Knowledge, Attitude, and Practices Regarding Exercise During and After Pregnancy Among Women Aged 18-49 in Kulhudhffushi city: A Cross-sectional Study

Exercise during and after pregnancy is widely recognized as beneficial for maternal and fetal health, yet little is known about women’s knowledge, attitudes, and practices in the Maldivian context. This study aimed to assess knowledge, attitudes, and practices related to exercise during and after pregnancy among women of reproductive age (18-49) in Kulhudhuffushi City, and to examine the influence of demographic factors. A descriptive cross-sectional survey was conducted from July to August 2025 using a validated, structured questionnaire administered through face-to-face interviews. A total of 353 women participated, selected through simple random sampling. Knowledge and attitude were assessed among all participants, whereas practice-related items were evaluated only among women who had experienced pregnancy. The findings showed that 68.2% reported engaging in antenatal exercise, most commonly walking, while participation declined to 49% in the postpartum period. The mean knowledge score was 20.3 (SD = 5.43) out of 37, with less than half of participants demonstrating adequate knowledge. The mean attitude score was 9.34 (SD = 2.09) out of 14, with generally positive perceptions. However, many participants reported never receiving appropriate guidance on safe exercise during pregnancy. Motivators for antenatal exercise included preparing for normal delivery, reducing risks, and maintaining activity, while postpartum motivations centered on weight loss, regaining strength, and improving mental health. Reported barriers included fatigue, childcare responsibilities, lack of support, and limited awareness about safety. Inferential analysis using the Kruskal-Wallis test revealed no statistically significant differences in knowledge or attitude scores across marital status, literacy levels, number of children, or delivery type. These findings highlight important gaps in awareness and practice, underscoring the need for targeted educational strategies and stronger professional guidance to promote safe maternal exercise in the Maldives.