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Barriers to physical activity in pregnant women: a cross-sectional study

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  • Published: 06 April 2026
  • article number , (2026)
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BMC Pregnancy and Childbirth Aims and scope Submit manuscript
Barriers to physical activity in pregnant women: a cross-sectional study
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  • Romina Fili  ORCID: orcid.org/0009-0005-0705-80071,
  • Fereshteh Behmanesh  ORCID: orcid.org/0000-0001-5837-42652,
  • Atefeh Omrani  ORCID: orcid.org/0000-0002-4264-722X4,
  • Hossein-Ali Nikbakht  ORCID: orcid.org/0000-0002-8556-431X3,
  • Sana Nazmi  ORCID: orcid.org/0000-0002-7005-27171 &
  • …
  • Leila Amiri Farahani  ORCID: orcid.org/0000-0003-3691-82465 

  • 42 Accesses

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Background

Despite the American College of Obstetricians and Gynecologists’ (ACOG) recommendations on the benefits of physical activity during pregnancy, low levels of physical activity are reported worldwide. This research aims to identify the barriers to physical activity (PA) and their predictors among pregnant women.

Methods

In this cross-sectional study, data were collected from 351 pregnant women aged 18–45 with gestational ages of 10–37 weeks through convenience sampling. These women took part in the study from May 2022 to August 2024 and completed a demographic-obstetric scale and the Barriers to Physical Activity during Pregnancy Scale (BPAPS). Data were analyzed using univariate and multivariate linear regression.

Results

The total BPAPS score was 78.07 ± 16.25(range 29 to 145). The highest and lowest scores among the subscales were related to environmental barriers (43.67 ± 17.80) and interpersonal barriers (38.74 ± 17.93). The most commonly reported environmental barriers were limited access to sports facilities and the difficulty of exercising in hot or cold weather. In multivariate analysis, educational level (B = 4.39), employment status(B = 9.54), regular physical activity before pregnancy (B = 7.34), and maternal age (B = 0.91) were identified as strong independent predictors of physical activity barriers.

Conclusions

This study found that environmental barriers were the most prominent obstacles to physical activity among pregnant women, while interpersonal barriers were perceived as less influential. Higher education, employment, regular physical activity before pregnancy, and younger maternal age were associated with fewer perceived barriers during pregnancy. These findings suggest that addressing physical inactivity in pregnancy may require multilevel approaches that extend beyond individual counseling and consider environmental conditions. The results highlight modifiable factors that may inform future interventions and support healthcare providers in identifying women who are more likely to experience greater barriers to physical activity during pregnancy.

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  • Maternal Physical Activity and Health Outcomes

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

PA:

Physical Activity

ACOG:

American College of Obstetricians and Gynecologists

BPAPS:

Barriers to Physical Activity in Pregnant Scale

PPAQ:

Pregnancy Physical Activity Questionnaire

BMI:

Body Mass Index

GA:

Gestational Age

References

  1. Hailemariam TT, Gebregiorgis YS, Gebremeskel BF, Haile TG, Spitznagle TM. Physical activity and associated factors among pregnant women in Ethiopia: facility-based cross-sectional study. BMC Pregnancy Childbirth. 2020;20:1–11.

    Google Scholar 

  2. Watson ED, Van Poppel MN, Jones RA, Norris SA, Micklesfield LK. Are south African mothers moving? Patterns and correlates of physical activity and sedentary behavior in pregnant black south African women. J Phys Activity Health. 2017;14(5):329–35.

    Google Scholar 

  3. De Haas S, Ghossein-Doha C, Van Kuijk S, Van Drongelen J, Spaanderman M. Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta‐analysis. Ultrasound Obstet Gynecol. 2017;49(2):177–87.

    Google Scholar 

  4. Ribeiro MM, Andrade A, Nunes I. Physical exercise in pregnancy: benefits, risks and prescription. J Perinat Med. 2022;50(1):4–17.

    Google Scholar 

  5. Davenport MH, McCurdy AP, Mottola MF, Skow RJ, Meah VL, Poitras VJ, et al. Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis. Br J Sports Med. 2018;52(21):1376–85.

    Google Scholar 

  6. Santini C, Imakawa TS, Moisés ECD. Physical activity during pregnancy: recommendations and assessment tools. Revista Brasileira de Ginecol e Obstetrícia. 2017;39(08):424–32.

    Google Scholar 

  7. Sytsma TT, Zimmerman KP, Manning JB, Jenkins SM, Nelson NC, Clark MM, et al. Perceived barriers to exercise in the first trimester of pregnancy. J Perinat Educ. 2018;27(4):198.

    Google Scholar 

  8. Connolly CP, Feltz DL, Pivarnik JM. Overcoming barriers to physical activity during pregnancy and the postpartum period: The potential impact of social support. Kinesiol Rev. 2014;3(2):135–48.

    Google Scholar 

  9. Obstetricians A, Of. gynecologists. Physical activity and exercise during pregnancy and the postpartum period. Committee opinion 650. Obstet Gynecol. 2015;126(6):e135–42.

    Google Scholar 

  10. Flannery C, McHugh S, Anaba AE, Clifford E, O’Riordan M, Kenny LC, et al. Enablers and barriers to physical activity in overweight and obese pregnant women: an analysis informed by the theoretical domains framework and COM-B model. BMC Pregnancy Childbirth. 2018;18:1–13.

    Google Scholar 

  11. McKeough R, Blanchard C, Piccinini-Vallis H. Pregnant and postpartum women’s perceptions of barriers to and enablers of physical activity during pregnancy: A qualitative systematic review. J Midwifery Women’s Health. 2022;67(4):448–62.

    Google Scholar 

  12. Okafor UB, Goon DT. Physical activity level during pregnancy in South Africa: a facility-based cross-sectional study. Int J Environ Res Public Health. 2020;17(21):7928.

    Google Scholar 

  13. Meander L, Lindqvist M, Mogren I, Sandlund J, West CE, Domellöf M. Physical activity and sedentary time during pregnancy and associations with maternal and fetal health outcomes: an epidemiological study. BMC Pregnancy Childbirth. 2021;21:1–11.

    Google Scholar 

  14. Zhou T, Lin Y, Xu F, Ma X, Wang N, Ding Y. Factors influencing physical inactivity status among Chinese pregnant women: a cross-sectional study. BMC Public Health. 2022;22(1):2310.

    Google Scholar 

  15. Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Jafarabadi MA, Soltanpour S, Aghamiri V, Bagherinia M. Physical Activity during Pregnancy and its Relationship with the Functional Status of Primiparous Women Six Weeks after Childbirth: A Cohort Study. J Clin Diagn Res. 2018;12(11). https://doi.org/10.7860/JCDR/2018/36692.12245.

  16. Todorovic J, Terzic-Supic Z, Bjegovic-Mikanovic V, Piperac P, Dugalic S, Gojnic-Dugalic M. Factors associated with the leisure-time physical activity (LTPA) during the first trimester of the pregnancy: the cross-sectional study among pregnant women in Serbia. Int J Environ Res Public Health. 2020;17(4):1366.

    Google Scholar 

  17. Merkx A, Ausems M, Budé L, de Vries R, Nieuwenhuijze MJ. Factors affecting perceived change in physical activity in pregnancy. Midwifery. 2017;51:16–23.

    Google Scholar 

  18. Whitaker KM, Wilcox S, Liu J, Blair SN, Pate RR. Pregnant women’s perceptions of weight gain, physical activity, and nutrition using Theory of Planned Behavior constructs. J Behav Med. 2016;39:41–54.

    Google Scholar 

  19. Leppänen M, Aittasalo M, Raitanen J, Kinnunen TI, Kujala UM, Luoto R. Physical activity during pregnancy: predictors of change, perceived support and barriers among women at increased risk of gestational diabetes. Matern Child Health J. 2014;18:2158–66.

    Google Scholar 

  20. Downs DS, Chasan-Taber L, Evenson KR, Leiferman J, Yeo S. Physical activity and pregnancy: past and present evidence and future recommendations. Res Q Exerc Sport. 2012;83(4):485–502.

    Google Scholar 

  21. Gaston A, Cramp A. Exercise during pregnancy: a review of patterns and determinants. J Sci Med sport. 2011;14(4):299–305.

    Google Scholar 

  22. Gaston A, Vamos CA. Leisure-time physical activity patterns and correlates among pregnant women in Ontario, Canada. Matern Child Health J. 2013;17(3):477–84.

    Google Scholar 

  23. Santos PC, Abreu S, Moreira C, Lopes D, Santos R, Alves O, et al. Impact of compliance with different guidelines on physical activity during pregnancy and perceived barriers to leisure physical activity. J Sports Sci. 2014;32(14):1398–408.

    Google Scholar 

  24. AMEZCUA-PRIETO C, LARDELLI‐CLARET P, OLMEDO‐REQUENA R, MOZAS‐MORENO J, BUENO‐CAVANILLAS A, JIMÉNEZ‐MOLEÓN JJ. Compliance with leisure‐time physical activity recommendations in pregnant women. Acta Obstet Gynecol Scand. 2011;90(3):245–52.

    Google Scholar 

  25. Juhl M, Madsen M, Andersen AM, Andersen PK, Olsen J. Distribution and predictors of exercise habits among pregnant women in the Danish National Birth Cohort. Scand J Med Sci Sports. 2012;22(1):128–38.

    Google Scholar 

  26. Haakstad LA, Voldner N, Henriksen T, Bø K. Why do pregnant women stop exercising in the third trimester? Acta Obstet Gynecol Scand. 2009;88(11):1267–75.

    Google Scholar 

  27. Dolatabadi Z, Amiri-Farahani L, Ahmadi K, Pezaro S. Barriers to physical activity in pregnant women living in Iran and its predictors: a cross sectional study. BMC Pregnancy Childbirth. 2022;22(1):815.

    Google Scholar 

  28. Okafor UB, Goon DT. Physical activity and exercise during pregnancy in Africa: a review of the literature. BMC Pregnancy Childbirth. 2020;20:1–17.

    Google Scholar 

  29. Davoud A, Abazari M. The relationship between quality of life and physical activity, worry, depression, and insomnia in pregnant women. Iran J psychiatry. 2020;15(2):159.

    Google Scholar 

  30. Findley A, Smith DM, Hesketh K, Keyworth C. Exploring womens’ experiences and decision making about physical activity during pregnancy and following birth: A qualitative study. BMC Pregnancy Childbirth. 2020;20:1–10.

    Google Scholar 

  31. Rabiepoor S, Rezavand S, Yas A, Ghanizadeh N. Influential factors in physical activity amongst pregnant women. Baltic J Health Phys Activity. 2019;11(2):4.

    Google Scholar 

  32. Sattler MC, Jaunig J, Watson ED, van Poppel MN, Mokkink LB, Terwee CB, et al. Physical activity questionnaires for pregnancy: a systematic review of measurement properties. Sports Med. 2018;48:2317–46.

    Google Scholar 

  33. Nulty DD. The adequacy of response rates to online and paper surveys: what can be done? Assess evaluation High Educ. 2008;33(3):301–14.

    Google Scholar 

  34. Fili R, Nazmi S, Behmanesh F, Omrani A, Nikbakht H, Amiri Farahani L. Barriers to Physical Activity in Pregnant Women: An Explanatory Sequential Mixed-method Study (Study Protocol). J Client-Centered Nurs Care. 2024;10(3):191–8.

    Google Scholar 

  35. Amiri-Farahani L, Ahmadi K, Hasanpoor-Azghady SB, Pezaro S. Development and psychometric testing of the ‘barriers to physical activity during pregnancy scale’(BPAPS). BMC Public Health. 2021;21:1–9.

    Google Scholar 

  36. Koleilat M, Vargas N, vanTwist V, Kodjebacheva GD. Perceived barriers to and suggested interventions for physical activity during pregnancy among participants of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Southern California. BMC Pregnancy Childbirth. 2021;21:1–9.

    Google Scholar 

  37. Kianfard L, Niknami S, SHokravi FA, Rakhshanderou S. Facilitators, barriers, and structural determinants of physical activity in nulliparous pregnant women: a qualitative study. J pregnancy. 2022;2022(1):5543684.

    Google Scholar 

  38. Alaglan AA, Almousa RF, Alomirini AA, Alabdularazaq ES, Alkheder RS, Alzaben KA, et al. Saudi women’s physical activity habits during pregnancy. Women’s Health. 2020;16:1745506520952045.

    Google Scholar 

  39. Velez S, McCarthy T, Spaeth A. Physical Activity and Pain During Pregnancy. Aresty Rutgers Undergrad Res J. 2024;1(5). https://doi.org/10.14713/arestyrurj.v1i5.223.

  40. Tavakoly Sany SB, Vahedian Shahroodi M, Hosseini Khaboshan Z, Orooji A, Esmaeily H, Jafari A, et al. Predictors of physical activity among women in Bojnourd, north east of Iran: Pender’s health promotion model. Archives Public Health. 2021;79:1–12.

    Google Scholar 

  41. Grenier LN, Atkinson SA, Mottola MF, Wahoush O, Thabane L, Xie F, et al. Be healthy in pregnancy: exploring factors that impact pregnant women’s nutrition and exercise behaviours. Matern Child Nutr. 2021;17(1):e13068.

    Google Scholar 

  42. Lee A, Newton M, Radcliffe J, Belski R. Pregnancy nutrition knowledge and experiences of pregnant women and antenatal care clinicians: A mixed methods approach. Women Birth. 2018;31(4):269–77.

    Google Scholar 

  43. Xiang M, Zhang J, Liang H, Zhang Z, Konishi M, Hu H, et al. Physical activity and dietary intake among Chinese pregnant women: an observational study. BMC Pregnancy Childbirth. 2019;19:1–8.

    Google Scholar 

  44. Santo EC, Forbes PW, Oken E, Belfort MB. Determinants of physical activity frequency and provider advice during pregnancy. BMC Pregnancy Childbirth. 2017;17:1–11.

    Google Scholar 

  45. Coll CV, Domingues MR, Gonçalves H, Bertoldi AD. Perceived barriers to leisure-time physical activity during pregnancy: A literature review of quantitative and qualitative evidence. J Sci Med sport. 2017;20(1):17–25.

    Google Scholar 

  46. Mottola MF, Campbell MK. Activity patterns during pregnancy. Can J Appl Physiol. 2003;28(4):642–53.

    Google Scholar 

  47. Evenson KR, Savitz A, Huston SL. Leisure-time physical activity among pregnant women in the US. Paediatr Perinat Epidemiol. 2004;18(6):400–7.

    Google Scholar 

  48. Mendinueta A, Esnal H, Arrieta H, Arrue M, Urbieta N, Ubillos I, et al. What accounts for physical activity during pregnancy? A study on the sociodemographic predictors of self-reported and objectively assessed physical activity during the 1st and 2nd trimesters of pregnancy. Int J Environ Res Public Health. 2020;17(7):2517.

    Google Scholar 

  49. Szubert M, Ilowiecka M, Wilczynski J, Bilinski P, Wojtyla C. Health-related behaviors of pregnant women residing in urban and rural areas in Poland. Int J Environ Res Public Health. 2020;17(12):4395.

    Google Scholar 

  50. Naeeni MR, Simbar M. Effect of child birth preparation classes on empowering Iranian pregnant women: a systematic review. J Educ Community Health. 2018;5(1):61–71.

    Google Scholar 

  51. Malekpour AF, Salari P, Azar PH, Ismaeili H. Evaluation of the, effect of the education module preparing for childbirth on the level of anxiety during pregnancy and labor in primigravida women. 2005.

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Acknowledgements

The authors would like to thank the Shahid Yahyanejad Clinical Research Development Center and all the pregnant women who participated in the study.

Funding

This study was financially supported by Babol University of Medical Sciences. Grant Number: 724134896.

Author information

Authors and Affiliations

  1. Student Research Committee, Babol University of Medical Sciences, I.R, Babol, Iran

    Romina Fili & Sana Nazmi

  2. Clinical Research Development Unit of Shahid Yahyanezhad Hospital, Babol University of Medical Sciences, Babol, I.R. of Iran

    Fereshteh Behmanesh

  3. Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R., Iran

    Hossein-Ali Nikbakht

  4. Faculty of Health Sciences and Wellbeing, School of Nursing and Health Sciences, University of Sunderland in London, London, United Kingdom

    Atefeh Omrani

  5. Nursing and Midwifery Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, I.R., Iran

    Leila Amiri Farahani

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Contributions

F.B. & R.F. Conceptualization, Methodology, Software. HA.N. Validity tests, Data curation, R.F. & F.B. Writing- Original draft preparation. F.B. Supervision, Visualization, Investigation. R.F., F.B., A.O., L.A.F., S.N., & HA.N. Writing- Reviewing and Editing.

Corresponding author

Correspondence to Fereshteh Behmanesh.

Ethics declarations

Ethics approval and consent to participate

The present cross-sectional study was part of a mixed-methods research project approved by the Ethics Committee of Babol University of Medical Sciences (IR.MUBABOL.HRI.REC.1401.238). Participation was voluntary, and only women who provided informed written consent completed the questionnaires. Participants were assured that their choice not to participate or to withdraw from the study would not affect the quality of their prenatal care. Additionally, confidentiality and the privacy of the participants were strictly upheld. Research conducted in accordance with the Helsinki Declaration.

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Not applicable.

Competing interests

The authors declare no competing interests.

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Supplementary Material 1. (download DOCX )

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Fili, R., Behmanesh, F., Omrani, A. et al. Barriers to physical activity in pregnant women: a cross-sectional study. BMC Pregnancy Childbirth (2026). https://doi.org/10.1186/s12884-026-09034-z

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  • Received: 30 January 2025

  • Accepted: 30 March 2026

  • Published: 06 April 2026

  • DOI: https://doi.org/10.1186/s12884-026-09034-z

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Keywords

  • Physical activity
  • Barriers
  • Pregnant women
  • Pregnancy
  • Cross-Sectional Studies
  • Women

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  1. Romina Fili View author profile

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