A Comparative Analysis of Stretching Exercise and Pregnancy Exercise on Sleep Quality in Pregnancy: A Quasi Experiment

Sleep problems are very common during pregnancy, especially in the third trimester, when physical discomfort, hormonal changes, and anxiety often make it difficult for women to rest well. Poor sleep can affect a mother's physical and emotional health, contribute to stress and fatigue, and may even influence labour and delivery outcomes. Although exercise is widely recommended during pregnancy, there is still limited research on which types of exercise are most helpful for improving sleep.

This study aims to better understand whether traditional pregnancy exercise or stretching exercise can help improve sleep quality among third trimester pregnant women living in Palangka Raya, Central Kalimantan. Both types of exercise are commonly used in Indonesia, but their specific effects on sleep have not been directly compared in a structured research setting.

A total of 60 pregnant women between 28 and 30 weeks of gestation will take part in the study. Participants are divided into two groups based on the midwifery clinic where they receive care. One group will participate in traditional pregnancy exercise, a structured program developed by the Indonesian Ministry of Health that includes breathing techniques, gentle movements, and relaxation. The other group will take part in a stretching exercise program, which focuses on improving flexibility and reducing muscle tension.

Both programs run for three weeks, with two supervised sessions per week, each lasting about 45-60 minutes. Participants also receive a booklet and video materials so they can practise at home.

To understand how these exercises affect sleep, participants complete several assessments before and after the program:

• Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality
• Hamilton Anxiety Rating Scale (HARS) to assess anxiety levels
• International Physical Activity Questionnaire (IPAQ) to evaluate overall physical activity
• Basic health measurements such as blood pressure, weight, and height

By comparing the results from both groups, the study will explore whether one type of exercise leads to greater improvements in sleep quality or anxiety. The findings may help midwives, health workers, and pregnant women choose effective, safe, and accessible exercise options to support better sleep during late pregnancy.

The goal of this research is to promote healthier pregnancies by finding easy, non-medicinal ways to help expectant mothers sleep better and enhance their overall well-being.

Inclusion criteria

• Pregnant women in their third trimester (28-30 weeks of gestation at enrollment).
• Having sleeping disturbance complaints.
• Aged more than 19 years old.
• Being under prenatal clinical follow-up
• Not having or participating in specific treatment for sleeping disturbance in the last 3 months
• Able to participate in light to moderate physical activity as assessed by clinic staff.
• Signing informed consent for study participation.

Exclusion criteria

• Failure to attend at least 70% of the 12 planned sessions
• Having pregnancy complication.
• Gestational ages < 28 or > 30 weeks.
• Not having bleeding history, abortion.
• Not having multiple pregnancy.
• Medical or obstetric conditions that make exercise unsafe (e.g., preeclampsia, placenta previa, risk of preterm labor, uncontrolled hypertension)
• Current participation in another structured exercise program.
• Severe musculoskeletal problems that limit movement.