Knowledge, Information Needs, Perceived Barriers, and Facilitators to Antenatal Exercise Among Primiparous Pregnant Women in Sri Lanka: A Qualitative Exploratory Study

Abstract Background Antenatal exercises are low-impact physical activities recommended during pregnancy to promote maternal and fetal health. However, participation in antenatal exercise remains below recommended levels in many countries. Women's engagement in antenatal exercise is influenced by multiple factors, including their knowledge, information sources, barriers, and available facilitators. Therefore, this study aimed to explore knowledge, information needs, perceived barriers, and facilitators related to antenatal exercise among primiparous pregnant women in Sri Lanka. Methods A qualitative exploratory study was conducted among 19 primiparous pregnant women attending antenatal clinics in a tertiary hospital, Sri Lanka. Participants were recruited using purposive sampling. Data was collected through in-depth one-to-one interviews using the pre-designed semi-structured interview guide. Collected data were transcribed, examined, organized and then analyzed by inductive thematic analysis. Findings were interpreted using the COM-B model to identify behavioral determinants of antenatal exercise participation. Results Three broad themes emerged as (1) knowledge and information needs regarding antenatal exercise, (2) perceived barriers to antenatal exercise, and (3) facilitators of antenatal exercise. Knowledge gaps were attributed to limited awareness, inadequate information sources, insufficient guidance, and lack of exposure to antenatal exercise education. Knowledge deficit was the prominent stated barrier to engage in exercises while family support and improved information sources were the commonly cited facilitators. The findings reflect limitations in psychological and physical capability, constraints in physical and social opportunity, and motivational influences affecting engagement in antenatal exercise based on COM-B model. Conclusion Primiparous pregnant women demonstrated positive views toward antenatal exercise but reported considerable knowledge gaps, information needs, and multiple barriers to participation. Strengthening health education, improving access to reliable information, enhancing professional guidance, and implementing structured antenatal exercise programs may facilitate engagement in physical activity and exercise during pregnancy.