Determining The Recreational Health Practices By Pregnant Women In Selected Antenatal Clinics
Determining The Recreational Health Practices By Pregnant Women In Selected Antenatal Clinics
Chapter One
Introduction
1.1 Background to the Study
Pregnancy is the development of one or more offsprings, known as an embryo or fetus, in a woman’s uterus. This spans a period from fertilization of the female sex cell by the male sex cell to the birth of the offspring. This period is also called gestation period. The cells undergo rapid division and growth according to Jukic, Baird, Weinberg, McConnaughey and Wilcox (2003) such that in eight weeks it becomes stable and big enough to be called a fetus. The continous growth of this fetus results in physiological changes in the pregnant woman.
Shrock (2008) stated that during the childbearing period, from conception through postpartum recovery, a woman’s body undergoes extensive changes which fequently necessitate many adoptations. Physical and hormonal changes occur gradually throughout the nine months of pregnancy, and these are reversed in a matter of weeks during postpartum recovery. Skeletal tissue, muscle and connective tissues, blood volume, cardiac output, body weight and posture are affected. The effect it has can bring positive or negative impact on the unborn child and/or the mother.
Pregnant women are usually exposed to care during pregnancy. Such care is termed antenatal or prenatal care. Such care is usually given by trained personnel in hospitals, primary health centres or by traditional birth attendants. Ante – natal care is thus defined by World Health Organization (WHO) (2003) as the provision of special care for women during pregnancy through the public health service. Until the second half of the 20th century, pregnant women were only given maternity care during delivery. There used to be very high level of maternal and child mortality until care was given to pregnant women in the course of the pregnancy. This development was stimulated by the realization that maternal mortality due to puerperal sepsis, haemorrhage and obstructed labour had declined substantially during the early years of the 20th century (WHO, 2003). Today further understanding of obstetrics and gyneacology has improved upon services given to women in antenatal clinics. Good care during pregnancy is important for the health of the mother and the development of the unborn baby.
Pregnancy is a crucial time to promote healthy behaviour and parenting skills. Ante-natal care also provides women with appropriate information and advice for a healthy pregnancy, safe childbirth, and postnatal recovery, including care of the newborn, promotion of exclusive breastfeeding and assistance with deciding on future pregnancies in order to improve pregnancy outcomes. An effective ante-natal care package depends on competent health care providers in a functioning health system with referral services and adequate supplies of routine drugs and laboratory support. Different health practitioners have different packages for antenatal care. The new World Health Organization’s model of antenatal care separates pregnant women into two groups, those likely to need only routine ante-natal care and those with specific health conditions or risk factors that necessitate special care. For the first group, a standard programme of four antenatal visits is recommended with additional visits should conditions emerge which require special care. The World Health Organization (2003) guidelines are also specific as regards the timing and content of antenatal care visits according to gestational age. The guidelines stipulate that “only examinations and tests that serve an immediate purpose and that have been proven to be beneficial should be performed”. These examinations include measurement of blood pressure, testing of urine for presence of sugar and protein and blood test to detect anaemia. Routine weight and height measurement at each visit is considered. Some packages include the use of recreational activities like exercises and games for the pregnant women.
According to Hoeger and Hoger (2010) during pregnancy the body experiences dramatic physiological and psychological changes which is natural, inorder to remain healthy, the pregnant woman must indulge in regular physical activities called exercise. According to Hornby (2010), exercise is an activity requiring physical effort done to improve health, it is a physical or mental activity that is done to stay healthy or become stronger. Exercise session in antenatal clinic should be designed to stimulate interest in the physical changes occurring to promote body awareness and to facilitate physical and mental relaxation.
According, to Makinde, Adeyemo and Ogundele (2014), the professional health workers need to carefully design recreational and physical exercise programme to enable the pregnant woman remain healthy. Recreational health practices do wonders for the woman during pregnancy. It helps to prepare her for childbirth by strengthening her muscles and building endurance (Ministry of Health, Brazil 2001). Green (1993) also discussed about breathing and relaxation exercises that were widely used and were most successful for the relief of labour pain and to enhance better emotional wellbeing. The health of the mother and that of the fetus is improved when the mother performs some simple exercises during pregnancy. Exercise has been known scientifically and physically to promote blood circulation to the mother and the fetal vital organs such as the brain, liver and heart etc., exercise also improves pelvic bone and muscle tone thus enhancing normal safe delivery of the baby during labour (Dianne & Myles 2004). Shrock (2008) observed that as more pregnant women engage is demanding occupations, physical activities, and sports, the obstetrician and midwives who take care of them must become knowledgeable about the physical changes of pregnancy and the effects of exercise on the mother and fetus. Because prevention is the best approach to health care, understanding both the bodily stresses that may result from pregnancy changes and the means to prevent unnecessary problems enables health care to be instituted early in pregnancy and continued through the postpartum period. Therefore a properly organized antenatal care classes would have a physiotherapist or midwife teach pregnant women the rudiment of recreation during pregnancy, telling them the benefits derivable and the limits they should go. Such benefits include that recreational exercise improves blood circulation, strengthens the pelvic floor muscles and prevent backaches (Dianne & Myle 2004).
Recreational Health activities according to McLean, Hurd and Rogers (2005) are activities often done for enjoyment, amusement, or pleasure and which are considered to be of health benefit to the individual undergoing it. Recreation as defined by Boye (2009) is any form of free activity that an individual performs at his or her leisure hours. It could be done indoors or outdoors and it could be passive or active. Recreation can be done for mental, physical, emotional and social development, recreational health activities have been found to be of immense benefit to both the pregnant woman and the unborn child.
It is one aspect for the care givers to recommend the recreational practices and it is another for pregnant women to adhere to it. Adherence would depend on several factors of which an awareness of the benefits is one. A study carried out among pregnant women attending antenatal clinic by Sarfraz, Islami, Hammed, Hasan and Ahmad (2013) showed that 95.2% of the women agreed that physiotherapy has positive role in ante-natal care although only 30% were currently following the exercise programme. Where awareness is lower, adherence to the exercise would be very much lower.
Another very important aspect of recreational practices by pregnant women undergoing antenatal care clinics is that of monitoring. Makinde et al (2014) found that 294 (58.8%) of respondents in their study wanted prenatal exercise to be performed by the expert while 116 representing 23.3% of the total respondents did not prefer expert to perform exercise for them. This goes on to show that pregnant women are taught the need for recreational activities at antenatal clinics but few carry out the practices on their own. They prefer to be monitored or directed by specialists.
1.2 Statement of the Problem
Prenatal exercise is of benefit to every pregnant mother. Exercise can reduce the length of labour, shorten the recovery time and even help with post-partum weight management (Dianne and Margaret, 2004). The physiotherapists in the hospital always come to the clinic as early as possible but they usually meet only few pregnant mothers because they come late to the clinic for the exercise as they see little or no need for prenatal exercise. The purpose of this study is to study how pregnant mothers perceive usefulness of antenatal exercise as it is being performed in the antenatal clinics. There is need to find a way to change the perception of pregnant women about antenatal clinic through training, seminars and health talks on important of exercises in pregnancy and antenatal clinics.
1.3 Objective of the Study
The main objective of this study is to determine the recreational health practices of pregnant women in selected antenatal clinics in Etinan Local Government Area.
The specific objectives include the following:
- To examine the perceived benefits of exercise among pregnant women.
- To determine the perceived barriers to exercise among pregnant women.
- To make useful recommendations based on the findings of this study.
1.4 Research Questions
- What are the perceived benefits of exercise among pregnant women?
- What are the perceived barriers to exercise among pregnant women?
1.5 Research Hypotheses
Hypothesis 1
- H0: There are no perceived benefits of exercise among pregnant women.
- H1: There are perceived benefits of exercise among pregnant women.
Hypothesis 2
- H0: There are no perceived barriers to exercise among pregnant women.
- H1: There are perceived barriers to exercise among pregnant women.
1.6 Significance of the Study
Exercise during pregnancy has the following importance:
- Fast labour.
- Weight loss in obese pregnant women.
- Relief of fatigue, swelling and back pain.
Therefore, this study will help in educating pregnant women on the importance of exercise during pregnancy, which has great advantage on the their health.
1.7 Scope of the Study
The study focus on determining the recreational health practice of pregnant women in selected antenatal clinics in Etinan Local Government Area of Akwa Ibom State.
1.8 Limitation of the Study
There is no study undertaken by a researcher that is perfect. The imperfection of any research is always due to some factors negatively affecting a researcher in the course of carrying out research. Therefore, time constraint has shown no mercy to the research. The limited time has to be shared among many alternative uses, which includes reading, attending lectures and writing of this research, also distance and its attendant costs of travelling to obtain information which may enhance the writing of this study was a major limitation.
Chapter Five
Summary, Conclusion and Recommendations
5.1 Introduction
This chapter presents the summary, conclusion and recommendations for further studies.
5.2 Summary
The study was carried out to determining the recreational health practice of pregnant women in selected antenatal clinics in Etinan Local Government Area of Akwa Ibom State. It was discovered that:
Table 2 revealed that the mean value of 1.3667 is greater than the standard deviation value of 0.66868. It therefore implies that there are perceived benefits of exercise among pregnant women.
In table 3, it was found out that the mean value of 1.2667 is greater than the standard deviation value of 0.63968. It therefore implies that there are perceived barriers to exercise among pregnant women.
5.3 Conclusion
Based on the findings of this study and subsequent recommendations, it is concluded that although pregnant women in General Hospital Etinan, Nigeria generally have a high perception of the benefits of exercise during pregnancy, they also perceive significant barriers that inhibit their exercise practice. Efforts should be made to encourage pregnant women to get more involved in antenatal exercises to help reduce the barriers perceive—real or imagined. The probability that the pregnant women are likely to adopt one exercise is high when more exercises that are antenatal are available.
5.4 Recommendations
Based on the findings of this study, the researcher made the following recommendations:
- Pregnant women should be educated on the benefits of exercise beyond its usefulness for physical fitness but also its usefulness to mental and physiological wellbeing.
- Obstetric care providers should always discuss exercise with their patients and provide accurate, adequate and relevant information on exercise.
- Health care providers should be abreast with the latest recommendations on exercise as only then can they give appropriate exercise prescription.
- Efforts should be made to encourage women regardless of parity to exercise as women who routinely exercise are more likely to continue to do so even during pregnancy.
- Increased social support should be given to pregnant women to help them exercise. Thus, employers, parents, relatives and spouses of pregnant women should likewise be engaged through adequate and appropriate health education.
- Women should be educated on exercising at low moderate intensity as this will help avoid burn-out or exercise tiredness— a major barrier to antenatal exercises.
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