The biopsychosocial barriers and enablers to being physically active following childbirth: a systematic literature review

Abstract

Background: Physical activity brings significant health benefits. Childbirth presents many physical, emotional and practical challenges to women and is known to disrupt engagement in regular physical activity. However, the specific barriers and enablers to physical activity in the postpartum period have not yet been systematically identified. Adequate understanding of these issues is crucial before effective interventions can be developed.

Objectives: The primary objective was to identify the biopsychosocial barriers and enablers to physical activity following childbirth.

Methods: A systematic literature review of qualitative research was conducted. Relevant literature was sourced using five online databases (CINAHL, Maternity and Infant Care, MEDLINE, PsycINFO and PubMed) and primary snowballing. Studies which met the pre-determined inclusion criteria were critically appraised independently by research team members and then collectively discussed to reach consensus.

Results: A total of 391 potential records were identified. Following the application of eligibility criteria and removal of duplicates, six qualitative studies remained, all of which identified barriers and enablers to postpartum physical activity. Data demonstrated that lack of time and issues surrounding childcare were the most common barriers to physical activity, whilst a common enabler was social support. Reported benefits of physical activity in the postpartum period included improved mental well-being and weight loss.

Conclusions: A number of specific barriers, enablers and benefits were identified. Future research should aim to develop and evaluate postpartum physical activity interventions. Outcomes should be collected prospectively at multiple time points and more diverse participant samples should be recruited.

Keywords:

• Exercise
• parturition
• postpartum period
• qualitative research
• review

Acknowledgements

The authors would like to acknowledge Pauline Shaw, librarian at the University of the West of England, Bristol who assisted with development of the search strategy.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Catherine Burton

Catherine Burton has a first class honours degree in Sport Rehabilitation and currently works within private practice and rugby union. Her research interests include end-stage rehabilitation of musculoskeletal disorders and pain psychology.

Emily Doyle

Emily Doyle is a Sport Rehabilitator currently studying a Master of Science in Musculoskeletal Sport Science and Health at Loughborough University. In the future, she aspires to work with and enhance an elite sports team using a musculoskeletal rehabilitation background as well as a sport science perspective to improve performance.

Kariss Humber

Kariss Humber is currently employed as an Academy Sport Rehabilitator at an elite rugby union club. Her main interests include implementing rehabilitation strategies and protocols with musculoskeletal disorders in order to return individuals to sport.

Camille Rouxel

Camille Rouxel is a Sport Rehabilitator working in multiple private clinics as an Injury and Rehabilitation Specialist in South Wales. Her main research interests relate to the prevention and enhancement of health through the use of physical activity interventions.

Steffany Worner

Steffany Worner is a Sport Rehabilitator currently working as Head of Medical of a rugby club in Bristol and within multiple private clinics. Her key interests are the rehabilitation of musculoskeletal injuries and strength and conditioning within sport, and working with clients to get them back competing.

Richard Colman

Richard Colman is a Sport Development Professional working for the West of England Sport Trust (Wesport). The charity aims to increase participation in sport and physical activity across the West of England. Wesport contribute to Improving Lives in the West of England through championing, developing and delivering sport and physical activity.

Shea Palmer

Shea Palmer is a physiotherapist currently employed as Professor of Musculoskeletal Rehabilitation at the University of the West of England Bristol. His main research interests are related to the assessment and management of musculoskeletal disorders.