Socio-cultural barriers to physical activity participation among urban, educated postpartum women in Wuhan, China: a qualitative study

Introduction Postpartum physical activity (PA) is crucial for physical and maternal health. However participation rates among Chinese women remain low. While common barriers like time constraints are documented globally, the underlying socio-cultural mechanisms specific to the Chinese context remain underexplored. This study investigates the unique socio-cultural factors hindering PA participation among urban, educated women in Wuhan, China, using an intersectional lens to examine how cultural, familial, and structural influences interact. Methods A qualitative study was conducted, integrating an 18-month WeChat-based ethnographic observation of a postpartum care group in a community in Wuhan, along with semi-structured in-depth interviews with 17 women who were 6–18 months postpartum ( n = 17). 12 were interviewed in-person and 5 by telephone. Results Participation was low, 1/3 engaged in PA, commencing at 3 months ( n = 2), 6 months ( n = 1), or beyond 12 months ( n = 2) postpartum. Analysis identified three interrelated socio-cultural barriers: (1) restrictions stemming from the traditional “Zuo yuezi” (confinement) custom and complex intergenerational dynamics; (2) constraints imposed by a gendered family division of labor and motherhood-centric parenting knowledge systems; and (3) inadequate public policies and social support structures. Discussion These intertwined socio-cultural barriers form a self-reinforcing system that subordinates maternal self-care to collective family duties. The study reveals how these factors intersect to constrain women’s agency, offering a contextualized, intersectional analysis of postpartum health behavior in China. Addressing this requires multi-level interventions targeting cultural norms, equitable family labor, and institutional support to enable context-sensitive health promotion.