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Maternal and Child Health Journal

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30-07-2022 | Mood Disorders

Examining the Relationship Between Return to Work After Giving Birth and Maternal Mental Health: A Systematic Review

Authors: Rachel Elizabeth McCardel, Emily Hannah Loedding, Heather Marie Padilla

Published in: Maternal and Child Health Journal | Issue 9/2022

Abstract

Introduction

The negative impacts of mental health disorders on the well-being of women and their infants are clear. However, less is known about the relationship between returning to work after giving birth and mental health. Previous reviews examined the relationship between maternity leave and mental health, but we defined return to work as the process of returning to part-time or full-time work after giving birth and caring for infant. This systematic review aims to: (1) describe operational definitions for return to work and (2) describe the evidence on the relationship between return to work and maternal mental health.

Methods

We searched PubMed, PsycINFO, CINAHL, and Web of Science for peer-reviewed studies. Articles were selected if they were published within the past 20 years, examined at least one mental health condition (e.g., depression, anxiety), and included a study sample of U.S. working mothers.

Results

We identified 20 articles published between 2001 and 2020. We found conflicting evidence from longitudinal and cross-sectional data demonstrating that return to work was associated with improvements and negative consequences to mental health. Work-related predictors of mental health included: access to paid maternity leave, work–family conflict, total workload, job flexibility, and coworker support.

Discussion

This review provides evidence that return to work and mental health are related, though the study samples have limited generalizability to all U.S. working mothers. More research is needed to understand the direction of this relationship throughout the perinatal period and how return to work affects other mental health conditions (e.g., anxiety, stress).

Aitken, Z., Garrett, C. C., Hewitt, B., Keogh, L., Hocking, J. S., & Kavanagh, A. M. (2015). The maternal health outcomes of paid maternity leave: A systematic review. Social Science and Medicine, 130, 32–41. https://doi.org/10.1016/j.socscimed.2015.02.001CrossRefPubMed

Allen, M., Betrus, P., Kogan, H., & Elmore, S. K. (1986). Perception of functional ability. University of Washington.

Andres, E., Baird, S., Bingenheimer, J., & Markus, A. (2016). Maternity leave access and health: A systematic narrative review and conceptual framework development. Maternal and Child Health Journal, 20(6), 1178–1192. https://doi.org/10.1007/s10995-015-1905-9CrossRefPubMed

Armijo-Olivo, S., Stiles, C. R., Hagen, N. A., Biondo, P. D., & Cummings, G. G. (2012). Assessment of study quality for systematic reviews: A comparison of the Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment Tool: Methodological research. Journal of Evaluation in Clinical Practice, 18(1), 12–18.PubMedCrossRef

Ashley, J., Cashdollar, W., Etcheverry, R., & Magill, K. (2017). Transition back to work: Policies to support return to work after illness or injury. US Department of Labor.

Barnett, R. C., Davidson, H., & Marshall, N. L. (1991). Physical symptoms and the interplay of work and family roles. Health Psychology, 10(2), 94–101.PubMedCrossRef

Bauman, B. L., Ko, J. Y., Cox, S., D’Angelo, D. V., Warner, L., Folger, S., Tevendale, H. D., Coy, K. C., Harrison, L., & Barfield, W. D. (2020). Vital signs: Postpartum depressive symptoms and provider discussions about perinatal depression—United States, 2018. Morbidity and Mortality Weekly Report, 69(19), 575–581.PubMedPubMedCentralCrossRef

Beck, A. T., & Steer, R. A. (1987). Beck Depression Inventory manual. Psychological Corporation.

Beck, C. T., & Gable, R. K. (2000). Postpartum Depression Screening Scale: Development and psychometric testing. Nursing Research, 49(5), 272–282.PubMedCrossRef

Bond, J. T., Galinsky, E., Lord, M., Staines, G., & Brown, K. (1991). Beyond the parental leave debate: The impact of laws in four states. Young Children, 47(1), 39–42.

Cantor, D., Waldfogel, J., Kerwin, J., Wright, M. M., Levin, K., Rauch, J., Hagerty, T., & Kudela, M. S. (2001). Balancing the needs of families and employers: Family and Medical Leave Surveys, 2000 Update. U.S. Department of Labor.

Carlson, D. S., Grzywacz, J. G., Ferguson, M., Hunter, E. M., Clinch, C. R., & Arcury, T. A. (2011). Health and turnover of working mothers after childbirth via the work–family interface: An analysis across time. Journal of Applied Psychology, 96(5), 1045–1054.PubMedCrossRef

Chatterji, P., & Markowitz, S. (2012). Family leave after childbirth and the mental health of new mothers. Journal of Mental Health Policy and Economics, 15(2), 61–76. https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=cin20&AN=108135828&site=eds-live&custid=uga1

Chatterji, P., Markowitz, S., & Brooks-Gunn, J. (2013). Effects of early maternal employment on maternal health and well-being. Journal of Population Economics, 26(1), 285–301.PubMedCrossRef

Collins, B. S., Hollander, R. B., Koffman, D. M., Reeve, R., & Seidler, S. (1997). Women, work and health: Issues and implications for worksite health promotion. Women and Health, 25(4), 3–38.PubMedCrossRef

Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150(6), 782–786.PubMedCrossRef

Dagher, R. K., Hofferth, S. L., & Lee, Y. (2014a). Maternal depression, pregnancy intention, and return to paid work after childbirth. Women’s Health Issues, 24(3), e297–e303.PubMedCrossRef

Dagher, R. K., McGovern, P. M., Alexander, B. H., Dowd, B. E., Ukestad, L. K., & McCaffrey, D. J. (2009). The psychosocial work environment and maternal postpartum depression. International Journal of Behavioral Medicine, 16(4), 339–346.PubMedCrossRef

Dagher, R. K., McGovern, P. M., & Dowd, B. E. (2014b). Maternity leave duration and postpartum mental and physical health: Implications for leave policies. Journal of Health Politics, Policy and Law, 39(2), 369–416.PubMedCrossRef

Dagher, R. K., McGovern, P. M., Dowd, B. E., & Lundberg, U. (2011). Postpartum depressive symptoms and the combined load of paid and unpaid work: A longitudinal analysis. International Archives of Occupational and Environmental Health, 84(7), 735–743.PubMedCrossRef

Dolan, E. D., Mohr, D., Lempa, M., Joos, S., Fihn, S. D., Nelson, K. M., & Helfrich, C. D. (2015). Using a single item to measure burnout in primary care staff: A psychometric evaluation. Journal of General Internal Medicine, 30(5), 582–587.PubMedCrossRef

Falletta, L., Abbruzzese, S., Fischbein, R., Shura, R., Eng, A., & Alemagno, S. (2020). Work reentry after childbirth: Predictors of self-rated health in month one among a sample of university faculty and staff. Safety and Health at Work, 11(1), 19–25. https://doi.org/10.1016/j.shaw.2019.12.006CrossRefPubMed

Fawcett, E. J., Fairbrother, N., Cox, M. L., White, I. R., & Fawcett, J. M. (2019). The prevalence of anxiety disorders during pregnancy and the postpartum period: A multivariate Bayesian meta-analysis. The Journal of Clinical Psychiatry. https://doi.org/10.4088/jcp.18r12527CrossRefPubMedPubMedCentral

Feldman, R., Sussman, A. L., & Zigler, E. (2004). Parental leave and work adaptation at the transition to parenthood: Individual, marital, and social correlates. Journal of Applied Developmental Psychology, 25(4), 459–479. https://doi.org/10.1016/j.appdev.2004.06.004CrossRef

Feldman, R., & Zigler, E. (1994). The Parental Leave Inventory (Unpublished manual). Yale University.

Field, T. (2018). Postnatal anxiety prevalence, predictors and effects on development: A narrative review. Infant Behavior and Development, 51, 24–32.PubMedCrossRef

Frone, M. R., Russell, M., & Barnes, G. M. (1996). Work–family conflict, gender, and health-related outcomes: A study of employed parents in two community samples. Journal of Occupational Health Psychology, 1(1), 57–69.PubMedCrossRef

Furtado, M., Chow, C. H., Owais, S., Frey, B. N., & Van Lieshout, R. J. (2018). Risk factors of new onset anxiety and anxiety exacerbation in the perinatal period: A systematic review and meta-analysis. Journal of Affective Disorders, 238, 626–635.PubMedCrossRef

Gandek, B., Ware, J. E., Aaronson, N. K., Apolone, G., Bjorner, J. B., Brazier, J. E., Bullinger, M., Kaasa, S., Leplege, A., & Prieto, L. (1998). Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: Results from the IQOLA Project. Journal of Clinical Epidemiology, 51(11), 1171–1178.PubMedCrossRef

Gjerdingen, D. K., & Center, B. A. (2003). First-time parents’ prenatal to postpartum changes in health, and the relation of postpartum health to work and partner characteristics. The Journal of the American Board of Family Practice, 16(4), 304–311.PubMedCrossRef

Greenberger, E., Goldberg, W. A., Hamill, S., O’Neil, R., & Payne, C. K. (1989). Contributions of a supportive work environment to parents’ well-being and orientation to work. American Journal of Community Psychology, 17(6), 755–783.PubMedCrossRef

Grice, M. M., Feda, D., McGovern, P., Alexander, B. H., McCaffrey, D., & Ukestad, L. (2007). Giving birth and returning to work: The impact of work–family conflict on women’s health after childbirth. Annals of Epidemiology, 17(10), 791–798.PubMedCrossRef

Grice, M. M., McGovern, P. M., Alexander, B. H., Ukestad, L., & Hellerstedt, W. (2011). Balancing work and family after childbirth: A longitudinal analysis. Women’s Health Issues, 21(1), 19–27.PubMedCrossRef

Guintivano, J., Manuck, T., & Meltzer-Brody, S. (2018). Predictors of postpartum depression: A comprehensive review of the last decade of evidence. Clinical Obstetrics and Gynecology, 61(3), 591–603. https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=edsbl&AN=vdc.100064305475.0x000001&site=eds-live&custid=uga1

Howard, L. M., & Khalifeh, H. (2020). Perinatal mental health: A review of progress and challenges. World Psychiatry, 19(3), 313–327. https://doi.org/10.1002/wps.20769CrossRefPubMedPubMedCentral

Hughes, D. (1987). The inter-relationship between job characteristics, work/family interference, and marital outcomes. Unpublished Doctoral Dissertation, University of Michigan.

IMPAQ & Institute for Women’s Policy Research. (2017). Qualifying for unpaid leave: FMLA eligibility among working mothers. U.S. Department of Labor. https://www.dol.gov/sites/dolgov/files/OASP/legacy/files/IMPAQ-Working-Mothers.pdf

International Social Security Association. (n.d.). ISSA guidelines: Return to work and reintegration. ISSA. https://ww1.issa.int/guidelines/rtw/174799

Jou, J., Kozhimannil, K. B., Abraham, J. M., Blewett, L. A., & McGovern, P. M. (2018). Paid maternity leave in the United States: Associations with maternal and infant health. Maternal and Child Health Journal, 22(2), 216–225.PubMedCrossRef

Karasek, R. (1985). Job Content Questionnaire. University of Southern California.

Killien, M. G., Habermann, B., & Jarrett, M. (2001). Influence of employment characteristics on postpartum mothers’ health. Women and Health, 33(1–2), 63–81.PubMedCrossRef

Linnan, L. A., Cluff, L., Lang, J. E., Penne, M., & Leff, M. S. (2019). Results of the workplace health in America survey. American Journal of Health Promotion, 33(5), 652–665. https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=s3h&AN=136799389&site=eds-live&custid=uga1

Mandal, B. (2018). The effect of paid leave on maternal mental health. Maternal and Child Health Journal, 22(10), 1470–1476.PubMedCrossRef

Mandal, B., Roe, B. E., & Fein, S. B. (2010). The differential effects of full-time and part-time work status on breastfeeding. Health Policy, 97(1), 79–86. https://doi.org/10.1016/j.healthpol.2010.03.006CrossRefPubMed

Mårdberg, B., Lundberg, U., & Frankenhaeuser, M. (1991). The total workload of parents employed in white-collar jobs: Construction of a questionnaire and a scoring system. Scandinavian Journal of Psychology, 32(3), 233–239.CrossRef

Marshall, N. L., & Barnett, R. C. (1993). Work–family strains and gains among two-earner couples. Journal of Community Psychology, 21(1), 64–78.CrossRef

McGovern, P., Dagher, R. K., Rice, H. R., Gjerdingen, D., Dowd, B., Ukestad, L. K., & Lundberg, U. (2011). A longitudinal analysis of total workload and women’s health after childbirth. Journal of Occupational and Environmental Medicine, 53(5), 497–505.PubMedCrossRef

Mirkovic, K. R., Perrine, C. G., Scanlon, K. S., & Grummer-Strawn, L. M. (2014). Maternity leave duration and full-time/part-time work status are associated with US mothers’ ability to meet breastfeeding intentions. Journal of Human Lactation, 30(4), 416–419. https://doi.org/10.1177/0890334414543522CrossRefPubMedPubMedCentral

Moos, R. H. (1980). Work Environment Scale manual. Consulting Psychologists Press, Inc.

Netemeyer, R. G., Boles, J. S., & McMurrian, R. (1996). Development and validation of Work-Family Conflict and Family-Work Conflict Scales. Journal of Applied Psychology, 81(4), 400–410.CrossRef

Newkirk, K., Perry-Jenkins, M., Laws, H. B., & Hien, M. (2020). Workplace policies and perinatal depressive symptoms among low-income single and partnered working mothers. Family Relations, 69(4), 770–778.CrossRef

Onoye, J. M., Shafer, L. A., Goebert, D. A., Morland, L. A., Matsu, C. R., & Hamagami, F. (2013). Changes in PTSD symptomatology and mental health during pregnancy and postpartum. Archives of Women’s Mental Health, 16(6), 453–463. https://doi.org/10.1007/s00737-013-0365-8CrossRefPubMedPubMedCentral

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., & Brennan, S. E. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71CrossRefPubMedPubMedCentral

Pennsylvania Department of Labor and Industry. (n.d.). What is return-to-work? Pennsylvania Department of Labor and Industry. https://www.dli.pa.gov/Businesses/Compensation/workplace-comm-safety/ReturnToWork/Pages/What-is-Return-to-Work.aspx

Perry-Jenkins, M., Smith, J. Z., Wadsworth, L. P., & Halpern, H. P. (2017). Workplace policies and mental health among working-class, new parents. Community, Work and Family, 20(2), 226–249.PubMedCrossRef

Quinn, R. P., & Staines, G. L. (1979). The 1977 Quality of Employment Survey: Descriptive statistics, with comparison data from the 1969–70 and the 1972–73 surveys. Institute for Social Research, University of Michigan.

Sandler, D., & Szembrot, N. (2019). Maternal labor dynamics: Participation, earnings, and employer changes. United States Census Bureau. https://www2.census.gov/ces/wp/2019/CES-WP-19-33.pdf

Shepherd-Banigan, M., Bell, J. F., Basu, A., Booth-LaForce, C., & Harris, J. R. (2016). Workplace stress and working from home influence depressive symptoms among employed women with young children. International Journal of Behavioral Medicine, 23(1), 102–111.PubMedCrossRef

Slavit, W. (Ed.). (2009). Investing in workplace breastfeeding programs and policies: An employer’s toolkit. Center for Prevention and Health Services.

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, 1–55.

Spielberger, C. D. (1972). Anxiety: Current trends, theories and research (Vol. 1). Academic.

Stack, S. W., Jagsi, R., Biermann, J. S., Lundberg, G. P., Law, K. L., Milne, C. K., Williams, S. G., Burton, T. C., Larison, C. L., & Best, J. A. (2019). Maternity leave in residency: A multicenter study of determinants and wellness outcomes. Academic Medicine, 94(11), 1738–1745.PubMedCrossRef

Thompson, E., & Budzynski, H. (1989). Interpretation of the Symptoms of Stress (SOS) Inventory. University of Washington.

Tucker, J. N., Grzywacz, J. G., Leng, I., Clinch, C. R., & Arcury, T. A. (2010). Return to work, economic hardship, and women’s postpartum health. Women and Health, 50(7), 618–638.PubMedCrossRef

U.S. Department of Labor. (n.d.-a). Family and medical leave. U.S. Department of Labor. https://www.dol.gov/general/topic/benefits-leave/fmla

U.S. Department of Labor. (n.d.-b). Mothers and families. U.S. Department of Labor. https://www.dol.gov/agencies/wb/data/mothers-families

Ware, J. E., Kosinski, M., Turner-Bowker, D. M., & Gandek, B. (2002). How to score version 2 of the SF-12(R) Health Survey. QualityMetric, Inc.

Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 Health Survey: Manual and interpretation guide. The Health Institute, New England Medical Center.

Weiss, D., Dowis, R., England, G., & Lofquist, L. (1967). Manual for the Minnesota Satisfaction Questionnaire. Minnesota Studies in Vocational Rehabilitation, 22, 120.

Weissman, M. M., Sholomskas, D., Pottenger, M., Prusoff, B. A., & Locke, B. Z. (1977). Assessing depressive symptoms in five psychiatric populations: A validation study. American Journal of Epidemiology, 106(3), 203–214.PubMedCrossRef

Wontman, C., Emmons, C., Tiedje, L., Lang, E., & Biernat, M. (1986). Stress and coping among women professionals. University of Michigan.

Yim, I. S., Stapleton, L. R. T., Guardino, C. M., Hahn-Holbrook, J., & Schetter, C. D. (2015). Biological and psychosocial predictors of postpartum depression: Systematic review and call for integration. Annual Review of Clinical Psychology, 11, 99–137. https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=edsbl&AN=RN600892769&site=eds-live&custid=uga1

Title: Examining the Relationship Between Return to Work After Giving Birth and Maternal Mental Health: A Systematic Review
Authors: Rachel Elizabeth McCardel
Emily Hannah Loedding
Heather Marie Padilla
Publication date: 30-07-2022
Publisher: Springer US
Keywords: Mood Disorders
Affective Disorder
Published in: Maternal and Child Health Journal / Issue 9/2022
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-022-03489-0

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Examining the Relationship Between Return to Work After Giving Birth and Maternal Mental Health: A Systematic Review

Abstract

Introduction

Methods

Results

Discussion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion

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