Body image profiles and exercise behaviours in early motherhood. A latent profile analysis

Abstract

Early motherhood may impact body image, and its relationship to exercise, potentially affecting mother and infant wellbeing. This study examined whether duration of weekly exercise differed according to body image profile (BIP) based on relative levels of body dissatisfaction and body appreciation. Survey data from 262 women, 0–5 years postpartum, were analysed. Latent profile analysis identified “average”, “dissatisfied” and “appreciative” BIPs. Significantly lower exercise was found in the dissatisfied compared to the appreciative BIP (p = 0.005), with marginally lower exercise in the dissatisfied compared to the average BIP (p = 0.029 with adjusted α = 0.02). This research has implications for designing targeted interventions supporting postpartum wellbeing.

Keywords

body appreciation body dissatisfaction body image exercise mothers

Early motherhood is typically an exciting time, but this period is also associated with significant physical, psychological, and social change (Gross and Marcussen, 2017). Alterations to women’s body image after pregnancy, childbirth, and early child-rearing is a common but poorly understood phenomenon (Grogan, 2017; Yager et al., 2020). The complexities of body image in early motherhood are important to understand given changes may significantly impact the wellbeing of both mothers and their infants due to the associated relationships with physical and mental health outcomes (Fern et al., 2014; Silveira et al., 2015).

Body image, the psychological experience of one’s body, profoundly influences quality of life (Cash and Smolak, 2011). Positive body image refers to the love, acceptance, and gratitude for functionality and health of one’s body (Tylka and Wood-Barcalow, 2015b) and includes body appreciation. Negative body image is a subjective concern with any part of one’s appearance (Thompson and Stice, 2001) and includes body dissatisfaction.

Body image concerns are known to occur in early motherhood (the period from birth to 5 years postpartum), and are strongest at 6–9 months after birth, once the pressure to be thin returns (Clark et al., 2009b; Rocco et al., 2005). During the postpartum period there are intense and unrealistic body image pressures for many mothers, given strong sociocultural messages commonly promote the value of attaining a thin, toned, postpartum body (Fern et al., 2012; Lovering et al., 2018; Montgomery et al., 2013). Unsurprisingly therefore, body dissatisfaction has been reported among postpartum women during the first-year post birth (Gjerdingen et al., 2009; Hiser, 1987; Jenkin and Tiggemann, 1997; Rallis et al., 2007), with dissatisfaction still evident for some women at least up to three-years postpartum (Fern et al., 2014). Of concern are findings from prospective longitudinal research, which revealed that body dissatisfaction at nine-months postpartum was associated with a range of adverse outcomes for women including: disordered eating, higher body weight, worse mental health and non-breastfeeding status (Gjerdingen et al., 2009). Yet, studies tracking body image after 1-year post-birth are lacking.

Despite the negative body image that some women experience postpartum, positive body image experiences have also been reported in early motherhood. This includes a new appreciation of body functionality after the amazing feats of pregnancy and postpartum infant care (Fern et al., 2014; Fox and Neiterman, 2015; Yager et al., 2020). Some women report feeling stronger and fitter postpartum and are more positive about their bodies in the initial weeks after birth (Clark et al., 2009a; Strang and Sullivan, 1985). Prospective and cross-sectional studies have shown associations between positive body image (i.e., measures of appreciation and satisfaction) and participation in exercise in the first year postpartum (Erbil et al., 2012; Hinton and Olson, 2001), suggesting a potentially adaptive relationship.

Importantly, there are reports of women experiencing body dissatisfaction and body appreciation concurrently after having children (DeLuca and Bustad, 2017). This finding is consistent with the contention that both negative and positive body image exist on related but separate continua (Bailey et al., 2016). In addition, research predicting health behaviours from multiple, interacting body image constructs (i.e., weight/shape and muscularity concerns) supports the notion that body image may function through more complex profiles rather than as single constructs (Hoffmann and Warschburger, 2018). While research on postpartum body image is limited, with a particular dearth of studies incorporating measures of positive body image, it is clear from the available research that body image after childbirth is complex. In addition, studies investigating how women experience positive relative to negative body image postpartum, and how the balance between the two might influence health outcomes, appear absent.

Given negative and positive body image independently contribute to mothers’ overall body image, there may be value in combining the opposing valences of body image to explore whether previously undefined subgroups, or body image profiles (BIPs) exist according to differing proportions of positive versus negative body image. Person-centred statistical approaches for deriving group membership, such as latent profile analysis are designed for this purpose (Vermunt, 2017). Given the changes experienced in motherhood, it is possible that women may experience an increase in both positive and negative body image, or one valence may predominate more than another for some women. For example, there might be a group of women who display a body image profile with moderate levels of appreciation but relatively high levels of dissatisfaction postpartum, while another group may display the inverse profile. In turn, these profiles may be better able to predict various health-related behaviours in early motherhood -especially those influenced by body image, such as exercise - than unidimensional constructs can. Profiles are likely better predictors because they reflect a more integrated and nuanced model of body image expression.

In this study we focussed on women’s experiences of body dissatisfaction relative to body appreciation in the first 5 years after childbirth, and links to the important health-related behaviour of postpartum exercise. Research indicates that early mothers undertake lower levels of exercise than their non-parent counterparts (Armstrong et al., 2000; Berge et al., 2011), falling under recommended guidelines for health and wellbeing (Australian Government Department of Health, 2017). A sedentary lifestyle postpartum may be problematic, given links to poorer physical and mental health, disordered eating, and higher body weight (Davenport et al., 2011; Downs et al., 2008; Walker et al., 2016). While there are several explanations for women reducing exercise in early motherhood (Evenson et al., 2009), one hypothesis is that greater body dissatisfaction in the postpartum period may contribute to exercise avoidance or maladaptive exercise patterns (More et al., 2019). Conversely, body appreciation has been linked with higher levels of exercise in non-postpartum females (Andrews et al., 2018), especially for reasons of health and selfcare. Encouraging positive body image among early mothers may therefore facilitate healthful physical activity postpartum. How these relationships are experienced in postpartum women, however, requires further research, as the literature exploring body image and exercise in early motherhood, is scant (Downs et al., 2008; Raspovic et al., 2020).

The aim of this research therefore was to further understand the multifarious nature of body image in the first 5 years after birth. To do this, we used latent profile analysis to explore the existence of body image profiles, or groupings of women with similar relative proportions of negative versus positive body image valence. We then examined whether the postpartum weekly exercise amount differed significantly across profiles. Four latent profiles were expected based on the possibility of high and low scores across measures of positive and negative body image (i.e., high/high, low/high, high/low and low/low). We predicted lower weekly exercise would occur in latent profiles associated with elevated dissatisfaction and lower body appreciation, and predicted higher weekly exercise in profiles with higher appreciation and lower dissatisfaction.

Materials and methods

Participants and procedures

Cross-sectional data from 262 early mothers was taken from a larger (n = 2075) online (Qualtrics) survey of adult women (the EMBRACE survey; details published in (Yager et al., 2020). Approval for the study was granted from the Social and Behavioural Research Ethics Committee at Flinders University [SBREC 7481]). The EMBRACE survey recruited a convenience sample from the online Body Image Movement (https://bodyimagemovement.com) Facebook page, collecting information on demographic, body image and behavioural (i.e. exercise and dietary) measures. The present study utilised data from a selection of these measures, focusing on body image and exercise.

Inclusion criteria for the present analyses were completed measures of body dissatisfaction, body appreciation and weekly exercise amount, provided by mothers who were 18 years of age or over with at least one biological child of 5 years or younger. This period of motherhood was selected as it captures the formative years before a child begins schooling, when women’s body image and exercise patterns can be challenged by childbirth and child rearing, including breastfeeding, fatigue, weight gain, and carer responsibilities (Craig, 2006). It is well known that the physical, psychological and social impacts of pregnancy, birth and child-rearing extend for several years (Babetin, 2020). Furthermore, we deemed the 5 year mark as significant because children usually commence schooling around this age, signifying a major change in life stage for both mothers and their children. Completion of the respective body image scales were required for study inclusion, with partial completers removed. Overall, 262 early mothers’ responses (13%) from the EMBRACE survey, met these criteria.

Measures

Body appreciation

Positive body image was measured using the Body Appreciation Scale-2 (BAS-2; (Tylka and Wood-Barcalow, 2015a), which consists of 10 items rated on a five-point Likert scale (never = 1, seldom = 2, sometimes = 3, often = 4, always = 5). The total score was an average across the 10 items, with a higher score indicating greater body appreciation, or more positive body image. In the current study, Cronbach’s alpha for the BAS-2 was high at α = 0.96.

Body dissatisfaction

The Post-Partum Body Image Scale (PP-BIS), developed for use in this study, consists of 10 items, assessing attitudes and behaviours related to body dissatisfaction since having children. Ratings are via a five-point Likert scale (not at all true for me = 1, untrue for me = 2, neutral = 3, true for me = 4, very true for me = 5). Positively worded items were reversed scored such that higher total scores averaged across all 10 items, indicated greater body dissatisfaction, or more negative body image. A sample question from the PP-BIS is: Since having my child(ren). . .“I have felt worse about my looks than I did before children”. The PP-BIS was informed by a systematic review and meta-synthesis of postpartum body image research (Hodgkinson et al., 2014), has good face validity and maps onto a pre-existing validated scale for momentary evaluative/affective experiences of appearance (Cash et al., 2002). In this study, Cronbach’s alpha for the PP-BIS was good at α = 0.81. Test re-test reliability of the PP-BIS on a subgroup of 32 participants was high at r = 0.96 (p < 0.001).

Exercise

Participants indicated the number of times they exercised per week (frequency) and the amount of time spent exercising in minutes on each occasion (duration). Following Prichard and Tiggemann (2008), total duration of weekly exercise was calculated (ExD-Tot), by multiplying frequency by duration, and summing each to gain total minutes of exercise per week. This approach to measuring exercise is pragmatic and has been utilised in past research (Burgess et al., 2006; Prichard and Tiggemann, 2008).

Demographic, anthropometric and child-related variables

Age, cultural background, education level, height, weight, age of youngest child and experience of postnatal depression were extracted from the survey dataset. Body mass index (BMI) was calculated by dividing weight in kilograms by height in metres squared.

Data analysis

For the current study, assumptions for statistical tests were checked according to procedures by Pallant (2011) and Berlin et al. (2014). Visual observation of histograms did not reveal any overt anomalies and formal test of skewness and kurtosis were not conducted as they are reported as too sensitive for large samples (i.e. over200+) (Pallant, 2011: 57). SPSS (version 27) was utilised to generate descriptive statistics, and scale reliability scores.

Latent profile analysis (LPA) was conducted to identify whether participants’ respective body dissatisfaction (PP-BIS) and body appreciation (BAS-2) scores fell into reliable and significantly different body image profiles (BIPs). Latent profile analysis is a person-centred clustering approach where groupings of scores on continuous variables are taken to represent important underlying (latent) variables, which cluster individuals into profiles (commonly called “classes” in the LPA literature), according to membership probability (Hoffmann and Warschburger, 2018). This technique was selected, in comparison to well-known variable centred methods, as subgroups with similar patterns of body image may be more robustly linked to health behaviours than single body image constructs alone. Models with between two and five profiles were considered. Berlin et al. (2014) recommend fitting one class more than theoretically expected, hence a maximum of five were considered given four latent profiles were expected. The final model was selected based on fit statistics alongside parsimony and interpretability with theoretical ideas (Berlin et al., 2014). Fit statistics used for evaluation were the information criteria - Akaike information criteria (AIC), Bayesian information criteria (BIC) and sample size-adjusted Bayesian information criteria (aBIC) - the bootstrap likelihood ratio test (BLRT), Entrophy (Ent) and Vuong-Lo-Mendell-Rubin likelihood ratio test (VLMR). Lower AIC, BIC and aBIC values, higher Ent, and significant BLRT and VLMR values indicate better fit. MPlus (version 8.4) was used for the latent profile analysis and to generate fit statistics (Muthén and Muthén, 1998).

Finally, statistical testing for comparing means of weekly amount of exercise (ExD-Tot) between pairs of BIPs was conducted using independent paired t-tests (SPSS, version 27). This step allowed determination of whether ExD-Tot was different between any combination of BIPs identified. As three comparisons were computed, the alpha was adjusted to α = 0.02 to reduce the risk of type 1 error.

Data sharing statement

The current article includes the complete raw data-set collected in the study including the participants’ data set, syntax file and log files for analysis. Pending acceptance for publication, all of the data files will be automatically uploaded to the Figshare repository.

Results

Participant characteristics

Participants were on average 35 years old, with their youngest child just under 3 years old (Table 1). Mothers were generally well educated (45.0% Bachelor degree) and of White background (93.1%). The majority of participants had two children (39.7%), followed by one child (34.4%). Self-report perinatal or post-natal depression had been diagnosed in 20.2% of participants, which is representative of women in higher income countries around the world (Shorey et al., 2018).

Table 1.

Participant demographic, anthropometric, child, body image and exercise data.

	n	Mean	SD+/-	Minimum	Maximum
Age (years)	261	35.38	4.75	21.00	47.00
Height (cms)	246	166.46	6.44	151.00	183.00
Weight (kgs)	230	78.51	19.47	43.00	160.00
BMI	223	28.35	7.22	16.61	64.91
Age youngest child (years)	262	2.72	1.57	0.80	5.92
Number of children	262	2.00	0.94	1.00	6.00
PP-BIS	260	3.15	0.73	1.20	5.00
BAS-2	262	3.39	0.84	1.00	5.00
ExD-Tot (minutes)	236	185.50	148.72	0.00	720.00

PP-BIS: Post-Partum Body Image Scale - mean score; BAS-2: Body Appreciation Scale-2 - mean score; ExD-Tot: duration of total minutes per week exercise.

Once three extreme outliers on total exercise were removed (Tabachnick and Fidell, 2013), 9.92% (N = 26) of the study sample had missing exercise data. Height or weight data were missing for 14.89% (N = 39) of participants, precluding BMI calculation. These data cannot be considered missing at random, as certain subgroups of women, for example those at high weight or with strong body dissatisfaction, may be less likely to report body measures. Data imputation therefore was not appropriate.

Latent profile analysis

Fit indices for a series of two, three, four, and five profile models showed a three-profile model as most parsimonious, compared to the four-profile model initially considered (Table 2). A combination of lower AIC, BIC and aBIC, higher Ent, and significant BLRT and VLMR in the three-profile model revealed the best match. The average probabilities for the most likely profile membership were high (Table 3), further supporting accurate assignment.

Table 2.

Fit indices for the latent profile analysis, two to five profile models.

N^o profiles	AIC	BIC	aBIC	Ent	BLRT α	VLMR α
2	1124.773	1156.888	1128.354	0.692	0.001	<0.001
3 ^#	1084.645	1134.602	1090.216	0.756	<0.001	<0.001
4	1088.671	1156.470	1906.232	0.676	0.809	0.803
5	1084.501	1170.141	1094.050	0.750	1.000	0.176

AIC: Akaike information criteria; BIC: Bayesian information criteria; aBIC: sample size-adjusted Bayesian information criteria; Ent: entrophy; BLRT α: bootstrap likelihood ratio test; VLMR α: Vuong-Lo-Mendell-Rubin likelihood test.

Best model fit = Lower AIC, BIC & aBIC, higher Ent and statistically significant BLRT &VLMR α at p ⩽ 0.05 (Berlin et al., 2014).

Table 3.

Average latent profile probabilities for most likely membership (row) to latent body image profile.

	Average	Dissatisfied	Appreciative
Average	^# 0.908	0.041	0.050
Dissatisfied	0.166	^# 0.834	0.000
Appreciative	0.096	0.000	^# 0.904

Highest probability of membership in that body image profile (BIP).

The three-profile model revealed different clustering of mothers based on their relative levels of body dissatisfaction and body appreciation. Just over half of the sample fell into the profile characterised by average levels of both body dissatisfaction and body appreciation (“Average Profile”, n = 146, 55.73%). A second profile showed higher than average body dissatisfaction and lower than average body appreciation (“Dissatisfied Profile”, n = 56, 21.37%) and a third was distinguished by higher than average body appreciation and lower than average body dissatisfaction (“Appreciative Profile”, n = 60, 22.90%). The latter two profiles had approximately the same frequency. There was no difference in number of children or age of the youngest child between body image profiles. Table 4 depicts mean scores on body image measures across profiles.

Table 4.

Descriptive statistics according to body image profiles.

Body image profiles	n %	Scale	Mean	Variance	Standard error
Average	146	BAS-2	3.43	0.18	0.04
Average	55.73	PP-BIS	3.20	0.23	0.04
Dissatisfied	56	BAS-2	2.20	0.23	0.07
Dissatisfied	21.37	PP-BIS	3.97	0.24	0.06
Appreciative	60	BAS-2	4.39	0.10	0.04
Appreciative	22.90	PP-BIS	2.28	0.14	0.05

BAS-2: Body Appreciation Scale-2; PP-BIS: Post-Partum Body Image Scale.

Exercise patterns according to body image profile

Table 5 shows the average amount of weekly exercise (ExD-Tot) according to body image profile (BIP). Independent t-tests, with an adjusted α set at 0.02, indicated statistically significant lower ExD-Tot in the dissatisfied (M = 137.14, SD = 123.34) compared to the appreciative (M = 221.65, SD = 171.06) BIPs (t (99) = 2.867, p = 0.005, two-tailed). The magnitude of the mean difference (84.52, 95% CI: 25.99–143.04) was moderate (η² = 0.07) (Cohen, 1988). ExD-Tot was lower in the dissatisfied (M = 137.14, SD = 123.34) compared to the average BIP (M = 188.51, SD = 144.00), but this just marginally missed the adjusted α set at .02 (t (181) = 2.200, p = 0.029, two-tailed). This mean difference (51.37, 95% CI: 5.31–97.44) was small (η² = 0.03). There was no difference in ExD-Tot between the average and appreciative BIPs. In contrast to the BIP findings, body dissatisfaction was not significantly associated with exercise duration in simple linear bivariate correlations, however a small, but statistically significant correlation was found between body appreciation and weekly exercise amount (r = 0.20, p = 0.002).

Table 5.

Mean exercise amount according to body image profile.

Body image profiles	n	Mean ExD-Tot (mins/week)	SD+/-
Average	135	188.51	144.00
Dissatisfied	48	137.14	123.34
Appreciative	53	221.65	171.06

ExD Tot: total duration of exercise (mins/week); SD+/-: 1 standard deviation.

Discussion

This study aimed to identify profiles of negative and positive body image among early mothers, then to examine relationships between body image profiles and postpartum exercise. Overall, three distinct body image profiles (BIPs) were present in this postpartum sample. Just over half of the women (56%) could be classified as having average levels of both body dissatisfaction and body appreciation. This profile potentially reflects the most common and arguably normative body image state of postpartum women. A little over 21% of mothers exhibited higher body dissatisfaction relative to appreciation (i.e. the dissatisfied profile). Approximately the same proportion exhibited greater body appreciation relative to dissatisfaction (i.e. the appreciative profile).

The discovery of discrete profiles in this study is consistent with emerging research supporting the use of latent profiling of multiple constructs as a powerful tool for body image research. Although one previous study has used LPA with body image measures (Hoffmann and Warschburger, 2018), it focussed only on the negative body image valence, and sampled adolescents. In concordance with the present study, Hoffmann and Warschburger (2018), also found a three-profile solution, with the most populous profile characterized by small amounts of weight, shape and muscularity concerns. Their final two profiles represented body image concerns of increasing clinical relevance. A particularly novel addition of the current study was the use of measures across valence; both negative and positive body image measures. Our findings support the contention that body dissatisfaction and body appreciation, co-occur as related but independent constructs.

Research to date has typically focussed on body dissatisfaction or body appreciation alone or considers them on a continuum. However, results from the present study reflects previous work by Bailey et al. (2016) who proposed that body image does not exist on a single continuum. Further, this study extends these findings to the experience of early mothers. Importantly, the scale used in this study was specific to post-partum. Intuitively, it makes sense that women could simultaneously experience both body dissatisfaction and body appreciation, when evaluating their overall body image status as new mothers with altered experiences of their bodies compared to pre-conception.

Our results may also suggest a relationship between body image profiles and exercise. Profile analysis allows consideration of women’s body image experiences from a more integrated perspective and might be more important in predicting exercise behaviors, given previous research has often found conflicting evidence as to the link between unidimensional body image measures and exercise (LePage and Crowther, 2010; Liechty and Yarnal, 2010). In the current study, there was a significantly lower level of exercise undertaken by women with the dissatisfied profile, compared to women with the appreciative profile. Interestingly, the associations between exercise and body appreciation or body dissatisfaction as single constructs (i.e. when examined with bivariate correlations) were low or non-significant respectively, but when body dissatisfaction and appreciation were joined together in the LPA, there was differentiation of health behaviour (i.e. weekly exercise duration). Previous studies have suggested that positive and negative body image can interact to influence the expression of exercise patterns (Homan and Tylka, 2014; Raspovic et al., 2020) however this is the first time where discrete profiles have been identified as linked to differential exercise behaviors, and the first to do so in postpartum women.

One explanation for our finding, consistent with past research in non-postpartum populations that links exercise to body appreciation for self-care (Andrew et al., 2016), is that mothers who felt more appreciative of their bodies - with less influence of body dissatisfaction - engaged in more healthful levels of exercise. This research adds further evidence to the relationship between body appreciation and physical activity, suggesting that adult women who have positive body image are more likely to look after their body and engage in exercise (Cox et al., 2019; Tylka and Homan, 2015). Conversely, one reason why mothers with greater body dissatisfaction relative to appreciation engaged in less exercise could be because they are experiencing lower levels of the protective influence of body appreciation. This is also consistent with past research suggesting that exercise avoidance may act as a negative reinforcer by circumventing critical self-evaluation (Neumark-Sztainer et al., 2006; Raspovic et al., 2020). Further research however is required to confirm these findings. Further investigation of whether there are differences in the initial postpartum period compared to later postpartum (e.g. the first year after birth compared to the first 5 years), and how BMI and especially experiences of weight stigma may moderate or mediate these relationships (Hart et al., 2021), would also be useful to better understanding postpartum body image and its relationship with exercise. Nonetheless, the current study re-confirms that the link between body image and exercise postpartum is a complex, multi-dimensional one, where women encounter markedly different experiences. Profiling in this way therefore provides us an opportunity to test and deliver interventions according to discrete profiles in order to provide programs that are more relevant to, and helpful for end users.

The strengths of this study lie with its originality, integrated design and focus on an under-researched population that is core to the healthy functioning of children, families and communities. This research begins to address several gaps in our understanding of the relationship between body image and exercise in early motherhood. To the authors’ knowledge, this the first study where the balance between negative and positive body image, and subsequent links to a key health behavior, have been statistically evaluated in postpartum women. Although past research has studied the relationship between exercise and body satisfaction in women of various ages (Tiggemann and Williamson, 2000), the current study offers new information during an especially vulnerable life-stage marked by great change and sometimes detriments to both mother and baby.

It is important to interpret findings in light of study limitations. The data analysed were cross-sectional, capturing one point in time of women’s shifting early motherhood experiences, therefore results cannot be inferred as causal. A further consideration is the specificity of the measures used. The outcome measure of duration of weekly exercise in minutes was a conglomerate index of both frequency and duration of individual sessions. While this approach has been used to examine exercise in previous research (e.g. Prichard and Tiggemann, 2008), it does not reveal how body image may be linked to specific exercise patterns and motivations. Furthermore, while the Post-Partum Body Image Scale (PP-BIS) captured body dissatisfaction in the context of the unique postpartum period and has good face validity, the scale could be tested more formally in a larger sample. BMI data was missing for 14.83% (N = 39) of the sample and as these participants may represent a subgroup who experience a unique body-exercise relationship, other latent profiles may exist that are not represented in the current research.

Practically, the findings of this research could be applied to assist in the promotion of mental and physical health for adult women and their families. Intervention programs, tailored to a mother’s specific body image profile could help women engage in exercise for health and stress relief, rather than appearance concerns. The development and testing of interventions specific to early motherhood, focussed on reducing body dissatisfaction and increasing body appreciation, are indicated (Wallis et al., 2021). As body values are a core driver of body image and exercise patterns (Raspovic et al., 2020) it is anticipated that addressing fundamental self-beliefs around body values, such as using cognitive dissonance interventions to encourage mothers to reject the “thin, fit ideal” (Stice, 2002) and interventions to enhance body appreciation (Alleva et al., 2015) may have optimal outcomes both around body image positivity and resultant health behaviours. Currently programs exist to help promote positive body image in children (i.e. Confident Body, Confident Child, Hart et al., 2016), however, there is a need for the development of interventions to increase mothers’ body appreciation and healthful reasons for exercise, in order to also improve mothers’ role modelling capacity (Damiano et al., 2020).

In sum, the findings of this work add knowledge to the under-researched but important life-stage of early motherhood. The current research reports novel findings on body image as a co-valanced construct, with discrete profiles postpartum, and differential impacts on exercise. Latent profile analysis identified that early mothers statistically clustered into three profiles - average, dissatisfied or appreciative, which trended towards average, lower and higher exercise amounts respectively. Further large scale, longitudinal research on the body image-exercise relationship, and the development and testing of interventions to enhance body appreciation and diminish body dissatisfaction targeted at early mothers, is indicated. Given the broad importance of maternal wellbeing on family and child health, targeted body image research in early motherhood is likely to have large-scale benefits for society and should therefore be a key focus of future research.

Footnotes

Acknowledgements

We wish to acknowledge early mothers who completed the EMBRACE survey and Dr Xia for assistance with statistical analysis.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by a student grant to A. Raspovic provided by the School of Psychology and Public Health at La Trobe University and a Colin Dodds Postdoctoral Fellowship provided to L. Hart by Australian Rotary Health.

ORCID iDs

Anita M Raspovic

Yager Zali

Supplemental material

Supplemental material for this article is available online.

References

Alleva

Martijn

Van Breukelen

GJP

, et al. (2015) Expand your Horizon: A programme that improves body image and reduces self-objectification by training women to focus on body functionality. Body Image 15: 81–89.

Andrew

Tiggemann

Clark

(2016) Predictors and health-related outcomes of positive body image in adolescent girls: A prospective study. Developmental Psychology 52(3): 463–474.

Andrews

Hill

Skouteris

(2018) The relationship between antenatal body attitudes, pre-pregnancy body mass index, and gestational weight gain. Midwifery 56: 142–151.

Armstrong

Bauman

Davies

(2000) Physical activity patterns of Australian adults. Results of the 1999 National Physical Activity Survey. Canberra: Australian Institute of Health and Welfare.

Australian Government Department of Health (2017) Australia’s physical activity and sedentary behaviour guidelines. Australian Government Department of Health.

Babetin

(2020) The birth of a mother: A psychological transformation. Journal of Prenatal & Perinatal Psychology & Health 34(5): 410–428.

Bailey

Cline

Gammage

(2016) Exploring the complexities of body image experiences in middle age and older adult women within an exercise context: The simultaneous existence of negative and positive body images. Body Image 17: 88–99.

Berge

Larson

Bauer

, et al. (2011) Are parents of young children practicing healthy nutrition and physical activity behaviors? Pediatrics 127(5): 881–887.

Berlin

Williams

Parra

(2014) An introduction to latent variable mixture modeling (Part 1): Overview and cross-sectional latent class and latent profile analyses. Journal of Pediatric Psychology 39(2): 174–187.

10.

Burgess

Grogan

Burwitz

(2006) Effects of a 6-week aerobic dance intervention on body image and physical self-perceptions in adolescent girls. Body Image 3(1): 57–66.

11.

Cash

Fleming

Alindogan

, et al. (2002) Beyond body image as a trait: The development and validation of the body image states scale. Eating Disorders 10(2): 103–113.

12.

Cash

Smolak

(2011) Body Image: A Handbook of Science, Practice and Prevention. New York, NY Guilford Press.

13.

Clark

Skouteris

Wertheim

, et al. (2009a) My baby body: A qualitative insight into women’s body-related experiences and mood during pregnancy and the postpartum. Journal of Reproductive and Infant Psychology 27(4): 330–345.

14.

Clark

Skouteris

Wertheim

, et al. (2009b) The relationship between depression and body dissatisfaction across pregnancy and the postpartum: A prospective study. Journal of Health Psychology 14(1): 27–35.

15.

Cohen

(1988) Statistical Power Analysis for the Behavioural Sciences. New York, NY: Routledge Academic.

16.

Cox

Ullrich-French

Tylka

, et al. (2019) The roles of self-compassion, body surveillance, and body appreciation in predicting intrinsic motivation for physical activity: Cross-sectional associations, and prospective changes within a yoga context. Body Image 29: 110–117.

17.

Craig

(2006) Children and the revolution: A time-diary analysis of the impact of motherhood on daily workload. Journal of Sociology 42(2): 125–143.

18.

Damiano

McLean

Nguyen

, et al. (2020) Do we cause harm? Understanding the impact of research with young children about their body image. Body Image 34: 59–66.

19.

Davenport

Giroux

Sopper

, et al. (2011) Postpartum exercise regardless of intensity improves chronic disease risk factors. Medicine & Science in Sports & Exercise 43(6): 951–958.

20.

DeLuca

Bustad

(2017) ‘My baby and this mom body’: Examining post-partum bodywork through stroller fitness. Qualitative Research in Sport, Exercise and Health 9(1): 133–148.

21.

Downs

DiNallo

Kirner

(2008) Determinants of pregnancy and postpartum depression: Prospective influences of depressive symptoms, body image satisfaction, and exercise behavior. Annals of Behavioral Medicine 36(1): 54.

22.

Erbil

Şenkul

Başara

, et al. (2012) Body image among Turkish women during the first year postpartum. Health Care for Women International 33(2): 125–137.

23.

Evenson

Aytur

Borodulin

(2009) Physical activity beliefs, barriers, and enablers among postpartum women. J Womens Health (Larchmt) 18(12): 1925–1934.

24.

Fern

Buckley

Grogan

(2012) Women’s experiences of body image and weight loss after childbirth. British Journal of Midwifery 20(12): 860–865.

25.

Fern

Buckley

Grogan

(2014) Women’s experiences of body image and baby feeding choices: Dealing with the pressure to be slender. British Journal of Midwifery 22(11): 788–794.

26.

Fox

Neiterman

(2015) Embodied motherhood: Women’s feelings about their postpartum bodies. Gender & Society 29(5): 670–693.

27.

Gjerdingen

Fontaine

Crow

, et al. (2009) Predictors of mothers’ postpartum body dissatisfaction. Women & Health 49(6–7): 491–504.

28.

Grogan

(2017) Body Image. Understanding Body Dissatisfaction in Men, Women and Children. Abingdon: Routledge.

29.

Gross

Marcussen

(2017) Postpartum depression in mothers and fathers: The role of parenting efficacy expectations during the transition to parenthood. Sex Roles 76(5): 290–305.

30.

Hart

Damiano

Paxton

(2016) Confident body, confident child: A randomized controlled trial evaluation of a parenting resource for promoting healthy body image and eating patterns in 2- to 6-year old children. International Journal of Eating Disorders 49(5): 458–472.

31.

Hart

Ferreira

Ambwani

, et al. (2021) Developing expert consensus on how to address weight stigma in public health research and practice: A delphi study. Stigma and Health 6(1): 79–89.

32.

Hinton

Olson

(2001) Postpartum exercise and food intake: The importance of behavior-specific self-efficacy. (Research). Journal of the American Dietetic Association 101: 1430+.

33.

Hiser

(1987) Concerns of multiparas during the second postpartum week. Journal of Obstetric, Gynecologic, & Neonatal Nursing 16(3): 195–203.

34.

Hodgkinson

Smith

Wittkowski

(2014) Women’s experiences of their pregnancy and postpartum body image: A systematic review and meta-synthesis. BMC Pregnancy and Childbirth 14(1): 330.

35.

Hoffmann

Warschburger

(2018) Patterns of body image concerns in adolescence and early adulthood: A latent profile analysis. Eating Behaviors 29: 28–34.

36.

Homan

Tylka

(2014) Appearance-based exercise motivation moderates the relationship between exercise frequency and positive body image. Body Image 11(2): 101–108.

37.

Jenkin

Tiggemann

(1997) Psychological effects of weight retained after pregnancy. Women & Health 25(1): 89–98.

38.

LePage

Crowther

(2010) The effects of exercise on body satisfaction and affect. Body Image 7(2): 124–130.

39.

Liechty

Yarnal

(2010) Older women's body image: A lifecourse perspective. Ageing and Society 30(7): 1197–1218.

40.

Lovering

Rodgers

George

, et al. (2018) Exploring the Tripartite Influence Model of body dissatisfaction in postpartum women. Body Image 24: 44–54.

41.

Montgomery

Aniello

Phillips

, et al. (2013) Experiences accompanying postpartum weight loss: Benefits, successes, and well-being. Health Care for Women International 34(7): 577–591.

42.

Phillips

Eisenberg Colman

(2019) Evaluating the potential roles of body dissatisfaction in exercise avoidance. Body Image 28: 110–114.

43.

Muthén

(1998) Mplus User’s Guide. Los Angeles, CA: Muthén & Muthén.

44.

Neumark-Sztainer

Paxton

Hannan

, et al. (2006) Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. Journal of Adolescent Health 39(2): 244–251.

45.

Pallant

(2011) SPSS Survival Manual. Crows Nest, NSW: Allen & Unwin.

46.

Prichard

Tiggemann

(2008) Relations among exercise type, self-objectification, and body image in the fitness centre environment: The role of reasons for exercise. Psychology of Sport and Exercise 9(6): 855–866.

47.

Rallis

Skouteris

Wertheim

, et al. (2007) Predictors of body image during the first year postpartum: A prospective study. Women & Health 45(1): 87–104.

48.

Raspovic

Prichard

Yager

, et al. (2020) Mothers’ experiences of the relationship between body image and exercise, 0–5 years postpartum: A qualitative study. Body Image 35: 41–52.

49.

Rocco

Orbitello

Perini

, et al. (2005) Effects of pregnancy on eating attitudes and disorders. Journal of Psychosomatic Research 59(3): 175–179.

50.

Silveira

Ertel

Dole

, et al. (2015) The role of body image in prenatal and postpartum depression: A critical review of the literature. Archives of Women’s Mental Health 18(3): 409–421.

51.

Shorey

Chee

, et al. (2018) Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. Journal of Psychiatric Research 104: 235–248.

52.

Stice

(2002) Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin 128(5): 825–848.

53.

Strang

Sullivan

(1985) Body image attitudes during pregnancy and the postpartum period. Journal of Obstetric, Gynecologic, & Neonatal Nursing 14(4): 332–337.

54.

Tabachnick

Fidell

(2013) Using Multivariate Statistics. Boston, MA: Pearson Education.

55.

Thompson

Stice

(2001) Thin-ideal internalization: Mounting evidence for a new risk factor for body-image disturbance and eating pathology. Current Directions in Psychological Science 10(5): 181–183.

56.

Tiggemann

Williamson

(2000) The effect of exercise on body satisfaction and self-esteem as a function of gender and age. Sex Roles 43(1): 119–127.

57.

Tylka

Homan

(2015) Exercise motives and positive body image in physically active college women and men: Exploring an expanded acceptance model of intuitive eating. Body Image 15: 90–97.

58.

Tylka

Wood-Barcalow

(2015a) The body appreciation scale-2: Item refinement and psychometric evaluation. Body Image 12: 53–67.

59.

Tylka

Wood-Barcalow

(2015b) What is and what is not positive body image? Conceptual foundations and construct definition. Body Image 14: 118–129.

60.

Vermunt

(2017) Latent class modeling with covariates: Two improved three-step approaches. Political Analysis 18(4): 450–469.

61.

Walker

Murphey

Xie

(2016) Missed opportunities for postpartum behavioral and psychosocial health care and acceptability of screening options. Journal of Obstetric, Gynecologic & Neonatal Nursing 45(5): 614–624.

62.

Wallis

Hart

Prichard

(2021) (in press). The body confident mums challenge: A feasibility trial and qualitative evaluation of a body acceptance program delivered to mothers using Facebook. BMC Public Health.

63.

Yager

Prichard

Hart

, et al. (2020) Mumbod? A comparison of body image and dietary restraint among women with younger, older, and no children. Journal of Health Psychology. Epub ahed of print 28 October 2020. DOI: 10.1177/1359105320967422.