Return to Sport After Childbirth: Current Evidence on Pelvic Floor Dysfunction, Rehabilitation and Safe Return to Physical Activity - A Narrative Review

Abstract

Background: Childbirth is a major physiological event that may affect women’s health, functional capacity, and participation in physical activity for several months postpartum. Exercise is important in restoring physical function, psychological well-being, and quality of life.  Aim: To summarize current evidence on pelvic floor dysfunction, postpartum rehabilitation, and recommendations for safe return to physical activity and sport after childbirth.  Material and methods: A narrative review was conducted using PubMed, Scopus, and Google Scholar (2010–2025). Randomized controlled trials, cohort studies, systematic reviews, and clinical guidelines on postpartum exercise and return to sport were included and analyzed qualitatively.  Results: Postpartum pelvic floor dysfunction, including urinary incontinence and pelvic organ prolapse, is common and may limit physical activity. Pelvic floor muscle training and trunk stabilization exercises are recommended as first-line interventions. Evidence supports a symptom- and function-based approach to return-to-sport decisions rather than fixed timelines. However, heterogeneity of interventions and limited high-quality evidence, especially in athletic populations, weaken the strength of recommendations.  Conclusions: Return to sport after childbirth should be individualized and based on functional recovery and symptom resolution. Further high-quality research is needed to develop standardized postpartum rehabilitation guidelines.