Table 5 Midwives’ perceived opportunities in changing pregnant women’s exercise behaviour

“The only exercise, there’s only a small amount of women who would take up anything remotely official, exercise like swimming or yoga or gym and that’s the ladies who have good jobs or husbands with good jobs, they only have one child at home, perhaps two maximum, those who can afford the time and the money.” [Kate]

Theme 1:

Recognising and addressing barriers in the uptake and maintenance of exercise participation during pregnancy.

“You could do it as students, yes involve it into the uni, but as a qualified midwife we have two mandatory days a year. One of them we have smoking updates, about smoking, we have mental health updates, maybe that should be in as a separate topic for us as midwives to be promoted, or even maybe not on the generalised one but the community update, cause the community midwives are the ones that get up from the beginning. So maybe on that study day they should be involving, explaining us and finding out and giving us that information on what is out there and how we can promote that.” [Tina]

Theme 2:

Professional development

“I think, umm, midwives can do the initial umm, talk, because it isn’t rocket science, everyone can give a little talk on the importance of, uh, exercise and as you said incorporate it with, it’s walking, or perhaps taking the children swimming, playing in the park, that sort of thing. But it would be nice to have something then we can say, if you like to know more about this, this is where you go to or if you’re happy, like with smoking, it’s filling out a form and send it off and then someone will contact them.” [Sue]

Theme 3:

Inter-professional collaboration

“No, I think maybe the only other thing is that maybe some kind of online, umm, facility for women, or an app. I mean I know there are loads of apps out there, umm, but we don’t have any real way of, you know, checking whether they’re credible or not, so maybe some kind of NHS approved app that could motivate women in pregnancy specifically.” [Vicky]

Theme 4:

Communicating effectively through simple, credible resources

“It would be good, it would be really nice actually if, you know, especially places like Children’s Centres could put on an exercise facility for pregnant women and some of the midwives could be trained to deliver that.” [Sally]

Theme 5:

Improved access, availability and awareness of suitable activities in the local community.

“And I think actually it would be really good because then it gives women the chance to meet other women that are pregnant as well so it would really, it would really, umm, help to incorporate some women into groups that find it very difficult to come to groups, you know, if they’re going to do an exercise class then they get to meet people every week at the same class.” “Umm, so they would build up a social network as well which is really important.” [Sally]

Theme 6:

Encouraging a support network

“I would say that, umm, like most things for pregnant women, you feel that you have to sell it, umm, and like the stop smoking, like all of the health things, umm, I would probably say it will make your birth easier and I would say that umm it will help with not gaining so much weight in your pregnancy, that that’s not necessary and that you don’t want to pile it on in pregnancy and they’re the things that would help if you do some, you know, small amounts of exercise.” [Amy]

Theme 7:

“Selling” physical activity by challenging misconceptions and focusing on benefits.

“And for lots of ladies that’s quite good, rather than from what I’ve seen in the past, umm, they start off and they will fizzle out after a while, but if they’ve got, knowing that perhaps they can get free children’s places or, umm, I don’t know, whatever vouchers to use, umm, that will keep them going more.” [Sue]

Theme 8:

Suitable motivation, incentives, and reward.