Nurses' Experiences of Returning to Work After Maternity Leave: A Qualitative Systematic Review and Meta-Synthesis

To synthesize international qualitative evidence on nurses' experiences of returning to work after maternity leave and to develop an integrated understanding of the challenges, supports, and transition processes involved.

Returning to work after childbirth represents a major professional and personal transition for nurses, with implications for well-being, workforce retention, and quality of care. Although qualitative research in this area has grown, the existing evidence remains fragmented and lacks an integrated conceptual understanding.

A qualitative systematic review and meta-synthesis were conducted. Multiple electronic databases were searched for qualitative studies published in English or Chinese that explored nurses' experiences of returning to work after maternity leave. Methodological quality was critically appraised using the JBI critical appraisal tool, and findings were synthesized using a meta-aggregative approach. Confidence in the synthesized findings was assessed using the ConQual approach.

Four interconnected domains characterized nurses' return-to-work experiences: conflict, including emotional distress, physical recovery challenges, work-family strain, and organizational barriers; support, encompassing family involvement, peer relationships, and workplace resources; coping, referring to strategies used to manage competing demands; and growth, involving career reflection and identity reconstruction. Confidence in the synthesized findings ranged from moderate to high.

Return-to-work experiences are shaped by the dynamic interaction of personal recovery, family responsibilities, and organizational conditions. Supportive environments-including flexible work arrangements, breastfeeding accommodations, and empathetic leadership-facilitate healthier transitions and help mitigate early reintegration difficulties.

Returning to work after maternity leave is a multidimensional transition influenced by individual, interpersonal, and organizational factors.

Healthcare organizations and policy-makers should implement family-friendly and gender-responsive measures, including structured reintegration pathways, flexible scheduling, breastfeeding-friendly environments, and psychosocial support, to promote postpartum nurses' well-being, retention, and sustainable workforce development.