Negotiating activity and rest during pregnancy at risk of preterm birth: A qualitative study of parents’ experiences

Background : Preterm birth (PTB), defined as birth before 37 weeks, is estimated to affect >10 % of pregnancies worldwide. In Denmark, women with a short cervix (<15 mm) are often recommended to restrict physical activity to prevent preterm birth. It is uncertain how women and their partners balance rest and activity in daily life during a high-risk pregnancy in this situation. Aim: To explore how women at risk of PTB and their partners navigate decisions regarding activity and rest. Methods : Qualitative, semi-structured interviews with 13 women hospitalised for cervical shortening and risk of PTB and 9 partners. Data was analysed using reflexive thematic analysis. Results: Three main themes were developed. 1) Following the prescribed boundaries of “safe” activity describes how couples relied on healthcare professionals (HCPs) to define acceptable activity, thereby distributing responsibility for potential adverse outcomes. 2) “She was pregnant, but the baby was ours” describes how some partners left the decision-making to the pregnant women, either trusting her embodied judgment or downplaying their own concerns. Others intervened when they perceived her behaviour as “risky”. 3) Doing what felt right to me , illustrates how women adjusted activity in response to bodily sensations and negotiated between minimizing risk and maintaining self-care. However, for some, bodily sensations were difficult to interpret. Conclusion: When in risk of PTB, HCPs play a decisive role in women’s decision-making regarding activity levels. However, professional advice is actively managed and negotiated in the context of the woman’s relationship with her partner and her bodily sensations.