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

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.