The U.S. Surgeon General’s recent initiatives, such as the Call to Action and Let’s Move, underscore the importance of increasing physical activity (PA) and advocate for walking as an accessible and effective means to enhance overall PA. Walking is particularly beneficial for individuals who lead sedentary lifestyles and for pregnant women, offering significant health advantages. For pregnant women, regular walking can help mitigate risks such as gestational diabetes and preeclampsia, contribute to maintaining a healthy birth weight, and reduce postpartum weight retention.
Walking during pregnancy presents several notable benefits. It helps lower the risk of gestational diabetes mellitus (GDM), a condition characterized by high blood sugar during pregnancy, and preeclampsia, which involves high blood pressure and potential organ damage. Additionally, walking supports weight management during pregnancy and can reduce the amount of weight retained after childbirth. For fetal health, walking may assist in maintaining a healthy birth weight and potentially decrease the likelihood of preterm birth, although evidence on the latter is not fully conclusive.
Despite these advantages, there are multiple barriers to walking during pregnancy. Physical barriers include fatigue, discomfort, and nausea, which can make regular walking challenging. Environmental and lifestyle factors, such as time constraints, childcare responsibilities, and adverse weather conditions, can further hinder walking. Psychosocial barriers, including the need for social support and concerns about the safety and acceptability of walking, also play a role in limiting participation.
Interventions aimed at increasing walking during pregnancy have had varied success. Many existing programs focus broadly on increasing physical activity rather than specifically encouraging walking. Some interventions have effectively increased walking by approximately 30 minutes or 4000 steps per day, while others have not achieved significant results. The effectiveness of these programs can vary due to differences in study methods and intervention designs. Home-based programs are cost-effective but often face higher dropout rates due to a lack of supervision. In contrast, supervised programs, though more resource-intensive, tend to have lower dropout rates and better participant retention.
Behavior-change strategies, such as goal setting, self-monitoring, and problem-solving, are effective components of successful interventions. However, many current programs do not incorporate these strategies and rely on less effective methods like simple feedback and education. Additionally, measuring walking behavior poses challenges. Questionnaires, while cost-effective, can suffer from recall bias and inaccuracy. Activity monitors, such as pedometers and accelerometers, can also be variable in their accuracy, especially as pregnancy progresses and body changes affect device placement.
Currently, although general walking programs are available, there is a noticeable lack of public health initiatives specifically designed for pregnant women. Existing programs often do not address the unique challenges faced by this population. There is a clear need for dedicated programs that target walking during pregnancy, supported by thorough evaluations to identify best practices and guide effective implementation.
In conclusion, walking is an ideal form of physical activity for pregnant women due to its numerous health benefits and minimal barriers compared to other types of exercise. However, to fully harness these benefits, there is a need for more targeted interventions, improved measurement tools, and better evaluation of existing programs. Such efforts will help maximize the positive impact of walking on maternal and fetal health.
