Exploring Social Influences on Antenatal Physical Activity:the Players of Influence, the Positions of Negotiation and the Sense-Making Experiences of Pregnant Women Navigating their Physical Activity Relationships and Identities

Abstract

Background: Despite antenatal physical activity conferring numerous health benefits on maternal and foetal wellbeing, physical activity uptake generally declines throughout pregnancy. While literature increasingly cites interpersonal factors as important, there remains a paucity of research exploring social influence specifically. The proceeding thesis addresses this gap, by drawing upon various qualitative methodologies to illuminate, conceptualise and articulate social influence within this specific context, formulating a theory-informed approach to the dual-question: what are pregnant women’s social experiences concerning their physical activity relationships and identities and how do they navigate them? Methods: Three studies were conducted. A systematic review and meta-synthesis of 50 qualitative studies, aimed to identify the individuals and social support types of potential influence on antenatal physical activity. A discursive psychology study examined how pregnant women navigate and account for their physical activity relationships and identities. A longitudinal interpretative phenomenological analysis approach explored pregnant women’s sense-making of social experience concerning their physical activity throughout pregnancy. Results: Study one identified 13 groups of individuals and six social support types as influential, including novel findings of the ‘proximity principle’, ‘Role’ and ‘Monitor/overseer’ support. Study two presents a discursive navigation model along a ‘proactive’ and ‘protective’ antenatal physical activity continuum, depicting ten subject-positions and 12 discourses available to pregnant women when accounting for their physical activity identity/relationship. Study three yielded socio-behavioural themes of social comparison, social selection and social contrivance, describing pregnant women’s sense-making of physical activity-related social experience over time. Conclusion: This thesis presents a diverse exploration of social influence on antenatal physical activity, generating novel findings unarticulated elsewhere. Recommendations include a hybrid digital-person-facing intervention incorporating social support, and equipping pregnant women with coping mechanisms to retain a sense of agency and autonomy. Thus, supporting pregnant women to establish a physical activity relationship/identity compatible with their transition to motherhood, while navigating the myriad of social experiences that ebb and flow throughout the tidal vicissitudes of pregnancy.