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Bridging the Gap: Integrating Gym-Based Childcare For Non
Communicable Disease Prevention in Post Partum Women
Verena Atud Achick-Muyu
Wolfson Institute of Population Health, Queen Mary University of London, London, UK
DOI: https://dx.doi.org/10.51584/IJRIAS.2025.10100000216
Received: 07 November 2025; Accepted: 14 November 2025; Published: 26 November 2025
ABSTRACT
Background: Postpartum women face elevated risks of developing non-communicable diseases (NCDs),
including cardiovascular disease, diabetes, and depression. Despite well-documented benefits of physical
activity, many mothers struggle to meet recommended activity levels due to structural, social, and
psychological barriers, chief among them being a lack of childcare support.
Objective: This narrative review examines the intersection between postpartum physical activity, gym
accessibility, and childcare availability, identifying existing policy gaps and proposing gym-based childcare
services as a pragmatic and equity-driven solution to promote maternal health.
Methods: A narrative review was conducted using PubMed, Scopus, and Google Scholar databases. Studies
published between 2019 and 2024 focusing on postpartum women’s health, physical activity, childcare
barriers, and NCD prevention were included. Twenty (20) peer-reviewed articles were analyzed thematically to
identify recurring barriers, facilitators, and gaps in policy and program design.
Results: The thematic synthesis identified three primary themes: 1) Exercise as Clinical Therapy for mental
health (e.g., PPD); 2) Structural and Cultural Inequities that impede access (e.g., childcare burden, modesty
requirements); and 3) Policy Deficits in integrating fitness and healthcare. Findings reveal persistently low
physical activity rates among postpartum women, largely due to childcare burdens, fatigue, time constraints,
and lack of tailored gym programs. Despite high-level evidence supporting exercise as a clinical treatment for
postpartum depression (Deprato et al., 2025), structural inequities such as the absence of childcare in fitness
centers and poor urban planning further limit access.
Conclusion: Postpartum physical activity remains a strategy that is not adequately implemented for NCD
prevention. Integrating childcare services into gyms offers a promising, community-based solution that
promotes both maternal well-being and gender equity. Multisectoral collaboration among healthcare, urban
planning, and fitness sectors is urgently needed to make physical activity accessible and sustainable for
postpartum women.
Keywords: Postpartum, physical activity, childcare, non-communicable diseases, gender equity, health policy,
gym accessibility.
INTRODUCTION
Non-communicable diseases (NCDs) are the leading cause of disability and mortality among women of
reproductive age (Abdullahi et al., 2025), yet they often go unaddressed in the postpartum period (Adams et
al., 2023). Studies have consistently shown that regular physical activity supports cardiovascular health,
metabolic health, mental health, weight regulation, and plays a key role in reducing NCD risk. Still, there have
been barriers to postpartum women’s participation in physical activity. Some of these barriers including but not
limited to lack of childcare and limited access to supportive exercise environments remain widely overlooked
in public health systems.
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The postpartum period is a critical, yet often neglected, phase in maternal health, defined by profound
physical, emotional, and psychological changes. While many healthcare systems rightly prioritize prenatal
care, the crucial postpartum phase frequently receives insufficient attention. This oversight is significant, given
its clear link to major maternal health issues, including postpartum depression (Suzuki, 2022), increased stress,
and the elevated risk for chronic non-communicable diseases (NCDs). These chronic risks, which include
cardiovascular disease, diabetes, and certain cancers (Wilcox et al., 2024), contribute substantially to disability
and mortality among women of reproductive age. Unfortunately, these long-term conditions are routinely
missed or addressed insufficiently in current early postpartum care strategies.
Addressing the persistent threat of these chronic NCDs in the postpartum phase requires moving beyond
standard clinical follow-up toward sustainable, community-based strategies that offer long-term benefits to
women’s well-being. A key determinant of postpartum health that is often overlooked is physical activity.
Several studies have demonstrated that regular physical activity improves mood, reduces symptoms of anxiety
and depression, enhances cardiovascular and metabolic health, and supports weight regulation and social
engagement (You et al., 2024). Crucially, recent systematic evidence confirms that exercise-only interventions
significantly reduce the odds of developing major postpartum depression, establishing physical activity as a
powerful, non-pharmacological treatment option (Deprato et al., 2025).
Gender norms have historically shaped women’s participation in physical and social activities, but postpartum
women face especially heavy inequity. Many cannot access recovery resources like indoor fitness centres due
to lack of childcare support, fatigue, time constraints, childcare responsibilities, low motivation, and limited
access to affordable childcare (Hawkins et al., 2025; Kumar & Anand, 2025). Women living in urban settings
may face even greater challenges due to the erosion of traditional family structures, limited informal support,
and restricted access to safe outdoor spaces or parks. In some areas, air pollution and traffic concerns further
limit the feasibility of outdoor activity (Otu et al., 2024; Peters & Nagel, 2025).
Although home-based fitness programs and outdoor activities have benefits, they often lack the structure,
intensity, and professional support of gym-based programs. Moreover, many postpartum women who
previously engaged in gym-based fitness are more likely to return to familiar routines, and gyms may provide a
more motivating environment than isolated home workouts. However, the absence of supervised childcare
within fitness centres remains a major barrier. Without support, mothers are unable to participate in gym-based
programs that not only improve physical fitness but also alleviate isolation and foster social connection
(Ajibade et al., 2023).
This paper proposes a practical, equity-centered solution: integrating nursery services within gyms and fitness
centres. This model eliminates a key structural barrier childcare while enabling postpartum women to resume
or initiate structured physical activity in a supportive environment. In addition to improving health outcomes,
it promotes gender equality, social well-being, and economic participation.
LITERATURE REVIEW
2.1 Defining the Postpartum Period
The postpartum period is generally known as the time after birth till six weeks after (Grandi et al., 2024).
However, many experts extend this timeframe up to one year due to ongoing physiological, psychological, and
social changes during this phase (Deering et al., 2024). This period is critical for maternal recovery,
encompassing hormonal fluctuations, physical healing, emotional adjustments, and new caregiving
responsibilities (Le, 2025). Despite these complexities, healthcare systems predominantly focus on care within
the immediate weeks following delivery, often overlooking the extended needs of postpartum women (Phillips
et al., 2024).
2.2 Non-Communicable Diseases (NCDs) in the Postpartum Period
Non-communicable diseases (NCDs), including cardiovascular disease, diabetes, certain cancers, and mental
health disorders, account for approximately 74% of global deaths annually and contribute significantly to
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disability among women of reproductive age (Malik & Ahmad, 2025; Naeem et al., 2025). Physiological
changes during pregnancy and childbirth may heighten the risk for NCDs (Pannia et al., 2022). Increased
blood volume and clotting factors, insulin resistance, and elevated blood pressure during pregnancy increase
the likelihood of gestational diabetes and pregnancy-induced hypertension, conditions that often persist
postpartum (Gerede et al., 2025; Karcz & Królak-Olejnik, 2024). Women with gestational diabetes have up to
a tenfold increased risk of developing type 2 diabetes later in life (Vounzoulaki, 2023). Additionally,
postpartum weight retention, particularly following excessive gestational weight gain, is strongly linked to
obesity and metabolic syndrome, both significant risk factors for NCDs (Madlala et al., 2023).
Mental health outcomes such as postpartum fatigue, chronic stress, and depression are also closely associated
with NCD risk (Hossain et al., 2025). These often arise due to sleep disruption, hormonal changes, and
caregiving demands without sufficient support(Samuel-Soma Mofoluwa Ajibade et al., 2024). High-certainty
evidence from a recent systematic review and meta-analysis confirms that engaging in regular physical activity
postpartum significantly reduces the symptoms of both depression and anxiety (Samuel-Soma M Ajibade,
Gloria Nnadwa Alhassan, et al., 2024; Hopper, 2024). Social and environmental barriers, including fatigue,
childcare burden, limited access to fitness facilities, and inadequate support systems, further reduce postpartum
women’s opportunities for physical activity (Atkinson et al., 2025).
2.3 Physical Activity as Primary Prevention for Postpartum NCDs.
Physical activity is a preventive measure that can address various NCDs, including cardiovascular disease,
type 2 diabetes, certain cancers, and mental health disorders (Ming et al., 2025; Wang et al., 2023). When
exercise is adequately and regularly done in the postpartum period, it supports physical recovery and prevents
long-term health complications. A systematic review reported that moderate postpartum physical activity
significantly reduces the risk of postpartum depression, improves mood, and enhances quality of life (Deprato
et al., 2025). Furthermore, evidence suggests that to achieve a moderate clinical reduction in depressive
symptoms, women need to accumulate a minimum of 350 MET-min/week (Metabolic Equivalent of Task) of
physical activity (Samuel-Soma M Ajibade, Angela Siew Hoong Lee, et al., 2024; Deprato et al., 2025).
Because depression and chronic stress contribute to cardiovascular and metabolic disorders (Lisco et al.,
2024), these findings highlight the importance of promoting exercise postpartum.
Postpartum physical activity also improves glucose metabolism and weight regulation, reducing risks
associated with obesity and insulin resistance (Taousani et al., 2025) . A study found that women resuming
physical activity within six months postpartum had lower rates of weight retention and central adiposity, which
are predictors of cardiovascular risk (Ajibade et al., 2025; Hoong et al., 2025; Quaderer et al., 2025). Group-
based exercise programs can provide extra psychological and social advantages by reducing feelings of
isolation and encouraging peer support (Dam & Rhind, 2020).
Despite these benefits, physical activity levels among postpartum women remain low. Data from the UK
Millennium Cohort Study showed that only 20–30% of women after childbirth meet the recommended
physical activity guidelines, and there are notable declines in physical activity during the first year postpartum
(Samuel-Soma M Ajibade, Anwar PP Abdul Majeed, et al., 2024; Mielke et al., 2021).
2.4. Barriers to Gym Access and Built Environment Challenges
Postpartum women face multiple social and structural barriers restricting access to gyms and fitness centers.
The most frequently reported barrier is lack of affordable and accessible childcare (Spence et al., 2024).
Gender norms often position caregiving as the woman’s primary responsibility, limiting opportunities for self-
care and exercise (Adam et al., 2023). Additional structural constraints include gym costs, inconvenient
locations, limited postpartum-specific programming, and transportation challenges (Adamo et al., 2024).
Barriers such as fatigue, limited time, inadequate social support, and lack of childcare disproportionately affect
urban women and those with fewer resources (Love et al., 2024). Furthermore, in many cultures, such as those
examined in Iran, women report a distinct necessity to exercise in indoor, private, and female-only facilities
due to cultural requirements for modest dress (Yap et al., 2024). This cultural barrier makes reliance on public
outdoor spaces non-viable and reinforces the necessity of accessible gym infrastructure (Mohamadpour, 2025).
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Psychological barriers such as body image concerns, feelings of guilt, and fear of judgment can also
discourage postpartum women from attending gyms, especially when facilities lack mother-friendly
environments or trained instructors (Mohamadpour, 2025). Even women with prior gym experience may
struggle to re-engage postpartum without adequate childcare or flexible class options (Darroch et al., 2025).
Urban planning efforts often neglect postpartum women’s needs, failing to provide indoor exercise spaces near
homes and lacking integration with childcare services (Wanner et al., 2024). This infrastructural gap reinforces
health inequities by favoring individuals with greater time, resources, and informal support networks.
2.5 Outdoor Physical Activity: Benefits and Limitations.
Several studies have pointed to the positive effects of green spaces on physical and mental health and in turn
addressing NCDs (Geneshka, 2023; Vaidya et al., 2023). Whether walking with a stroller or participating in
fitness groups in parks, outdoor physical activity is widely recommended as a cost-effective alternative to
gym-based activity for postpartum women (Lavoie et al., 2025). Exposure to nature has been linked to reduced
stress and enhanced mood, supporting mental and physical well-being.
However, outdoor physical activity presents challenges including adverse weather, seasonal variation, safety
concerns, and lack of pedestrian-friendly infrastructure (Lewis, 2024; Lomadze, 2024). Moreover, outdoor
activity often lacks the intensity, structure, social support, and professional guidance available in gym settings,
which are important for specific postpartum recovery goals like pelvic floor rehabilitation and cardiovascular
conditioning (Donnelly et al., 2024; Van Hauwaert et al., 2025).
2.6 Influence of Pre-Pregnancy Gym Habits on Postpartum Exercise.
Women’s familiarity with gym environments before pregnancy strongly influences their likelihood of resuming
structured exercise postpartum. Regular pre-pregnancy gym users tend to return to exercise routines more
readily due to established habits, confidence, and stronger exercise identity (Jamshidi et al., 2023). This
continuity supports motivation and perceived competence, facilitating adherence (Kvarnström et al., 2021).
Nevertheless, common postpartum barriers such as childcare demands, fatigue, and guilt affect even
experienced exercisers. Women without prior gym experience may encounter additional psychological
obstacles, including a lack of confidence and fear of judgment. Customized interventions that offer childcare,
beginner-friendly programming, and peer support can promote inclusivity and increase exercise participation
across all experience levels (Ajibade et al., 2022; Ominyi & Clifton, 2025).
2.7. Policy Gaps
Although postpartum health is increasingly recognized as critical for NCD prevention, existing public health
policies inadequately address the social and structural barriers limiting postpartum women’s access to physical
activity (Hafeez et al., 2023). Many existing policies address clinical postpartum care, such as postpartum
hospital visits and routine medical check-ups, without adequately focusing on holistic maternal and infant
monitoring. Furthermore, these existing policies underprioritize preventive, community-based strategies that
support long-term health outcomes.
One notable gap is that gyms and fitness centers don't offer incentives or requirements for childcare services.
This is important because a lack of childcare is a well-known barrier to exercise after giving birth (Lavoie et
al., 2025). Additionally, urban planning and public health initiatives frequently overlook the need for safe,
accessible green spaces tailored to postpartum women’s needs, further restricting physical activity
opportunities (Chan et al., 2024). Again, fitness facilities sometimes lack postpartum-specific programming,
and health promotion campaigns rarely target postpartum women with tailored messaging.
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2.8. Justification for Scope
Although the postpartum phase is defined by conventional medicine as the period from birth up to 6–8 weeks,
the consequences of birth can lead to conditions like postpartum depression, a mental disorder in women that
can persist even decades after birth. This challenge in defining the endpoint leads some researchers to argue for
an extended conceptual definition. For the purpose of this study, Postpartum may span up to 5 years for women
with small children who have not started school and are dependent on parental care, reflecting the duration of
the primary childcare barrier.
Addressing these gaps requires multisectoral collaboration between healthcare, urban planning, social services,
and the fitness industry to develop inclusive, equitable infrastructures supporting postpartum physical activity.
3. Methodology: Search Strategy and Selection
Data Sources and Search Strategy
This narrative review was conducted to identify, synthesize, and summarize relevant peer-reviewed literature
related to postpartum physical activity and non-communicable disease (NCD) prevention. The search was
conducted across three major electronic databases: PubMed, Scopus, and Google Scholar (for comprehensive
academic coverage).
The search strategy utilized Boolean operators ("AND", "OR") to combine key terms and concepts, including:
"postpartum," "physical activity," "non-communicable diseases," "childcare," "gym access," "barriers," and
"health policy."
Inclusion and Exclusion Criteria
Studies were included if they met the following criteria:
1. Addressed postpartum women’s physical activity, NCD prevention, or related behavioral/environmental
factors.
2. Were peer-reviewed and published in the English language.
3. Published within the timeframe of 2019 to 2024 to ensure the most current evidence was used.
Study Selection and Data Management
Records were managed using a reference manager to facilitate the systematic selection process, which is
detailed in Table 1 and represented in Figure 1:
Table1: Study Selection and Data Management Steps
PRISMA Step
Description
Number of Records ()
Records Identified
Initial database searches yielded: PubMed (), Scopus
(), and Google Scholar ().
900
Records After Duplicates
Removed
Records were combined, and a total of 575 duplicate
records were removed.
325
Records Screened by
Title/Abstract
Unique records were screened against inclusion
criteria (e.g., language,).
150
Full-Text Articles
Assessed
Full-text articles were retrieved and assessed for
eligibility against the full criteria. (130 excluded for
not meeting specific review scope).
20
Studies Included in Final
Synthesis
Articles that fully met all inclusion criteria were
synthesized.
20
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Figure 1: PRISMA flowchart
RESULTS
Role of the Results Section in a Narrative Review
In a narrative review, the Results section is distinct from the Discussion. Its primary role is to describe what
was found in the literature before interpreting those findings.
Records identified from
Databases (n = 198)
Records screened
(n =167)
Records excluded after
reading Abstract (n=20)
Reports assessed for eligibility
(n = 82)
Reports synthesized and
included in this Study (n = 20)
Flowchart showing the Identification of studies from Databases
Id
en
tif
ic
ati
o
n
S
cr
ee
ni
n
g
In
cl
u
de
d
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Result Section Focus: Descriptive summary of the included studies, often presented via thematic
analysis, tables, or figures (e.g., themes, key findings, study characteristics).
Discussion Section Focus: Interpretive analysis of the findings, explaining what the results mean in the
context of your objective, comparing them with existing knowledge, and proposing solutions/policy.
Since your review is thematic, the Results section should describe those themes and provide context via a
table.
4.1. Thematic Synthesis of Included Studies
The analysis of the twenty included studies yielded three overarching, interconnected themes that directly
address the barriers, benefits, and policy deficits of postpartum physical activity access:
1. Theme 1: Physical Activity as an Effective Intervention for Mental Health. High-level evidence
(meta-analyses and systematic reviews) establishing exercise as a non-pharmacological treatment for
postpartum depression (PPD) and anxiety and defining the minimum effective dose required to achieve
clinical benefit.
2. Theme 2: Structural and Cultural Barriers to Access. Findings that go beyond individual motivation
to identify systemic and gendered constraints, notably the lack of childcare, inflexible fitness
environments, and the influence of cultural norms (e.g., modesty requirements or family priority) on
access to safe exercise spaces.
3. Theme 3: Policy Gaps and Calls for Multisectoral Integration. Studies highlighting the failure of
current public health, urban planning, and fitness sector policies to address the long-term, holistic needs
of the postpartum period, leading to a breakdown between evidence and practice.
4.2. Overview of Included Studies and Thematic Contribution
The Table 2 below summarizes the 20 most recent and relevant studies included in this review, classifying their
primary focus and contribution to the identified themes.
Table2: Summary of Previous Works and their Study Design
Ref. No.
Lead Author (Year)
Study Design/Focus
Primary Theme Contribution
1
Deprato et al. (Deprato et
al., 2025)
Systematic Review
& Meta-Analysis
Theme 1: Defined dose () for PPD
treatment.
2
May et al. (May et al.,
2024)
Scoping Review
(Iran)
Theme 2: Cultural/modesty barriers; need
for indoor, private facilities.
3
Marconcin, Priscila, et al.
(Marconcin et al., 2021)
Systematic Review
& Meta-Analysis
Theme 1: Confirmed exercise efficacy for
mental health.
4
Marschner, Simone, et al.
(Marschner et al., 2023)
Review
Theme 3: Highlights heightened
cardiovascular risk postpartum (NCD
connection).
5
Bulut, Tevfik (Bulut, 2025)
Global Report
Theme 3: NCD burden globally;
justification for prevention.
6
Pascual-Morena, Carlos, et
al. (Pascual-Morena et al.,
2021)
Cohort Study
Theme 2: Social support and its influence
on leisure-time activity.
7
Corcoran, Breann, et al.
Observational Study
Theme 2: Environmental/weather
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(Corcoran et al., 2023)
constraints limiting outdoor activity.
8
Ryan et al. (Ryan et al.,
2022)
Cross-sectional
Study
Theme 2: Social/environmental barriers;
gender roles in limiting time.
9
Jones, Paris AT, et al. (Jones
et al., 2025)
Systematic Review
& Meta-Analysis
Theme 1: Established exercise benefits for
mood and quality of life.
10
Anderson et al. (Bellew et
al., 2020)
Policy
Recommendations
Theme 3: Need for targeted policy and
practice recommendations.
11
Liu, Xin-qi, et al. (Liu et al.,
2023)
Review
Theme 2: Psychosocial stress and mental
health barriers.
12
Muñóz, Aránzazu Muñóz,
et al. (Muñóz et al., 2019)
Cohort Study
Theme 2: Role of pre-pregnancy habits vs.
postpartum barriers (childcare).
13
Asada, Yuka, et al. (Asada
et al., 2023)
Systematic Review
Theme 2: Childcare confirmed as a
dominant barrier to exercise.
14
Racey, Megan, et al. (Racey
et al., 2025)
Intervention Design
Theme 3: Importance of designing family-
friendly exercise interventions.
15
Verhoeven, Josine E., et al.
(Verhoeven et al., 2024)
Review
Theme 1: Evidence base for exercise in
postpartum health.
16
Raspovic, Anita M., et al.
(Raspovic et al., 2020)
Qualitative Study
Theme 2: Psychological barriers (body
image, social comparison) to gym use.
17
Singh et al. (Singh et al.,
2023)
Global Health
Action
Theme 3: Burden of NCDs in reproductive
age women.
18
May, Linda E., et al. (May
et al., 2024)
Scoping Review
Theme 2: Environmental determinants of
physical activity (urban planning).
19
Ramson, Jenny A., et al.
(Ramson et al., 2024)
Policy Analysis
Theme 3: Policy gap in reframing
postpartum care for NCD prevention.
20
Slomian, Justine, et al.
(Slomian et al., 2019)
Systematic Review
Theme 1: Consequences of maternal PPD
(connects mental health to NCD risk).
DISCUSSION
This review underscores the systemic neglect of postpartum women’s access to structured, gym-based physical
activity as a viable NCD prevention strategy. Although the health benefits are well-established, postpartum
exercise remains inadequately supported both socially and institutionally. Support for mothers usually
decreases after early postpartum care, providing them with little long-term assistance. The consequences of
inaction increased long-term risk for cardiovascular disease, Type 2 diabetes, and the clinical development of
postpartum depression, demand effective, systemic interventions. Barriers such as lack of childcare, inflexible
gym environments, and social expectations reflect gendered assumptions that continue to undervalue
caregiving work. Even women with prior gym experience struggle to re-engage postpartum due to fatigue,
time constraints, and societal pressure to prioritize family over personal health. Outdoor exercise, though
accessible, is inconsistent and fails to provide the structured rehabilitation and support required for sustainable
recovery.
The requirement of approximately of moderate-intensity activity to achieve therapeutic benefits for depression
(Deprato et al., 2025) provides a specific challenge in the context of time scarcity. Meeting this dose demands
consistent, efficient exercise, which is difficult to achieve via unstructured outdoor activity. Consequently,
there is a strong argument for gyms and fitness facilities to optimize their structure around the time-poor
mother. Integrating childcare services and offering efficient, high-quality 30-to-45-minute classes would
enable postpartum women to meet the necessary weekly volume quickly and reliably. This structure is
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essential not only for adherence but for ensuring that the exercise provided is sufficient to yield the proven
clinical mental health outcomes.
A notable gap across studies is the narrow definition of “postpartum,” often limited to six weeks or one year.
As justified in Section 2.1, this clinical framing fails to reflect lived realities, many mothers continue to
experience physical, social, and emotional constraints well beyond this period. Expanding the conceptual
definition of postpartum health is essential to designing inclusive fitness and policy frameworks.
Cultural and socioeconomic disparities compound these challenges. The findings from the thematic synthesis
(Section 4.1) confirm that structural barriers are not universal; in certain cultures (e.g., Iran), the necessity of
indoor, private fitness facilities due to modest dress requirements is a non-negotiable access factor (May et al.,
2024). For some groups, gyms are perceived as elite or inappropriate spaces for mothers, particularly in
migrant or conservative communities. Policies and fitness programs seldom acknowledge these differences,
further entrenching inequality. Ultimately, the inability to access physical activity after childbirth is not simply
a matter of motivation; it is a matter of equity. By embedding childcare within gyms, we shift responsibility
from the individual to the system, promoting inclusivity, autonomy, and health equity. Such interventions align
with the Sustainable Development Goals (SDGs 3, 5, and 8) by enhancing health, reducing gender gaps, and
supporting women’s economic reintegration.
CONCLUSION
Postpartum women face compounded risks of NCDs due to inactivity, social isolation, and systemic neglect.
Yet, with strategic innovation, this period can become an opportunity for prevention. Gym-based childcare
represents a practical, evidence-informed, and equity-driven intervention to improve women’s physical and
mental health outcomes. Integrating this model within broader public health policy can transform postpartum
care from reactive to preventive bridging healthcare, community, and urban planning for a healthier, more
inclusive society.
REFERENCES
1. Abdullahi, Z. M., Kingsley, O. I., Yusuf, M., EO, U., Otutu, M., & Nwose, E. U. (2025). Epidemiology,
Prevention and Management of Non-Communicable Diseases (NCDS): A Review. Journal of Health,
Wellness and Safety Research.
2. Adam, R., Nair, R., Duncan, L. F., Yeoh, E., Chan, J., Vilenskaya, V., & Gallacher, K. I. (2023).
Treatment burden in individuals living with and beyond cancer: A systematic review of qualitative
literature. PloS one, 18(5), e0286308.
3. Adamo, A., Bradley, L. D., Vanzella, E., Claeyssens, A., Welch, B., Diego, J. M., Mahler, G., Oguri, M.,
Sharon, K., & Hsiao, T. Y.-Y. (2024). Bound star clusters observed in a lensed galaxy 460 Myr after the
Big Bang. Nature, 632(8025), 513-516.
4. Adams, Y. J., Miller, M. L., Agbenyo, J. S., Ehla, E. E., & Clinton, G. A. (2023). Postpartum care needs
assessment: women’s understanding of postpartum care, practices, barriers, and educational needs. BMC
pregnancy and childbirth, 23(1), 502.
5. Ajibade, S.-S. M., Alhassan, G. N., Jasser, M. B., ALDharhani, G. S., & Al-Hadi, I. A. A.-Q. (2024).
Evolutionary Insights in Ontology: A Bibliometric Analysis of Cognitive Computing Applications in
Cancer Research. Journal of Scientometric Research, 13(3), 816-832.
6. Ajibade, S.-S. M., Alhassan, G. N., Zaidi, A., Oki, O. A., Awotunde, J. B., Ogbuju, E., & Akintoye, K. A.
(2024). Evolution of machine learning applications in medical and healthcare analytics research: A
bibliometric analysis. Intelligent Systems with Applications, 24, 200441.
7. Ajibade, S.-S. M., Jasser, M. B., San, L. W., Achick-Muyu, V. A., Moorthy, U., & VE, S. (2025).
Intelligent Obesity Pattern Prediction using Machine Learning: Applications in Automated Health
Analytics. 2025 8th International Conference on Computing Methodologies and Communication
(ICCMC),
INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN APPLIED SCIENCE (IJRIAS)
ISSN No. 2454-6194 | DOI: 10.51584/IJRIAS |Volume X Issue X October 2025
Page 2665
www.rsisinternational.org
8. Ajibade, S.-S. M., Lee, A. S. H., Jasser, M. B., & Akinola, T. F. (2024). Application of Artificial
Intelligence in Healthcare Systems: A Scientometric Analysis. 2024 International Conference on
Science, Engineering and Business for Driving Sustainable Development Goals (SEB4SDG),
9. Ajibade, S.-S. M., Majeed, A. P. A., Jasser, M. B., ALDharhani, G. S., Al-Hadi, I. A. A.-Q., & Kumar, G.
(2024). Application of Artificial Intelligence in Malignant Tumors: A Science Mapping Analysis. 2024
IEEE 15th Control and System Graduate Research Colloquium (ICSGRC),
10. Ajibade, S.-S. M., Zaidi, A., Bekun, F. V., Adediran, A. O., & Bassey, M. A. (2023). A research
landscape bibliometric analysis on climate change for last decades: Evidence from applications of
machine learning. Heliyon, 9(10).
11. Ajibade, S.-S. M., Zaidi, A., Tapales, C. P., Ngo-Hoang, D.-L., Ayaz, M., Dayupay, J. P., Dodo, Y. A.,
Chaudhury, S., & Adediran, A. O. (2022). Data mining analysis of online drug reviews. 2022 IEEE 10th
Conference on Systems, Process & Control (ICSPC),
12. Asada, Y., Lin, S., Siegel, L., & Kong, A. (2023). Facilitators and barriers to implementation and
sustainability of nutrition and physical activity interventions in early childcare settings: a systematic
review. Prevention Science, 24(1), 64-83.
13. Atkinson, S. H., Suchdev, P. S., Bode, M., Carducci, B., Cerami, C., Mwangi, M. N., Namaste, S.,
Winichagoon, P., Leung, S., & Mutua, A. M. (2025). Getting back on track to meet global anaemia
reduction targets: a Lancet Haematology Commission. The Lancet Haematology, 12(9), e717-e767.
14. Bellew, W., Smith, B. J., Nau, T., Lee, K., Reece, L., & Bauman, A. (2020). Whole of systems
approaches to physical activity policy and practice in Australia: the ASAPa project overview and initial
systems map. Journal of Physical Activity and Health, 17(1), 68-73.
15. Bulut, T. (2025). Classifying the WHO European countries by noncommunicable diseases and risk
factors. Health Policy, 153, 105247.
16. Chan, R. R., Yakiwchuk, E. M., & Halpape, K. (2024). Take-Home Naloxone Access and Use among
Older Adults Living with Pain: A Scoping Review. The Canadian Journal of Hospital Pharmacy, 77(1),
e3506.
17. Corcoran, B., Bhatti, P., Peters, C. E., Feldman, F., & Darvishian, M. (2023). Impact of Playground
Shade Structures on Ultraviolet Radiation Exposure and Physical Activity among Children at a
Childcare Facility. International Journal of environmental research and public health, 20(13), 6306.
18. Dam, S. L., & Rhind, D. J. (2020). The perceived benefits of community-based group exercise sessions
for survivors of stroke. International Journal of Therapy and Rehabilitation, 27(2), 1-14.
19. Darroch, F., Roberts, C., Jean-Pierre, L., Montaner, G. G., & Adamo, K. B. (2025). Postpartum Women’s
Perceptions of Risk of Musculoskeletal Injuries in the Canadian Armed Forces: A Qualitative Research
Study. Armed Forces & Society, 51(1), 248-268.
20. Deering, R. E., Donnelly, G. M., Brockwell, E., Bo, K., Davenport, M. H., De Vivo, M., Dufour, S.,
Forner, L., Mills, H., & Moore, I. S. (2024). Clinical and exercise professional opinion on designing a
postpartum return-to-running training programme: an international Delphi study and consensus
statement. British journal of sports medicine, 58(4), 183-195.
21. Deprato, A., Ruchat, S.-M., Ali, M. U., Cai, C., Forte, M., Gierc, M., Meyer, S., Sjwed, T. N., Shirazi,
S., & Matenchuk, B. A. (2025). Impact of postpartum physical activity on maternal depression and
anxiety: a systematic review and meta-analysis. British journal of sports medicine, 59(8), 550-561.
22. Donnelly, G., Coltman, C., Dane, K., Elliott‐Sale, K., Hayman, M., McCarthy‐Ryan, M., Perkins, J.,
Rollins, S., & Moore, I. (2024). Prioritise safety, optimise success! Return to rugby postpartum.
European Journal of Sport Science, 24(12), 1701-1718.
23. Geneshka, M. (2023). The associations between exposure to green and blue spaces with multimorbidity:
observational analyses of UK Biobank cohort University of York].
24. Gerede, A., Domali, E., Chatzakis, C., Margioula-Siarkou, C., Petousis, S., Stavros, S., Nikolettos, K.,
Gouveri, E., Sotiriou, S., & Tsikouras, P. (2025). Metformin for Treating Gestational Diabetes: What
Have We Learned During the Last Two Decades? A Systematic Review. Life, 15(1), 130.
25. Grandi, G., Del Savio, M. C., Tassi, A., & Facchinetti, F. (2024). Postpartum contraception: A matter of
guidelines. International Journal of Gynecology & Obstetrics, 164(1), 56-65.
26. Hafeez, A., Dangel, W. J., Ostroff, S. M., Kiani, A. G., Glenn, S. D., Abbas, J., Afzal, M. S., Afzal, S.,
Ahmad, S., & Ahmed, A. (2023). The state of health in Pakistan and its provinces and territories, 1990–
INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN APPLIED SCIENCE (IJRIAS)
ISSN No. 2454-6194 | DOI: 10.51584/IJRIAS |Volume X Issue X October 2025
Page 2666
www.rsisinternational.org
2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Global Health,
11(2), e229-e243.
27. Hawkins, M. S., Levine, M. D., Ragavan, M. I., Buysse, D. J., Davis, E. M., Hamm, M. E., McTigue, K.
M., Srinivasan, S., Wasilko, R., & Chang, J. C. (2025). Postpartum dietary, sleep, and physical activity
behaviors: A qualitative study to inform efforts to address postpartum weight retention. Women's Health,
21, 17455057251384412.
28. Hoong, J. T. Y., Ajibade, S.-S. M., Jasser, M. B., Majeed, A. P. A., Alebiosu, D. O., Issa, B., Adediran, A.
O., & Kwan, C. S. C. (2025). Evaluation of Machine Learning Techniques for Prediction of Breast
Cancer. 2025 21st IEEE International Colloquium on Signal Processing & Its Applications (CSPA),
29. Hopper, H. (2024). An exploration of preconception care for people with health conditions using realist
methodology: what works, for whom, and in what circumstances?
30. Hossain, A. T., Rahman, M. H., Manna, R. M., Akter, E., Islam, S. H., Hossain, M. A., Ara, T., Usmani,
N. G., Chandra, P., & Khan, M. A. (2025). Enhancing access to mental health services for antepartum
and postpartum women through telemental health services at wellbeing centers in selected health
facilities in Bangladesh: implementation research. JMIR Pediatrics and Parenting, 8, e65912.
31. Jamshidi, G., Abbasian Ardakani, A., Ghafoori, M., Babapour Mofrad, F., & Saligheh Rad, H. (2023).
Radiomics-based machine-learning method to diagnose prostate cancer using mp-MRI: a comparison
between conventional and fused models. Magnetic Resonance Materials in Physics, Biology and
Medicine, 36(1), 55-64.
32. Jones, P. A., Ruchat, S.-M., Khan-Afridi, Z., Ali, M. U., Matenchuk, B. A., Leonard, S., Jantz, A. W.,
Vander Leek, K., Maier, L., & Osachoff, L. (2025). Impact of postpartum physical activity on maternal
sleep: a systematic review and meta-analysis. British journal of sports medicine, 59(8), 576-583.
33. Karcz, K., & Królak-Olejnik, B. (2024). Impact of gestational diabetes mellitus on fetal growth and
nutritional status in newborns. Nutrients, 16(23), 4093.
34. Kumar, N., & Anand, I. (2025). Women Entrepreneurs and the Struggle for Balance: Navigating Work
and Life Challenges. In Work-Life Balance and Its Effect on Women Entrepreneurs (pp. 95-114). IGI
Global Scientific Publishing.
35. Kvarnström, K., Westerholm, A., Airaksinen, M., & Liira, H. (2021). Factors contributing to medication
adherence in patients with a chronic condition: a scoping review of qualitative research. Pharmaceutics,
13(7), 1100.
36. Lavoie, H. A., Mejia, D., & Jake-Schoffman, D. E. (2025). Exploring fitness influencer content
preferences among female college students in the southeastern United States. Journal of American
College Health, 1-13.
37. Le, S. T. (2025). Doing the Month: Social Support and Its Impact on Postpartum Mood in Vietnamese
American Mothers Reiss-Davis Graduate School].
38. Lewis, E. (2024). Stepping Towards Sustainability: Analyzing Walkability in Urban Environments.
39. Lisco, G., Giagulli, V. A., De Pergola, G., Guastamacchia, E., Jirillo, E., Vitale, E., & Triggiani, V.
(2024). Chronic stress as a risk factor for type 2 diabetes: endocrine, metabolic, and immune
implications. Endocrine, Metabolic & Immune Disorders-Drug Targets (Formerly Current Drug Targets-
Immune, Endocrine & Metabolic Disorders), 24(3), 321-332.
40. Liu, X.-q., Huang, J., Song, C., Zhang, T.-l., Liu, Y.-p., & Yu, L. (2023). Neurodevelopmental toxicity
induced by PM2. 5 Exposure and its possible role in Neurodegenerative and mental disorders. Human &
Experimental Toxicology, 42, 09603271231191436.
41. Lomadze, E. (2024). Pedestrian Perception of Walkability in Public Spaces: Example of a Historical
Neighbourhood In Batumi. In.
42. Love, I., Nikolaev, B., & Dhakal, C. (2024). The well-being of women entrepreneurs: the role of gender
inequality and gender roles. Small Business Economics, 62(1), 325-352.
43. Madlala, H. P., Bengtson, A. M., Hannan, L., Malaba, T. R., Kalk, E., Nyemba, D., Boulle, A., & Myer,
L. (2023). Maternal weight trajectories and associations with infant growth in South African women.
BMC public health, 23(1), 2055.
44. Malik, Z. I., & Ahmad, A. M. R. (2025). Non-communicable disease (NCD) burden and their
contributing factors among women. Health Care for Women International, 46(6), 687-701.
INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN APPLIED SCIENCE (IJRIAS)
ISSN No. 2454-6194 | DOI: 10.51584/IJRIAS |Volume X Issue X October 2025
Page 2667
www.rsisinternational.org
45. Marconcin, P., Peralta, M., Gouveia, E. R., Ferrari, G., Carraca, E., Ihle, A., & Marques, A. (2021).
Effects of exercise during pregnancy on postpartum depression: a systematic review of meta-analyses.
Biology, 10(12), 1331.
46. Marschner, S., Mukherjee, S., Watts, M., Min, H., Beale, A. L., O'Brien, J., Juneja, A., Tremmel, J. A., &
Zaman, S. (2023). Prevention of cardiovascular disease in women with pregnancy‐related risk factors: a
prospective Women's Heart Clinic study. Journal of the American Heart Association, 12(17), e030015.
47. May, L. E., Moss, S. J., Szumilewicz, A., Santos-Rocha, R., & Shojaeian, N. A. (2024). Barriers and
facilitators of physical activity in pregnancy and postpartum among Iranian women: a scoping review.
Healthcare,
48. Mielke, G. I., Crochemore-Silva, I., Domingues, M. R., Silveira, M. F., Bertoldi, A. D., & Brown, W. J.
(2021). Physical activity and sitting time from 16 to 24 weeks of pregnancy to 12, 24, and 48 months
postpartum: findings from the 2015 Pelotas (Brazil) birth cohort study. Journal of Physical Activity and
Health, 18(5), 587-593.
49. Ming, T. K., Ajibade, S.-S. M., Jasser, M. B., Majeed, A. P. A., Ehineni, K., & Achick-Muyu, V. A.
(2025). Machine Learning Ensemble Techniques for Prediction of Diabetes. 2025 21st IEEE
International Colloquium on Signal Processing & Its Applications (CSPA),
50. Mohamadpour, S. (2025). Optimized Emergency Shelter Ranking: A Multi-Criteria Decision-Making
Framework for Post-Disaster Response University of Manitoba].
51. Muñóz, A. M., Gómez-Cantarino, S., De Dios, M. d. l. M., Abellán, M. V., López, B. G., Gallego, B. M.,
Pascual, J. L. G., & Palencia, N. M. A. (2019). Nutritional habits and levels of physical activity during
pregnancy, birth and the postpartum period of women in Toledo (Spain): study protocol for a two-year
prospective cohort study (the PrePaN study). BMJ open, 9(7), e029487.
52. Naeem, I., Zehra, A., Rehman, F., Hussain, A., Hussain, A., Hussain, N., Waseem, M., Alqahtani, R. M.,
Shamlan, G., & Ahmed, I. A. M. (2025). Polycystic ovarian syndrome a risk factor for non-
communicable diseases: insights into recent research and prevention approaches. Journal of Ovarian
Research, 18(1), 1-15.
53. Ominyi, J., & Clifton, A. (2025). Barriers and enablers to physical activity participation among women
in underserved communities: a mixed-methods study. Women, 5(1), 5.
54. Otu, E., Ashworth, K., Tsekleves, E., & Ackley, A. (2024). Empowering London primary school
communities to know and tackle air pollution exposure. Sustainability, 16(17), 7491.
55. Pannia, E., Hammoud, R., Simonian, R., Kubant, R., & Anderson, G. H. (2022). Folate dose and form
during pregnancy may program maternal and fetal health and disease risk. Nutrition Reviews, 80(11),
2178-2197.
56. Pascual-Morena, C., Cavero-Redondo, I., Alvarez-Bueno, C., Luceron-Lucas-Torres, M., Sanabria-
Martinez, G., Poyatos-Leon, R., Rodriguez-Martin, B., & Martinez-Vizcaino, V. (2021). Exercise versus
metformin to improve pregnancy outcomes among overweight pregnant women: a systematic review
and network meta-analysis. Journal of clinical medicine, 10(16), 3490.
57. Peters, B. G., & Nagel, M. L. (2025). From benign to malign: unintended consequences and the growth
of Zombie policies. Policy and Society, puae039.
58. Phillips, S. E., Celi, A. C., Margo, J., Wehbe, A., Karlage, A., & Zera, C. A. (2024). Improving care
beyond birth: A qualitative study of postpartum care after high-risk pregnancy. Journal of Women's
Health, 33(12), 1720-1729.
59. Quaderer, S., Brandstetter, S., Köninger, A., Melter, M., Kabesch, M., Apfelbacher, C., & Fill
Malfertheiner, S. (2025). Risk factors for substantial weight retention at 1 year postpartum: evidence
from a German birth cohort study (KUNO-Kids). Archives of Gynecology and Obstetrics, 311(4), 997-
1006.
60. Racey, M., Alliston, P., Sherifali, D., Sriskandarajah, A., Sushko, K., & Lipscombe, L. (2025). Co-
Designing a postpartum diabetes prevention program after gestational diabetes Mellitus: A MoSCoW
prioritization workshop exercise. Diabetes Research and Clinical Practice, 112269.
61. Ramson, J. A., Williams, M. J., Afolabi, B. B., Colagiuri, S., Finlayson, K. W., Hemmingsen, B.,
Venkatesh, K. K., & Chou, D. (2024). Pregnancy, childbirth and the postpartum period: opportunities to
improve lifetime outcomes for women with non‐communicable diseases. Med J Aust, 221(7), 350-353.
62. Raspovic, A. M., Prichard, I., Yager, Z., & Hart, L. M. (2020). Mothers’ experiences of the relationship
between body image and exercise, 0–5 years postpartum: A qualitative study. Body image, 35, 41-52.
INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN APPLIED SCIENCE (IJRIAS)
ISSN No. 2454-6194 | DOI: 10.51584/IJRIAS |Volume X Issue X October 2025
Page 2668
www.rsisinternational.org
63. Ryan, R. A., Lappen, H., & Bihuniak, J. D. (2022). Barriers and facilitators to healthy eating and
physical activity postpartum: A qualitative systematic review. Journal of the Academy of Nutrition and
Dietetics, 122(3), 602-613. e602.
64. Singh, S. K., Chauhan, K., & Puri, P. (2023). Chronic non-communicable disease burden among
reproductive-age women in India: evidence from recent demographic and health survey. BMC Women's
Health, 23(1), 20.
65. Slomian, J., Honvo, G., Emonts, P., Reginster, J.-Y., & Bruyère, O. (2019). Consequences of maternal
postpartum depression: A systematic review of maternal and infant outcomes. Women's Health, 15,
1745506519844044.
66. Spence, J. C., Mangan, A., & Sivak, A. (2024). Effectiveness of the Children’s Fitness Tax Credit: A
scoping review. Canadian Journal of Public Health, 115(2), 356-366.
67. Suzuki, S. (2022). National Subsidy Program for screening of postpartum depression in Japan. Asian
Journal of Psychiatry, 73, 103151.
68. Taousani, E., Papaioannou, K.-G., Mintziori, G., Grammatikopoulou, M. G., Antonakou, A., Tzitiridou-
Chatzopoulou, M., Veneti, S., & Goulis, D. G. (2025). Lifestyle Behaviors and Gestational Diabetes
Mellitus: A Narrative Review. Endocrines, 6(1), 6.
69. Vaidya, S., Suri, A., Batla, V., Keshta, I., Ajibade, S.-S. M., & Safarov, G. (2023). A computer-aided
feature-based encryption model with concealed access structure for medical Internet of Things. Decision
Analytics Journal, 7, 100257.
70. Van Hauwaert, R., Tomé, A., de Almeida, R. P. P., Vilela, F., Coutinho, A. L., Alpoim, D., de Jesus, R. S.
F., & Virga, E. (2025). Physical Exercise and Pelvic Floor Muscle Training: A Vital Tool in Mitigating
Pelvic Floor Dysfunction During Pregnancy and Postpartum. Global Innovations in Physical Education
and Health, 169-202.
71. Verhoeven, J. E., Wolkowitz, O. M., Barr Satz, I., Conklin, Q., Lamers, F., Lavebratt, C., Lin, J.,
Lindqvist, D., Mayer, S. E., & Melas, P. A. (2024). The researcher's guide to selecting biomarkers in
mental health studies. BioEssays, 46(10), 2300246.
72. Vounzoulaki, E. (2023). Type 2 diabetes in women after a diagnosis of gestational diabetes:
understanding uptake to screening, progression rates and costs, using evidence synthesis methodologies
University of Leicester].
73. Wang, Z., Ma, L., Liu, M., Fan, J., Hu, S., Health, W. C. o. t. R. o. C., & China, D. i. (2023). Summary
of the 2022 report on cardiovascular health and diseases in China. Chinese medical journal, 136(24),
2899-2908.
74. Wanner, L., Jung, M., Paleri, S., Butterworth, B. J., Desai, A. R., Sühring, M., & Mauder, M. (2024).
Towards energy-balance closure with a model of dispersive heat fluxes. Boundary-Layer Meteorology,
190(5), 25.
75. Wilcox, N. S., Amit, U., Reibel, J. B., Berlin, E., Howell, K., & Ky, B. (2024). Cardiovascular disease
and cancer: shared risk factors and mechanisms. Nature Reviews Cardiology, 21(9), 617-631.
76. Yap, J. J., Yong, Y. L., Jasser, M. B., Ajibade, S.-S. M., & Al-Hadi, I. A. A.-Q. (2024). Improving object
detection in videos: a comprehensive evaluation of faster R-CNN employed in partial occlusion
handling. 2024 20th IEEE International Colloquium on Signal Processing & Its Applications (CSPA),
77. You, Y., Wang, R., Li, J., Cao, F., Zhang, Y., & Ma, X. (2024). The role of dietary intake of live
microbes in the association between leisure-time physical activity and depressive symptoms: a
population-based study. Applied Physiology, Nutrition, and Metabolism, 49(8), 1014-1024.