The Psychological Benefits of Exercise on Postnatal Women.

Brooke Allen, Eugenie Austin, Amelia Burton, & Victoria Morgan

For this study, 21 women between 3 weeks and 9 months post partum, completed the Maternal Attitudes and Maternal Adjustment (MAMA) Questionnaire to assist in answering of the question of whether exercise benefits the psychological well-being of postnatal women. Within the 21 women, there were 2 groups, non-exercisers (Group 1) and exercisers (Group 2). The results of this study found that there was significant difference in the mean values of exercisers and non-exercisers in the overall effect of exercise on the mental well-being, at P < 0.05 level of significance. Using Pearson’s Correlation analysis between and within the 5 sub-scales of the MAMA Questionnaire, there was a correlation between body image, somatic symptoms, marital relations, attitude to baby and attitude to sex at the P < 0.01 and P< 0.05 level of significance. It is recommended that there is further investigation into the psychological state and well being of postnatal women and the benefits of exercise.

Introduction

There has been an increase in the amount of research conducted on the topic of the beneficial effects associated with exercise, on both the general population and special populations across society. This study attempts to address the issue of whether exercise is beneficial for the psychological wellbeing of postnatal women.

The first three months after childbirth is a time of increased depression, anxiety, stress and mood changes. (Berger, 1998, 1996; Carlucci, Goldfine, Ward, Taylor and Rippe, 1991; Koltyn and Schultes, 1997 and Weyerer, 1997). Research in this area of study has been minimal and this has been thought to be due to the fact that Postnatal Depression lies in the centre of a continuum of psychological decrements associated with postnatal depression.

Previous studies that have been conducted have shown that aerobic exercise may have a positive influence on improving and maintaining the mental wellbeing of the general population (Koltyn et al. 1997; Mondin et al. 1996; Wyerer, 1997). Aerobic exercise has been seen to improve anxiety, depression, and self-esteem, which are just some of the adverse effects of pregnancy (Carlucci et al. 1991; Koltyn et al. 1997). There have been many explanations put forward on the reason why aerobic exercise has been found to be beneficial.

There has been contradicting evidence put forward in a study by Raglin, (1990) who found there to be no significant difference in the level of depression after exercise. However, a significant amount of research has been conducted in a number of areas that directly effect the overall psychological wellbeing of an individual. These areas include depression, anxiety, changes in mood states, stress and body image.

The hypothesis of this study was that an association between aerobic exercise and psychological wellbeing would be found.

Subjects

Twenty-one (n=21) postnatal female volunteers between 6 weeks and 9 months post partum were recruited. The volunteers were divided into 2 groups, non-exercising (Group 1) and exercising (Group 2). Group 2 were classified as women partaking in aerobic exercise two or more times per week for no less than 30 minutes of a moderate to high intensity level. Group 1 did not fill the above mentioned criteria and therefore were labelled non-exercisers.

Measurements

The measurement tools used were three separate questionnaires.

The purpose of the first questionnaire was to determine the exercise history of the participant.

The second questionnaire was used to outline the current exercise regime of each of the participants, therefore being able to determine whether they were exercisers or non-exercisers.

The third instrument that was used was the Maternal Adjustment and Maternal Attitudes Questionnaire (MAMA. Kumar et al 1984). This questionnaire was designed to investigate patterns of change in maternal adjustment, attitudes to the baby, and marital relationships. This questionnaire is designed to illuminate signs of both physical and mental disturbances in mothers between 6 weeks and nine months post partum. The questionnaire was divided into 5 sub-scales, body image, somatic symptoms, marital relations, attitude to sex and attitudes to baby.

The results were determined using a 4 point Likert scale, with 4 points being awarded to for the most positive response for each question, and 1 point for the most negative response.

Procedures

The researchers were allocated 10 questionnaires each and approached the different locations to obtain the volunteers for the study.

Data Analysis

Using one-way ANOVA between groups, and Pearson's Method of Correlation to test for a correlation between and within the sub-scales of the questionnaire.

The results indicate that the mean average was higher in all five sub-scales of the MAMA Questionnaire for the exercising group, compared to the non-exercising group. This is shown in Table 1

Table 1: Mean results of MAMA sub-scales for exercisers and non-exercisers.

There was also a significant difference (p<0.05) between the means of the 2 groups (exercisers and non-exercisers).

Using Pearson’s correlation method, there was a varied level of significance amongst the relationships between and within the sub scales (Table 2).

Table 2: Correlation between and within variables (sub-scales).

• Significant correlation at p<0.05 level.

• Significant correlation at p<0.01 level.

The results of this study indicate that women who participated in a regular exercise program had more positive perception on their body image, marital relations, somatic symptoms, attitude to sex and attitude to their baby. A study undertaken by Koltyn et al (1997) supported these results by finding that women who exercised regularly experienced positive mood state changes and benefits were greatest for those who participated in a greater number of exercise sessions.

Berger (1996), Carlucci et al (1997) and Mondin (1997) found a significant reduction in self perception directly after child birth and the results from this study indicated that body image was the lowest rating sub scale support this finding.

Marital relations featured as the lowest scoring sub scale for non-exercising group and as the third lowest sub scale for the exercising group. This supported the study conducted by Watson et al (1984) that a dissatisfaction in marital relations had a direct association with postnatal depression.

Attitude to sex results saw a lower than expected rating of this sub scale. The correlation between attitude to sex and body image, marital relation, somatic symptoms and attitude to baby meant that any improvement in these related sub scales would see a significant improvement in the other sub scales.

Exercising groups have a more positive outlook on life in general than their non-exercising counterparts. This may be due to the physical and psychological changes brought about by exercising regularly or from the mere distraction from daily life that exercise provides.

Therefore, exercise should be used as a treatment for those suffering from the negative effects of child birth but should not be used independently of any other forms of treatment. As a preventative measure against developing these symptoms and maintaining a positive state of mental health, exercise may also assist.