eMpower: Recommendations for Physical Activity by Midwives During and After Pregnancy

Abstract

Background: Considering cardiovascular diseases being the leading cause of death in Europe and the global rise in diabetes the role of physical activity (PA) during and after pregnancy is of particular importance, pregnant and postpartum women can derive advantages by maintaining or adapting their activity levels, aligning with established guidelines. Midwives have a central role in promoting PA during and after pregnancy. Midwives promote PA during and after pregnancy in alignment with current guidelines, showing women the advantages of maintaining or adapting their activity levels. Objective: Aim of the study was to investigate the knowledge, recommendations according to WHO guidelines, attitudes, and personal practices of midwives regarding PA during and after pregnancy. Besides, it aims to contribute valuable insights for enhancing PA promotion within maternal care. Methods: The "eMpower" project administered an online questionnaire to midwives in the German-speaking region. A tool from the university of Alberta was translated and underwent rigorous adaptation for the survey. data collection spanned May to August 2023, utilizing QR codes, flyers, emails, and social media for distribution. Descriptive and group analyses involved 360 midwives, using IBM SPSS Statistics, with statistical significance set at p < 0.05. Results: Midwives' knowledge of guidelines was limited, with only 16% aware of pregnancyrelated guidelines. They were more likely to know guidelines on PA during pregnancy, when their PA met the recommendations for frequency (29,3% resp. 13,1%; p=0,002) and for duration (18,7% resp. 8,4%; p=0,028) according to the WHO guideline Recommendations often fell short of WHO guidelines. Midwives with previous work-related experiences of PA (1,73±0,724; p=0,009) were more likely to provide appropriate recommendations on PA during pregnancy. In contrast more than 20 years of professional practice correlated to a higher number of midwives correct recommendations on PA in the postpartum period (1,51±0,611; p=0,030). Midwives that worked as freelance (1,48±0,609; p=0,035) were more likely to give more correct recommendations on PA after pregnancy. Discussion: The study identified potential influences on midwives' recommendations, including personal PA and work-related characteristics. It emphasized the need for intervention, educational and occupational policy level. Limitations include potential biases and the exploratory design's generalizability constraints. Conclusion: Strategies such as professional training, educational programs, and occupational health initiatives should be implemented to support midwives’ development of competencies on providing appropriate information and advice on PA for pregnant and postpartum women. Future efforts should focus on developing national guidelines and research on identifying facilitators and barriers specific to German midwives promoting PA during and after pregnancy.