Improving Physical and Mental Health in Mothers through Online and Community- Based Exercise. Research report Nov 2014

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Improving Physical and Mental Health in Mothers through Online and Community- Based Exercise Research report Nov 2014

Summary Online and community- based exercise can increase a mother s self- reported activity levels, and progress towards fitness goals. In turn, they achieve benefits to their physical and mental health including weight- loss and increased self- esteem. Mothers want exercise to fit with every- day life. They report that positive, specific goals can be very motivating. And accessible, credible advice is essential. The combination of an online training programme and community exercise groups can be a powerful enabler of sustained, effective exercise for mothers. Healthcare professionals can play a significant role in encouraging mothers to be physically active.

Introduction This research is part of an effort to inform medical professionals on safe, effective pre and postnatal exercise, to support them in their work with pregnant women and new mothers. The work was led by Katy Tuncer, mother- of- two and postnatal fitness expert, and supported by Ready Steady Mums. The Ready Steady Mums team supports and engages with mothers in communities around the UK and online. To complement survey- based research, they have provided practice- based insight on motivations, enablers and barriers to exercise for women in pregnancy and beyond.

What is at stake? Many women suffer low self- confidence and feel negative towards their bodies A third of mums never regain pre- pregnancy weight Juggling career and family can cause stress and inactivity Motivation is challenging with limited social life Stress and everyday pressure can lead to comfort eating Financial constraints can make self- care unaffordable 4

Approach 500 mothers have taken part in some of all of: A progressive online exercise programme from pregnancy exercises; to gentle physical activity to aid recovery from birth (pelvic- floor muscle training, conditioning of the transversus abdominus, postural correction); to more advanced postnatal exercises Informal weekly Socialcise sessions led by local mothers Website, blog and social media forums for motivation, setting and sharing goals, asking questions of experts Data sources: Survey of 100 mothers on attitudes and habits towards pre and postnatal exercise Consultation with medical professionals (in midwifery, health visiting, physiotherapy, gynaecology, general practice) Activity analysis of 200 unique users of the online exercise programme Interviews with 20 women who have participated in one of 50 Socialcise groups Comments via social media, email and phone by >500 mothers taking part in Ready Steady Mums programmes

Key Findings Mothers want to exercise and value the benefits However, most do not get enough physical activity and they perceive some big barriers to exercise Mothers want exercise to fit with every- day life Positive, specific goals can be very motivating Accessible, credible advice is essential Mothers can benefit from an online and community exercise programme

Mothers want to exercise and they value the benefits Which fitness goals motivate sustained exercise? % of new mums who found fitness goal extremely or very motivating Lose fat 81% Be toned 79% Be slim 68% Wear a bikini on holiday 54% Fit in a great dress 52% 91% found an appearance goal to be extremely or very motivating 95% found a health and wellbeing goal to be extremely or very motivating Look like a celebrity I admire Role- model a healthy lifestyle for my family 6% %73 Exercise makes me feel relaxed and energised, it s the only time I have for myself. Improve long- term health 73% I love setting an example to my kids. Improve my mental wellbeing Get a stronger core 68% 58% The best bit is the feeling afterwards of feeling well and released. Reduce physical pain 46% Make friends through exercise 31% Source: Ready Steady Mums Survey 2014 (100 mothers surveyed in September 2014, 82% with at least one child under 5)

Profile of a new mother who does recommended level of weekly physical activity 71% exercise with their kids 79% have set a fitness goal 88% like or love exercise to be part of their daily routine 96% exercise outdoors 75% exercise with friends Source: Ready Steady Mums Survey 2014 8

However, most mothers do not get enough exercise Mothers who meet the NHS recommendations for physical activity % Of mothers surveyed 29% met the recommended weekly exercise level for adults 71% 29% Moderate to vigorous physical activity (MVPA) Physical activity recommendation by the NHS for adults: at least 150 minutes of moderate or 75 minutes of vigorous intensity physical activity Source: Health Survey for England (HSE) 2012 Source: Ready Steady Mums Survey 2014

Mothers perceive some big barriers to exercise Which barriers stop you from exercising? % mothers who find barrier sometimes or always a major barrier Time Childcare 89 86 >50% of new mums identify time as always a major barrier to exercise Low motivation 49 I feels it s just too much to fit my kids, cleaning and sorting my house and working out. I'm just exhausted by the time they are in bed. Not sticking with my plan 32 I am too exhausted looking after 2 toddlers. When I am not with them (which is rare) I just want to put my feet up! Source: Ready Steady Mums Survey 2014

Mothers want exercise to fit with every- day life What do you do most often for exercise? # times activity mentioned Swimming 7% Mind- body fitness (yoga, pilates, etc.) 8% How do you prefer to exercise? # mums who like or love each form of exercise As part of day- to- day life e.g., walking With friends 76% 94% Outside 87% Walking 38% Others 15% In a formal exercise class 70% Exercise classes 17% Running 15% I want to exercise on my own terms. Getting outside for fresh air is good for me and my daughter. [I choose] running as it's free and I can fit it around my family. Pre- babies, I loved doing classes. Source: Ready Steady Mums Survey 2014

Positive, specific fitness goals can be very motivating Words most commonly used in mothers fitness goals 62% of new mums surveyed have ever set themselves a fitness goal I want to admit that my weight has gone up and do something about it. When I commit to exercise with a friend I know I ll actually show up. Source: Ready Steady Mums Survey 2014 (question A fitness goal is something you aim to achieve from doing exercise. Have you ever set yourself one? If so, what is your most recent fitness goal? )

Accessible, credible advice is essential Importance of each type of advice when considering pre and postnatal exercise % of mothers who considered each characteristic essential or very important Easy to find and access Clear and simple to understand Tailored to health needs Evidence based Tried and tested 62% 58% 58% 68% 83% I was a bit apprehensive about exercise, I needed safe and reliable guidance. The reassurance my midwife gave me about where to start and what was safe made me start and stick with [exercise]. Reassuring Medically supported 50% 46% Source: Ready Steady Mums Survey 2014

Mothers can benefit from an online and community- based exercise programme Top Reported Benefits (ranked by frequency of mention) of participation in the Ready Steady Mums programme 1. Weight- loss 2. Increased self- esteem 3. Social capital 4. Improved core muscle strength (continence and posture) 5. Leadership confidence 6. Calmness as a mother The programme changed my life, my best friends are the ones I met in my exercise group and I have transformed my health. We have made great new friends and so have our babies. I didn't know how I would be able to continue the outdoor activities that I loved so much after I became pregnant, but now I feel fitter than ever before, it has really helped me shape up to do exactly what I want to do and be a better mum. I thought I couldn't get my body back but I did, I am fitter now than I was before I got pregnant. I love how the programme is tailored for me. I wasn't that fit before, Ready Steady Mums got me going. I feel better as a woman and better as a mum. [It was really hard for me to find time to exercise at first. I started out doing 15 minutes at a time at home while Tom was sleeping. It made me feel so much better.] Source: Ready Steady Mums Survey 2014, interviews with programme participants

Medical professionals have a role to play in helping mothers exercise safely How can medical professionals help? Help mums set specific and positive goals Encourage goal sharing to increase commitment and motivation Recommend simple exercises for the early postnatal period: Pelvic floor muscle training; Posture correction; Breathing exercises; Balancing Reassure mothers that exercise does not reduce milk supply (although proper hydration is essential) Encourage new mums to set up social exercise groups together