'It's just one step too far': Negotiating physical activity for perinatal mental health.

Background: Physical activity is recommended as a self-help strategy for some mild to moderate perinatal mental illnesses. Despite this, we know very little about how women remain active, or take up physical activity, in the context of changing family life and perinatal mental illness. We seek to explore: a) how women negotiate physical activity for their mental health during transitions into parenthood and the early years; and b) the experiences of women with perinatal mental illness in relation to physical activity.

Methods: An anonymous UK-wide qualitative online survey was used to better understand how physical activity may be used for perinatal mental health, barriers to activity and changes over time. 186 women with babies and children up to four years completed the survey. Reflexive thematic analysis was used to analyse the qualitative data and generate themes.

Results: Themes generated from this data were: 1) negotiating being active for perinatal mental health (the benefits and how these women remained active); 2) barriers to PA associated with mental illness (some women were active but still experienced general barriers to further PA, and there were several emotional barriers from mental illness); and 3) PA, guilt and the importance of valuing walking (guilt about not being active enough, guilt and feelings of failure exacerbated by questions about PA levels without support offered; regular walking not valued as PA exacerbating feelings of guilt).

Conclusions And Implications: This study provides new empirical data on the experiences of new mothers', physical activity and mental health with important implications for physical activity messaging and support for women during this time through maternity care. Individualised conversations are important and the value of walking and incidental activity from activities that mothers and families find enjoyable should be promoted.