean they were aware that they were dealing with pregnant women" (I:3)
One individual had received conflicting information from midwives about physical activity, one of whom expressed the opinion that it was hazardous to the child if the woman's heart rate became too high, while others claimed that this was incorrect. In other cases the pregnant woman found that the midwife, during their conversations, reassured her that it was in order to continue aerobics or begin swimming.
"but then I preferred to take it a bit easier and such, but then my midwife said that it was okay to swim, that it was the best thing to do" (I:12)
Sense of benefit
This category contains two sub-categories: Feelings of happiness and Physical well-being. Women who continued to exercise during pregnancy experienced that physical activity had contributed to a wonderful pregnancy both physically and mentally.
Superlatives are prevalent as women relate how they experienced their physical activities during pregnancy. They found it gave more pleasure, well-being, energy and lightheartedness to be physically active. It was described as enjoyable to use one's body, big though it was. It was regarded as a psychological boost to be able to be more active than one anticipated.
"just being active, it gave me energy and made me happy, it made me wildly happy" (I:4)
Yoga as an activity is perceived as pleasurable, relaxing and meditative for the women who tried it, and is described as a good way to cope with the distended pregnant body. Jogging is described by some as pleasant both early in the pregnancy when the breasts were sore but also later in the pregnancy when the stomach was heavy - others did not share this experience. Strength training is described as wonderful. Swimming was found to be the most satisfying form of exercise and was described as pleasant, fantastic and great during pregnancy, even though many of the women did not actually care for swimming prior to their pregnancy.
"but it has been fantastic, and I'm not otherwise much for swimming, but um, it got me into the water anyway" (I:5)
The pregnant women were happy to be active during pregnancy. Several pushed themselves to increase their heart rate, which was experienced as feeling good. Physical activity was perceived to reduce weight gain and have a positive impact on aches in the back and lumbar region. The perception was that jogging could mitigate the sensation that "one's body was a big lump". While swimming, the woman felt that she could use her body as she did before her pregnancy - as almost the only form of exercise to do so. Swimming could, for a while, allow the woman feel a lightness and weightlessness and unburdened by her heavy body. It was pleasant to lie on one's stomach in the water, which wasn't possible on land. It was good to feel the tiredness following a swim. Swimming was perceived to improve blood circulation in the body and partly alleviate edema in the legs. Feelings of discomfort when swimming were also expressed. One woman described that she did not feel it was pleasant to swim in the last part of her pregnancy. She felt she was drowning and was afraid of drowning.
"it was pleasant to for example lie face down when doing the breast stroke, because for a long time it wasn't possible to lie on your stomach" (I:10)
"being out of the water felt heavy and cumbersome towards the end and in the water it just felt like you weighed 50 kilos again" (I:12)