Participants’ characteristics

The total study sample consisted of 235 women aged between 24 and 52, with an average age of 36 ± 4.67 years. In terms of geographical distribution, around 80% of the sample lived in the Lisbon and Tagus Valley region, around 6% in the Azores archipelago, 4.7% in the North of Portugal, 4.3% lived outside the country, 2.6% lived in the Center region, 2.6% in the South (Algarve), and 0.43% in the Madeira archipelago. Regarding the level of education of the participants, the majority have completed higher education (63.8%), followed by 23% who have advanced academic training (i.e., a master’s degree or doctorate). The remainder have secondary education (11.5%) and only 1.7% have basic education. All the women who answered the questionnaire were already mothers or pregnant. Between 2021 and 2023, 83% had one pregnancy, 16% had two pregnancies, and 1% had three pregnancies. The main characteristics of the sample are shown below in Table 1.

Physical activity practice during pregnancy

According to the collected data, we found that 20% of the women did not practice physical activity (PA) during their pregnancy. The majority of the participants, around 39%, only practiced it 1–2 times a week, and only 2% said they did it every day, see Graph 1A. Regarding the time spent practicing PA in minutes, around 28% of the participants practiced between 60 and 90 min per day, 26.4% practiced between 30 and 44 min per day and around 19% practiced between 45 and 59 min, see Graph 1B.

Among the 13 categories of PA practices defined to include the activities listed by the participants [16], the five most representative were: (1) Health and Wellness Training, practiced by 48% of the participants; (2) Fitness programs for pregnant and postpartum women, with a frequency of 16.7%; (3) Pilates, practiced by 14.5% of the participants; (4) Group classes; and (5) No activity, reported by 13% of the participants.

Within the ‘Health and Wellness Training’ category, during pregnancy, participants identified that 95% of the activities practiced consisted of walking, with the remaining 5% involving cardiovascular activities such as gym workouts, cycling, or treadmill exercises.

In the ‘Group Classes’ category, swimming accounts for approximately 39.5% of the activities identified. Other activities include dancing, practiced by 14% of the participants; aqua aerobics, practiced by 12%; body balance, practiced by 7%; and gymnastics and aerobics, practiced by 4.5%, among others with smaller percentages.

Physical activity practice during the postpartum period

During the puerperium, it was observed that 37% of the women did not practice any PA, and only 4% engaged in PA more than five times a week, as shown in Graph 2A. Most of the participants, approximately 47.7%, practiced PA one to two times per week, while around 11% practiced three to four times per week.

Regarding the time spent practicing PA in minutes, approximately 29% of the sample reported not engaging in any type of activity, i.e., 0 min, as shown in Graph 2B. Around 25% practiced between 30 and 44 min per day, 23% practiced between 60 and 90 min per day, and approximately 12% practiced between 45 and 59 min. Less than 30 min of PA was practiced by 7%, with a minority of 3% practicing PA for more than 90 min.

Among the 13 categories of physical activity practices defined [16], in the postpartum phase, the five more representative were: Health and Wellness Training, practiced by 48% of the participants; Fitness programs for pregnant and postpartum women, practiced by 21%; Group classes, practiced by 7%; Pilates, practiced by 6%; and No activity, reported by 17% of the participants.

In the ‘Health and Wellness Training’ category, similar to the pregnancy period, in postpartum, participants identified their main activity as walking, which accounted for 90% of the activities practiced. The remaining 10% consisted of cardiovascular activities such as gym workouts, cycling, and running.

In the ‘Group Classes’ category, dance accounted for approximately 26% of the most practiced activities. Swimming and gymnastics each accounted for around 16%, cycling and HIIT (high intensity interval training) each accounted for around 10.5%, with the remainder associated with activities such as stretching, gymnastics, and aqua aerobics, among others, having smaller percentages.

App usage

Concerning the engagement in PA under the supervision of an exercise professional during pregnancy, 52% of women reported participating in supervised PA. This percentage slightly decreases to 47% in the postpartum period.

Regarding the preferred location for engaging in physical activity, 36% of the participants prefer outdoor training, 30% prefer practicing in a fitness club, 29% at home, and only 2% conducted their activities in centers or clinics specialized in pre- and post-natal care. A minority of 2% did not use any specific location or used their workplace.

Regarding the use of computer applications, it was found that 53% already used a general fitness mobile application, while 87% had never used a mobile app specifically for fitness during pregnancy and postpartum. In terms of application usage frequency, the majority, 60%, did not use it on any day of the week, 26% used it 1 to 2 times per week, 8% used it 3 to 4 times per week, and only 6% used it between 5 and 7 days per week.

Preferences regarding the future “active pregnancy app”

The attribution of value and recognition of sharing valuable information through the app was highly recognized by most participants. Practically three quarters of the participants, 73%, agreed or strongly agreed that the app could improve knowledge about recommendations for an active lifestyle, including physical activity, exercise, and sports. Equally, 78% believed the app would provide updated recommendations in specific areas of PA and physical exercise during pregnancy and postpartum. This attribution of value also extends to the healthy lifestyle, in which statement 77% agreed or strongly agreed that the app would offer valuable information on health, sleep, nutrition, and stress management.

Regarding exercise sessions, 80% agree or strongly agree that the app will allow pregnant or postpartum women to practice exercise at home and outdoors, and 71% maintain this opinion regarding the outdoor environment. On the other hand, only 54% agreed or strongly agreed that the app could help the user to realize exercise in the gym context, with 23% remaining neutral. Direct contact with professionals was extremely valued by participants. Direct contact with health professionals (e.g., doctors, nutritionists, psychologists, nurses, physiotherapists) was considered important by 73% of the respondents, and 72% valued direct contact with exercise professionals (e.g., personal trainers, exercise physiologists, sport coaches).

Guidance on childbirth and parenting preparation programs was deemed important by 72% of the women, and 79% agreed or strongly agreed on the importance of postpartum recovery programs. Recording health and fitness parameters (e.g., blood pressure, heart rate, weight, blood glucose) was supported by 75% of the participants, and the same percentage agreed on recording physical activity parameters or training plans.

Regarding food diary records, 54% agreed or strongly agreed, although 28% were neutral. Similarly, 56% supported recording sleep and rest patterns, with 30% remaining neutral. Emotional state tracking was agreed upon by 50%, with 32% neither agreeing nor disagreeing. The app’s ability to record daily step counts, distance traveled, walking speed, and effort intensity through heart rate was important to 73% of the women.

Interoperability with other applications for tracking daily steps, distance, and heart rate was supported by 68% of the respondents. Finally, 47% agreed or strongly agreed on the importance of interoperability with social networks and contact with other pregnant and postpartum women, while 35% were neutral on this aspect.

To gather more personalized information regarding women’s preferences about the app, we posed an open-ended question: “What suggestions would you like to make regarding the functionality and usefulness of a fitness app specifically for pregnancy or postpartum?“. Most participants responded to this question (75.55%), adding value and depth to the questionnaire. To summarize and illustrate the responses obtained, we provide some examples below:

• Usability-related questions: “be simple”, “be easily accessible”, “be flexible”, “be user-friendly”, “be versatile”, “be practical”, “not be too expensive”, “be free”, “allow connection with smartwatch and ideally with the National Health System or health insurance with information available to private hospitals as well”;

• Specificity: “adapted to each pregnant woman’s reality”, “specific to each person”, “exercise adapted to various pregnancy and postpartum conditions”, “exercises suitable for high-risk pregnancies”, “adapt exercises to the stages of pregnancy”;

• Contact with professionals: “allow contact with experienced professionals in the field of exercise and health”, “allow monitoring by professionals”, “have a chat/share forum among pregnant women”, “have direct chat with professionals”, “daily support with information for pregnant women and mothers”;

• Exercise prescription: “availability of recorded workouts”, “have videos with short workouts”, “have tips and exercise suggestions”, “inform when to resume physical activity after childbirth”, ” have breathing exercises”;

• Data evaluation and recording: “allow data recording in case of gestational diabetes or hypertension”, “records on exercise evaluation and postpartum recovery progress”, “help with sleep issues during pregnancy”, “assess psychological well-being”, “include breastfeeding records”;

• Motivational and fear: “have pop-up alerts”, “have reminders”, “have active and motivational notifications”, “help pregnant women overcome the fear of exercising by being advised by health and fitness professionals”.

Besides the practical suggestions, it is also important to note that a few participants also mentioned that there were some concerns regarding the use of the app, such as the following examples: “with the app, human contact is lost. I recognize that it is useful for recording and reading, but only that”, “my concern is that women will follow the app’s guidance more than their doctor’s” and “nothing replaces in-person and physical contact, especially at this stage”.