Motherhood at work: Exploring maternal mental health

Up to 1 in 5 women in the postpartum period will experience a mental health disorder like postpartum depression or generalized anxiety disorder.

How an organization handles a mother's return to work can have a significant impact on her mental health, according to new research from the University of Georgia.

Organizations control the majority of work-related factors that predict better mental health outcomes. This can include access to paid maternity leave, total workload, and job flexibility.

But previous research examining maternal mental health with respect to work has lumped return to work in with maternity leave, said lead author Rachel McCardel, a doctoral student in UGA's College of Public Health.

"But return to work is more than that because, while maternity leave is an important resource, it doesn't necessarily capture the actual process of when leave ends and when you start resuming work, and when you start combining your roles as an employee and a mother," she said.

Understanding the role that return to work plays in a working mother's mental health may help navigate solutions. It will point to where interventions or support could prevent or lessen the burden of conditions like depression or anxiety.

The roles of mother and employee can clash

The authors performed a systematic review of the peer-reviewed articles from the last 20 years that explored mental health among working mothers in the U.S. The studies included cross-sectional and longitudinal studies that varied and sometimes conflicted on whether return to work improved or hurt mental health.

"But when synthesizing all the studies together, we saw a type of conflict emerge between balancing responsibilities and demands associated with being an employee, as well as the responsibilities associated with being a parent, and wanting to meet the needs of both roles," said McCardel.

A greater conflict between the two roles, they found, led to worse mental health outcomes.

In workplace research, explained co-author Heather Padilla, return to work is a term that applies to people who've been injured or out of work for a long time with an illness and are coming back to the workplace.

"There are return to work programs and, in some cases, a very systematic process to assess an employee's capability and adjust their job responsibilities to help their transition back because the research shows that there's positive benefits to coming back to the workplace after an injury or an illness, but there's a balance," said Padilla, an associate professor in the College of Public Health.

"I don't know that we have those same conversations about return to work after you've had a baby even though we treat pregnancy very much as a disability and illness in the U.S. workplace."

The results of this study reveal some strategies individuals can take on to support their mental health as they return to work. Co-worker support, for one, was cited as an important resource for parents returning to work. But the organization's policies ultimately will have the greatest impact.

McCardel says this review emphasizes why it's critical for workplaces to address maternal mental health in an intentional way.

"It's about creating that structure to say you are not alone. To show that as an organization, you care about your employees and value them. Let's have a structure in place where we can have those conversations and meet those needs," said McCardel.

The paper was published in the July issue of Maternal and Child Health Journal.