Proactive pelvic floor health behaviors during pregnancy: a qualitative study based on the integrated theory of health behavior change

Background Pelvic floor health management during pregnancy is essential for postpartum recovery, yet the factors shaping women’s proactive engagement remain insufficiently understood. Objective To explore the cognitive, self-regulatory, and social determinants influencing pregnant women’s proactive engagement in pelvic floor health behaviors. Study design This was a theory-informed qualitative study. Twenty-one pregnant women were purposively sampled from a tertiary hospital in Shenzhen, China. Semi-structured interviews were conducted, and data were analyzed using a deductive framework based on the three core constructs of the Integrated Theory of Health Behavior Change (ITHBC). Inductive coding was used to refine predefined categories and identify context-specific experiences not fully captured by the framework. The study was reported in accordance with the COREQ guidelines to enhance reporting transparency. Result This was a theory-informed qualitative study. Twenty-one pregnant women were purposively sampled from a tertiary hospital in Shenzhen, China. Semi-structured interviews were conducted, and data were analyzed using a deductive framework based on the three core constructs of the ITHBC. Inductive coding was used to refine predefined categories and identify context-specific experiences not fully captured by the framework. The study was reported in accordance with the COREQ guidelines to enhance reporting transparency. Conclusion Proactive pelvic floor health behaviors during pregnancy are shaped by the interplay of cognitive, self-regulatory, and social factors. These findings may inform the future development and evaluation of tailored, theory-informed antenatal support. The effectiveness of specific digital tools, culturally adapted approaches, and feedback strategies requires further evaluation. These findings support the relevance of the ITHBC for understanding proactive pelvic floor health behaviors during pregnancy and provide context-specific insights for theory-informed antenatal health promotion. Trial registration not applicable.