Clinical Work Experiences of Nurses Returning to Work Postpartum: A Systematic Review and Qualitative Meta-Synthesis

The global nursing shortage underscores the critical need to retain experienced clinicians. The postpartum return to clinical practice represents a vulnerable transition period that can significantly impact nurse retention, yet the nuanced lived experiences of nurses during this reintegration are not well synthesized.

To systematically review and synthesize qualitative evidence on the clinical work experiences of nurses returning to work after childbirth.

A systematic review and meta-synthesis.

A systematic search was conducted in PubMed, Cochrane Library, CINAHL, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Wanfang Database, Weipu Database and China Biomedical Literature Database (CBM) to identify qualitative studies published between December 1990 and December 2025 that focused on the clinical work experiences of nurses returning to work postpartum. This systematic review follows the meta-synthesis method guided by ENTREQ and PRISMA and uses the Critical Appraisal Skills Programme (CASP) to assess the quality of included studies. Qualitative findings from the primary studies were integrated and analyzed using thematic synthesis.

A total of 19 studies were included, with 76 main findings extracted, summarized into 9 subthemes, and organized into 3 main themes: The Multi-Faceted Challenges of Reintegrating into Professional Practice, Enduring Multidimensional Physical and Psychological Strain, and Relying on a Multilayered Support Ecosystem for Successful Transition.

The return to clinical work postpartum is a period of multidimensional strain and identity negotiation. Retention is contingent upon a coherent support ecosystem. Moving beyond broad work-family conflict narratives, this review offers a targeted evidence base supporting essential structural enablers-such as flexible work policies, protected lactation facilities, and tailored reintegration pathways-alongside culturally competent interpersonal support, to promote sustainable reintegration and preserve an experienced nursing workforce.

Nurse managers should proactively establish supportive structural policies, including flexible scheduling and dedicated lactation facilities, to support the successful reintegration of postpartum nurses. Developing tailored return-to-work orientation pathways and fostering a supportive, empathetic ward culture are critical managerial strategies to mitigate transition-related stress, enhance job satisfaction, and retain experienced clinical staff amidst the global nursing shortage.