Effects of Exercise Interventions on Physical, Psychological, and Functional Outcomes Within the First 12 Months Postpartum: A Systematic Review

Background/Objectives: Pregnancy and childbirth are associated with substantial physical and psychosocial changes that may affect the wellbeing of postpartum women. This systematic review aimed to map the types of supervised exercise interventions during the postpartum period and the physical, functional, and psychological outcomes assessed. Methods: Following the PRISMA 2020 statement, PubMed, Web of Science and Scopus were searched for randomized controlled trials (RCTs) published between January 2015 and December 2025. Eligible trials evaluated supervised exercise interventions in women within 12 months of childbirth. Risk of bias was assessed with the Cochrane Risk of Bias tool, and results were summarized through a narrative synthesis by outcome domain and type of comparison. Results: Seventeen randomized controlled trials were included (1605 randomized and 1325 analyzed women). Most trials enrolled women with diastasis recti abdominis or low back or lumbopelvic pain, and neuromuscular and core stabilization programs were the most frequently investigated. Compared with no exercise or usual care, between-group differences favored exercise for inter-recti distance in four of eight trials, for pain in four of five, and for disability in three of four; these trials were few, and several were at high risk of bias. No exercise program was consistently superior to another. Risk of bias was high in all trials for participant-reported outcomes and in 11 of 15 trials for assessor-measured outcomes, mainly because of unblinded participants and outcome assessors and of inconsistencies in reported data. Conclusions: Within the scope of this review, evidence on supervised postpartum exercise is mainly rehabilitative and focused on specific musculoskeletal conditions. Future trials should include women not selected for specific conditions, use standardized outcome measures across domains, and investigate the long-term effects.