# Motivation and emotion/Book/2019/Postpartum return to work motivation

* Multimedia presentation (3 min)

## Overview

Society encourages women to return to work postpartum and yet there is limited resources available in helping women transition back into the workforce (Spiteri & Xuereb, 2012) and as such it can be more beneficial for them to stay home. This paired with psychological theories leads to the question when or if women should return to work postpartum. According to the Australian Bureau of Statistics in 2017 there were 582,300 babies born in Australia. In 2011 of the Australian mothers with children that were 2 years old or younger, 68% had a job during their pregnancy. 98% of women stayed in the same job while 2% moved onto a new workplace. Of these women 48% worked part time. It was found first time mothers were less likely to work part time at 25% while mothers who already had a child sat at 69%. It was found that young mothers aged 15 to 24. Only 46% had a job while pregnant compared to mothers aged 30 to 39 years old with 74% working while pregnant. In Australia the average age for a woman to have her first baby has increased from 29 years in 2011 to 30.5 in 2017, with women aged between 30 to 34 years old having the highest fertility rate. In 2017, 77% of women remained in their prior postpartum position, 65% stayed in their original job maintaining the same roles and responsibilities they had before maternity leave. Of the women working while pregnant who returned to work 43% waited until their baby was 7 months or older before returning to the workforce. 74% returned to work when their baby was 4 months old in 2017 compared to 65% in 2011. With 25% of the women who returned to work their baby was 10 months or older. Various factors can influence when a woman begins working postpartum and the hours they do such as peer and spousal support, number of hours they work and the role they're employed in (Hock, DeMeis and McBride, 1988).

## Psychological Theories

Maslow's theory
Abraham Maslow stated that to achieve self-actualization and fulfilment humans have fundamental needs that have to be satisfied. Maslow's theory was that people have a "hierarchy of needs" that drives individuals in a particular direction (Hansen, 2017). However, what happens when certain needs drive individuals in different directions or when needs conflict with each other. A stay at home mother may feel the need to meet her physiological needs of belonging and love postpartum compared to a mother returning to work who is driven by safety, esteem, and self-actualization needs. A stay at home mother is able to meet the physiological, love and belonging needs through maternal bonding, breastfeeding or maternal attachment to achieve a sense of competence and emotional satisfaction (Mulder & Johnson, 2010). Mothers who return to work postpartum are driven by different needs such as safety, esteem, and self-actualization. When these needs are previously being met in the workplace it can drive women to return to work postpartum in order to once again satisfy these needs (Benson & Dundis, 2003). While there is a hierarchy of needs this does not determine which needs women feel have to be fulfilled postpartum as stay at home mothers and working mothers are driven by different needs but this does not mean that one need is more important than the other but that individuals strive to fulfil the needs based on what holds value to them.
Postpartum Depression in Working Mothers
The American Psychiatric Association defines postpartum depression (PPD) as a serious but treatable mental health condition that can cause extreme sadness, indifference and/or anxiety, sleep deprivation, changes of energy levels and appetite. PPD can affect women during pregnancy and after child birth and affects approximately 1 in 7 women. However, data from the 2010 Australian National Infant Feeding Survey found that 1 in 5 mothers with children aged 24 months or less had been diagnosed with PPD. Women most at risk were 25 years or under, smokers, from a lower income household, spoke English at home, were overweight/obese or experienced an emergency caesarean section. PPD can affect mothers returning to work. Selix and Goyal (2015) state that PPD can be one of the most costly conditions that an employer can experience, with women being more likely to be diagnosed with PPD in the first year. Mothers who return to work are the most at risk due to workplace stressors, sleep deprivation, the demands of caring for a baby as well as workplace responsibilities and that mothers and employers need to work together. Mothers who suffered depression showed increased negative effects, including irritation or intrusiveness in face to face situations with them experiencing 4 times greater negative feelings then those of non-depressed mothers (Cohn, Campbell, Matias & Hopkins, 1990). In 1998 Killian conducted a study involving 142 employed mothers that were partnered, well-educated and mostly of Caucasian background to examine the effects of maternal gratification, stress, separation anxiety and the relationship between returning to work in the first year. Participants were examined at 1, 4 and 8 months postpartum using a mailed questionnaire. It was determined that greater parenting stress and anxiety was associated with a decrease in parental satisfaction though not enough to be clinically diagnosed and was unrelated to the workplace. Women who return to the workforce should receive evaluation in regards to fatigue, mental and physical symptoms. It was also stated that clinical support could help decrease job stress, increase social support at home and at work and that leave can help manage symptoms (McGovern et al., 2007)
* Case study
* A study conducted by Gjerdingen and Chaloner in 1994 used mailed questionnaires at 1,3,6,9 and 12 months postpartum. It was found that there were significant changes in mothers' general mental health, depression, and anxiety over the first year, especially in the first month postpartum. It was also concluded that poor mental health was associated with work related factors such as longer work hours and maternity leave shorter than 24 weeks.
Postpartum Depression in Stay at Home Mothers
Stay at home mothers can also suffer from PPD. Highly educated and successful women who become stay at home mothers experience a complex range of emotions and experiences (Rubin & Wooten, 2007). McCarten (2003) used meta-analytical techniques to find that employed mothers have a slight advantage to stay at home mothers in experiencing lower depression rates and having higher self-esteem rates. In 2013 Adhikari studied 60 mothers with 30 working mothers and 30 non-working mothers to examine the dual role relationship in working mother compared to the single role of stay at home mothers. The result showed that there were significant differences in the degree of depression and anxiety. The working mothers’ group had a mean anxiety level of 49.90 compared to the non-working mother’s group with an anxiety mean of 29.03. Similar results were found with depression with the working mothers mean for depression at 36.13 compared to the non-working mothers depression mean at 14.57. It was concluded that for both anxiety and depression non-working mother’s levels were significantly lower than those of working mothers.
Separation Anxiety
In addition to PPD mothers can also experience separation anxiety which can lead women to stay home after the birth of their child. Maternal separation anxiety is an emotion where mothers experience worry, guilt or sadness during short terms when they're separated from their child (Hock et al., 1992). Women who are separated from their children report experiencing an emotional strain and anxiety (Nystrom and Axelsson, 2002). Lutz and Hock (1995) found that first time mothers experienced high levels of separation anxiety when their babies were approximately 2 months old. Stifter, Coulehan and Fish (1993) found that babies of employed mothers who experienced separation anxiety were more likely to experience intrusive behaviours and develop anxious-avoidance attachments.
Attachment theory
Social-emotional development begins with babies establishing an emotional connection with a mother, father, or primary caregiver allowing them to develop socially and create future relationships (Gerrig et al., 2009). In attachment babies use primary care givers as a source of security, comfort, and safety allowing them to explore and develop (Benoit, 2004). When mothers return to work attachment can be a primary concern for mothers in fear of negatively changing their maternal-infant bond. Children who engage in long-regular day-care are more likely to avoid their mothers when reunited (Schwartz, 1983). Women who are committed to work and experience less anxiety about utilising day-care and are secure in their maternal attachment are more likely to return to work sooner (Harrison & Ungerer, 2002).

## Socialization

Maternal social isolation and social exclusion can be detrimental on the health of mothers and infants causing negative emotions, moods, and effects (Eastwood et al., 2013). Being a stay at home mother can cause social isolation compared to mothers who return to work. By returning to work mothers are staying in contact with friends and maintaining social connections they have established and have an expanded support network compared to those that stay at home. During the postpartum period social interaction and support plays a detrimental role for mothers and it is important to identify support networks to try and prevent depression and promote a healthy recovery from birth (Negron et al., 2013). Stay at home mothers face stigma that is associated with them receiving financial support from the government postpartum. It has been found however that people are more accepting of mothers receiving financial assistance if they are bettering themselves such as education (Davis and Hagen, 1996). Young mothers especially face the financial stigma with this group being most reliant on financial assistance as well as facing social isolation. When young mothers are isolated from a social support network the children also run a greater risk of maternal rejection (Colletta, 1981). It can be difficult for women to build new social networks and is usually easy for mothers who are determined and seek out groups to meet other mothers and babies (Russell, 2005).
Self-Identity Theory and Self-Concept
Tajfel characterized Social Identity Theory (SIT) as the idea that in any point in a person's life they categorize themselves into a social group or social identify such as a mother, wife, student or employee etc. This distinguishes them from other people and allows themselves to associate with relevant social groups based on social categorization, social identification, and social comparison (Hodson & Earle, 2017). Self-concept plays an important role I'm SIT, self-concept allows individuals to confidently define themselves and their internal identity consistently and feel temporarily stable (Bobrowski, 2018). SIT can pose a challenge for new mothers that transition from the workplace to motherhood with them experiencing a feeling of disruption when trying to adapt to their change of roles, new self-identity and self-concept (Horne, Corr & Earle, 2011).

## Individual Circumstances

Breastfeeding and Planned Behaviour Theory
Planned behaviour theory (PBT) is used to understand and predict future behaviours using attitudes toward the behaviour, subjective norms, and perceived behavioural control (Kan & Fabrigar, 2017). Planned behaviour can apply to new mothers who intend on breastfeeding their babies and hold breastfeeding as a high priority. Due to limited support breastfeeding and working can seem almost impossible and feel like an unneeded strain that prevents women from returning to work. Prenatal attitudes towards breastfeeding can predict mother's actions postpartum (Wambach, 1997) this enables women to plan their maternity leave and time they will take off postpartum such as reaching a year of breastfeeding and then returning to work after this milestone. PBT is a comprehensive, theoretical, and empirical based tool that can be used to predict and understand mother's individual motivation and emotion in regards to their breastfeeding journey postpartum and how that will affect when they return to work and the frequency they return for such as part-time or full-time (Duckett et al., 1998).
Breastfeeding and Postpartum Depression
It has been shown that breastfeeding is an effective form of preventing or minimizing PPD. However, returning to work can make breastfeeding more challenging and affect when a mother returns to work, the duration or amount of hours that she works in order to suit her breastfeeding schedule and continue feeding or expressing. Krol and Grossman (2018) identify that breastfeeding impacts children’s brain, cognitive, and socio-emotional development and can help mothers by affecting their mood, affect stress and improve maternal care. Breastfeeding helps reduce negative moods in mothers (Mezzacappa and Katkin, 2002) and can also protect babies from being impacted when their mothers suffer from depression through the benefits of breastfeeding (Jones, 2005). Breastfeeding helps reduce the risk of women developing PPD especially in the first 4 months (Hamdan and Tamim, 2012).
While it is easier and more convenient for stay at home mothers to breastfeed it is not impossible for working mothers to continue to breastfeed, however, there are more obstacles. Yilmaz, Gurakan, Akgun and Ozbek (2002) state that in order to support breastfeeding at work maternity leave should be extended and breastfeeding conditions at work need to be improved. Green (2003) identifies that the separation of employment complicates breastfeeding making it more difficult. Without employer support and job flexibility, breastfeeding is negatively impacted. This can be because both mothers and employers can lack the knowledge of the benefits of breastfeeding and how breastfeeding can work for the employed mother to be able to efficiently sustain breastfeeding for working mothers. Breastfeeding is possible and more likely when working mothers receive support from their employers, and while some workplaces may have more extensive policies and procedures to support breastfeeding in the workplace all companies are able to implement a support program specific to their companies and budgets (Dinour and Szaro, 2017).
Financial Pressure
In Australia Centrelink provides up to 18 weeks maternity leave for those who are eligible (Refer to link below to check eligibility). While this Centrelink payment is eligible to any woman in the workforce that meets the requirements generally casual workers do not receive paid maternity leave or are guaranteed their position when they're ready to return to the workforce unless they are long term casuals (12 months+ employment). While there are regulations in place in Australia to protect women from being fired while on maternity leave or because they are pregnant, different organizations have different policies and procedures in regards to paid and unpaid maternity leave and the amount and duration mothers are entitled to. If women come from a low income family where they are dependent on the mother's pay for every day essential's it could motivate them to return to work sooner. Financial stress can increase risks and rates of depression and negatively impact parenting quality (Jackson et al., 2000). Gyamfi, Brooks-Gunn and Jackson (2001) also found that depression, anxiety and stress levels were more elevated in unemployed women, in lower income families who were under financial pressure than those among women who worked.
While returning to work can help alleviate financial pressure by having an additional pay check, it can also create new financial stressors such as the cost of day-care. 56% of Australian women starting or returning to the workforce after a baby relies on informal help such as grandparents, partners, family or friends opposed to using day-care, with 26% of women having their parents look after their children while they work. Regardless, day-care has risen from 33% in 2011 to 44% in 2017. 80% of women are having to use long day-care hours which could mean increased work hours for it to be financially worthwhile. While there are day-care subsidies available in Australia, again, Centrelink has eligibility requirements (see link below for eligibility). If people do not meet these requirements they may face the entire bill which takes away the financial advantage working provides and can lead to resentment towards the workplace or even between partners. Day-care is a vital piece of the puzzle in managing a work-life and family-life balance to ensure a positive relationship between the two (Power, 2005). It has also been established that even when women return to the workforce they continue to do more housework then their male partners (Fagan, 2001). This can lead to issues at home as studies have found that more than half of working mothers prioritised work duties above household duties (Govender et al., 2006).
Stay-at-home Fathers
Stereotypes have diminished where mothers are returning to work while father's stay at home and become the primary caregiver. This makes sense especially if the mother earns more money or wants to return to work and daycare makes working redundant. The number of stay at home dads is grossly underestimated by millions (Latshaw, 2011). This shift in roles can promote a positive arrangement and satisfaction for both mothers and fathers especially in circumstances where father’s jobs are more unstable and have shifts in employment and wives are supportive of this change of roles (Chesley, 2011). Studies have shown that stay at home fathers who receive social support, find themselves highly efficient in parenting and hold low value to the traditional and masculine roles of stereotypes and are more likely to have a positive experience with being stay at home fathers and experience a better adjustment then others. While fathers acknowledge there is a stigma associated with being a stay at home father they tend not to feel threatened or doubt their masculinity by adapting to a new role as primary caregiver rather than the primary breadwinner. (Rochlen, McKelley, Suizzo and Scaringi, 2008). Studies have found that couples where roles are reversed and the mother is the primary earner and the father stays at home experience the same satisfaction and feelings of equality in their relationship as those with the traditional roles where the mother stays at home and the father works (Zimmerman, 2000).

## Conclusion

Australian mothers face many challenges and individual circumstances and as such it cannot be determined what is the main influence for a mother deciding if or when she will return to work or stay home after the birth of their children. Women may be affected by one or more motivational factors emotions that help determine their decision and it is situational on what suits the interests of that family the best and thus meaning there is no correct overall decision that suits everyone on whether to return to work or stay home and as such it should not be judged on what decision is made. The most important thing is that families receive support to ensure a positive and healthy environment for new mothers, babies and their families when deciding what is right for them.