Among the total study sample (n=19), 31.5%, 31.5% and 37% of pregnant women were in their first, second and third trimester, respectively (table 1). Qualitative findings are presented in this paper under two major sections: (1) pregnant women’s perceptions, attitudes on performing antenatal exercises and (2) pregnant women’s beliefs regarding exercises during pregnancy.

1. Pregnant mothers’ perceptions and attitudes on performing antenatal exercises

Based on pregnant mothers’ views, four principal themes and interrelated subthemes were elicited from the perceptions and attitudes on performing exercises during pregnancy (table 2).

Table 2

Themes and subthemes for pregnant mothers’ perceptions on performing antenatal exercises

The majority of participant mothers (11) broadly described the benefits of antenatal exercises, while others (8) presented its drawbacks and limitations. Basically, among the advantages which were stated by them, common eminent facts were only mentioned instead of explaining specific health-related benefits.

Help to maintain the health and well-being of mothers was the most commonly cited (10) view among them and screened as first subtheme.

As we know exercises are important to maintain our health, I think doing exercises in pregnancy also offers benefits to us, specially, it may help us to keep healthier pregnancy, and may help to ignore difficulties that arise during the period, also I heard in a TV program about this, they said that well-being in pregnancy can be ensured, if mothers can do some suitable exercises according to the number of weeks to get numerous advantages. (Woman no. 4, first trimester, Sinhala)

Number of mothers (9) concerned with Strengthening bones and muscles as a good outcome from exercises during pregnancy.

According to the way I think exercises give some strength to muscle and bones, then, it helps to make the capability of doing works with better weight-bearing, if we perform, can be active as pre-pregnancy, by gaining energy & feeling physical fitness to our bones & muscles. (Woman no. 10, second trimester, Sinhala)

Some expectant mothers (5) further explained that performing exercises in pregnancy helps for the reduction of stress and discomfort, so this was defined as the third subtheme under the main reflective view.

In my point of view, doing exercises could reduce difficulties, and worries in pregnancy, also it provides some relaxation in both of our body and mind, so it gives comfort & relief at this stressful condition. I think it is the major benefit. (Woman no. 19, third trimester, Sinhala, 23 years)

‘Provide flexibility and strength in normal labour process’ is derived as fourth subtheme out of five mothers’ concerns. As an example, one pregnant mother said that,

I think if we perform exercises in pregnancy period, it will make our body flexible, it will provide good strength and fitness, therefore, it will be very beneficial especially at the time of normal delivery, I heard, if we do exercise, without much struggling, baby will come out with no trouble, delivery duration will be reduced in the labor room. (Woman no. 7, second trimester, Tamil)

Some pregnant mothers (3) expressed that exercises are essential for being healthy. Through their views, exercises are essential for a healthy pregnancy is derived as the fifth subtheme.

I think we need to engage in exercises in pregnancy obligatory, we have to do some selected and appropriate exercises to get number of benefits, thereby managing and handling discomfort, stress and also deal with labor, therefore, it is necessary, I heard that, although we don’t do exercises, in abroad pregnant ladies do exercises, because, we are not advised or supported to engage in exercises in pregnancy period. Midwife Ms., or doctor usually, do not give any explanation about suitable exercises. (Woman no. 5, first trimester, Sinhala)

Some of them (5) identified exercises as useful for the growth and development of the fetus. So, it can be specified as another subtheme.

I have seen in a TV program, that performing some exercises in pregnancy period, it helps a lot to fetus to grow, they said that it is good for the development of organs and blood circulation, baby movements, kicks, mental growth such as. So, I think exercises are very beneficial. (Woman no. 11, second trimester, Burger)

According to the above specified views, ‘antenatal exercises are advantageous’ was drawn as the first main theme. Although participants realised the importance of exercises, insufficient knowledge was an apparent feature among the study sample. All the pregnant women did not have a clear, comprehensive understanding of the impact of exercises on a healthy pregnancy. Furthermore, none of the participants articulate the idea about the role of antenatal exercises in gestational weight gain, cardio-respiratory health and complicated pregnancy (Gestational DM, Pre-eclampsia).

Even if participants had optimistic insight and positive attitudes about exercises, they usually did not have a tendency to do exercises during their pregnancy period due to certain barriers. Yet, they have heard about the requirement of antenatal exercises through mass media, but they were not received proper direction from the antenatal clinic or health professionals.

While the majority of mothers clarified the advantages and necessity of PA, few women (3) had contrasting views and perceptions.

One woman expressed her ideas ‘I think doing exercises is not good at all, we should be very careful, if we do exercises with bending, stretching or expending more energy, it will badly influence to growing baby who is in the womb, sometimes may result in abortions also’ (Woman no. 14, third trimester, Sinhala) for example. Thus, exercises make adverse effects on fetus derived as the seventh subtheme.

Furthermore, ‘exercises are risky during pregnancy’ was revealed as another drawback and pointed out here as the eighth subtheme. For instance, one mother said,

Pregnancy is a risk condition, if we do exercise in this period, it will increase the risk furthermore … because, we don’t know what happens to us from exercises, also, this time is not suitable for test anything. (Woman no. 8, second trimester, Sinhala)

On their verbalisations, the second theme was constructed as exercises are not suitable during pregnancy.

When discussing preferences on antenatal exercises, some mothers elaborated about their insufficient enthusiasm to perform them during pregnancy due to several causes. Among mothers, six of them stated about fear where, fear to do exercises was elicited as the ninth subtheme based on their views. For example,

I am afraid of engage any exercise, because we don’t know how exercise influences to our body and especially for the baby, therefore, I don’t like to do things such. May be unsafe. (Woman no. 2, first trimester, Burger)

‘Feeling tiredness and discomfort with increased body weight’ was identified as the 10th subtheme based on mothers’ (4) explanation about physical difficulties that may prevent them from exercising.

Ah ms., I don’t like, because, I feel more tiredness after doing even small works. So, couldn’t do extra things with this weight & size of my body, it may be very difficult. (Woman no.17, third trimester, Sinhala)

‘No willingness to do’ was recognised as the 11th subtheme based on mothers’ (3) verbalisation about their loss of interest or eagerness. As an example,

Actually, I don’t feel like exercising, no thoughts about, with this situation, feeling no need of doing such things by expending energy. (Woman no. 11, second trimester, Burger).

Lack of motivation for engage in exercises is derived as the third theme through their perceptions of the above three subthemes.

As next subtheme exercises are appropriate only for healthy pregnant mothers was elicited based on mothers’ perceptions (5), one of them described as follows for example.

According to my point of view, exercises are good for healthy expectant mothers, it is not appropriate for mothers who present with high blood pressure, diabetes, and high cholesterol. (Woman no. 9, second trimester, Sinhala)

Exercise should be done under medical supervision was elicited as the last subtheme under this section according to two mothers’ opinions, for example,

I think if we do exercises, definitely should be done with counseling and supervision of VOG doctor, otherwise troubles will arise. In our clinic setting, no services like that. (Woman no. 1, first trimester, Sinhala)

Through the above two subthemes. It can be merged with the fourth main theme ‘Restrictions attached with antenatal exercises’.

So, it is obvious that a substantial percentage of participants endorsed misconceptions and conflicting views on antenatal exercises mainly due to knowledge deficit. Certain gaps in knowledge and societal myths could be detected through these observations. Analytically, it is clear that lack of proper guidance and support, inadequate information sources and not receiving appropriate stimulation by healthcare providers were frequently acknowledged as potential barriers to prevent them from exercise, while pregnancy-related discomfort is another specified significant issue.

2. Pregnant mothers’ beliefs regarding exercises during pregnancy

In the study sample, the majority of pregnant women (13) expressed their positive beliefs on antenatal exercises among some prominent misconceptions. Basically, nine themes were derived through their opinions and grouped into five categories as follows (table 3).

Table 3

Themes and categories for pregnant mothers’ beliefs regarding exercises during pregnancy

Positive beliefs on normal delivery

Through their verbalisations (8), it is identified that exercises provide assistance for normal labour process as a most prevalent belief among them and stated as the first theme. One woman said,

Our family belief regarding this is ‘PA & exercises give strength, power in a normal delivery with more flexibility. I also, believe that, I can face the normal delivery with adequate energy, strength and good mentality if I perform exercises”. (Woman no. 3, first trimester, Sinhala) for example.

Pregnant woman who does exercises can go for a normal labour was a prevalent belief among prenatal mothers (7) and identified as the second key theme. It was well noted by their verbalisations such as a mother said ‘A woman who does physical activities, works, and exercises can deliver a baby by normal labour process. Otherwise, they face caesarean section to deliver their baby’ (Woman no. 12, second trimester, Sinhala) for instance.

Positive beliefs on postpartum recovery

Facilitate for early postpartum recovery was elucidated as the third theme based on their views (8). As an example, one mother said ‘Actually, I believe that, if we do household work & exercises, we can come back to normal after labor rapidly, maybe a better help for difficulties such as back pain, leg pain, discomfort’ (Woman no. 10, second trimester, Sinhala).

The fourth major theme emerged as ‘Support for adaptation of normal day-to-day activities after delivery’ according to mothers’ explanations (5). One of them said,

Our family, that is to say, my mother, mother-in-law, and elder sister believe that, if we do household tasks on our own, especially do exercises during the pregnancy, we can adapt to living and baby care activities after delivery easily with better capability & strength. (Woman no. 18, third trimester, Sinhala).

Positive beliefs on newborn baby

‘Exercises help baby to be active’ was derived as the fifth main theme and presented below with an example according to six mothers’ verbalisations.

I think being physically active in this period, may help our baby to being active in the womb too. (Woman no. 6, first trimester, Sinhala)

If the mother perform exercises in pregnancy, the baby will adapt to the environment well after delivery was derived as the next theme based on mothers’ concerns (04) and presented below with an example.

Usually, there is a belief among us that, if we follow daily routines and exercises without laziness in the pregnancy period, then our baby may adapt to the environment well soon after delivery, they will suck well, easily familiarize to the usual setting without any trouble, I also like to do light exercises, but feels fear. If midwife supports and advises, then can-do exercises. (Woman no. 7, second trimester, Tamil).

Positive beliefs on benefits and exercise type

A number of pregnant mothers (7) also believed that ‘Exercises are useful for legs, hands and back’. Therefore, this theme was presented here as the seventh key theme and it can be well defined through their opinions such as ‘I think if we do exercises, need to choose activities, especially for legs, hands and back, to gain advantageous in this period, my belief is, doing exercises for these sites may reduce pain and discomfort. Further makes good strength and fitness’ (Woman no. 9, second trimester, Sinhala) for example.

They expressed their ideas on walking as a mostly practising exercise. On their speeches (11), walking is good exercise at the last stage of pregnancy was elicited as the next theme

Midwife ms & doctor usually advise to walk more in the last stages of pregnancy, we believe it facilitates normal labor and gives benefits to the body. (Woman no.19, third trimester, Sinhala)

Even though, participants relatively perceive constructive opinions on antenatal exercises, most of the presented facts were not grounded in their knowledge and acquired information. Antenatal exercise-related social interpretations, family beliefs and peer concerns appeared as influences which generate pregnant mothers’ perceptions and beliefs. Also, pregnant women express the necessity of midwives’ assistance and supervision to carry out exercises.

Negative beliefs and misconceptions on exercises

Some of women (3) strongly trust that exercises are not good in the first 3 months of pregnancy. So, this theme is identified as a ninth theme and it can be demonstrated by for instance, a woman said ‘We believe that exercises are not good at all in the first 3 months of gestation, because it may cause harm to the baby’ (Woman no. 15, third trimester, Sinhala).

Two expectant mothers verbalised that, no baby’s head turning/movements happen, if the mother does the same activity in the same position continuously. So, doing continuous exercises may negatively effects on fetal movements was recognised as the 10th theme which can be evidenced by a mother said ‘My mother always reminds me to prevent continuous activities in same position, because she believes that, if we do the same activity for a long time, spontaneous baby turning will not happen like that…’ (Woman no. 5, first trimester, Sinhala) for example.

Doing exercises at term may lead to premature labour was presented as the last theme and only based on one mother’s opinion. The part of that verbatim quote is mentioned below.

My mother-in-law believes that doing activities or exercises in last week’s cause pushing baby’s head down then, open labor passage early to due date leading to the labor process, therefore it may be a big problem for the baby specially. (Woman no. 13, third trimester Sinhala)

So, it is evident that numerous misconceptions and fallacies which exist among the study sample due to control or negative beliefs of their family and undesirable peers’ attitudes.