Despite the immense benefits provided by physical activity, it has been grossly underutilised by pregnant women due to various barriers encountered and the failure to prioritise physical activity in maternal health services in several countries, including Nigeria. Hence, pregnancy physical activity has remained persistently low in Nigeria as most pregnant women prefer rest over activity. Notably, Adeniyi et al. and Adeoye within the same study setting, reported that none of the pregnant study participants met the WHO recommendation of 150 min of moderate-intensity physical activity per week in Nigeria [29, 30]. Unfortunately, the barriers towards pregnancy physical activity have been sparsely investigated except in a few countries—South Africa [33], Nigeria [31], and Iran [16]. In this current study, we assessed the attitude, perceptions, and barriers against physical activity among pregnant women in Ibadan, Nigeria and the associated factors, using the social-ecological framework, which examined interpersonal, non-pregnancy related intrapersonal, interpersonal, environmental, organisational and political barriers in a mixed method study.

Essentially, our respondents had a positive attitude towards physical activity, as a significant proportion reported that pregnancy physical activity (PPA) is safe and beneficial because it improves sleep and general health, decreases birth complications, and improves mental health. A positive attitude toward PPA has been supported by other studies [35, 36]. Conversely, other researchers described a negative attitude toward PPA [37,38,39]. This variation may result from participants' level of awareness, education and health literacy, and differences in social and environmental contexts. Optimistic attitudes to PPA can be improved by access to accurate information and education from healthcare providers, prenatal classes, and increased awareness of the benefits of PPA through social marketing and behavioural change communication. In this study, the important  sources of information on physical activity were antenatal clinic education, health professionals, family, friends, media, television, and radio. Moreover, healthcare professionals should be trained to provide and support PPA, ensure a positive attitude and address fears and misconceptions.

Notably, based on the socioecological framework, we investigated the barriers to PPA using BPAPS and its subscales. We found a high overall barrier score (85.35 ± 22.82). Similar to the barrier score reported among Iranian pregnant women (88.55 ± 19.28) [16]. Specifically, intrapersonal barriers to physical activity (34.46 ± 8.79), including lack of energy and tiredness, drowsiness, pains, and shortness of breath, were the most significant barriers reported by our study participants. The intrapersonal barriers were also supported by our qualitative findings, where participants reported tiredness, body pain (back pain, leg pain), dizziness, morning sickness, and laziness as common barriers. Other studies have also reported high levels of intrapersonal barriers, including—fear of pregnancy complications, the feeling of drowsiness, pains, nausea and vomiting, heaviness, or swelling, and pregnancy is a time to rest [16, 24, 27]. Even though pregnant women have challenges to PPA due to the anatomical and physiological changes that occur during pregnancy—increased lumbar lordosis and gestational weight gain, we found that women could not engage in PA because of perceived misconceptions such as pregnancy was a time to rest and not for PA [9, 40, 41]. Pregnant women can start their exercise routine tailored to their health and fitness levels [3, 42]. Hence, healthcare professionals should examine pregnant women to personalise their physical needs and provide tailored programs to make PPA more effective.

The qualitative findings corroborate the intrapersonal reports from our quantitative results, which was the predominant type of barrier experienced by our respondents [43, 44]. Our study participants reported back pain, body pain, weakness, tiredness, vomiting, morning sickness, and fear of safety as the predominant barriers to physical activity. As quoted: “I feel back pain, my leg will be weak, body pain” “Tiredness, back pain, vomiting, spitting" "Body pain” “Morning sickness was a major barrier earlier, now it's mostly fear of safety for me and my baby.” Other studies have reported maternal ill health or co-morbid conditions in pregnancy, financial challenges, mood and depression, having wrong advisers and some cultural beliefs as influencing their participation in physical activity [31]. Our respondents also shared some of their experiences with physical activity. As quoted, “Sometimes it seems I want to deliver the baby , because the baby seems to come down and  I will have strength”, “I used to feel tired, very tired”, and “I feel lighter and relaxed with no pain at all.’ “Physical activity tends to drain me easily and cause dizziness”. Consequently, developing tailored pregnancy-specific exercise classes can help increase the level of physical activity among pregnant [45].

We also examined non-pregnancy-related intrapersonal barriers, which included the notion that physical activity is hard work, lack of patience to do physical activity and lack of confidence in my physical ability. In contrast, previous studies reported a lack of a regular schedule in life, insufficient time, and a lack of motivation [16, 24]. This variation could be due to differences in the study population/geographical region or societal norms and views. Increasing self-efficacy, providing support and guidance, and promoting a change of mindset towards prioritising physical activity and having workable exercise routines are strategies for addressing these barriers.

The interpersonal barriers, the least of the obstacles (11.67 ± 4.25) among our study participants, were lack of partner support and encouragement, lack of advice from health workers on safety and the benefits of physical activity, lack of access to complete information, and societal views. Other studies have reported a lack of knowledge, conflicting advice, prohibition from friends and family to limit participation in physical activity, feelings of exclusion at fitness facilities, and absence of social norms promoting physical activity [16, 26, 33, 46]. Therefore, facilitating social support networks in maternal care, emphasising male involvement, group exercise classes, health communication of maternal lifestyle, especially physical activity partners, providing culture sensitive and specific PA advice involving family members or friends in physical activity programs to promote accountability and encouragement can increase pregnant women engagement in physical activity. The FGD participants also stated that having spousal and family support and access to information can provide massive motivation as quoted: “Support motivates me to do it more”, “Yes, support from my husband motivates me”, “Yes, having some encouragement and guidance helps motivate me.” This aligns with the study by Shum et al. 2022 [44], which found that support systems and informational support influenced women’s physical activity behaviour during pregnancy.

The critical environmental factors that prevent pregnant women from maintaining an active lifestyle include weather conditions, air pollution, transportation options, safety concerns, financial constraints, proximity to facilities and lack of adequate facilities for physical activity. Furthermore, participants reported “unfavourable weather (too cold/hot),” “access to a suitable vehicle for transportation,” and “no specific physical activity programs designed for pregnant women” as the most significant barriers to engaging in physical activity. Notably, outdoor exercise may be challenging during the rainy season. This finding is consistent with other studies.[16, 27, 43]. Physical, organisational and policy environments (geographical terrain, access to recreational facilities) fostered low physical activity levels among pregnant women in the USA [47]. Therefore, improved access to safe and convenient physical activity facilities or resources (e.g., parks, walking trails, gyms) and policies promoting active transportation (e.g., walkable neighbourhoods and bike lanes) can encourage pregnant women to be more active [33].

We found that the factors associated with the barriers to PPA were maternal education, religion, antenatal admission, pregnancy complaints, a lack of physical activity advice, and prenatal physical activity. However, only maternal education, antenatal admission and prenatal physical activity remained significant after controlling for confounders. High maternal education level, i.e. secondary education (adjusted β coeff.: − 15.26) and tertiary education (adjusted β coeff.: − 20.06), had significantly lower total barrier scores than those with primary education. Other researchers corroborate this [46]. Therefore, interventions focusing on targeted education programs for women with lower educational attainment can further improve their level of awareness. In contrast, there was no statistically significant relationship between education and PPA among Portuguese women [48].

We also found that women who had antenatal admission had an increase in physical activity barrier score (adjusted β coeff.: 12.20). This aligns with other studies, which had reported that women with pregnancy complications or high-risk conditions were more likely to perceive physical activity as risky and face increased barriers [14, 47]. Therefore, precise exercise prescription is needed to tailor physical activity interventions for high-risk pregnancies. Notably, respondents who engaged in pre-pregnancy physical activity had significantly lower total barrier scores (adjusted β coeff.: − 12.27) than those who did not. Previous studies have shown that women who were physically active before pregnancy reported fewer barriers to physical activity during pregnancy [46, 47]. This indicates the importance of physical activity among women of reproductive age as part of pre-conceptual care [23].

Walking was the predominant form of pre-pregnancy physical activity among our study participants. Walking is a low-impact and low-intensity physical activity. It is versatile as it can be adapted to diverse environments and has various health benefits, which include improved posture and balance, cardiovascular fitness, improved sleep and weight management, reduced risk of gestational diabetes and so on [49]. Studies have shown that women who walk regularly during pregnancy may have a lower risk of cesarean delivery and other complications [50].

This research identifies the barriers, attitudes and perceptions of PPA and the associated factors, and it is also an essential contribution to maternal health services, policies, and programmes in Nigeria. It provides substantial evidence for maternal healthcare professionals, public health programmes, and policymakers to promote a healthy maternal lifestyle starting from the antenatal period. Hence, the following recommendations are provided: Perinatal care providers should educate and reassure pregnant women about the benefits and safety of physical activity during pregnancy. They should also provide guidance on proper exercise techniques, ensure compliance and address their concerns. However, maternal health providers may lack the required skills for promoting and implementing PPA; hence, there is a need for further research on the gaps in the health workers' knowledge and competency on PPA for re-orientation and training. It is also crucial to foster collaboration with other healthcare workers, especially physiotherapists, exercise physiologists, health education experts and social workers. Maternal health care providers should be re-oriented and trained on PPA prescription and support through behavioural change communication on physical activity during antenatal visits. Adequate spousal, family and workplace support for pregnant women is also necessary.

This study's strength lies in using a mixed method (sequential explanatory method), which has given a better insight into pregnancy physical activity barriers in Nigeria. We used a standardised tool (Barriers to Physical Activity during Pregnancy Scale) to measure the barriers quantitatively based on socioecological theory. The study was conducted in three local government areas (LGAs) across the three tiers of healthcare and primary, secondary, and tertiary healthcare facilities to increase the generalisability of our findings. However, the study still has its limitations. Firstly, the cross-sectional nature of the study precludes causal inferences. It is also difficult to rule out the influence of social desirability bias and recall bias because of the self-reported responses to the questions. Hence, there may have been misclassification bias due to overestimating or underestimating the estimates. However, the qualitative findings corroborated the quantitative aspects. Also, the sample only represents women attending ANC in urban areas; hence, we should carefully extrapolate the findings to the larger community or rural areas.