Physical Activity and Pregnancy Norms Among Daasanach Semi-Nomadic Pastoralist Women in Northern Kenya

OBJECTIVES: In subsistence populations, high physical activity is typically maintained throughout pregnancy. Market integration shifts activity patterns to resemble industrialized populations, with more time allocated to sedentary behavior. Daasanach semi-nomadic pastoralists living in northern Kenya face lifestyle heterogeneity due to the emergence of a market center. We investigate how Daasanach women manage the energetic demands of pregnancy with subsistence labor tasks and how market integration relates to variation in energetic demands, physical activity, and coping strategies. METHODS: We conducted nine focus group discussions with 72 pregnant women. We also deployed wrist-worn fitness trackers with 21 pregnant women in two community types: central or peripheral to the market center to capture variation in market integration. Data from focus group discussions were analyzed using thematic analysis. We used multiple linear regression to examine the relationship between gestational age and physical activity. RESULTS: We identified themes of increased fatigue, diet restrictions, and assistance with labor tasks during pregnancy. Gestational age negatively predicted mean daily steps, with a decrease of 1160 ± 437 steps per day with each consecutive pregnancy month. Stratified by community type, gestational age only negatively predicted mean daily steps for peripheral communities, with a decrease of 1443 ± 629 steps per day with each consecutive pregnancy month. CONCLUSIONS: Results suggest that physical activity differs with market integration early, but not late, in pregnancy. Daasanach women cope with the energetic demands of pregnancy by reducing physical activity late in pregnancy and receiving assistance with labor tasks from family and neighbors.