Objective: To gain insight into how low-income, pregnant African-American women viewed physical activity and how they approached nutrition during pregnancy. 

Design: Descriptive study using three focus groups

Setting:  Women were recruited from urban prenatal care sites and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) services in a medium-sized urban Northeastern city.

Patients/Participants: Twenty-six adult, low-income, pregnant African-American women, aged 18-39 years old, the majority of them within the first 20 weeks of pregnancy.

Methods: Three focus groups were conducted utilizing open-ended questions related to physical activity and dietary practices during pregnancy. Content analysis was used to analyze the verbatim transcripts. Analysis focused on meaning, intention and context. Groups were compared and contrasted at the within and between group levels to identify themes.

Results: Two themes were identified that provided insight into how women viewed physical activity during pregnancy: (a) fatigue and low energy dictate activity, and (b) motivation to exercise is not there. Three themes were identified that related to diet: (a) despite best intentions appetite, taste, and cravings drive eating behavior, (b) I’ll decide for myself what to eat, and (c) eating out is a way of life.

Conclusion/Implications for nursing practice: Women reported that being physically active and improving their diets was not easy. Most women indicated they had decreased their physical activity since becoming pregnant and those inactive before pregnancy did not plan to become active. Attempts at improving diets were undermined by frequenting fast food restaurants and cravings for highly dense, palatable foods. Women ceded to the physical aspects of pregnancy, often choosing to ignore the advice of others. A combination of low levels of physical activity and calorie dense diets increased the risk of excessive gestational weight gain in this sample of women, consequently increasing the risk for weight retention after pregnancy. Nurse need to be creative when promoting physical activity and healthy diets during pregnancy. Building on the idea of listening to their bodies, nurses can promote listening to other aspects of their bodies by encouraging healthy foods and activities women enjoy on good days. Nurses can query women about beliefs regarding physical activity and diet and offer information to ensure understanding of what contributes to healthy pregnancy outcomes. Intervention can focus on factors such as cravings and what tastes good, suggesting ways to manage these pregnancy effects within a healthy diet.

Keywords: Pregnancy, diet, physical activity