Pregnancy and the postpartum period represent critical phases characterised by substantial physical, psychological, and social changes that may affect women’s quality of life (QoL) and physical activity levels. Although global evidence is increasing, research directly comparing these outcomes among pregnant and postnatal women within the Saudi Arabian population remains limited. This study aimed to assess and compare physical activity levels and quality of life among pregnant and postnatal Saudi women, as well as to examine associated factors, including psychological distress and urinary incontinence.

A cross-sectional study was conducted with 85 participants (54 pregnant and 31 postnatal women). Data collection utilised validated Arabic versions of standardised questionnaires: SF-36 (quality of life), IPAQ (physical activity), DASS-21 (psychological distress), ICIQ (urinary incontinence), and EPDS (postnatal depression). Statistical analyses included t-tests, means, and standard deviations for group comparisons.

Postnatal women exhibited significantly higher physical activity levels than pregnant women (p < 0.05). No significant differences were found between groups in quality of life, psychological distress, or urinary incontinence. Despite increased physical activity, postnatal women reported notable postpartum depressive symptoms. Overall, quality of life scores were similar in both groups.

These findings indicate that physiological and functional recovery after childbirth may enable increased physical activity; however, this improvement does not necessarily lead to better overall quality of life or psychological well-being. The persistence of depressive symptoms postpartum demonstrates that mental health challenges may continue despite physical recovery. Furthermore, the similarity in quality of life and urinary incontinence between groups suggests that both pregnant and postnatal women experience comparable health burdens, likely influenced by ongoing physical demands, hormonal changes, and sociocultural factors within the Saudi context.

Physical activity levels differ significantly between pregnant and postnatal women, with higher activity observed postpartum. However, comparable levels of quality of life, psychological distress, and urinary incontinence indicate that physical recovery alone may not lead to improved overall well-being. These findings underscore the need for integrated, culturally sensitive physiotherapy and maternal healthcare interventions in Saudi Arabia.

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