Understanding providers' beliefs, knowledge and practices of prenatal physical activity endorsement for the prevention and management of hypertensive disorders of pregnancy: a qualitative study.

BACKGROUND

Hypertensive disorders of pregnancy (HDP), including gestational hypertension and preeclampsia, increase risk of acute complications, later development of hypertension and coronary artery disease and maternal mortality. Prenatal physical activity (PPA) reduces the risk of HDP development. Obstetric care providers (OCPs) are crucial in advising patients on safe PPA. Despite the belief among OCPs in other developed countries that PPA is beneficial, few are familiar with endorsed guidelines or discuss PPA with their patients.

OBJECTIVES

This study aimed to explore what a subset of OCPs based in Southwestern Ontario believe, know and practice with respect to PPA and its endorsement for HDP prevention.

DESIGN

Virtual, qualitative interview-based study.

METHODS

Semi-structured virtual interviews were conducted with nurse practitioners (n = 2; 39.5 ± 4.9 (X ± SD) years of age) and midwives (n = 4; 39.5 ± 7.3 years of age) who were actively practising in Southwestern Ontario.

RESULTS

Four overarching themes were identified using reflexive thematic analysis: (1) Restricted Scope of PPA Practice for HDP, (2) PPA is Very Important for Health in and Beyond Pregnancy, (3) PPA is a Highly Individualized Patient Experience and (4) Lack of Training in PPA Among Providers. All participants strongly affirmed the benefits and importance of PPA in general, despite constraints imposed by referral protocols for those with HDP. This belief stemmed from experience, knowledge of Canadian PPA guidelines and evidence-based literature. PPA recommendations were individualized yet grounded in national guidelines. Participants identified a gap in PPA training and provided suggestions for improvement.

CONCLUSION

PPA participation may assist in the prevention or management of HDP and promote comprehensive wellbeing for patients. Further exploration of OCP recommendation and patient uptake of PPA for HDP within a Southwestern Ontarian context and beyond is warranted.