CHAPTER ONE
INTRODUCTION
Background of the study
Universally, and in contemporary societies like Nigeria pregnancy being an important phase in the life of women has been found from previous studies to be a risk factor associated with decreased physical activity. Nevertheless, women also wish to be physically active during pregnancy as it is expected of every healthy pregnant women to do 30 minutes or more of light or moderate physical activities or exercise on most days of the week if it is impossible to do it in all days of the week (American College of Obstetricians and Gynecologists (ACOG), 2012). This also shows that pregnant mothers need exercises because of its importance to increased blood circulation in the body system of a pregnant mother. Physical activity and exercise are important components of a healthy lifestyle. According to the World Confederation for Physical Therapy (WCPT, 2011) exercise in pregnancy enables pregnant women to develop, maintain and restore maximum movement and functional ability throughout their pregnancy. Exercise is defined as a planned, structured, and repetitive subset of physical activity that improves or maintains physical fitness, overall health or well-being as an intended intermediate or final objective (WCPT, 2011). Exercise during pregnancy is associated with reduced back pain improved sleep and improved health perception as shown by results from few randomized controlled trials which examined the efficacy and safety of exercise during pregnancy. Historically, pregnancy was regarded as a state of confinement. More recently, however, results from researches demonstrated many potential health benefits of aerobic and strength-conditioning exercise in pregnancy and the postpartum period. It is now considered safe, and even advisable, for otherwise healthy pregnant women to initiate or continue an active lifestyle during pregnancy. Lack of exercise during pregnancy might result in loss of muscular and cardiovascular fitness, excessive maternal weight gain with a raised risk of GDM, varicose veins, dyspnea, lower-back pain and poor psychological adjustment. Previous studies have reported that exercise during the second half of pregnancy could reduce the severity of lower back pain. A study was carried out to evaluate a population of pregnant women and results suggest that the practice of water-based physical activity is beneficial to pregnant women, although it was not associated with any increase in quality of life. Although exercise programs during pregnancy after childbirth is designed to minimize impairment and helps the woman maintain or regain function while she is preparing for the arrival of the baby and then caring for the infant, it is submitted that pregnant women are not meeting the exercise recommendations of previous studies (De-Barros, Lopes, Francisco, Sapienza & Zugaib, 2010). This is linked to numerous factors such as the beliefs and attitudes of pregnant women with respect to exercise in pregnancy, level of knowledge, level of education, safety concern of the pregnant woman especially a precious pregnanacy and her physician, race/ethnicity, and previous involvement in regular exercise (Mbada, Adebayo, Adeyemi, Arije & Dada, 2014). Studies have also shown that pregnant women’s perception and attitude towards exercise in pregnancy was influenced mostly by tiredness, lack of feeling to exercise, and insufficient information on exercise. Similar findings have been reported by other authors (Cioffi, Schmied, Dahlen, Mills& Thornton, 2014). Furthermore, knowledge about benefit and contraindication to antenatal exercise significantly influences the perception and attitude of the women towards exercise in pregnancy. There is ample and consistent evidence that physical activity and exercises in women of reproductive age may be a promising approach for the prevention of excessive weight gain, gestational diabetes mellitus and subsequent complication suffered by children born from pregnancies (Ferraro, Rutherford, Keely, Dubois & Adamo, 2015). This finding of previous studies revealed that there is significant association between adequate knowledge of antenatal exercises and perceived benefits of exercise during pregnancy among women of reproductive age (Abedzadeh, Saberi & Sadat, 2015). Since pregnancy is an ideal time for behaviour modification and for adopting a healthy lifestyle because of increased motivation and frequent access to medical supervision. Patients are more likely to control weight, increase physical activity, and improve their diet physician recommends that they do so. Therefore, motivation counseling tools have been used successfully for diet and exercise counseling. Therefore, pregnancy is a good time to develop healthy lifestyle habits including regular exercise and good nutrition.