Inadequate Observational Design

Target population was pregnant women less than fourteen weeks gestation that had a sedentary lifestyle. The researcher used two data collection instruments to complete this study. The first is The Cornell Protocol Fitness Tool that measured cardiovascular fitness level and peak oxygen consumption. The second data collection instrument used was The Minnesota Leisure Time Physical Activity Questionnaire assessed energy expenditure and daily physical activity. Candidates were excluded if they had chronic hypertension, gestational diabetes, and any medical condition that will prohibit daily exercise, communication problems, or recommendation of primary care provider not to participate (Yeo 2009).

The risks associated with obesity in pregnancy do not only surround physical issues it also affects effective care given to obese women using maternity services and the outcomes of their delivery. Schmied et al (2010) found a that obesity affects the appropriate care that obese women receive. The midwives documented difficulties palpating the abdomen of obese women and not being able to determine fetal position or auscultation of the fetal heart, in return making it hard to assess fetal well being. In agreeance Singleton and Furber (2013) suggest that a midwife’s role is to promote normality, but for high risk obese women in labour, it is increasingly difficult to do so. The study found that auscultation using a pinard stethoscope and sonicaid proved difficult in many cases for women with a BMI of over 30, therefore the use of a cardiotocography (CTG) was needed to monitor fetal well being. Slavin, Fenwick and Gamble (2013) found that the use of CTG in labour reduces mobility of

The exclusion criteria included BMI below 25%, those currently pregnant or nursing, a loss of ten pounds or more within the last month, and those with identified medical issues and unable to obtain medical approval. In addition, a delay of one allowed the subjects to obtain required medical clearance. Failing to acquire medical approval, eight women could not participate in this study. Four others had difficulties committing to the time. This dictated the sample size.

| The discussion refers often to the topic and with adequate evidence from the literature. There is appraisal of the literature(19-21)

Another important factor is doing daily activities as tolerated. Exercise in moderation, and incorporate stretching lower and upper extremities with rest period. Also monitor daily weight daily and notify physician if any critical change. The pregnant woman will be encouraged to practice deep breathing exercises and this can be used to minimize anxieties and promote energy. This will also prepare the pregnant woman for proper fitness and endurance during delivery and caring for the newborn. These regimens mentioned will minimizes fatigues both on the mother and the developing fetus.

While exercise may not be able to eliminate all of the discomfort associated with pregnancy, it can help with circulation, digestion, and constipation, as well as improve posture and muscle tone, which you will need to support joints that are loosened by various hormones as your body prepares for childbirth. Additionally, exercise can counteract the changes in body image and self-esteem that you possess. Most importantly, an appropriate exercise program can help prepare for the mental and physical demands of labor and delivery.

10. What are some of the limitations of this study that decrease the potential for generalizing the findings to the target population?

o Review of related literature: In what ways does the literature review support the need for this study?

studies (such as Bifulco, Cobb & Bell, 2009). As a result, the present study fills a

4. This study only contains one study, and the results they discover support the current literature about increasing

Elements of health promotion that focuses on the benefits of exercise would be the main educational points. The rationale for this topic was a result of noted limited time spent with patients in the office setting. This media piece can serve as reinforcement of the rationale related to regular exercise during pregnancy. The waiting area is very accommodating to this type of media and would allow for repeated playing in the waiting room.

This study was limited due to the small sample size. Although the conclusions are valid, more research with a

Based on this, the author acknowledges that the SR has adopted a narrow and more specific research question as

In light of the, fifth objective the researcher has made certain observations in the study and corresponding to the same following suggestions have been made to plug gaps and to overcome the abovementioned difficulties :

It has been shown through studies that exercising aids in strength, flexibility, muscle tone and endurance, all in which help in areas such as carrying extra weight, preparing for the physical stresses of labor and contributing in shedding the pounds postpartum (Gulino 2). Exercise also helps in relieving that excess weight gain, swelling, varicose veins, fatigue and leg cramps. It helps to prevent depression and establish confidence both before and after labor. Exercise lowers stress and improves emotional health. It has been shown through studies that women who exercise during pregnancy have shorter labors as well as a decreased need for painkillers and an epidural during labor and delivery (Hudson 1).