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Journal of Reproductive and Infant

Psychology
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Influence of a relaxation session and

an exercise class on emotional states in
pregnant women
a b b
Monika Guszkowska , Marta Langwald & Katarzyna Sempolska
a
Faculty of Tourism and Recreation , Józef Piłsudski University of
Physical Education in Warsaw , Warsaw , Poland
b
Faculty of Physical Education , Józef Piłsudski University of
Physical Education in Warsaw , Warsaw , Poland
Published online: 03 May 2013.

To cite this article: Monika Guszkowska , Marta Langwald & Katarzyna Sempolska (2013) Influence
of a relaxation session and an exercise class on emotional states in pregnant women, Journal of
Reproductive and Infant Psychology, 31:2, 121-133, DOI: 10.1080/02646838.2013.784897

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 Journal of Reproductive and Infant Psychology, 2013
Vol. 31, No. 2, 121–133, http://dx.doi.org/10.1080/02646838.2013.784897

Influence of a relaxation session and an exercise class on

emotional states in pregnant women
Monika Guszkowskaa*, Marta Langwaldb and Katarzyna Sempolskab
a
Faculty of Tourism and Recreation, Józef Piłsudski University of Physical Education in
Warsaw, Warsaw, Poland; bFaculty of Physical Education, Józef Piłsudski University of
Downloaded by [Flinders University of South Australia] at 10:21 05 October 2014

Physical Education in Warsaw, Warsaw, Poland

(Received 20 November 2012; final version received 9 March 2013)

Objective: The aim of the study was to compare changes in state anxiety and
mood dimensions in pregnant women after a session of physical exercise and
relaxation. Methods: This study used a quantitative comparative design to com-
pare two groups of pregnant women aged 22–38 years: (1) 46 women partici-
pated in physical exercise for pregnant women and (2) 46 women participated in
relaxation session. Emotional states were assessed with the UWIST Mood Adjec-
tive Checklist and State–Trait Anxiety Inventory. The measurement of emotional
states was done immediately before and after the classes. Results: The main time
effect was observed in all emotional states assessed: the level of state anxiety
and tension arousal decreased and the level of hedonic tone and energetic arousal
increased. The main group effect was significant only for energetic arousal
(higher level in the exercise group). Analysis within the groups found significant
time effect for energetic arousal only in the exercise group. Conclusions: Both a
relaxation session and one-time physical exercise can improve the emotional
comfort of pregnant women. Relaxation training will probably bring more bene-
fits to women having higher levels of anxiety or depression, while physical exer-
cise can be particularly useful for women having problems with fatigue and
decreased energy levels.
Keywords: pregnancy; physical activity; relaxation; emotional states; acute
effect

Introduction
The psychological well-being of pregnant women has a significant impact on the
course of pregnancy, the state of a newborn and child development in subsequent
periods of life. Pregnant women experiencing high stress are more likely to be at risk
of spontaneous miscarriage or delivery prior to the due date, during which surgical
intervention and the use of surgical instruments are a must (Andersson, Sundström-
Poromaa, Wulff, Astrom, & Bix, 2004; Martini, Knappe, Beesdo-Baum, Lieb, &
Wittchen, 2010). Stress during pregnancy is connected to delivery before due date,
low birthweight and a degraded psychophysical state of a newborn (Bodecs et al.,
2011; Parcells, 2010; Suri et al., 2007).

*Corresponding author. Email: mguszkowska@wp.pl

Ó 2013 Society for Reproductive and Infant Psychology

 122 M. Guszkowska et al.

Retrospective and prospective research provide evidence confirming the relation

between prenatal exposure to stress, anxiety disorders, depression disorders of a
mother and functional disorders of the child during different periods of development
including separation anxiety, ADHD and behaviour disorders (Martini et al., 2010;
Mulder et al., 2002; Parcells, 2010). Because stress in a pregnant woman can
influence pregnancy complications and development disorders of the child, it is par-
ticularly important to take action to decrease that stress. Early identification of those
pregnant women who experience high levels of stress and show higher levels of
depression and anxiety helps to provide prophylaxis for those women (Parcells,
2010).
Relaxation exercises are a standard method of intervention for people with
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anxiety disorders. According to the results of the meta-analysis carried out by

Manzoni, Pagnini, Castelnuovo, and Molinari (2008), the anti-anxiety effect of
relaxation exercises fluctuates between moderate and strong. It was discovered that
meditation is particularly effective, although other techniques (autogenic training,
progressive relaxation and mixed techniques) are also effective. None of the
research included in the meta-analysis concerned pregnant women and thus there is
insufficient evidence about the effectiveness of relaxation in this group. In research
conducted by Urech et al. (2010), the authors compared the acute effects (influence
of one-time classes) of three relaxation techniques: progressive relaxation, relaxation
through imagination and passive relaxation. In each type of relaxation, a significant
decrease of cortisol, noradrenaline and adrenocorticotropic hormone levels was
observed; progressive relaxation and relaxation through imagination led to a
decrease in the mother’s pulse. Relaxation through imagination was better than the
two other methods in reducing cardiovascular activity in pregnant women and in
arousing a subjectively recognized state of relaxation.
After active relaxation, decreases in anxiety level and the mother’s pulse rate
were larger than after passive relaxation, although during passive relaxation a sig-
nificant decrease of noradrenaline was observed. This did not occur in women
actively attempting to be relaxed. In both groups, a significant decrease of cortisol
levels was observed, while levels of adrenaline did not change in any of the
groups (Teixeira, Martin, Prendville, & Glover, 2005).
The results of the meta-analysis of the research – in which the effectiveness of
different strategies to decrease stress during pregnancy was assessed with the State–
Trait Anxiety Inventory by Spielberger et al. (1970) – show that the biggest
decrease in anxiety was observed in the case of muscular progressive relaxation
(Newham, Westwood, Aplin, & Wittkowski, 2012). Those results suggest that an
anxiolytic effect can be achieved in a relatively short amount of time. Most sessions
were less than 45 minutes, and positive changes of emotional state could be
observed after a session lasting only 10 minutes. Because the decrease in anxiety
was observed after different procedures, we can suppose that the type of interven-
tion is not very important. Repeating verbal instructions that suggested the elimina-
tion of and avoidance of situations causing stress, and engaging in pleasant and
relaxing activity, caused a similar decrease of stress level, bad mood, depression
and cortisol level in pregnant women (Urizar et al., 2004).
The effectiveness of relaxation training can vary depending on the psychological
characteristics of the participants. Results of research on women in the third
trimester of pregnancy show fewer benefits from one-time relaxation exercises in
women having a high level of anxiety. In those women, the state of anxiety and
 Journal of Reproductive and Infant Psychology 123

level of negative affect were higher during the whole relaxation session (Alder,
Urech, Fink, Bitzer, & Hoesli, 2011).
During pregnancy, a lower reactivity to stimuli can be observed. It is caused by
neurohormonal changes typical for pregnancy. A confrontation with physical, cogni-
tive and psychological stressors makes activation of mechanisms engaged in the
stress response weaker (DiPietro, Mendelson, Williams, & Costigan, 2012). The
decreased reactivity of a mother’s body to external challenges is a buffer that
protects the foetus from the harmful effects of the mother’s stress response. The
weakening of reactivity can also be observed in the stimuli that have positive mean-
ing for both mother and child. As a result, we can observe weaker reactivity of a
pregnant woman to acts that are supposed to decrease the level of arousal, e.g.
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relaxation training. DiPietro et al. (2012) compared physiological reactions occur-

ring in pregnant and non-pregnant women during an 18-minute session of relaxing
through imagination. The decrease of activation rate in pregnant women was
reduced, but there were no differences in the subjective assessment of the level of
relaxation. Relaxation appears to be a successful method of reducing the level of
stress and negative emotions during pregnancy; however the extent of changes may
be reduced in non-pregnant women.
Physical exercise can be an alternative to relaxation sessions, especially for
those women whose pregnancy is free from abnormalities. Because the results of
research conducted on the general population confirm the occurrence of positive
emotional changes after one-time physical exercise, it can be better to refer to
reviews and meta-analysis of that research rather than to refer to the results of each
particular analysis. The majority of previous research focused on the possibility of
using physical exercise to reduce negative emotional factors such as anxiety or
depression. Since 1981, more than 40 research papers have been published, with
most of them confirming that physical exercise reduces anxiety and depression
(Biddle, 2000; Biddle & Mutrie, 2008; Landers & Arent, 2007). In the first such
study, Yeung (1996) stated that the results of research mostly prove that mood
improves after one-time physical exercise, and that this is independent of sex, age,
or handicap of a participant. Positive effects were observed after both aerobic and
non-aerobic exercise of different duration and intensity; the effects usually lasted up
to 3–4 hours after finishing exercise. It is interesting that among participants studied
by Yeung (1996), the only group in whom mood worsened after physical exercise
was the group of pregnant women.
In the approach suggested by positive psychology, the emphasis has shifted to
factors responsible for psychological well-being. When accepting this approach, it
is important to discover whether one-time physical exercise improves positive state
factors, such as affect, vigour, level of energy, or euphoria. Reed and Ones (2006)
conducted a meta-analysis of 158 research studies conducted between 1979 and
2005. Only two of the research projects focused on pregnant women. Research
included in the meta-analysis showed that directly after aerobic exercise a signifi-
cant increase of positive arousal factors was observed, especially when the initial
level of positive arousal was lower than average. The effects were explicitly posi-
tive in the case of exercise of lower intensity, duration less than 35 minutes, and a
dose (intensity  duration) between small and moderate.
Is there a need to examine the acute effects of one-time physical exercise class?
Knowledge about the acute effects of exercise can contribute to the understanding
the mechanisms of the influence of physical activity on mental health. Long-term
 124 M. Guszkowska et al.

effects arise partly as a result of the accumulation of acute effects. There are few
studies on the influence of one-time physical exercise on the emotional states of
pregnant women. After one-time physical aerobic exercise, a significant decrease of
depression and anxiety factors was observed in pregnant women (Koltyn, 1994).
The research on pregnant women participating in aqua aerobics showed that the
exercise was responsible for an increase of positive mood level and mental state, a
decrease in levels of negative emotions, and a reduction in tiredness and fatigue
(Lox & Treasure, 2000). After one-time physical exercise classes, positive emo-
tional changes (decrease of anxiety and tension level) in pregnant women were
observed (Guszkowska & Bernatek, 2010).
The aim of the research was to compare changes in the level of emotional states
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after a session of relaxation and physical exercise and to determine the relationship
between those changes.

Methods
Participants
The research participants comprised 92 women aged 22–38 years (M = 29.61; SD =
3.45) in the second (n = 31) and the third (n = 61) trimesters of their pregnancy,
who upon enrolment into the study were between the 24th and 33rd weeks of their
pregnancies (M = 28.64; SD = 2.74). All the women had higher education, an
above-average socioeconomic status (middle class) and lived in a capital city or its
surrounding area. Of all the women, 77.2% (n = 71) were married, 22.8% (n = 21)
were in common-law relationships but were not officially married; 62.0% (n = 57)
did not work upon enrolment into the study, the rest were professionally active. All
respondents had been working before pregnancy. Women with multiple pregnancies,
women who had prior miscarriages and women who had abnormalities in the current
pregnancy were excluded from the research.
The relaxation group consisted of 46 pregnant women participating in birth
school classes with practical relaxation classes. The relaxation sessions took place
twice a week. The participants were familiarised with different relaxation
techniques: from breathing techniques, progressive relaxation, autogenic training
and relaxation supported by visualisation, to relaxation in pairs (mostly practiced
with the child’s father). Class duration varied depending on the subject, and fluctu-
ated between 30 and 50 minutes. The program lasted for 8 weeks (16 classes).
The second group underwent physical exercise and consisted of 46 pregnant
women. They participated in physical exercise classes from the Active nine months
programme for pregnant women twice a week, 50 minutes each class, and were
trained by experienced fitness instructors. The classes were voluntary. The
programme was established in content and form; it was comprised of general devel-
opmental exercises including elements of Pilates, yoga and body ball, muscle
strength and elasticity exercises, joint mobility exercises, and relaxation and breath-
ing exercises, and lasted for 8 weeks (16 classes).
The groups consisted of pregnant women enrolled in traditional birth school
classes organised by two obstetrics clinics in Warsaw. The programme of traditional
childbirth education classes focused on learning about pregnancy, labour, the period
of puerperium and childhood development in the infancy period. The programme
also developed the skills necessary for the care of a newborn and for proper
 Journal of Reproductive and Infant Psychology 125

responses during labour. The length of a class varied depending on the subject:
classes fluctuated lasting between 45 and 60 minutes. Classes were led by midwives
in cooperation with gynaecologists, paediatricians and psychologists. Classes ran for
6 weeks (12 classes). During birth school registration, women who met the preli-
minary criteria (in good health with a first, singleton, non-problematic pregnancy)
were offered participation in relaxation or physical exercise classes supplementary
to traditional birth school classes. Volunteers chose the supplementary classes
according to their preferences. Selection for the study was due to the fact that, in
the case of pregnant women, a control group awaiting intervention could not be cre-
ated (the duration of pregnancy is limited). Pilot studies had indicated that it would
be hard among pregnant women to obtain volunteers who would accept participat-
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ing in the research as a control group (without supplementary classes, but charged
with the necessity of completing the measurement tools). The study of the acute
effects accounted for only a part of the project. Long-term changes in various
psychological variables were also monitored, which required the use of the battery
of tests. An additional condition was to show a certificate from the woman’s physi-
cian confirming that there was no reason to disqualify her from the classes. Only
pregnant women who did not participate in organised exercise and relaxation
classes during pregnancy and in a period of three months prior to pregnancy
participated in the study. Women systematically exercising at home or already
participating in others physical or relaxation exercises classes were excluded.

Table 1a. Sociodemographic characteristics of exercise and relaxation group.

Exercise
n (%) Relaxation n (%) χ2
Trimester of pregnancy:
Second 15 (32.6) 16 (34.8) 0.049
Third 31 (67.4) 30 (65.2) ns
Marital status:
Married 38 (82.6) 33 (71.7) 3.152
Unmarried 8 (17.4) 13 (28.3) ns
Physical activity before pregnancy:
Active 30 (65.2) 29 (63.0) 0.047
Inactive 16 (34.8) 17 (37.0) ns
Employment during pregnancy:
Yes 17 (37.0) 18 (39.1) 0.905
No 29 (63.0) 28 (60.9) ns

Table 1b. Sociodemographic characteristics of exercise and relaxation group.

Exercise (M ± SD) Relaxation (M ± SD) ANOVA F

Age 29.48 ± 3.61 29.74 ± 3.32 0.130 ns
Week of gestation 28.52 ± 2.66 28.76 ± 2.83 0.174 ns
Self-rating of physical fitness 3.74 ± 0.65 3.67 ± 0.56 0.267 ns
Self-rating of health 4.11 ± 0.60 3.98 ± 0.58 1.120 ns
 126 M. Guszkowska et al.

This study used a quantitative comparative design. Because selection of the

groups did not meet the conditions of randomization, the participants were com-
pared by sociodemographic variables (Tables 1a,b). The one-way ANOVA and the
chi-square test were used. There were no significant differences between groups in
terms of age, marital status, working during pregnancy, physical activity before
pregnancy, self-rated health and physical fitness as well as characteristics of preg-
nancy (trimester, gestation week).

Instruments
To examine emotional states, the UWIST Mood Adjective Checklist (UMACL) by
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Matthews, Chamberlain and Jones (1990) was applied, in a Polish adaptation

designed by Goryńska (2005). The authors distinguished three dimensions of core
affect: tense arousal (TA), energetic arousal (EA), and hedonic tone (HT). For the
instructions applied in this research, the participants were asked to determine how
they felt ‘at the moment’. The Polish version of UMACL has good psychometric
properties. The scale’s reliability measured with Cronbach’s α varied between 0.89
(TA) and 0.95 (HT). Theoretical validity was defined through factor analysis, inter-
correlations and the correlations between UMACL scales and personality and self-
esteem indices.
The state-anxiety scale of the State–Trait Anxiety Inventory (STAI) by
Spielberger et al. (1970), in a Polish adaptation of Wrześniewski, Sosnowski, and
Matusik (2002), was also used. The reliability of the Polish version of the scale
was valued on the basis of inner consistency (Cronbach’s α for appropriate age
group = 0.87). The validity of the scale was estimated by correlating its results with
different personality dimensions.
The authors’ own survey instrument was also used. It provided basic informa-
tion about respondents (age, marital status, education, and employment before and
during pregnancy), their leisure time, physical activity before pregnancy (active–
inactive), and self-evaluations of one’s health and physical fitness on a 5-point Lik-
ert scale (from 1 = very poor to 5 = very good).
The measurement of emotional states was done in the middle of the course
immediately before and after the seventh classes. In the relaxation group, this was a
session of progressive relaxation by Jacobson (1948) and Siek (1999); in the
physical exercise group, it was a typical class of the Active nine months
programme.

Procedure
Progressive relaxation classes were held in groups of 8–10 people. At the beginning
of the class, the instructor reminded participants of the assumptions of progressive
relaxation that had been discussed in detail in the previous classes. After taking a
comfortable, recumbent position the Jacobson’s progressive relaxation procedure
utilising Morris’ modification (Morris, 1977; Siek, 1999) was followed according to
the instructions provided by the instructor. The training included 39 exercises; each
of the exercises lasted about 15–20 seconds; breaks between the exercises lasted
10–15 seconds. While performing the exercises described by the instructor, the
participants contracted and gradually loosened consecutive muscle groups, focusing
 Journal of Reproductive and Infant Psychology 127

on proprioceptive sensations. The exercises consecutively involved the muscles of

the arms and hands; neck, face and forehead; chest and abdomen; buttocks, thighs,
calves and feet. The participants then remained in a state of full relaxation and
focused on the sensations coming from the muscles. After class ended, there was a
discussion about potential difficulties, participants’ experiences during the training
and the possibility of using the exercises in everyday life.
The physical exercise classes were carried out in groups of 8–10 people. The
classes started with a 5-minute warm-up, which was followed by aerobic exercises
involving the leg, buttock and abdomen muscles with light to moderate intensity
and balance exercises (15 minutes). Next were pelvic floor muscle exercises (10
minutes) as well as stretching and joint mobility increasing exercises (10 minutes).
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During the cool-down stage, relaxing and breathing exercises (5 minutes) were
performed. After the end of the class, there was a short discussion about the experi-
ences of the participants.
The classes were 50 minutes long. The analysis was applied only to the results
of the women who took part in all prior classes.
The research project was accepted by the Senate Select Committee on Ethics of
Józef Piłsudski University of Physical Education in Warsaw.

Results
To determine whether the baseline emotional state of the participants in both groups
were similar, the result of the pre-test was compared by one-way ANOVA. No sig-
nificant differences were observed in the level of anxiety (F(1,91) = 0.005), hedonic
tone (F(1,91) = 0.061) and tense arousal (F(1,91) = 0.217). The differences between
groups in terms of energetic arousal reached the level of trend (F(1,91) = 3.015; p
= 0.086); energetic arousal was only a little higher in the physical exercise group
than in the relaxation group. Thus the emotional states of participants were similar
before the classes started and this allowed for further analysis to be conducted,
without controlling their initial level.
A repeated-measures ANOVA (time  condition) was used in order to define
the changes in emotional states and their inter-group variability. Appropriate data
have been presented in Table 2.
The level of state anxiety and the level of tense arousal decreased significantly
after classes (significant main time effect); they did not vary depending on the group
(main group effect and interaction time  condition were not significant). Hedonic
tone and energetic arousal increased significantly (main time effect). The main group
effect was significant only for energetic arousal; the time  condition interaction
reached the level of trend. The level of energetic arousal was higher in the exercise
group. Only in this condition was significant increase of energetic arousal observed.
A repeated-measures ANOVA conducted within the groups proved that there
was a significant decrease in anxiety and tense arousal in all of the respondents, but
that the effect was stronger in the relaxation group. Hedonic tone increased signifi-
cantly in both groups, where as there was a significant increase in energetic arousal
in the exercise group only.
The groups significantly varied in the post-test level of energetic arousal
(F = 10.217; p = 0.002): energetic arousal was significantly higher in the exercise
 Downloaded by [Flinders University of South Australia] at 10:21 05 October 2014

128

Table 2. Changes in emotional states after one-time classes of exercise and relaxation.

Exercise Relaxation Two-way ANOVA

Before After One-way ANOVA Before After One-way Time
Emotional state (M ± SD) (M ± SD) F, p, η2 (M ± SD) (M ± SD) ANOVA F, p, η2 F, p, η2 Group F, p, η2 Interaction F, p, η2
State anxiety 33.52 ± 6.70 28.85 ± 6.50 30.593; 33.65 ± 9.36 27.62 ± 7.62 33.209; 64,802; 0.130; ns 1.036; ns
< 0.001; < 0.001; < 0.001;
0.405 0.480 0.444
Hedonic tone 33.52 ± 4.58 35.78 ± 4.03 18.216; 33.24 ± 5.70 35.19 ± 5.75 17.280; 33.680; 3.247; ns 0.176; ns
< 0.001; < 0.001; < 0.001;
0.288 0.324 0.294
Energetic arousal 31.61 ± 4.76 34.00 ± 4.37 20.445; 29.51 ± 6.23 29.89 ± 7.24 0.155; ns 7.4033; 7.509; 3.715;
< 0.001; 0.01; 0.008; 0.057;
M. Guszkowska et al.

0.3012 0.080 0.085 0.044

Tense arousal 14.83 ± 4.09 12.52 ± 3.29 27.225; 14.41 ± 4.07 11.57 ± 3.91 34.938; 61.792; 0.665; ns 0.772; ns
< 0.001; < 0.001; < 0.001;
0.377 0.493 0.433

Note: bold indicated significant effects.

 Journal of Reproductive and Infant Psychology 129

group than in the relaxation group. There were no differences in state anxiety, tense
arousal, and hedonic tone after classes.

Discussion
The research results showed that after both the relaxation session and one-time
physical exercise, the emotional state of pregnant women improved. These results
agree with the results of research conducted among the general population and
among women showing acute effects of relaxation (Manzoni et al., 2008) and
physical exercise (Biddle & Mutrie, 2008; Landers & Arent, 2007; Reed & Ones,
2006).
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Until now, there has been little research done that compares the effectiveness of
relaxation session and one-time physical exercise on the emotional well-being of a
person. Only a few research projects have compared the anxiolytic effects of
different physical exercise and relaxation techniques (Brown, Morgan, & Raglin,
1993; Crocker & Grozelle, 1991; Glazer & O’Connor, 1992). No significant
differences were observed in the results of those two procedures.
Comparing the effect size in our study shows, however, that the emotional
benefits from the relaxation session and physical exercise were a little different.
Relaxation caused a distinct decrease of negative emotional states – anxiety and
tense arousal and an increase of hedonic tone – while energetic arousal did not
increase. In the physical exercise group, the decrease in anxiety and tension was
smaller, the increase in pleasure feeling was not as distinctive, but the increase in
energetic arousal was more significant. Saklofske, Blomme, and Kelly (1992)
achieved similar results by comparing the effects of exercise and relaxation. In both
cases, the decrease in tense arousal was significant and the level of energy increased
only in the physically active group. Therefore, physical exercise seems to be less
effective in reducing negative emotional states than relaxation sessions, but more
successful in increasing positive states.
The effectiveness of different relaxation methods in decreasing anxiety levels
was confirmed in a meta-analysis conducted by Manzoni et al. (2008). Also, research
on pregnant women showed the decrease of state anxiety level after relaxation clas-
ses (Newham et al., 2012). In the research presented in this paper, a progressive
relaxation technique was used. In previous research this technique was particularly
effective in both the general population (Manzoni et al., 2008) and in pregnant
women (Newham et al., 2008; Urech et al., 2010). Relaxation exercises were found
to be an effective way to reduce negative emotional states in pregnant women as
well, despite the women’s reduced reactivity for exterior stimuli. The effectiveness
of the relaxation sessions in the reduction of negative emotional states was slightly
higher than the effectiveness of the physical exercise classes. In the relaxation group,
however, no changes in energetic arousal were observed. Relaxation is directed to
reduce general activation level. It causes a decrease in the intensity of negative emo-
tions, but can also cause a decrease in vigour and an increase of drowsiness.
The results presented in this article are consistent with the results achieved
during the research in which it was stated that one-time physical exercise contributes
to the improvement of the emotional well-being of different groups (Biddle, 2000;
Biddle & Mutrie, 2008; Landers & Arent, 2007; Reed & Ones, 2006; Yeung, 1996),
including groups of pregnant women (Guszkowska & Bernatek, 2010; Koltyn, 1994;
 130 M. Guszkowska et al.

Lox & Treasure, 2000). The effectiveness of physical exercise seems to be especially
high in relation to arousing positive states connected to activation.
It is consistent with the Thayer (1989) model, which includes two dimensions
of arousal: energetic arousal and tense arousal. In Thayer’s view physical
activity directly influences energetic arousal, making it more intense, while relaxa-
tion techniques decrease tense arousal. Because energetic arousal and tense arousal
are inversely proportional, the increase of energetic arousal after exercise causes the
decrease of tense arousal (and vice versa). It brings about further emotional and
cognitive consequences. Energetic arousal is emotionally positive while tense arou-
sal is emotionally negative. Thus, the increase of energetic arousal and the decrease
of tense arousal leads to mood improvement in an exercising person; however, this
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is achieved differently.
Russell (1980) stated that there are two independent dimensions: valence (plea-
sure–distress) and activation (excitement–drowsiness). This allows four categories
of affect to be distinguished: positive activation (pleasant joyful excitement con-
nected to feeling the energy flow and vigour), positive deactivation (connected to a
feeling of inner peace and pleasure), negative activation (suffering) and negative
deactivation (sadness, depression). Relaxation, which leads to positive deactivation,
causes a decrease of negative states connected to negative arousal–anxiety and ten-
sion, a decrease (or stabilization) of general activation, and as a result, an increase
of feelings of pleasure. Physical exercise also leads to an increase of hedonic tone,
but does so differently: by causing an increase of general level of activation felt like
a surge of vitality, vigour and vital energy.
Compared to pregnant women participating in the relaxation classes, those
attending physical exercise already had slightly higher levels of energetic arousal in
the pre-test. It cannot be excluded that this was an effect of participating in previous
classes. Despite this fact, the increase of energetic arousal also occurred in this
group. This can be considered as additional evidence of the effectiveness of exer-
cise, as it is difficult to achieve a further increase of positive arousal in people
whose level is already above normal (Reed & Ones, 2006).
On the basis of the results obtained, some recommendations can be formulated
for people organising and conducting activities preparing for childbirth. First, tradi-
tional birth school classes can be successfully supplemented with the elements of
relaxation training. In this study, the practical effectiveness in lowering the anxiety-
based tensions by means of a one-time Jacobson’s training session with a Morris
modification has been confirmed. As the results of previous studies have indicated,
other techniques (Schultz’s autogenic training, meditation, imagination techniques)
can also benefit pregnant women (Newham et al., 2012; Teixera et al., 2005; Urech
et al., 2010). It seems that the greatest benefits occur when, during the classes, the
participants are familiar with various techniques in order to make their choice
according to their preferences. It is important to emphasise the need for regular
exercise (even several times a day) and to encourage pregnant women to monitor
its effects (e.g. using observation diaries). Relaxation exercises can be particularly
helpful for pregnant women who cannot attend physical exercise classes due to
medical contraindications.
The studies presented suggest that physical exercise can contribute in particular
to increasing energy and elimination of the sensations of weariness, fatigue and a
lack of energy. Physical exercise can be successfully offered to all pregnant women
who show no medical contradictions. However, it is good to first convince future
 Journal of Reproductive and Infant Psychology 131

mothers that physical exercise is not only safe but also beneficial for both them-
selves and their children, as many of them are not convinced of this fact (Evenson
& Bradley, 2010). Knowledge among medical staff is limited – 60% of American
midwives were unaware of the recommendations of the American College of
Obstetrics and Gynecologists concerning exercise during pregnancy (Bauer, Bro-
man, & Pivarnik, 2010). Thus, these issues should not only be the subjects of edu-
cation for pregnant women, but for medical staff as well.
The research presented in this article has some limitations. First, all the women
had higher education and lived in a capital city. All of them had worked before
pregnancy and had better-than-average financial situations. These factors
significantly limit the ability to generalise from the results. Second, the assignment
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of participants to the groups did not meet the conditions of randomisation, because
the respondents chose the group according to their personal preference. Third,
women in the physical exercise group had slightly higher energetic arousal before
the classes than women in the relaxation group.

Conclusions
Despite those limitations, the achieved results suggest that both the relaxation clas-
ses and the one-time physical exercise classes can cause significant increases in the
emotional comfort of pregnant women. Progressive relaxation mainly causes a
decrease of the negative affect, while physical exercise is mainly responsible for an
increase of positive arousal. Therefore, relaxation training will bring more benefits
to pregnant women having higher levels of anxiety and depression, while physical
exercise can be especially useful in fighting fatigue and a decrease in energy, which
are so common during pregnancy.

Acknowledgements
The research was financed under project no. NN 404 017838, ‘The influence of pregnant
women’s physical activity on their mental and physical health, the course of pregnancy, and
childbirth’, by the Ministry of Science and Higher Education in Poland.

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