Maternal Employment, Family Functioning, and Preterm Infant Development at 9 and 12 Months

The decade of the 1980s witnessed a dramatic increase in the number of employed mothers with young children. Indeed, nearly 50% of married women with children under 3 years old are employed (Shank, 1988). Although some researchers believe that maternal employment is a stressful situation for children (Barglow, Vaughn, & Molitor, 1987; Belsky & Eggebeen, 1991), the effects of this potential stressor with children born prematurely have not been studied. Research with healthy children may not be applicable to prematurely born children for several reasons. First, preterm infants are at increased risk for developmental delay and may be more sensitive to stressful environmental conditions than healthy children (Tobey & Schraeder, 1990). Second, family environments for preterm infants may be different than those for full-term infants because of increased caretaking demands and stressors. The purpose of this study was to investigate the effects of maternal employment on the family and on the mental and motor development of preterm infants at 9 and 12 months of age. Because of concern for the development and wellbeing of the child with an employed mother, a significant amount of research regarding the impact of maternal employment for healthy children has been conducted; however, the results are conflicting. Some investigators report negative effects of maternal employment on attachment (Barglow et al., 1987; Belsky & Rovine, 1988; Schwarz, 1983), mother–child interaction (Cohen, 1978; Field, Stoller, Vega-Lahr, Scafidi, & Goldstein, 1986), and cognitive development (Cohen, 1978; Schacter, 1981). Others report either no effects or positive effects on attachment (Easterbrooks & Goldberg, 1985; Hock, 1980; Owen, Easterbrooks, Chase-Lansdale, & Goldberg, 1984), mother–child interaction (Schubert, Bradley-Johnson, & Nuttal, 1980), and cognitive development (Doyle, 1975; Hock, 1980; Stith & Davis, 1984). These conflicting results suggest that the mechanism by which maternal employment may affect the child is complex, and may be influenced by other variables. Two factors that may affect the relationship between maternal employment and child outcomes have been identified: timing of the mother’s return to employment (Benn, 1986) and attitudes of the mother that conflict with her employment status (Hock, DeMeis, & McBride, 1987). Popular belief places importance on the mother’s staying home with the infant during the first 6 months. However, Benn (1986) believes that maternal employment begun during the second 6 months is more harmful, since the child’s attachment to the mother is thought to occur during this time (Bowlby, 1969/1982). Congruency between the mother’s employment status and her attitudes toward employment may play a part in child outcomes. In a series of studies, Hock found an interaction effect for employment status and attitudes toward separation from the infant (Hock, 1980, 1984; Hock & Clinger, 1980). For the most part, infants in these studies fared better when the mother’s employment status and her attitudes toward separation from the infant were consistent. Benn (1986) reported that insecure attachment of sons to their mothers was associated with lower integration of the employee and mother roles. Mothers who were employed by choice held more positive perceptions of their children than mothers who were employed due to financial need; however, education may blunt the effect of both employment for financial reasons and role conflict for employed mothers (Alvarez. 1985). Kindergarten children whose mothers were not employed but who felt that employment would be good for the child scored lower on measures which reflect preschool achievement and social competence (Farel, 1980). While these findings support the importance of attitude/behavior consistency for healthy children, the effects of this consistency for children at risk has not been reported. Since children are raised in a family context, Hoffman (1989) advocates identifying family process variables that could mediate the effects of maternal employment on the child. Three family variables—cohesion, adaptability, and satisfaction with family relationships—were selected for this study based on results from dyadic research. Cohesion, the emotional bond among family members, is a family concept that is closely related to attachment. Quality of the marital relationship, one aspect of family cohesion, has been related to the quality of parent–child attachment (Belsky & Rovine, 1988; Goldberg & Easterbrooks, 1984) and, in turn, has been shown to be important for the child’s social–emotional development (Bowlby, 1969/1982). Research regarding the effects of women’s employment on family cohesion, specifically the marital relationship, is sparse and conflicting. Some researchers find no relationship between women’s employment and husband’s wellbeing (Fendrich, 1984). depression (Ross, Mirowsky, & Huber, 1983), or marital satisfaction (Locksley, 1980; Staines, Pleck, Shepard, & O’Connor, 1978), while others find greater depression and lower self-esteem for husbands with employed wives (Kessler & McRae, 1982). Adaptability has been defined as “the ability of a marital or family system to change its power structure, role relationships, and relationship rules in response to situational and developmental stress” (Olson & McCubbin, 1982, p. 51). Olson (1989) includes in this definition changes that parents make in their parenting styles in response to changing developmental needs of the child. While the example Olson gives is with autonomy and adolescents, the same may be true for infants around their first birthday. Thus, adaptability is a family concept that is akin to parents’ responsiveness to their child’s needs. Responsivity of the mother has been positively related to cognitive development of preterm infants (Meisels & Plunkett, 1988). Satisfaction with family relationships refers to the degree of agreement between “real” and “ideal” family relationships, including relationships between the family and the individual, dyadic and higher order relationships within the family, and relationships between the family and others (Roberts & Feetham, 1982). While this concept may appear to overlap with cohesion, it is different because of the reference point. Scales that measure cohesion imply that the parent compare his/her family to other families on each of the items, whereas satisfaction uses the family members’ perceptions of their “ideal” family against which to compare their real family situation. In addition, satisfaction with family relationships includes relationships between the family and outside individuals and systems. Thus, maternal employment could have a negative indirect effect on the child through effects on family functioning. However, there have been few studies relating maternal employment to measures of family as opposed to dyadic functioning. Cohen (1978) reported negative effects of maternal employment on development and mother–child interaction for toddlers who were born prematurely. However, these findings were confounded by the number of parents in the home and, when Cohen excluded children from single parent families, the negative effects were no longer seen. Youngblut, Loveland-Cherry, and Horan (1991) studied correlates of maternal employment in a sample of two-parent families with preterm infants. Employment status was not related to developmental progress for infants at 3 months of age; however, the number of hours the mother was employed was positively related to the infant’s motor development. Family functioning measures (cohesion, adaptability, and satisfaction with family) were not related to employment status or number of hours employed. However, the mother’s degree of choice regarding her employment decision and her satisfaction with that decision were positively related to both child and family outcomes. To summarize, many gaps in the literature are apparent. Conceptualization of maternal employment as a simple dichotomy (employed versus not employed) does not adequately represent the complexities of the phenomenon, and only one study (Youngblut et al., 1991) has been reported that included measures of family. In addition, very few studies of maternal employment with preterm infants have been reported, despite the concern that families with preterm infants have a different childrearing experience than families with full-term infants. The secondary analysis reported here was conducted to address these gaps and, more specifically, to investigate whether there are long-term effects on family functioning and on child development when maternal employment is begun by the time the infant is 3 months old. The aims of this study were to describe: (1) differences in parents’ perceptions of family functioning and preterm infant developmental outcomes at 9 and 12 months of age by employment status at 3 months postpartum; (2) differences in family functioning and developmental outcomes at 9 and 12 months between families with mothers whose employment attitudes and behavior were consistent at 3 months postpartum and families with mothers whose attitudes and behavior were inconsistent; (3) relationships between employment-related variables measured at 3 months postpartum and family functioning and developmental outcomes at 9 and 12 months; and (4) within-family change in family functioning and developmental outcomes in each employment status group across time.