Q06”) 73T3

GAN STAT NUTVF RS TTY LTB BRARTE

WTITT TTTTT T Tl TIT TTT TTT TTT

3 1293 00539 3271

 

                   

 

 

 

 

 

 

 

 

 

 

 

LIBRARY
Michigan State
University

 

 

 

This is to certify that the
thesis entitled
THE EFFECTS OF RETURN TO EMPIOYMENT

ON MATERNAL ROLE ADAPTATION

presented by

Pamela Ann 'DeVisser

has been accepted towards fulfillment
of the requirements for

Master of Sc1ence degree in Nursmg

 

 

(:23 4 {QT/£1144?” 40

Major professor

Ma 27 1988
Date y '

 

0-7639 MS U is an Affirmative Action/Equal Opportunity Institution

 

 

MSU

 

 

RETURNING MATERIALS:
Place in book drop to

 

 

LJBRARJES remove this checkout from
—:——. your record. FINES will
be charged if book is
returned after the date
stamped below.
662??! 33 v1' -". "'5'
1 as; -

 

 

THE EFFECTS OF RETURN TO EMPLOYMENT
ON MATERNAL ROLE ADAPTATION

By

Pamela Ann DeVisser

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements

for the degree of

MASTER OF SCIENCE IN NURSING

College of Nursing

1988

M
" \
fl

5/777‘7’

ABSTRACT

THE EFFECTS OF A RETURN TO EMPLOYMENT
ON MATERNAL ROLE ADAPTATION

By

Pamela Ann DeVisser

A correlational study of thirty-three first time mothers returning
to employment in the first postpartum year was conducted to identify and
describe the relationships between length of the maternity leave, number
of hours worked per week, importance of financial and personal reasons
for working, and maternal role adaptation. Self-administered measures
were completed by the convenience sample prior to returning to
employment and two months after resuming the occupational role using the
Postpartum Self-evaluation Questionnaire. Data. were analyzed using
descriptive and inferential statistics.

There were no statistically significant relationships between
employment characteristics and maternal role adaptation. Trends for
relationships between the importance of personal and financial reasons
for working and maternal role adaptation were identified. Nursing
interventions are suggested to enhance maternal role adaptation and
well-being in new mothers facing multiple role obligations. Directions

for future research are outlined.

To my friend, Brenda

Always thoughtful and caring,

A good listener

iii

ACKNOWLEDGMENTS

A very special thank you is extended to Clare Collins, my thesis
chairperson and a working mother. She asked challenging questions at
the right times and lent her expertise in research and organization to
facilitate my learning experience. I am also grateful to Clare and
Linda Beth Tiedje for allowing me to use data from the Working Mothers'
Study for my research.

It was a priviledge to work with a great teacher, Barbara Given.
Thank you for your efforts on my Thesis Committee, as a professor in
graduate course work, my employer for the Family Care Study, and as a
role model. I will miss you.

Thanks to Linda Beth Tiedje for committee work, meeting time
deadlines promptly, and for all the words of encouragment. I really
appreciated your “dispositional optimism“ and on your comments that
encouraged me. Your dedication to working mothers' issues is admirable.

A special thank you to committee member Manfred Stommel, working
father. I appreciated your support and patience with statistical
analysis and reviewing my drafts with extraordinary promptness.

Thank you to Jayne Yoder for advice and assistance with preparing
the final draft of this manuscript. The support and encouragement of

classmates throughout my graduate studies was also appreciated.

iv

I am especially grateful to my husband, Don, for giving me time
when I needed it and encouragment throughout the whole process. To my
son, Mark, rest assured: I will never use "thesis“ as an excuse again!
And finally to Katie, thank you for your hilarious interpretations of
what a thesis is all about. The love, laughter, and fun we have as a

family makes it all worthwhile. I could not have done this without you.

Chapter I

Chapter 11

TABLE OF CONTENTS

Page
The Problem
Introduction and Background ............. 1
Purpose of the Study ................ 13
Problem Statement .................. 14
Definition of Variables ............... 15
Assumptions ..................... 16
Limitations ..................... 16
Overview of Chapters ................ 17
Theoretical Framework
Introduction .................... 19
Overview of Role Theory ............... 19
Definition of a Role ................ 19
Role Expectations . . . ............... 20
Stages of Role Adaptation . . . ........... 22
Role Strain . . . .................. 24
Summary of Chapter . . . . . . . .......... 32

vi

Page
Chapter III Review of the Literature
Overview . . . . . ................. 34
Historical Perspective of Maternal Employment . . . . 34
Maternal Role Adaptation .............. 39
Maternal Employment Research . . . . . . . . . . . . 54

Maternity Leave O O O O O O O O O O O O O O O O O O O 70

Role Strain . . . . . . . . ............. 75
Interventions with Working Mothers ......... 84
Chapter Summary ................... 89

Chapter IV Methodology and Procedures

Overview . . . . . . . . . . ............ 92
Research Questions ................. 93
Hypotheses ..................... 93
Sample...... ................. 93
Study Procedures . . . . . . . . . . ........ 94
Operationalization of the Study Variables ...... 96

Validity of Postpartum Self-Evaluation
weStionnaire O O O O O O O O O O O 0 O O O O 0 O O 97

Reliability of Postpartum Self-Evaluation

Questionnaire . . . . . . . . . . . . ....... 97
Human Subjects Protection .............. 101
Statistical Analysis of the Data ......... . 101
Summary ..... . ................. 104

vii

Chapter V

Chapter VI

References

Appendix A
Appendix 8
Appendix C
Appendix D

Data Presentation and Analysis

Overview . . . . . . . . ........ . . . . .
Sample Characteristics . .............
Reliability of Instruments ............
Research Questions . . . .............
Study Results . . . . . . . . . . . . . . . . . . .
Summary of Data Presentation ......... . .
Interpretation of Results . . . . . . . . . . . . .
Statement of Hypotheses and Research Questions . .

Summary of Findings ................

Summary and Conclusions

overVTEW O O O O O I O I O O O O ..... O O O 0
Recommendations for Future Research . . . . . . . .

Conceptual Framework for Nursing Assessment and
Interventions . . . . . . . . . . . . . . . . . .

Implications for Nursing Interventions . . . . . .
Clinical Nurse Specialist Education and Practice .

Summary . . . . . . ................

-- Pretest Questionnaire
-- Two-Month Questionnaire
-- PSEQ Subscales

Consent Form

viii

Page

105
105
109
112
113
121
122
124
132

134
135

138
146
152
154

157

Table
Table
Table
Table
Table
Table
Table
Table

Table
Table

Table
Table
Table
Table
Table

Table

Table

Table

GDVOMAWN

10

ll
12
13
14
15

17

18

LIST OF TABLES

Page
Factors Comprising Maternal Adaptation ......... 44
Variables Under Investigation--Mercer ......... 47

Parental Norktime Pattern by Occupational Status . . . . 69

Inter-R016 concurrence TypOTogy o o o o a o o o o o o o 83

Reliability Coefficients of Specific PSEQ Subscales . . 99

Location of Data and Subscales on Study Measures . . . . 102
Sociodemographic Characteristics of Sample ....... 106
Neekly Hours Worked Two Months After Return To

Employment . . . . . ................. 107
Length of Postpartum Maternity Leave . . . . . . . . . . 108
Infant's Age At Time of Measurement of Maternal Role

Adaptation O O O O O O O O ..... O O O O O O O O O 109
Coefficient Alphas--PSEQ ................ 110
Interscale Correlations of PSEQ Subscales ...... . 111
Reasons for Norking Subscales--Alpha Coefficients . . . 112
Mean Scores and Standard Deviations--PSEQ . . ..... 114
Mean Scores and Standard Deviations--Reasons for

Horking Subscales . . . . . . . . . . . ....... 115
Pearson's r for Length of Maternity Leave and Indicators

of Maternal Role Adaptation . . . . . . . . . . . . . 116

Analysis of Variance in Measures of Maternal Role
Adaptation as Hours Worked Per Week Varied . . . . . . 117

Mean Scores of PSEQ Subscales as Hours of Employment
Varied .

ix

Table 19

Table 20

Table 21

Table 22

Page

Correlation Coefficients for Reasons for Working and
PSEQ Subscales . . . . . . . ......... . . . . 118

Coefficient of Determination for Independent Variables
With PSEQ Subscales . . ............... 120

Correlation Coefficients for Reasons for Working and
Total PSEQ Scores . . . . . . . . . . . . . . . . . . 120

Nursing Assessment of Working Women Through Pregnancy
and Postpartum .................... 151

LIST OF FIGURES

Page
Figure 1 Relationship of Role Strain and Level of Maternal
Role Adaptation in Postpartum Period Prior to
Return to Employment . . . . ....... . . . . . 26
Figure 2 Impact of Return to Employment on Role Strain and
Subsequent Level of Maternal Role Adaptation in
Postpartum Period ................. 29

Figure 3 Roy‘s Adaptation Model and Maternal Role Adaptation . 140

xi

CHAPTER I
The Problem

Introduction and Background

 

The last decade has seen major changes in the ways working women
handle pregnancy. Today, the vast majority of employed women work
until almost the time of childbirth. Women are also returning to work
with increasing frequency after the birth of their babies. Currently
more than half of the women in the United States work outside the home
(Bureau of Labor Statistics, 1987). Of this group, 52% of the women
with children under the age of one year of age are in the work force
and women with children are the most rapidly growing segment of the
work force (Bureau of Labor Statistics, 1987). It is estimated that by
1990, 75% of American mothers will be in the work force. Families with
both parents employed are the most prevalent family type. The "typical"
American family where the husband is the wage earner and the wife is a
homemaker for two children, now only accounts for 3.7% of all the
nation's families (Bureau of Labor Statistics, 1987).

Until recently, the birth of the first child has been the single
most important factor in creating discontinuity in the education and
careers of women (Leifer, 1980). Now with more women continuing their
careers soon after the birth of a child, not only must a woman assume
the new role of mother but must also attempt to manage her previous

roles of wife and member of the labor force in a satisfactory manner.

The dilemma faced by many new mothers is how to balance career,
motherhood, and wife roles in such a manner to minimize conflict and
personal strain. These women are often faced with many decisions about
whether or not to continue in their careers, when to return to their
position, and whether to work full-time or part-time. For many women,
choices are restricted and influenced by employer policies regarding
maternity and disability leaves.

When women return to work soon after the birth of a baby, there is
an overlap of job/career roles with the maternal role adaptation process
that is still in progress. Most mothers, employed or not, negotiate the
maternal role without major difficulties. Others, however, may
experience problems with mothering.

The issue of maternal employment is of particular importance to
Clinical Nurse Specialists in primary care settings because nursing
intervention during the prenatal and postpartum period with the family
unit and in particular, the working mother, can assist with the role
adaptation and reorganization that must take place during that time.
Anticipatory guidance for working mothers regarding how to balance
their new roles and responsibilities, child care options that are
available, stress management techniques, and discussion of other
employment issues can be intervention strategies employed to promote
adaptation to the maternal role in the first year after delivery.
However, more research is needed about the factors influencing maternal
adaptation in women who return to work during the first postpartum

year.

Maternal Role

 

Women assume many roles over a lifetime. A role is a learned
sequence of actions or deeds that are performed by a person in an
interaction sequence (Sarbin, 1968). Similarly, Scott (1970) defines
role as a set of shared expectations focused upon a particular
position. This set of shared expectations evolve from the role
holder's socialization experiences, the values internalized while
preparing for the position as well as those socially defined
expectations of the role that the role holder adapts to (Hardy &
Conway, 1978). Women often assume the roles of mother, wife, and labor
force worker simultaneously, requiring the integration of many
expectations and responsibilities.

The concept of the maternal role was introduced into nursing
science literature over twenty years ago when Rubin (1967) attempted to
describe the psychological processes that occur during pregnancy and
the postpartum period. Rubin (1967) states that the maternal role is a
set of complex social and cognitive processes that are learned actively
by the mother. The maternal role is not an instinctive and passive
role that any woman can master in a short period of time.

The maternal role is also culturally defined and reflects the
social norms or rules of what is acceptable behavior for the role
holder (Mercer, 1985). In contrast to career roles which have more
specific guidelines and expected behaviors established by the employer
as the "job description," specificity in the mothering role is lacking.
Also lacking are clarity and consensus about expectations relating to
what mothers should and should not do which makes the transition to any
role more difficult (Burr, Leigh, Day, & Constantine, 1979). This is

especially true for many contemporary women who are combining motherhood
and career positions without the role models of their mothers and
grandmothers who most likely occupied traditional domestic roles.
Maternal Role Adaptation

Maternal role adaptation is defined as the process by which the
mother achieves competence in the role and integrates the mothering
behaviors into her established role set, so she is comfortable with her
new identity as a mother (Mercer, 1985). This process was first
described by Rubin (1967) as beginning prenatally and culminating in
the postpartum period with the formulation of a maternal identity.

Four phases of the maternal role adaptation process have been
identified. These are the anticipatory, formal, informal, and personal
stages. The anticipatory phase begins during the pregnancy as the
woman begins a psychosocial adjustment to the anticipated role by
seeking role models (Rubin, 1967). The formal stage begins with the
birth of the baby and is influenced by the expectations of others
(Thornton & Nardi, 1975). The informal stage ensues as the mother
develops her own unique style of mothering and begins to disregard the
“strict rules and directions“ of others. In the final and personal
stage, the mother feels a sense of harmony, confidence, and competence
in how the role is performed (Rubin, 1967; Thornton & Nardi, 1975).
This process of internalizing the maternal role has been observed to
occur within a range of three to ten months after the birth of the baby
(Mercer, 1985).

To summarize, maternal role adaptation is a process in which a
mother achieves competence in the role and integrates mothering

behaviors into her role set. The four phases of maternal role

adaptation that have been identified by role theorists are the
anticipatory, formal, informal, and personal stages. The culmination
of the process of maternal role adaptation that occurs during pregnancy
and the first year of the infant's life is the achievement of maternal
identity.
Factors Affecting Maternal Role Adaptation

The adaptation to any role can be affected by a number of
conditions that make role enactment difficult. The ease with which the
new mother moves into her role can be influenced by such factors as
maternal age, the socioeconomic standing of the family, the number of
children in the family, maternal education, child-rearing attitudes,
the perception of the birth experience, early maternal-child separation,
self-concept and personality traits of the mother, maternal or infant
illness, infant temperament, the support system of the mother, and
social stress (Mercer, 1986a; Walker, Crain, & Thompson, 1986). In
addition to these factors, simultaneous enactment of multiple roles such
as wife, mother, and employee can lead to considerable conflict and
strain in the new mother (Gilbert, Holohan, D Manning, 1981).

The concept of role strain has been defined and extensively
discussed by Goode (1960) as a subjective response to role problems or
(conflicts that result in the "felt difficulty in fulfilling role
obligations“ (p. 483). Other terms used to describe the psychological
response to role strain include anxiety, tension, frustration, apathy,
and futility (Hardy & Conway, 1978). Role strain can occur normally in
any new role acquisition process and the problem is how to make the

whole role system manageable in order to reduce the strain (Goode, 1960).

Role strain has been identified as a significant problem for
contemporary women attempting to combine maternal and career roles.
Role strain may result from conflicting expectations from the mother's
reference groups, the new mother occupying multiple positions or roles
simultaneously, and personal role expectations that are incongruent
(Hardy & Conway, 1978). The new mother may also feel incompetent in
her new role if adequate time to perform the role is not allotted before
the resumption of other role obligations occurs.

Although each parent in a dual-career family may have several
roles, husbands for the major part continue to be seen in the
breadwinner role and wives remain in the homemaker role (Sekaran,
1986). Despite the increasing prevalence of supportive husbands in
dual-career families, the impact of the role strain or stress is felt
most by the woman because less is expected of the man in regard to
family responsibilities (Skinner, 1980). Therefore, the new mother
returning to the labor force, although sharing childcare tasks with her
husband, may continue to bear the bulk of the responsibility, and the
resulting stress and strain.

Role strain and specifically, role conflict have been reported to
occur in most women during the postpartum period in varying degrees
(Gilbert et al., 1981; Gray, 1983; Johnson & Johnson, 1977; Majewski,
1986; Mercer, 1986a; Van Meter a Agronow, 1982). Mercer (1986a) found
that 89% of the new mothers in her study reported some degree of role
strain at four months after delivery. When measured at eight and 12
months postpartum, the role strain had not significantly changed.
TrMajewski (1986) found the greater the extent of role conflict, the

greater the difficulty in the transition to the maternal role.

{Although Mercer (1986a) and Majewski (1986) both reported
significant levels of role strain and role conflict in new mothers,
there did not seem to be a significant difference in those mothers that
were employed versus those unemployed during the same period of time.
However, analysis of different aspects of a woman's employment status
is needed to better understand the effect it may have on the ongoing
process of maternal role adaptation. »

In sum, many factors affect the ease of maternal role adaptation.
Role strain, or the felt difficulty in fulfilling role obligations, has
been identified as a significant problem for women attempting to
combine the maternal and worker roles. In spite of supportive husbands,
many women continue to have most of the household and child care
responsibilities. Role strain has been reported to occur in most women
during the postpartum period; although differences in role strain
between employed and nonemployed mothers are undocumented relative to
the number of roles occupied.
Employment Status after Childbirth

Some women have options to consider regarding their return to
employment after the birth of their baby. These options affect how
they negotiate all of their role responsibilities. One consideration
for the new mother is when to return to work after the birth of the
baby. For most women, the choice is made for them by company policy
that dictates how long their maternity or disability leave will be and
what job or position they can return to after their leave. Only 40% of
employed women in the U.S. are entitled to a paid six-week disability
leave at the time of childbirth. Some women depend on sickness

benefits of a week or two plus vacation time in order to have a month

of paid time off when they give birth (Kamerman, Kahn, & Kingston,
1983). Many others do not even have that much time available after
delivery to adjust to their new role of mother and adequately learn to
function in that role.

Although the Pregnancy Discrimination Act of 1978 (PDA) led to an
increase in the number of women who have protection at the time of
childbirth, it left the provisions of these benefits up to the employer.
The law says if disability benefits are available from a company,
pregnancy and maternity issues must be included in these benefit
programs (Kamerman et al., 1983). Many employers, in particular those
companies with fewer than 100 employees, typically do not offer such
benefits in the first place. Furthermore, employers with 15 or fewer
employees are exempt from this law. The majority of working women are
concentrated in small businesses and low paying jobs where few or no
benefits are offered, thus offering them no protection from the
Pregnancy Disability Act (Kamerman et al., 1983).

Another consideration for some women is whether to return to work
in a part-time versus a full-time capacity after delivery. Frequently
if a woman chooses to decrease the number of hours worked per week, her
job security may be threatened forcing her to choose between a new job
or career and returning to her previous position on a full-time basis.
In many careers, women must also make a high degree of emotional
commitment and time involvement in order to remain competitive with
co-workers (Kamerman et al., 1983), thus necessitating full-time
employment. For many women who have delayed childbirth while
establishing themselves in their career, these choices can create

considerable conflict between occupational and maternal roles.

Strain and conflict can also occur when the working mother tries to
juggle her time to complete work-related assignments, fulfill household
responsibilities, and meet the needs of her child and husband (Kutzner &
Toussie-Weingarten, 1984). If she is working full-time, work competes
for more of her time and energy. Part-time employment may provide the
working mother with more personal time or at least more freedom to
determine how to spend the hours of her day and thus decrease the strain
she may feel.

Another variable that may affect the mother is whether she must
return to work based upon the family's economic need or whether her own
desire to continue her job/career is the motivating force. Economic
necessity is the major reason given for mothers to remain in the work
force (Kutzner & Toussie-Weingarten, 1984). However, "need for income"
is a socially acceptable defense for a mother who leaves her baby to
work outside of the home when she is confronted with negative attitudes
from relatives and neighbors (Brazelton, 1985; Howell, 1973). For some
dual-career or two-paycheck families, women may want to continue
employment to “enhance“ the economic standing of the family or maintain
a previous style of living that existed before the addition of a child
to the family unit.

Many women may also have personal motivations for returning to work
such as feelings of independence and self-satisfaction derived from
working, socialization with other adults, and enjoyment of their jobs.

A positive commitment to work was found to correlate with a more
positive adjustment to the first pregnancy and motherhood (Jimenez &
Newton, 1982). However, if a woman has a positive commitment to work

and feels restrained from returning to work by the demands of caring

10

for her new infant or pressure from her husband and family, her
mothering capacity may be adversely affected. Similarly, the woman who
wishes to stay at home full-time with her new infant and feels
pressured to work may also function less effectively (Collins, 1986).
Hoffman (1979) found that as a mother's satisfaction with her role
(whether employed inside or outside of the home) increases, so does her
effectiveness as a parent. Role strain due to role incongruity or
conflict can develop in the woman who is not satisfied with the
situation in which she finds herself.

To summarize, the length of the maternity leave, the number of
hours worked per week, and the degree of importance of personal and
financial reasons for working are some employment factors about which
the new mother may have to make decisions. Many women do not have
maternity leave time available to them or the option of when and if
they want to return to work. This lack of choice may lead to role
strain and more difficulty with the process of maternal role
adaptation.

Indicators of Maternal Role Adaptation

Numerous attempts have been made to identify those factors or
relationships that indicate the occurrence of maternal role adaptation
in the postpartum period. Shereshefsky and Yarrow (1973) arrived at
three general categories for their 12 indicators of maternal role
adaptation. These are: stimulating interactions between the mother
and infant, a perceived sense of satisfaction with the new role of
mother, and perceived satisfying interactions within the new family
unit, particularly marital adjustment in the new family. It was also

found that a good husband-wife relationship positively affected the

11

satisfaction with the mothering role and the maternal-infant
interactions (Shereshefsky & Yarrow, 1973).

In a more recent study of variables related to postpartum maternal
role attainment, Mercer (1986) identified the following indicators:
components of attachment, competency in the role, and acceptance of the
role obligations. Multiple measures of these dependent variables were
obtained to ascertain role attainment.

Lederman and Lederman (1984) have selected seven psychosocial
variables or dimensions of maternal adaptation as indicators of the
process. These were first developed for the experience of pregnancy
and later found to correlate with postpartum adjustment and satisfaction
with a motherhood role (Lederman & Lederman, 1984). These seven
dimensions are:

1. Quality of relationship with husband which focuses on the mother's
perceptions of her marital relationship in terms of mutual support and
understanding, and communication;

2. Mother's perception of father's participation in child care, a
dimension relating to desired versus actual help and support the mother
receives from her spouse pertaining to the realities of childrearing;

3. Mother's gratification from her labor and delivery experience which
reflects her overall recollection of a significant developmental step in
her life, and her sense of mastery of a reproductive function as well as
her interaction with her husband;

4. Mother‘s satisfaction with life circumstances, particularly major
factors in her life which support or inhibit her ability to function as

a mother (e.g. financial, career/job, and health factors);

12

5. Mother's confidence in her ability to cope with the tasks of
motherhood indicating the extent of self-doubt and inadequacy versus
self-confidence in mothering;

6. Mother's satisfaction with motherhood and infant/child care as a
reflection of her perceived conflicts and enjoyment in caring for her
children as well as her view of child caretaking as important and
fulfilling work;

7. Support for the maternal role from family and friends, a dimension
which indicates the extent to which the woman feels appreciated by
significant members of her family and peer group as well as the extent
to which she can count on others for assistance and support in child
care activities (Kutzner, 1984).

These seven dimensions of postpartum adaptation to the motherhood
role are similar to or consistent with patterns of relationships found
in previous research (Shereshefsky & Yarrow, 1973; Mercer, 1984) in the
areas of the marital relationship, maternal confidence and satisfaction
with the role, and support from family and friends (Kutzner, 1984).
The Postpartum Self-Evaluation Questionnaire (PSEQ) (Lederman &
Lederman, 1984) was developed to provide a quantifiable measure of the
seven dimensions of maternal adaptation in the immediate postpartum
period and was utilized in the intervention study from which data for
secondary analysis was taken for this study.

In summary, indicators of maternal role adaptation have been
identified by different researchers. The seven dimensions of the
Postpartum Self-Evaluation Questionnaire (Lederman & Lederman, 1984)

measure levels of maternal role adaptation through assessment of the

13

marital relationship, maternal confidence and satisfaction with the
maternal role, and support from family and friends.

Purpose of the Study

 

The purpose of this study is to examine the impact of select
occupational variables on a new mother's adaptation to the maternal
role in the postpartum period. Since most women today are resuming
employment during initial phases of the maternal role adaptation
process, it is important to study the relationship between these
variables and determine what factors may enhance or inhibit this
process.

When those situations that present risks for the development of
mothering difficulties are recognized, nursing interventions can be
directed toward helping the mother negotiate maternal role adaptation
more easily in the postpartum period. However, nursing contact with
new families usually ends abruptly after discharge from hospital
obstetrical units and the current trend toward shorter hospital stays
after delivery has significantly decreased the contact time between new
mothers and nurses. Answering research questions about postpartum
maternal role adaptation and employment can help formulate and direct
nursing interventions for those new mothers in high risk groups in such
settings as occupational health clinics, private practice, public
health clinics and home contacts.

Currently, research on nursing interventions with working mothers
in the postpartum period is minimal. In order for nurses to base their
anticipatory guidance and counseling on objective findings rather than
personal experience, single clinical observations, and personal

attitudes, more research needs to be done.

14

This research can also contribute to legislative policy decisions
regarding parental leave during the postpartum period. In 1986, the
American Nurses' Association listed the issue of parental leave as one
of their “top ten” federal legislative priorities (ANA, 1986). Women's
groups, some unions, and other organizations have also made a concerted
effort to get national legislation enacted that would mandate maternity
leave (Bureau of National Affairs, 1987).

Since the number of working mothers has been dramatically
increasing, especially the group of mothers with children under the age
of one year, difficulties with the maternal role adaptation process
could affect a majority of women in the United States today. Early and
continued nursing intervention may enhance the well—being and maternal
role adaptation of working women as they struggle with the proliferation
of roles during the first postpartum year.

Problem Statement

This study will be directed at answering the following research
questions: Is there a relationship between length of maternity leave,
number of hours worked per week by the new mother, reasons for
returning to employment after the birth of a first baby, and the level
of maternal role adaptation? Specifically: a) is there a relationship
between the length of the maternity leave and the mother‘s satisfaction
with motherhood and infant care, and the mother's confidence in her
ability to cope with the tasks of motherhood? b) is there a
relationship between the number of hours worked per week and the
mother's satisfaction with motherhood and infant care, and the mother's
confidence in her ability to cope with the tasks of motherhood? c) is

there a relationship between the degree of importance of personal or

15

financial reasons for working and the mother's satisfaction with
motherhood and infant care, and the mother's confidence in her ability
to cope with the tasks of motherhood?

Definition of Variables

 

The variables in this study are maternal role adaptation, the
length of the maternity leave, full-time and part-time employment, and
the mother's reasons for working after the birth of the baby.

Maternal Role Adaptation. Defined as the process occurring during the

 

first postpartum year in which the mother achieves competence in the
maternal role and integrates the mothering behaviors into her
established role set, culminating in maternal identity (Mercer, 1986a).
Maternal role adaptation will be operationalized in this study by
measuring factors cited as relevant to maternal adaptation. The
Postpartum Self-Evaluation Questionnaire (PSEQ) contains 81 items and
consists of seven subscales. Two of these subscales. The Mother's
Confidence in her Ability to Cope with the Tasks of Motherhood and The
Mother's Satisfaction with Motherhood and Infant Care (Lederman &
Lederman, 1984), will be used as an index of maternal role adaptation.
Occupational Variables

Length of Maternity leave. Defined as a period of time from the birth

 

of the baby to the return of the mother to employment outside the home.
Number of Hours of Employment. In this study, is defined as the number
of paid hours of work per week as stated by the mother.

Reasons for Working. This mother's reasons for working are divided
into two major categories: psychological and social reasons (personal)
for working and financial reasons for working. Seven questions will be

utilized to ascertain the level of importance of personal and financial

16

reasons for working when asked of the new mother prior to the actual
resumption of the occupational role.

Extraneous variables. The sociodemographic data of maternal age,

 

maternal educational level, occupation, family income, length of
employment in the same agency, sex of the infant, and the length of
time since the birth of the baby will be considered extraneous
variables that may affect maternal role adaptation. These variables
will be investigated in relation to maternal role adaptation rather
than controlling for the effects of the variables on role adaptation.
Assumptions

The following assumptions are made in this research:
1. The period of time studied and the data collection times are
representative of the period of time during which initial maternal role
adaptation occurs.
2. The testing instruments are sensitive to the concepts of maternal
role adaptation.

Limitations

 

This research has the following limitations:
1. Subjects who agreed to participate in this study may be different
from those who chose not to participate. Therefore, it is highly
likely that the findings are not representative of all women seeking
prenatal childbirth and childcare instruction.
2. The points of time at which data were collected may not be
representative of the times during which changes in maternal role
functioning have actually occurred.
3. All possible factors affecting maternal role adaptation are not

addressed in this study. Findings may be due in actuality, to an

17

interrelatedness of factors other than those identified. Examples of
such factors which are not included in this study are: maternal and
infant illness, personality traits and self concept of the mother, and
infant temperament.
4. The sample obtained was a convenience sample, and therefore the
findings of this study are not generalizable to a large population,
only to the population under study: married women having a first baby.
5. This study utilized data generated from a pilot intervention study
already in progress entitled "Promoting Well-Being in Employed
Mothers,“ funded by the American Nurses Foundation in 1985. The
intervention consisted of six-session group meetings during which
information theoretically designed to aid employed mothers in adapting
to multiple roles was presented. Such tapics as childcare alternatives,
myths about working mothers, stress and coping strategies, marital
relationships, time management strategies, and values clarification were
discussed during these sessions. The intervention may bias the results
obtained for analysis in this study by enhancing role adaptation in this
group of women.
Overview of Chapters

The presentation of this study is organized into six chapters.
Information in Chapter I is the introduction, the purpose of the
research, the problem statement and research questions, the definitions
of the variables, and the assumptions and limitations of this research.
In Chapter II, the concepts and relevant sociological role theory are
integrated into a conceptual framework that is the basis for generating
research questions and hypotheses for this study. A literature review

is presented in Chapter III which links this research with the work and

18

ideas of others concerned with maternal role adaptation. In Chapter IV
the methods of research used to conduct the study are presented. Data
and analyses are presented in Chapter V. In Chapter VI a summary and
discussion of findings, implications for nursing, and recommendations

for future research are presented.

CHAPTER II
Theoretical Framework
Introduction

Role theory from the field of sociology will be utilized as a
guiding framework for this study of the effect of maternal employment on
maternal role adaptation. A general discussion of select aspects of
role theory will be integrated with the concept of role strain as
conceived of by Goode (1960). A presentation of the maternal role
adaptation process occurring in new mothers during the first postpartum
year as formulated by Thornton and Nardi (1975) will also be utilized.
Research questions and hypotheses will be generated from these role
theory frameworks.

Overview of Role Theory

The term “role" was borrowed directly from the theater, and refers
to the sheet of parchment which was turned around a small wooden roller
and carried the written script or part the actor recited (Sarbin &
Allen, 1968). It was not until the early 19205 that the term began to
appear in the behavioral science literature (Hardy & Conway, 1978).
From that time on, its popularity has increased rapidly with extensive
use found in the literature of psychology, anthropology, social work,
and other fields.

Definition of A Role
The term "role" has been used to denote a position that a person

occupies or a set of standards, descriptions, norms, or concepts held

19

20

for the behaviors of a person or a position (Biddle & Thomas, 1966).
Another definition is that a role is a learned sequence of actions or
deeds that are performed by a person in an interaction sequence (Sarbin
& Allen, 1968).

Common to both these definitions is the idea that a role always
involves either an individual's definition of a specific situation or an
individual's acceptance of a group's definition of a situation (Hardy &
Conway, 1978). The definition of the role, whether derived from the
group or the individual, is based on expectations of the roles.

Role Expectations

Role expectations are comprised of the duties and obligations, the
rights and privileges of any occupant of a position or role in relation
to persons occupying other complimentary positions. These expectations
can vary from one time to another depending on the persons in the role
relationship (Sarbin & Allen, 1968). Various sources of role
expectations have been identified.

The first source of role expectations is from society at large and
these expectations are very general (Thornton & Nardi, 1975). For
instance, the individual may be influenced by portrayals of the role on
television, in movies, or in written descriptions. Next, they may arise
from members of the role set or that “complement of role-relationships
in which persons are involved by virtue of occupying a particular social
status" (Merton, 1957, p. 110). Within the role set, two sources can be
identified: pe0ple enacting the same role or those enacting a
reciprocal role. The third source of expectations is from the

individual's own socialization experience (Thornton & Nardi, 1975).

21

These expectations may have various content. They may refer to the
ways in which an individual should behave (behavioral expectations), to
particular attitudes and values that are appropriate (attitudinal
expectations), and to the knowledge and skills one should have
(cognitive expectations) (Thornton & Nardi, 1975). The maternal role
expectations would include such things as taking proper care of the
infant (behavioral), being excited about having a baby (attitudinal),
and learning about infant care (cognitive).

There are various reactions that one can have to the role
expectations (Thornton & Nardi, 1975). The first reaction is social
adjustment or the adequate meeting of role expectations and performance
according to them. The second is psychological adjustment which is the
achievement of congruity between the role expectation and the
individual's psychological needs and desires. This congruity may occur
through strict conformity to role expectations or may be a result of
modification of the role by the individual. The third and final
adjustment is adaptation. This occurs if the role has been internalized
so that the person and the role in a sense are one. Social and
psychological adjustment may lead to adaptation but do not necessarily
result in adaptation to a role (Thornton & Nardi, 1975).

In summary, role expectations are comprised of rights and
privileges, obligations and duties one has to those occupying
complimentary positions. The sources of role expectations are society,
members of a role set, and the individual's own socialization
experience. Role expectations have behavioral, cognitive, and

attitudinal content for the role holder. The reactions of the

22

individual to these role expectations are social and psychological
adjustment followed by adaptation if the role is internalized.
Stgges of Role Adaptation

According to Thornton and Nardi (1975), the adaptation to a role
_involves four stages. The first stage is that of anticipatory
socialization. In this phase, preparation for adaptation or acceptance
into a new role begins to take place. Incomplete, generalized, and
stereotyped conceptions begin to form of the role at this time. The new
role is often idealized and this may lead to incongruity with the actual
experience at a later point. The degree of congruity between what one
anticipates about a role and what is subsequently experienced can affect
the adjustment to the new role (Thornton & Nardi, 1975). During
pregnancy, cultural norms, values, and expectations of what motherhood
will be like are intense and often conflicting, and role models are
sought.

The second stage of role adaptation is the formal stage and the
person is now experiencing the role from an internal perspective as a
role holder. Role expectations are now arising mainly from one's role
set--those in similar roles or in reciprocal roles. The expectations
encountered during this stage are the duties inherent with the position
such as the duty of a parent to care for a child properly. There is
usually a very high degree of consensus within one's role set about what
the role expectations should be in this stage leading to conformity on
the part of the role holder. Social adjustment is occurring by meeting
the role requirements rather than trying to modify them (Thornton a
Nardi, 1975).

23

The formal stage of role adaptation for the new mother begins at
the birth of the baby. Her significant others may include her husband,
her mother, and the baby. The new mother begins to act out the formal
behavior of a mother and is trying to match the ideals of motherhood
from the anticipatory socialization stage with the real life situation
in which she now finds herself.

The informal stage is the third phase of role adaptation and brings
out the informal, unofficial expectations or ways of doing things
(Thornton & Nardi, 1975). These informal expectations are usually
transmitted through the interaction of the role holder with other
individuals in one's peer or work group rather than arising from formal
statements of what the role entails.

Many times these informal expectations are in direct contradiction
to the formal expectations previously learned and enacted. Again,
primary sources of role expectations are from those in the role set, but
one tends to rely on one's own role expectations to handle discrepancies
between the two. The role is now being shaped to fit the individual's
past experiences and future goals, and final psychological and social
adjustment commence (Thornton a Nardi, 1975).

The informal stage of maternal role adaptation begins as the new
mother develops her own unique style of mothering (Thornton a Nardi,
1975). It is a time of struggle as the mother tries out different ways
of coping with new situations. For instance, the new mother may have
been given instructions by her own mother on how to "raise her infant
correctly.“ The new mother may seek out the advice of other mothers or
observe the practices of new mothers in similar situations to help her

decide what to do in caring for her own child. The ”musts" of the role

24

are exchanged for the “mays” or informal expectations (Thornton & Nardi,
1975).

Thornton and Nardi (1975) state that in the personal stage of role
adaptation which is the final stage, role consensus begins to appear as
the individual imposes one's own style on the role performance, and
others in the role set begin to accept it. Psychological adjustment is
said to have occurred if one's psychological needs relate to the
requirements of the new role. Social adjustment has occurred if the
role has been modified from the formal role enactment stage, rather than
just conforming to it. When the social and psychological adjustment are
in place, then adaptation to a role can occur. Adaptation will be
successful if adjustment has been successful in terms of what the role
requires of the person and what the person requires of the role
(Thornton & Nardi, 1975).

In the personal stage of maternal role adaptation, the mother feels
a congruence of self and the new role. There is acceptance of her role
performance by others. The mother has modified the maternal role to fit
with her values and expectations rather than just conforming to the
expectations of others.

In sum, there are four phases to the process of adapting to a new
role. They are anticipatory socialization, the formal stage, the
informal stage, and finally the personal stage.

Role Strain

Role strain as defined by Goode (1960) is "the felt difficulty in
fulfilling role obligations“ (p. 483). If social and psychological
adjustment to role expectations does not proceed smoothly, role strain

may be felt. Since it is unlikely that one can always meet all the

25

demands of a role or concurrent roles to the satisfaction of those
members of one's role set, role strain is a normal occurrence. Role
relations are seen by Goode (1960) as a sequence of ”role bargains," or
processes of selecting between different role behaviors in order to
reduce the role strain experienced. However, if role strain is
unbearable, the activities and duties of a role are not accomplished
and adaptation to a new role can be hindered (Goode, 1960).
Types of Role Strain and the Postpartum Period

Role strain can be of four types or from four sources. The first
situation is when role demands are made upon an individual and even
though they may not be difficult or displeasing, conformity is still
required of the individual (Goode, 1960). Virtually no role demand is
so pleasurable that conformity is automatic and without some adjustment
necessary on the part of the role holder, thus some strain can be
expected to result. For the new mother, the first six to eight weeks
after childbirth may be physically demanding and exhausting despite the
great joy that may be felt with the birth of one's first child. Trying
to adjust to the infant's erratic sleeping and feeding schedule while
also in the process of recovery from the labor and childbirth experience
may be difficult and unescapable for the infant's primary caregiver and
role strain results. Thus, the assumption of any new role, regardless
of how pleasurable or displeasurable, will for a period of time result
in some role strain, and in turn, the level of maternal role adaptation
can be affected (Figure 1).

Additional sources of role strain may exist in the postpartum,
period as the new mother is adapting to the motherhood role. Each role

relationship typically demands several activities or responses which can

26

 

MOTHER

 

\ WORKER

 

 

 

 

ROLE STRAIN

T

LEVEL OF MATERNAL
ROLE ADAPTATION

 

 

 

 

 

 

 

Figure 1. Relationship of Role Strain and Level of Maternal Role
Adaptation in postpartum Period Prior to Return to Employment

27

become a second source of strain (Goode, 1960). Hardy and Conway (1978)
refer to this type of role strain as role incompetence, stating that
arole holder's resources are inadequate relative to the demands of the
position. For the new mother who is learning the expectations of the
maternal role (both formal and informal), adequate time in the role is
needed to perform it competently and consistently.

According to Goode (1960), the third type of strain may be
encountered due to all individuals taking part in many different role
relationships that have different obligations. There may be either
contradictory performances required of the role holder or conflicts of
time, place, or resources that result from the numerous roles (Goode,
1960) which can lead to role strain. This type of role strain has been
referred to as both role conflict and role incongruity (Hardy & Conway,
1978). In the new mother, the physical needs of the infant and her own
physical recovery consume a significant portion of her resources and
time. In addition, a changing relationship with one's spouse and
household chores may make further demands on the new mother's time.

Finally, Goode (1960) states multiple role relationships require
the role holder to engage in many interactions with different
individuals at the same time. If he or she attempts to conform fully in
one direction, fulfillment may be difficult in another. The
individual's role obligations on the whole are over-demanding (Goode,
1960). Role overload is the term utilized by Hardy and Conway (1978) to
describe this situation. In the new mother who is trying to be a wife,
mother, housekeeper, daughter, and friend in interactions with many

individuals, role overload would be likely to occur.

28

Thus, an individual is liable to face a wide variety and sometimes
conflicting array of role obligations. In summary, role strain is the
felt difficulty in fulfilling role obligations and may be a normal or an
abnormal phenomena depending on how the duties of a role are met. Goode
(1960) has identified four sources of role strain: the required role
demands themselves, numerous role relationships with different
obligations, inconsistencies in role activities or responses, and over-
demanding role obligations. In addition, Hardy and Conway (1978) have
labelled these types of role strain as role incompetence, role
incongruity, role conflict, and role overload.

Effect of Return to Employment on Role Strain and the Level of Maternal
Role Adaptation

The return to an employment situation outside of the home after the
birth of a child brings an additional role to the existing role set of a
new mother. For many women in contemporary society this is not an
entirely new role; rather the resumption of a role that had been
relinquished prior to the labor and delivery experience. This is
depicted in the theoretical model by the dotted lines for the worker
role (Figure 1) in comparison to the mother and wife roles which are
active roles at this time in the postpartum period.

According to role theory, the addition of another role to one's
existing role set brings more role obligations and duties to the role
holder. Since the maternal role adaptation process occurs over a number
of months during the postpartum period, resumption of the employment
role during this period may affect the level of role strain present
(Figure 2). The role holder must once again progress through the stages

of role adaptation and according to Goode (1960), will experience some

 

RETURN TO EMPLOYME NT

 

 

 

 

l
"\
\

 

 

 

\

Employment Chereeterletlce

 

-Number of houre
worked per week

-Length of meternfly Ieeve

-Reeeone for working

 

 

 

 

‘/
ROLE STRAIN T

T

LEVEL OF MATERNAL
ROLE ADAPTATION

 

 

 

 

 

Figure 2. Impact of Return to Employment on Role Strain and Subsequent
Level of Maternal Adaptation in Postpartum Period

3O

role strain. Therefore, merely resuming the employment role will cause
some role strain to exist for the working mother and influence the level
of maternal role adaptation. This is the first type of role strain
thatGoode (1960) referred to. However, there are other aspects of the
working mother's employment situation that may influence the role strain
experienced due to the other mechanisms of role strain as suggested by
Goode (1960) .

One possible mechanism of role strain created by the worker role is
that of role incompetence when there has been inadequate time for
learning the maternal role before taking on additional role obligations.
Specifically, the length of the mother's leave from the employment
situation may affect the level of adaptation to the maternal role. A
longer maternity leave may allow more time for learning the new role
before additional roles expectations are added (Figure 2). However, a
longer maternity leave may adversely affect the ease with which a
working mother adapts to the occupational role when it is resumed. This
relationship will not be investigated in this study but is an area in
which further research is needed.

A second characteristic of the working mother's employment
situation that may influence the amount of role strain experienced is
the number of hours the woman is employed per week. Merely returning to
work may place more demands on her time and physical resources than she
is able to meet, regardless of the number of hours employed. However,
full-time employment may accentuate the role strain experienced because
of the increased number of hours required by the work-related role
expectations. This may be explained by the type of role strain known as

role conflict where there is a conflict for the working mother's time

31

and energy. Fewer hours worked outside of the home may decrease these
demands on the mother, thus decreasing the strain experienced. Role
overload may also result and affect maternal role adaptation due to the
total demands of all the role obligations on the working mother (Figure
2).

A third aspect of the employment situation that may influence the
role strain and the level of maternal role adaptatipn.isTthe degree of
importance of financial or personal incentives as reasons for working
(Figure 2). Application of the role strain typology would suggest that
the woman who must return to employment for the economic survival of the
family might experience strain related to role incongruity or role
conflict if her attitudinal expectations of the motherhood role are that
mothers should not work outside of the home when they have a young
child. For the mother who returns to work for either personal and/or
financial reasons and does not believe new mothers must stay at home
with young children, role conflict and incongruity may not exist.
Therefore, the degree of importance of various reasons for returning to
work may influence maternal role adaptation through the effect on the
role strain present.

Of course, other occupational situations can exist that may
influence the amount role strain present for the working mother at any
point in the maternal role adaptation process. These situations may
include the specific maternity benefits available, the woman's
satisfaction with her job or career, and changes in the employment
situation directly resulting from the pregnancy or maternity leave.
These variables are beyond the scope of this study but warrant

consideration in future research efforts.

32

Summary of Effect of Return to Employment on Role Strain and the Level
of Maternal Role Adaptation

Role theory suggests there is a relationship between the roles a
person holds, the amount of role stain present, and the degree of
adaptation to a new role. Three characteristics of an employment
situation have been identified that may influence the amount of role
strain a new mother experiences as she returns to employment outside of
the home. These variables are the length of the maternity leave, the
number of hours worked per week, and the degree of importance of
personal or financial reasons for working.

Role strain in this model is a continuous variable and according to
Burr (1972), can range in degree from absent to a high amount. The
amount of role strain that results from occupying a role inversely
affects the ease of making a transition to the new role (Burr, 1972).
As the role strain in a new mother attempting to combine the wife,
mother, and worker roles increases, so does the difficulty in the
adaptation to this role. The issue for nursing becomes identification
of those variables that lessen the role strain and thereby enhance the
adaptation to the maternal role.

Summary of Chgpter

In summary, role theory has been utilized in this chapter to
conceptualize the adaptation to the maternal role in the postpartum
period. The concept of role was defined and the stages of adaptation to
a role discussed. Role strain was included in the framework as a basis
for exploring the impact of the occupational variables of the number of

hours worked by the new mother, degree of importance of financial or

33

personal reasons for working, and the length of the maternity leave
after delivery. A review of the literature relevant to the concepts

under study will be the focus of Chapter III.

CHAPTER III
Review of the Literature
Ell—"1.1.6!

Relevant literature pertaining to the study variables of maternal
role adaptation and maternal employment are reviewed in this chapter.

In addition, research findings regarding role strain in working mothers
and literature about interventions with working mothers are included in
this chapter. Initially, the historical evolution of the issues of
maternal employment and maternity leave will be presented in order to
provide the reader with background information on current practices and
legislative problems that impact these issues.

Historical Perspectives of Maternal Employment

Women have not always been full-time mothers throughout history,
nor have they been separated from the productive economy. In the United
States, cultural values and social norms that tell women the role of
wife and mother is a full-time occupation and that it is impossible or
irresponsible to try to combine it with a career, have originated in the
nineteenth century "cult of domesticity" (Harris, 1979).

In colonial America, the economy was characterized by small-scale
agricultural, trade, and industry, where the home and the place of
business were often one and the same. Wives and children worked
alongside the men to contribute to the family income. As economic
Patterns began to change and industrialization occurred, the work place
moved away from the home, leaving women behind as “angels of the hearth"
(Harris, 1979).

34

35

From 1860 to 1920, more women moved into institutions of higher
education and into the professions, though in smaller numbers. Because
of the strength of the “cult of domesticity," choosing a career usually
meant foregoing marriage and having children (Harris, 1979). "Propriety
and idealogy demanded that wives remain at home and, in many cases,
domestic chores and childbearing drained them of energy that they might
have devoted to intellectual activities or a career“ (Harris, 1979,

p. 79).

In the twentieth century, due to of the scarcity of male laborers
during World War I and World War 11, there was a dramatic influx of
women into the labor force. However, at the end of the wars, most women
returned to their domestic roles when the economic and social conditions
no longer demanded they be in the labor force (Collins, 1986).

In the 19605, despite contradictory social expectations, women
began to increase their participation in the labor force once again. In
1960, only 30% of all married women were employed outside of the home
and only 19% of women with small children were in the labor force
(Hayghe, 1982). By 1975, however, 42% of the mothers of preschoolers
were employed outside of the home and 53% in 1982 (United States Bureau
of the Census, 1983).

T Among the reasons cited for increased labor force participation of
mothers with young children are: (1) an increase in single-parent,
female-headed households resulting from the rise in the divorce rate and
the increased incidence of births to single women; (2) a need for two
incomes in intact two-parent families to ensure economic stability
and/or survival in precarious economic times; (3) the impact of the

Women's Movement of the late 19605 and the 19705 which has contributed

36

to a redefinition of attitudes toward women and increased nontraditional
options for women's development (Hock, Gnezda, & McBride, 1984); (4)
increased educational opportunities for women (Harris, 1979); and (5) a
decrease in family size and a less time-consuming housewife role due to
technological advances (Hoffman, 1984). Personality variables such as a
woman's need for power or achievement, a sense of competence, and a
sense of accomplishment or satisfaction from an occupational role that
is not conferred by domestic roles are other reasons given for women to
seek employment opportunities outside of the home (Hoffman, 1974).

Historical Background Of Maternity Leave Issues

 

As discussed briefly in Chapter 1, since 1978 the United States has
had a law that deals with discrimination in the work place related to
pregnancy: the Pregnancy Discrimination Act. Prior to that time,
working women who became pregnant quit their jobs considerably before
their delivery date. In fact, the medical establishment used to
recommend that women quit work no later than the sixth month of
pregnancy (Bureau of National Affairs, 1987). Women were placed on
mandatory unpaid leaves and most of the time, women returning to
employment after delivery had to begin again at a lower level job with
lower pay (Kamerman et al., 1983).

In the 1960s, the growing women's rights movement began to focus on
issues of equality in the work place for women as individuals and
workers, not wives and mothers (Kamerman et al., 1983). In the Civil
Rights Act of 1964, sex discrimination in the work place was declared
unlawful but there was no record of congressional intent regarding
whether childbirth and pregnancy-related disabilities were meant to be

included. In 1966, the general counsel of the Equal Employment

37

Opportunity Commission (EEOC) issued an opinion letter. “The Commission
policy in this are does not seek to compare an employer's treatment of
illness or injury with his treatment of maternity since maternity is a
temporary disability unique to the female sex and more or less to be
anticipated during the working life of most women employees“ (Kamerman
et al., 1983, p. 39—40). Therefore, exclusion of pregnancy as a covered
risk, was not discriminatory.

In 1972, the EEOC reversed its Opinion stating that disabilities
resulting from pregnancy must be covered under any health or temporary
leave plan available to employees or would be considered discriminatory
(Kamerman et al., 1983). The debate continued in the courts and in

1976, the Supreme Court held in Gilbert v. General Electric Corporation

 

that the exclusion of pregnancy-related disabilities from a company's
disability insurance program was not sex discrimination (Kamerman et
al., 1983).

Of course, the reaction to the Gilpggg decision was strong and
intense. As a result of the coalition of women's organizations, labor
unions, and civil rights groups, the Supreme Court's decision was undone
with the passage of the 1978 Pregnancy Disability Amendment (PDA) to
Title VII of the Civil Rights Act of 1964 (Kamerman et al., 1983).
Pregnancy discrimination, blatant and subtle, persists. In 1981, the
EEOC, charged with enforcement of the amendment, recorded 3,693
allegations of discrimination and in 1985, the number had increased to
5,090 charges (Bureau of National Affairs, 1987).

Currently, only 40% of all working women are covered by the PDA
because of stipulations regarding business size and the existence of a

disability package exempting the majority of businesses in this matter

38

(Bureau of National Affairs, 1987). However, more and more employers
will be forced to provide mandatory pregnancy leave for women. The U.S.
Supreme Court ruled in January, 1987, that a California statute
mandating employers to provide their employees up to four months of
(unpaid) pregnancy leave is not contradictory to the PDA, thus actually
providing more benefits for the pregnant woman (Bureau of National
Affairs, 1987).

The Family and Medical Leave Act is another issue under debate in
the 100th Congress that will require all but the smallest employers to
provide 18 weeks of unpaid leave for employees at the birth or adoption
of a baby (Bureau of National Affairs, 1987). This act is not a panacea
however, for most women who work in lower paying, non-professional jobs
might not be able to afford to take 18 weeks off from their jobs without
pay. Secondly, women are disproportionately employed in small
business, and would thus be exempt from coverage under the bill (Bureau
of National Affairs, 1987).

2TiRegardless of the recent progress made in the United States, no
comparison can be made to the statutory maternity leave policies of
other countries of the world. {Seventy-five countries, including many
developing nations and every industrialized country gxggpp the United
States has some variation of a guaranteed job-protected leave and the
cash benefit to replace wages for maternity or parental leaves
(Kamerman et al., 1983). Among the industrialized nations, the minimum
pglg leave is 12 weeks, and the modal pattern in Europe has become five
months. The maximum is 12 months in Sweden, provided as a parental
benefit to both mothers and fathers.) While most countries provide these

benefits through a national health insurance program, 16 countries have

such programs despite the absence of health insurance (Kamerman et al.,
1983).1

In summary, early legislative efforts attempted to protect working
women based on concerns for their childbearing abilities. The Civil
Rights Act of 1964 afforded women protection in the work place related
to sexually discriminatory practices but excluded pregnancy-related
issues. In 1978, the Pregnancy Discrimination Act required that
employers treat pregnancy and maternity the same as any other illness or
disability treatment provided to a male employee. 'Current legislative
efforts are under debate in Congress to provide unpaid parental leaves
during pregnancy. Many other countries in the world already provide
maternity benefits to their residents, which includes, on the average,
12 weeks of paid leave from employment. TThe United States has no
mandated benefits for its 33 million women of childbearing age in the
work force (Bureau of National Affairs, 1987).j

Maternal Role Adaptation
Introduction

Although role theory and the process of role adaptation have been
studied for over 50 years, it was not until the mid 19605 that the
maternal role and a woman's adaptation or transition to that role was
studied by a nurse researcher. In 1964, Rubin began to study the
adjustments made in a family with the addition of a new member.

Using role theory as the basis for study, Rubin (1967) conducted
qualitative research to determine how the maternal role was acquired.
Although not confirmed quantitatively, Rubin's (1967) work has been
important to the development of a theoretical perspective of maternal

role adaptation. The research on maternal role adaptation will now be

presented in chronological order to highlight the evolution of this area
of study.
Maternal Role Adaptation Research

In Rubin's (1967) longitudinal study, a convenience sample of five
primiparous and four multiparous subjects were interviewed in an
unstructured style during their pregnancies and in the first month
postpartum. The primiparous women, drawn from both private and
university maternity patients at two university hospitals, were
interviewed on the average of 23 times and the multiparous women
averaged 11 interviews during this period of time. The interviews were
conducted during the antepartum, either during the office visit or in
the home, and daily during the postpartum stay in the hospital. By not
directing or structuring those interviews, Rubin (1967) gathered
spontaneous responses to parental adjustment inquiries. To control for
subtle changes in the subject who over time is studied, control subjects
were interviewed one or two times and the responses of both groups were
compared.

Using qualitative methods of analysis, the data collected in these
interviews were classified into three dimensions of relevant items that
described the earnestness and intensity with which a woman takes into
herself the task and meaning of becoming a mother: (1) the self system,
including categories of the ideal image, the self image, and the body
image; (2) the taking-in process or method; and (3) role models or
referents. A high incidence of role-taking behaviors were elicited
which increased in the postpartum period and were consistently higher in

frequency for multiparous women than for primiparas. Identity or the “I

41

am the role,“ was the end point or goal in the process of maternal role-
taking (Rubin, 1967).

The operations involved in the “taking in" of the maternal role
were placed in five categories by Rubin (1967). They are: (1) mimicry,
the adoption of behavioral manifestations or symbols of the status to be
achieved; (2) role-play, the acting out of the role specific behaviors;
(3) fantasy, the replacement of the stereotypes of mimicry and role-
play with original material from the mother's situation; (4)
introjection-projection-rejection, the process of searching for a
model, matching the model to one's self, and then reinforcing behaviors
or rejecting them based on the "fit“; (5) grief work, a letting go of
former role incompatible with the new role (Rubin, 1967).

In further work on the formative stages of the maternal-child
relationship, especially the postpartum period, Rubin (1977) utilized
the term "binding in" to refer to the bonding or attachment that
occurred progressively over a period of 12-15 months from the beginning
of pregnancy. "Binding in“ is an active, intermittent and accumulative
process that occurs in progressive stages beginning with the perception
of fetal movement and after delivery accelerates, moving from a
symbiotic relationship to one of reciprocal yet separate roles, the
mother and the child (Rubin, 1977).

The maternal “binding in“ processes described by Rubin (1977) are
identification, claiming, and polarization. Identification involves
recognizing the infant as a separate being with its own appearance and
behavior. Claiming of the infant occurs when an association is made
between the infant and significant others through statements such as "he

looks like his father.“ Polarization involves the psychological

42

loosening of the infant from the new mother and the acceptance that the
infant is an independent human being. Factors that determine the length
of the binding-in process to the role relationship are: (1) the
mother's own recovery and state of well-being; (2) the amount and kinds
of social significant supports; (3) the endearing nature of the baby
itself (Rubin, 1977).

In a more recent publication, Rubin (1984) further addresses the
development of the maternal identity during pregnancy and the postpartum
period. However, little mention was made of the process of attaining
the maternal role. Several case studies were utilized to further
describe the concept of maternal identity but no new evidence to
validate the concept of maternal role adaptation was presented. Rubin
(1984) says of the maternal identity, “the outcome is more than a
sentimental attachment and more than a role that is stepped into and out
of again. There is a belonging as a part to the whole personality,
bound-in and inseparable...“ (p. 38).

In summary, Rubin initially attempted to define and describe the
process of maternal role attainment and the achievement of the maternal
identity as the culmination of this process. She recognized that the
process began in the early stages of pregnancy and continued over the
first postpartum year. Maternal and infant variables, and social
support were considered important in helping the new mother adapt to her
new role but Rubin did not measure the effects of these variables on the
new role.

Rubin was the first nurse researcher to identify and define the
concepts of maternal role and maternal identity. She stimulated further

research on the maternal role attainment process and the maternal

43

identity with her beginning qualitative efforts. However, many gaps
still existed in operationalizing the concepts and identifying
variables that affected the maternal role.

In 1973, Shereshefsky & Yarrow explored the psychological aspects
of a woman's adjustment to a first pregnancy and individual differences
in early mother-infant adaptations during the postpartum period.
Semistructured interviews, psychological tests, observations,
examinations, and combinations of these methods were utilized to obtain
data on a convenience sample of 57 married couples for the purpose of
examining adjustment and maternal adaptation in the postpartum period.

The participants, all primiparas. were followed from the third or
fourth month of pregnancy, through delivery, and until six months after
delivery (Shereshefsky & Yarrow, 1973). The women's age range was from
18-28 years and 79% of the women were of the white race. Of note, 74%
of the women in this study had at least one year of college, and 69% had
worked outside of the home prior to the birth of the baby. Thirty-two
percent of the women engaged in "scientific and professional work", and
34% were engaged in "clerical and sales work“ (Shereshefsky & Yarrow,
1973).

The woman's postnatal adaptation to the maternal role was
evaluated at one, three, and six months postpartum and 12 scales were
developed that comprised the outcome variable, maternal adaptation
(Table 1) (Shereshefsky & Yarrow, 1973). The factors in the prenatal
and postpartum periods that correlated at statistically significant
levels with the maternal adaptation scales were considered to be

predictors of maternal role adaptation.

44

Table 1. Factors Comprising Maternal Adaptation

 

Acceptance of the Maternal Role (1 mo. postnatal)

Acceptance of Infant (1 mo. postnatal)

Individualization of Infant (1 mo. postnatal)

Responsiveness to Infant (amount and quality of physical contact,
sensitivity and responsiveness, amount of stimulation, 1 mo.)

Responsiveness to Infant (amount and quality of physical contact,
degree of expression of affection, 3 mo.)

Acceptance of Infant (3 mo. postnatal)

Confidence in Maternal Role

Acceptance of Maternal Role (3 mo. postnatal)

Responsiveness to Infant (6 mo. postnatal)

Acceptance of Infant and Maternal Role (6 mo. postnatal)

Individualization of Infant (6 mo. postnatal)

Mother-Infant Adaptation

 

In the early period of mothering, based on evaluations at three,
seven and nine months of pregnancy, maternal adaptation could be
predicted when the mother had an early interest in and experience with
children, adapted well at each stage of pregnancy as indicated by her
mood, absence of anxiety, general well-being, and had an overall
positive reaction to the pregnancy experience (subjective and objective
evaluations) (Sherefshevsky & Yarrow, 1973).

In the postnatal period, the most significant factor that
correlated with maternal adaptation in each study period was the
husband-wife adaptation and the quality of the relationship with the
husband. Of the personality variables under study, nurturant qualities
of the woman were also highly related to maternal adaptation
(Shereshefsky & Yarrow, 1973). Thus, predictors of maternal role
adaptation were identified and measured for the first time in this

study.

45

Of these 57 couples, approximately one-third of the women were
found to have special difficulty in the early postnatal period with
assuming maternal care of their first-born infant. This difficulty was
manifested as intense, disruptive anxiety about infant care or adequacy
in the mothering role, overreacting to realistic problems (i.e. feeding
adjustments), depression, and hostile attitudes toward the infant. The
stresses of these families ranged from financial difficulties to job
dissatisfactions in the husband, and made postpartum adjustment harder
(Shereshefsky & Yarrow, 1973). Therefore, even with a normal pregnancy
and delivery for these women, common facets of everyday life created
difficulty in the adaptation to the maternal role.

In summary, predictors of maternal adaptation were identified in
this study as a positive adaptation to pregnancy in the prenatal period,
and the personality variable of being a nurturant woman. In the
postpartum period, the husband-wife adaptation and the quality of the
relationship with the husband were predictive of adaptation. One third
of this study sample reported difficulty and stress in assuming the
maternal role. Although this study provided much needed quantitative
data on maternal role adaptation, no mention was made of the employment
status of the women in the postnatal period even though a significant
number of these women were well educated and employed in professional
positions prior to delivery.

Another nurse researcher, Mercer (1981, 1982, 1985, 1986a, 1986b,
1986c), has extensively studied the factors that impact on maternal role
attainment in the first year of motherhood. Mercer (1985) building on
the earlier work of Rubin, defines maternal role attainment as a

”process in which the mother achieves competence in the role and

46

integrates mothering behaviors into her established role set, so that
she is comfortable with her identity as a mother“ (p. 198). Mercer
(1982) operationalized maternal role attainment to include the
components of attachment, competency, and acceptance of the role
obligation. The strength and relative weights of the relationships
between these components and maternal, infant, and confounding variables
were the objectives of Mercer's (1982) descriptive, correlational
research with 242 first-time mothers.

The participants were all women who delivered their first normal
live-born infant at 37 weeks or more gestation in a university-
affiliated hospital in the San Francisco area during a 16 month period.
Teenagers were recruited from two additional university hospitals. The
women, 52% of those asked to participate, were assigned to one of three
groups based on age: 15-19 years, 20-29 years, and 30-42 years. Of the
overall sample, the older the woman, the more likely she was to be
Caucasian, married, and to have a college degree and a higher income
level (Mercer, 1986).

The maternal, infant, and confounding variables under investigation
as independent variables in this study are found in Table 2 (Mercer,
1982). Interviews and questionnaires provided data on these variables
at five test periods: early postpartum, one, four, eight, and 12
months postpartum.

Data on the independent variables were collected utilizing 12
different measures. Maternal role attainment, the dependent variable,
was measured with four different scales: Leifer's Feelings About My
Baby (FAB), Russell's Gratification in the Mothering Role (GRAT),

Blank's interviewer rated Maternal Behaviors (MADE), and the self-report

47

Table 2. Variables Under Investigation--Mercer (1982)

 

Maternal Variables: Maternal age
Perception of birth experience
Early maternal-infant separation
Stress
Social support
Personality traits
Self concept
Health status
Childrearing attitudes
Marital status

Infant Variables: Temperament
Health status

Confounding Variables: Maternal educational level
Ethnicity
Socioeconomic status (SES)

 

Ways of Handling Irritating Child Behaviors (WHIB) developed by
Disbrow, Doerr, and Caulfield (Mercer, 1985). Role strain as a
dependent variable, was measured by an adaptation of the Burr et al.
(1979) scale on a continuum ranging from “none“ to “very high" role
strain (Mercer, 1985).

Overall, 37.9% of the variance in maternal role attainment levels
was accounted for by the predictor variables: 8.6% by SES ethnicity,
and marital status; 16.9% by self concept; 7.4% by maternal attitudes;
1.7% by negative life events (stress); 1.8% by infant related stress;
1.5% by the maternal attitude factor of maintaining control (Mercer,
1986a). Another significant finding was the consistently lower
gratification with the role scores for the older age group (30-42 years)
as compared to the two younger age groups. It was felt this was related

to the older mother's greater number of years in employment and

professional roles that provided more concrete feedback for her role
performance than did the maternal role (Mercer, 1982).

These same women were asked at one year postpartum, when they had
first felt comfortable with their mothering role. One third of the
women said this was accomplished the first two weeks after delivery, 49%
by two months, 64% in four months, and 85% within nine months. Ten
women had failed to internalize the role by one year after delivery
(Mercer, 1985). The assumption here is that comfort with the mothering
role is the same as role adaptation. No attempt was made to correlate
this feeling of “comfort“ with the indicators of role adaptation
utilized in this study.

In summary, Mercer has expanded on the work of Rubin with an
extensive study of the maternal role attainment process. This process
has been found to occur within three to ten months after delivery for
most women. Predictors of maternal role attainment included SES
ethnicity, marital status, self concept, maternal attitudes toward
childrearing, stress, and maternal control maintenance. Mercer also
observed that there were lower maternal role gratification scores in the
older age group. The findings from this study related to role conflict,
and reasons and timing for return to work will be presented at a later
time in this chapter.

Walker, Crain, and Thompson (1986a) in a descriptive endeavor,
studied 64 primiparous and 58 multiparous women to determine what
changes may be occurring in the level of maternal role attainment and
maternal identity in the postpartum period. Maternal role attainment
was defined as the process of enacting culturally defined behaviors

associated with the maternal role which results in the achievement of

49

the maternal identity. Within an attitudinal framework, measures
pertinent to maternal identity were the mother's attitude toward their
infants and toward themselves. Maternal self-confidence in caring for
infants also provided an indication of attaining the maternal role. A
second purpose of their research was to find out what relationship
infant sex, maternal age, maternal education and SES had with maternal
identity and maternal role attainment in both groups of women (Walker
et al., 1986a).

The convenience sample in this study consisted of married,
medically low-risk mothers who gave birth to healthy, full term infants
at a community hospital. The majority of the mothers were white, had
some college education, with the age range for the primiparas being
17-41 years (mean = 25.7 years) and for multiparas, 19-40 years
(mean = 29.2 years) (Walker et al., 1986a).

Perceived role attainment was measured using the Pharis Self-
Confidence Scale, a 13 item, five point scale that measures a parent's
self-confidence in carrying out baby care. Demonstrated role attainment
was measured by the maternal subscale of Price's (1977) Maternal-Infant
Adaptation Scale (MIAS) (cited in Walker et al., 1986a) which rates
maternal-infant interactions. Maternal identity was assessed by two
semantic differential scales: Myself as Mother which were maternal
self-evaluations, and My Baby which were evaluations of one's baby
(Walker et al., 1986a).

The subjects completed the attitude scales and were interviewed
first during the postpartum hospital stay and again during a home visit
at four to six weeks after delivery. It was found that maternal

attitudes during the postpartum period demonstrated both change and

50

stability (Walker et al., 1986a). Mothers became more self-confident
and positive toward themselves from birth to four to six weeks
postpartum. They also viewed their infants less positively at the end
of the postpartum period than at the beginning. Multiparas demonstrated
more positive attitudes toward themselves and their babies and were more
confident in their role than were primiparas. The positive attitudes
and self-confidence were stable across the postpartum period for both
groups of women (Walker et al., 1986a).

The indicators of maternal identity and role attainment were more
extensively interrelated among primiparas than multiparas which
indicates that role attainment in this group may be a more significant
factor in the formation of maternal identity than among multiparas
(Walker et al., 1986a). The four sociodemographic variables examined
showed little or no influence on the attitudes of either group of women.

To summarize, mothers became more self-confident and positive
toward themselves as the postpartum period progressed although they
viewed their infants less positively from birth to six weeks postpartum.
Multiparous women viewed themselves more positively and were more
confident in their roles than primiparous women. The results of this
study have documented what may have seemed obvious to many. However,
this study is limited by convenience sampling and in describing the
process of maternal role attainment due to the short period of time in
the postpartum period that was used for study. More descriptive data
about the socioeconomic status of these women is also needed to
ascertain the generalizability of these findings.

Curry (1983) studied twenty married, primiparous women to determine

the effect of variables such as maternal self-concept, age, SES, support

51

system, previous experience with children, perceived help from husband
and postpartum nurses, perception of the birth, and select infant
characteristics on maternal role adaptation. In this descriptive study,
self-evaluation and observations of maternal-infant interactions
provided data at three collections intervals: at the time of
recruitment in the third trimester of pregnancy, 36 hours after
delivery, and three months after delivery.

A convenience sample was obtained from a university hospital-
setting, obstetrical clinic. The women ranged in age from 20-31 years
(mean=24), with a median monthly family income of $1,000, with a range
of $250-2,500 per month. The mean educational level was 13 years with a
range of 12 to 20 years (Curry, 1983).

When the 20 subjects were asked how the adaptation to motherhood
had been, 15 described an easy adaptation while five stated it had been
difficult for them (Curry, 1983). The only variable that distinguished
the two groups prenatally was experience with infants and children:
easy adapters having had more experience in this area. This is similar
to the results of Shereshefsky and Yarrow (1973). The women who were
experiencing difficulty in adapting to the maternal role perceived less
support from the nursing staff and less help from their husbands during
the postpartum period and also confronted the responsibilities of
motherhood without the support of family during the first week at home
(Curry, 1983).

Adaptation to motherhood was perceived as difficult by 25% of the
women in this sample (Curry, 1983). These mothers also demonstrated
fewer maternal attachment behaviors toward their infants when observed

at three months postpartum than the easy adapters to the maternal role.

52

These women had felt unsupported in the hospital and at home and their
self-concept was measurably diminished. Curry (1983) felt the lowered
self-concept had a negative effect on feelings of maternal attachment
and was manifested by fewer attachment behaviors being displayed.

Thus, of the variables under study, experience with children, self-
concept, perception of support from nurses, and the perception of the
husband's help were the variables most related to maternal role
adaptation (Curry, 1983). Many suggestions for nursing interventions
were also presented based on the findings of this study. The use of
convenience sampling limits the generalizability of the findings and
Curry (1983) also felt other variables should have included that are
”obviously related to motherhood“ (p. 120) and may have interacted with
some of the variables under study. These variables included life
stress, marital adjustment, and the attitude toward the pregnancy.

In 1981, Lederman, Weingarten, and Lederman embarked on the
development of a scale to measure postpartum maternal adaptation. In
previous work on the relationship between psychosocial conflicts during
pregnancy and complications that arose during labor and delivery, a
self-report questionnaire, the Prenatal Self-Evaluation Questionnaire
(Lederman a Lederman, 1979) had been developed. Recognizing that
maternal role adaptation continued after delivery into the postpartum
period, eight scales were developed and subsequently, two of the scales
that dealt with support for the maternal role from parents, friends and
other family members were combined to form one scale leaving a total of
seven scales (Lederman et al., 1981).

The questionnaire was administered to 91 subjects at three days

postpartum and 58 subjects at six weeks postpartum in a sample drawn

53

from three hospitals in Michigan. There were 29 subjects who completed
the measures at both time periods. The mothers were all married, had
uncomplicated pregnancies, and the mean age was 27 years (Lederman

et al., 1981).

The results demonstrated lower intercorrelation coefficients than
reliability coefficients indicating that the scales were providing
unique information and thus justified the use of separate scales for
each dimension (Lederman et al., 1981). The seven dimensions of the
Postpartum Self-Evaluation Questionnaire are: (1) Quality of the
relationship with the husband; (2) Mother's perception of father's
participation in child care; (3) Mother's gratification with labor and
delivery experience; (4) Mother's satisfaction with life circumstances;
(5) Mother's confidence in ability to cape with tasks of motherhood;
(6) Mother's satisfaction with motherhood and infant care; and
(7) Support for maternal role from family and friends (Lederman et al.,
1981).

In Lederman's study, the relationship with the husband and
satisfaction with motherhood decreased over time in the postpartum
period (Lederman et al., 1981). The correlations of the repeated
measures were statistically significant for all the scales, thus it was
felt that early postpartum conflicts and concerns are likely to be
predictive of later perceptions as well.

In summary, the Postpartum Self-Evaluation Questionnaire consists
of seven dimensions of psychosocial adaptation to the maternal role, and
was patterned after a prenatal self-evaluation scale previously

developed by the same authors. Literature documentation of the use of

54

this scale is limited and in this case, the scale used was analyzed
using the first six weeks of the postpartum period.
Summary of Maternal Adaptation Research

In summary, maternal role adaptation is a process whereby the new
mother achieves competence in the role and integrates the mothering
behaviors into her established role set so that she is comfortable with
her identity as a mother. The maternal identity is the endpoint of this
process which has been observed to occur three to ten months after
childbirth. Many authors have identified measurable components or
dimensions of the development of the maternal role and variables that
impact on the adaptation to this role in the postpartum period.

Although mentioned briefly by Mercer (1985, 1986a), the
relationship between maternal employment and maternal role adaptation
has not been studied de5pite the increasingly large numbers of women who
return to work soon after the birth of their babies. In the next
section of this chapter, the body of literature available on maternal
employment will be discussed.

Maternal Employment Research

Contemporary women in America can read about their discontent,
stresses, and employment problems in many popular magazines available
today. With the large numbers of women in the work force, employment
issues for women have many potential readers. There is also a magazine
specifically for working mothers that attempts to address issues of
interest to this large segment of the work force.

There are many social biases that working mothers have had to

contend with as they have attempted to change the social attitudes

55

toward maternal employment. The following themes were identified in a
review of popular books about raising children (Zambrana, 1979):
(1) maternal employment during the early childhood years is detrimental
to the child; (2) a woman with a small child should be a mother first
and compromise her need to work; (3) the mother who returns to work for
financial reasons should only work part-time; (4) the mother should be
the primary caregiver as she is the only one who can adequately assume
the day-to-day responsibility.
Effect of Maternal Employment on Children

Research on the effects of maternal employment on children and
families began to appear in the 19305 as the numbers of women in the
labor force increased. Hoffman (1979) reviewed these research efforts
that included her own research on the subject which began in 1961.
Hoffman (1984) states the early studies began in a climate of
disapproval when maternal employment was considered undesirable, a
source of maladjustment in children, and the root of other social
malfunctions. For instance, in 1934, Gleuck and Gleuck suggested a
correlation between juvenile delinquency and maternal employment but
failed to control for extraneous variables as did many research efforts
of that time invalidating their results (Hoffman, 1984). A general lack
of theory and research skills, and insufficient criticism of results
when they matched expectations, limits the value of early research
efforts on the topic of the effects of maternal employment (Hoffman,
1984).

In the area of the effect of maternal employment on a child's
health and development, a review of research findings has not shown a

detrimental effect on children during infancy, early childhood, middle

56

childhood, or adolescence (Hoffman, 1979). In a similar review of
maternal employment research, Howell (1973) also concluded there are
almost no constant differences between the children of employed and
nonemployed mothers. In fact, a number of positive effects of maternal
employment have been reported.

Hoffman (1979) found school age children of working mothers are
more independent than those of nonemployed mothers. Daughters of
working mothers have shown an increase in academic and occupational
competence, and positive adjustment, in general, and are higher
achievers. The children of working mothers are also more likely to
attain a non-stereotyped view of sex-roles compared to children of
nonemployed mothers (Howell, 1973).

For adolescents, maternal employment studies have again
demonstrated more independence in this age group, as well as better
social and personality adjustment, a greater sense of personal worth,
better family relations, and better interpersonal relationships at
school (Hoffman, 1979). Furthermore, full-time maternal employment may
be better suited to the needs of the adolescent when the "hold“ on the
child should be loosened and it was felt that a working mother finds
this easier to accomplish because of an additional source of identity in
her job (Hoffman, 1979).

There remain many areas of research to be studied in the area of
maternal employment and its effect on a child's development.
Investigation of the effects of various day-care alternatives and the
development of “latch key children" as related to maternal employment
are two areas of study that should be pursued. More longitudinal

studies of the effects of maternal employment must also be undertaken.

57

As prevailing attitudes about maternal employment change, research
previously performed should be replicated to verify the stability of
previous findings.

Motivation for Return to Employment in the Postpartum Period

Another aspect of maternal employment that has been studied is the
woman's motivation for returning to employment after the birth of a
child. Until recently, the birth of the first child signalled the end
of a woman's education and/or career until the children were grown or at
least had started school. With women delaying childbirth, frequently
until their thirties, there has been time for a rewarding career and
professional advancements, and often this was what prompted the delay in
starting a family. These women must often choose whether to forego
their established careers to concentrate on the traditional maternal
role, or to try to combine the two sets of role expectations.

The decision for a woman to work after the birth of a child
usually involves several motivations. Even a single motivation can be
traced to a number of social factors. One social factor previously
discussed is the effect on the child of maternal employment, both
assumed and actual effects. Other social factors may be the Protestant
Work Ethic, birth control and being able to limit the family size and
childbearing period, and the degree of contact with one's extended
family (Hoffman, 1974).

As a result of the number of factors that may influence a woman's
motivation to return to work, research about a woman's choice is
conflicting. Poloma (1972) reported that when women have young
children, they feel the motherhood role supercedes the career roles.

Gilbert, Holahan, and Manning (1981) found considerable stress present

58

in their group of 22 “liberal and career-motivated women" who attempted
to combine work and motherhood. Gilbert et al. (1981) concluded that
the guilt feelings that resulted were a result of traditional views of
motherhood which they were reacting to on an emotional level, although
cognitively they no longer agreed with them.

In 1984, Hock, Gnezda, and McBride examined the attitudes of 317
randomly selected mothers, about the maternal role and maternal
employment. These first-time mothers had given birth to healthy infants
in three large midwestern metropolitan hospitals. The mean age of the
mothers was 25.7 years with a range of 20-36 years, and they had
completed a mean of 14.23 years of education. The mean head-of-
household income was $18,295. With respect to work status during
pregnancy, 88% of the women had been employed (Hock et al., 1984).

The subjects were asked to complete a questionnaire in the
maternity ward and three months later. The questionnaire included five
Likert-type items designed to measure attitudes toward exclusive
maternal care, as well as five items assessing the mothers' orientation
toward outside employment versus staying at home. Two scales were then
developed from these responses: Exclusive Maternal Care Scale and
Home/Employment Orientation Scale (Hock et al., 1984).

Despite the fact that 66% of these women planned to return to work
before their child's first birthday, and the average length of the
maternity leave was 12.73 weeks, there was a pervasive belief that the
maternal role should be a woman's primary role. Of these 317 women, in
the immediate postpartum period, 69% stated if given a choice between
working full-time and staying home with their child, they would choose

59

to stay home. Three months after delivery, this number had risen to 75%
(Hock et al., 1984).

However, when the responses of these women were compared based on
education and age, there were more traditional values in the younger
group and also in the less educated group (Hock et al., 1984). This
suggests that the older and better educated mother's employment
experiences may have led to more personal satisfaction and fulfillment
in the employment role and thus, less desire to relinquish employment.

In sum, most of the participants in this study expressed
traditional views about the primacy of the maternal role for women.
There was also an increased preference for staying at home with their
infants versus resuming full-time employment over the first three months
of the postpartum period, although in the older and more educated women
there was less support for the ”motherhood mandate." Further
exploration of flexible work schedules and hours is needed to determine
if this would impact on the woman's decision to return to work.

Pickens (1982) in a qualitative study of five career-oriented
primiparas, 30-33 years of age, described the identity reformulation
that took place as the women attempted to combine their career and
maternal roles. All five women were college graduates, four with
masters degrees, and were chosen while in the postpartum obstetrical
unit of a large, urban, teaching hospital. Four of the women were
married and had planned their pregnancy, while one was single and had an
unplanned pregnancy. Three of the women were school teachers, one had a
first-level management job in industry, and the other held a sales

position (Pickens, 1982).

Data collection was through unstructured interviews in the
postpartum unit, two to three weeks later in the home, and four months
after delivery in the home. The interviews were initiated by asking the
women, “How is everything going?“ and then notes were taken by the
interviewer. From these interviews, cognitive processes of identity
reformulation were identified and tabulated (Pickens, 1982). From data
analysis, it was determined that these women were experiencing an
“identity crisis“ (Pickens, 1982). The women expressed discontinuity
with many of their former attributes and were now feeling dependent and
incompetent in their current roles. These women felt they were
presented with a “no-win" situation as they felt frustrated and
unfulfilled if they stayed home with the baby, yet worried about missing
out on some important events in their baby's life if they went to work.
Their solution was to find successful role models after which they could
pattern the integration of the two roles. At four months postpartum,
the women expressed less identity confusion and felt more positively
about themselves (Pickens, 1982).

To summarize, a state of disequilibrium occurred in these career-
oriented women during the postpartum period as they assumed the maternal
role. They felt incompetent and dependent, and struggle with decisions
about returning to work. Due to the small sample size and the
characteristics of the sample, the results are not generalizable to the
general papulation of working women. However, some of the cognitive
processes and struggles of career women were highlighted in this study.
Although without a comparison to a sample of women not returning to
work, it is difficult to ascertain whether this state of disequilibrium

was a unique experience for these career-oriented women.

61

The major reason given by women for working is "money“ (Hoffman,
1979). This can be interpreted in many ways. Obviously, women who are
supporting dependents or are the sole support of the family, need to
work for financial gain and this has become more prevalent with the rise
in the number of single-parent families. Perception of financial need,
of course, varies with the situation and the individual. There are some
women who work to maintain a standard of living or achieve the standard
of those around them. This situation leads the woman to perceive a
financial need for her to work, although Hoffman (1979) refers to this
as a “financial desire.“ Acting on this desire has brought an
unprecedented high standard of living to many working-class families.

Money also operates as a motive for maternal employment in another
way. The role of housewife and mother is not a paid position and
therefore does not tend to carry with it a sense of achievement,
competence, and contribution (Hoffman, 1979). No one expresses this
more clearly than the woman who reports she is “just a housewife.“
Bringing home a paycheck, no matter what the money is used for, also
brings he woman a sense of achievement and a tangible contribution to
the family (Hoffman, 1979). Furthermore, financial necessity, or even
added income has been one of the most socially acceptable reasons
available for working women who cite this reason in order to avoid
negative social sanctions (Hoffman, 1974).

Behrman (1982) studied three groups of women who were first time
mothers and asked them about their plans after childbirth in regards to
returning to employment. The three groups were randomly selected and
consisted of 26 women who remained home full-time, 23 mothers who

returned to work full-time, and 21 women who returned part-time to

62

employment. The mean age of the full-time group was 29.8 years of age
and 28.55 for the other two groups. The women in the full-time group
also had more total years of education with 17.7 years compared to 16.9
years for the part-time group and 16.4 for the home group. Even more
noteworthy was the fact the full-time group of women tended to earn a
higher percentage of the total family income. On the average, these
women had earned 46% of the family income while women in the part-time
and home group contributed 35% and 31%, respectively. All of the women
were in professional, technical or managerial positions with no
significant differences between groups (Behrman, 1982).

In this descriptive study, the women were asked to rank their
reasons for their decision: 46% of the women working full-time cited
financial considerations as the primary reason for returning to work,
while the wife's needs and career considerations were tied for second in
importance in this group at 23%. For the women working part-time, the
wife's needs were the primary reason given 43% of the time and the
child's needs ranked second with 19% of the women responding positively
to this category. In the women who chose to remain at home, 88% of the
women said they did so because of the child's needs (Behrman, 1982).

Mercer (1986a) in her study of 242 primiparous women also asked
questions about the woman's plans to return to work following the birth
of their infants. Forty-five percent of the two older groups of women
indicated they planned to return to work and financial need was the
reason most frequently given for their plans; 21% of Group One (aged
15-19 years), 36% of Group Two (20-29 years), and 17% of Group Three
(aged 30-42 years) gave that reason (Mercer, 1986a). Twice as many of
the women in Group Three, 20% of the sample, indicated they wanted to

63

return to work which Mercer (1986a) felt reflected their greater
progress in career development. About one-third of each group listed
both the financial need and the desire to work as their reasons for
plans to go to work. The average age of the infants when their mother
returned to work was 15 weeks with the average infant in Group One 20
weeks old, Group Two infants 15 weeks, and Group Three infants, were 14
weeks old on the average (Mercer, 1986a).

Behrman (1982) and Mercer (1986a) reported similar findings from
their research: financial need was the most frequently stated reason
for returning to work after the birth of a first baby. }In both studies,
the older women who had more time invested in a career, expressed more
of a personal desire to return to work.

Another aspect of maternal employment that has been considered is
the woman's satisfaction with and commitment to employment once she
returns to work and how this may impact on the woman and her family. A
number of studies have indicated that the working mother is more
satisfied with her life than is the nonworking mother, and the mother's
satisfaction with her maternal role increases her effectiveness as a
parent (Gold a Andres, 1978; Hoffman, 1974). Conversely, the woman who
must return to work or stay at home when her desire is to do otherwise,
may function less effectively as a parent (Collins, 1986).

Jimenez and Newton (1982) studied the relation of reported job
commitment to emotions during later pregnancy and early postpartum in
120 married primiparae. The women were randomly selected from the
private practices of 16 obstetricians in the Chicago area. The mean age
was 26 years with a range of 18-35 years. Thirty-seven percent of the

women worked in professional and managerial jobs, 7% in technical jobs,

51% in clerical and service fields, 3% in artistic endeavors and 2% (2
women) had never worked (Jimenez & Newton, 1982).

The women completed a Job Descriptive Index in the prenatal period
and a Work Plans Questionnaire in the postpartum period. Jimenez and
Newton's (1982) results suggested that women who adapt well to work
also adapt well to childbearing. Women who scored higher in positive
job commitment had a more positive adjustment to their first pregnancy
and early motherhood. Furthermore, those women who reported more
interest in their jobs, tended to wait longer before starting a family,
worked longer during pregnancy, planned to return to work sooner after
delivery, and work more hours than those scoring lower in job
satisfaction (Jimenez & Newton, 1982).

Jimenez and Newton's (1982) study underscored the effect that job
satisfaction and job or career commitment can have on the motivation to
return to work. This supports the findings of Mercer (1986a) and
Behrman (1982) as well. Jimenez and Newton's (1982) sample was also
more representative of the general characteristics of the female labor
force than many of the other studies that have been reviewed. However,
this sample was not representative of a broad range of socioeconomic
levels.

Majewski (1986) in a correlational, descriptive study utilizing
data from a study by Mercer (1981), studied a subgroup of 86 first-time
mothers, in order to examine the relationships between employment role
attitude, employment status, and the ease of transition to the maternal
role. The women were between the ages of 20 and 39 years, currently
married, and 55% of the women were engaged in occupational roles by the

time the infant was eight months old.

65

Majewski (1986) found no correlation between a woman's employment
role attitude and her subsequent ease of transition to the maternal role
in these mothers. This is in contrast to Jimenez and Newton (1982) who
found that women who adapted well to work roles also adapted well to the
maternal role. The women were also asked to classify their employment
as either a job or career, and there were no correlations when the two
groups were analyzed separately related to employment role attitude.
Majewski (1986) suggested that complaining about work roles is more
socially acceptable than complaining about the difficulty in making the
transition to the maternal role, and thus may explain this finding which
is contrary to the findings of other researchers.

To summarize the research on a woman's motivation to return to
work, several reasons and social factors that may affect a woman's
decision were revealed in the literature. For many women, traditional
values about the primacy of the motherhood role persist. For other
women, financial concerns dominate or at least it has been more socially
acceptable to cite this reason. Some career-oriented women feel
committed to their employment situation and obtain a sense of
satisfaction, competence, and independence from working outside of the
home. The woman who returns to work or stays home when her desire is
otherwise, may function less effectively in any or all of the roles she
assumes.

Part-Time Versus Full-Time Postpartum Employment

Very little research has been done on maternal employment and the
number of hours a woman works outside of the home per week. In Poloma's
(1972) study of 45 dual-career families, 28 of the wives all of whom

were high status professionals, did not work at all until their children

66

were in school; another ten of the women worked part-time; only seven
worked full-time. This was the usual pattern of employment for women
until more recently. By 1986 in the U.S., the majority of employed
mothers worked full-time: 66% of the mothers with children under the
age of three and 77% of the mothers with children in the 14-17 year old
age group (U.S. Department of Labor, 1986). According to the Bureau of
Labor Statistics (1986), full-time workers are those who work 35 hours
or more per week and those who work less than 35 hours per week are
considered part-time workers.

Dropping out of the labor force or cutting back on career
involvement by working fewer hours is not without consequence for a
woman's career. Women have difficulty rising to positions of
responsibility, lose seniority, and receive smaller economic benefits
because of these adjustments in their employment status (Behrman, 1982).
For instance, only 15% of all part-time workers in 1979 had basic
medical coverage as a benefit of employment and 56% of the part-time
labor force consisted of women (Kamerman et al., 1983). In a 1986

reader survey by Working Woman magazine, 25% of the 4,900 women

 

responding said they were mothers and felt motherhood had negatively
affected their career. Thirty-seven percent of these mothers said their
career advancement had been slowed, 15% said they took a less demanding
job and 14% said they had changed to part-time work (Bureau of National
Affairs, 1987).

As previously cited, Behrman (1982) had three groups of first-time
mothers in respect to the number of hours they would work after
delivery: full-time group, part-time group, and the home group. In the

part-time group, the average woman was 29 years old, had worked for

67

about six years, and half had obtained a graduate degree. The decision
to return to work part-time resulted only after a great deal of
discussion with friends and colleagues, and they were still not sure
they would carry out their actual plans. This group of women expressed
an interest and investment in their careers but were not sure that
involvement in their career would not interfere with their mothering
role. “Thus, these women experienced conflictual feelings as they did
not want to interrupt their careers but had substantial concern for
their child's welfare. Therefore, they felt that a part-time career
would be "the best of both worlds“ (Behrman, 1982). When these women
were asked if they thought they would return to full-time work in the
future, 32% replied "yes,“ 26% replied “no,“ and 42% were not sure
(Behrman, 1982).

In the group of women who planned to return to work full-time, the
average woman was 30 years old, had obtained a graduate degree, and had
been working in a “prestigious“ occupation for approximately six years
prior to pregnancy (Behrman, 1982). The decision to return to work was
not felt to be a difficult one by the women in this group and they
indicated a fair amount of certainty with their plans. The did not see
the occupational and maternal roles as incompatible with one another and
many women expressed the belief that "it's the quality of the time spent
with the child and not the quantity" (Behrman, 1982, p. 105).

The women in the home group were about 29 years old, had a college
degree, and had worked for approximately five years prior to starting
their families (Behrman, 1982). The decision to quit work was a
relatively easy one for this group and at this stage in their lives, the

focal role was that of wife and mother. They perceived work as

interfering with their commitment to their children and families
(Behrman, 1982).

The women sampled in this study (Behrman, 1982) were urban, middle
class, college-educated subjects which limits the generalizability of
these results. Furthermore, the opinions expressed were perceptions of
how they thought they would manage the postpartum period since the
interviews were completed prior to delivery. More research is needed to
ascertain how the number of hours worked by a new mother affects her
adaptation to the maternal role.

In another study, Moen and Dempster-McClain (1987) analyzed data
from the 1977 Quality of Employment Survey to examine the work-time
preferences of dual-earner couples with children aged 12 and under. A
role strain framework was utilized to illuminate the factors related to
an employed parent's stated preference for fewer work hours. Six
factors were hypothesized to be related to the preferences of working
parents for reduced working hours: gender, family obligations,
subjective experience of role strain expressed as work-family
interference, current work hours, occupational status and job
flexibility (Moen & Dempster-McClain, 1987).

A subsample of 108 dual-earner wives and 116 dual-earner husbands
who had at least one child aged 12 or under were drawn from 1,515
respondents interviewed in the larger survey conducted by the University
of Michigan's Institute for Social Research (Moen & Dempster-McClain,
1987)."The respondents provided information on their spouses as well as
themselves in this study. Three classifications of occupational status

and work time patterns were identified in the subsample (Table 3).

69

Table 3. Parental Work-time Pattern by Occupational Status

 

Family Occupational Status Reduceda Regularb Extendedc

Total sample (%) 34.4 18.8 46.9
Both professional/managerial 39.3 3.6 57.1
Mixed 30.2 9.5 60.3
Both nonprofessional 35.3 26.3 38.3

aReduced=mother works part-time, father works full-time, overtime,
or moonlights (part-time=20-34.5 hrs/wk; full-time=34-40.5 hrs/wk;
overtime=41+ hrs/wk; moonlight=two jobs).

bRegular=both work full-time.

cExtended=both or one works full-time, overtime, moonlights and the
other works full-time (Moen & Dempster-McClain, 1987).

 

Multivariate analysis techniques were utilized to determine work-hour
preferences with the six variables under study.

The results revealed that gender is significantly related to work-
hour preferences for both self and spouse, with 53% of all wives wishing
to work fewer hours while 38% of all husbands wanted to work less (Moen
a Dempster-McClain, 1987). Further analysis of those mothers who wanted
to work fewer hours revealed they wanted to do so in order to spend more
time with their children and it was primarily those mothers who worked
full-time or more who stated this preference. Additionally, a
preference for a reduced work week was related to perceived strains in
managing both work and family roles. In fact, those parents reporting
work-family interference were five times more likely than those without

such strains to prefer reduced work hours.

70

A third factor related to a preference for fewer work hours was the
actual number of hours worked per week (Moen & Dempster- McClain, 1987).
In those couples working regular or extended hours, there was a
significantly greater percentage that desired fewer work hours for
themselves and their spouse. The other factors investigated (i.e.
family obligations, job flexibility, and occupational status of each
parent) did not reveal a significant degree of correlation with the
preference for fewer work hours. Implications for policy making were
also presented in relation to the findings of this study.

In summary, few studies have been done on the postpartum
employment of working mothers related to the number of hours worked per

week. In one study, only the anticipated work status after delivery was

 

reported. In another study, factors were analyzed that related only’to
the preference for the number of hours worked. In the latter study,
family size and the age of the youngest child in relation to the
employment status of the mother were not analyzed. Further research is
needed in order to ascertain the impact of maternal employment in a
full-time versus a part-time capacity on role strain and role
adaptations.
Maternity Leave

Another concern for many women is gggp to return to work after the
birth of their child. For many women, there is no choice about how long
the maternity leave will be as this is dictated by company policy. The
issue of maternity or parental leave is increasingly a subject of
legislative and research efforts (Kamerman et al., 1983; Catalyst,
1983; Catalyst, 1984; Bureau of National Affairs, 1987). These

efforts are mainly concerned with the documentation of current corporate

71

policy and legislation to provide equal disability benefits to all
employees and parental leave for both men and women, if so desired. The
issue of how the length of the maternity leave affects the maternal-
infant interaction and the maternal role adaptation has received less
attention.
Maternity Leave Research

With the prevailing social and legislative attitudes about women
working after the birth of a child slanted toward the need for a woman
to remain at home, little study of the ideal length of a maternity leave
has been done. Rather, personal opinions have been expressed that have
reflected traditional views of trying to mix motherhood and employment.

In 1980, the entire membership of the American Academy of
Pediatrics was polled regarding the members' attitudes toward maternal
employment (Heins, Stillman, Sabers, & Mazzeo, 1983). The pediatricians
were asked what age a child should be before a mother returns to work
(length of maternity leave), to rank the importance of factors that
would determine their advice to a mother regarding her working, and
under what circumstances they had recommended to a mother that she work,
or not work, outside of the home.

Responses were received from 5,758 pediatricians which was a 31%
response rate (Heins et al., 1983). The mean age of the respondents
was 44 years with a range of 25 to 90 years. When the ages were broken
into three groups, less than 37 years, 38-50 years, and more than 51
years old, there was a greater percentage of younger respondents than
was characteristic of the membership of the Academy. Also, women
composed 25% of the sample, although they comprise only 13% of the total

membership of the Academy. Thus, there may be bias' in some of the

72

results of this survey based on the age and sex of the respondents. Of
the respondents, 37% of the women and 27% of the men had mothers who
worked outside of the home when they were children (Heins et al., 1983).

When the pediatricians were asked about the child's age at the time
the mother returns to work when she does so for her “personal
fulfillment,“ 7% answered three months or less, 26% said three years,
36% said when the child starts school, 29% did not feel that it mattered
and 1% said a mother should never work (Heins et al., 1983). When
these responses were classified according to the sex and age of the
respondent, older respondents were more likely to say "a mother should
never work," and less likely to choose "it makes no difference.“ Women
were more likely to choose the latter response (Heins et al., 1983).

When asked open-ended questions about the circumstances under which
a mother could return to work, nine categories of answers resulted from
content analysis (Heins et al., 1983). In order these responses were:
economic reasons (25%), never recommend mother work (22%), mother's
emotional needs (18%), mother's fulfillment (15%), child is better off
without mother (9%), reassure mother (4%), adequacy of child care (4%),
child's age (2%), and mother does important work (1%). When taken
together, maternal needs accounted for 37% of all responses (Heins
et al., 1983).

In order to determine what factors pediatricians considered when
they advised a mother regarding her desire to work, they were asked to
rank nine variables on a five point scale (Heins et al., 1983).

Adequacy of child care or economic necessity was always ranked highest

when the respondents were classified according to age and sex, and the

73

importance of a women's self-fulfillment decreased as the age of the
respondent increased (Heins et al., 1983).

As demonstrated by this polling of pediatricians, bias against
maternal employment exists with many of these physicians holding the
belief that a mother's place is in the home. For those respondents who
did give a mother recommendations regarding the length of her leave from
employment, 7% answered three months or less; 26% answered three years;
36% said when child starts school; and 29% said it did not matter
(Heins et al., 1983). Also important in respect to interventions for
working mothers is the finding that 18% of these pediatricians said they
never give advice on this topic.

Another pediatrician, T. Berry Brazelton, has written extensively
on the subject of maternal employment and hosts a syndicated television
series on parent-child issues. Although clinical research has not been
done to support his recommendations, Brazelton in a 1981 publication,
stated "at least six months and even a year might be the ideal time
span“ (p. 12) for the length of the maternity leave. Later, in the
same publication Brazelton (1981) states, “I feel that a mother (or
father) should be at home and in charge of her or his baby for at least
the first four months, as an absolute minimum" (p. 191).

i/In 1985, Brazelton again states his opinion that the first four
months “should be inviolate“ (p. 22) and a mother should not leave her
baby during this time. Four stages in the parent-infant relationship
are described that occur during the first four months of the baby's
life. Based on the activities of the dyad (or triad) during these

stages, Brazelton states "...a law mandating four paid months of

74

maternity leave and one month paternity leave would effectively
emphasize the importance of this period“ (p. 60).

Kamerman et al. (1983) citing current child development research in
relation to the length of the maternity leave, concludes there is no
definitive answer about what is best for children and their parents.
They acknowledge that "...it would appear that the ability of a parent
to devote himself or herself to the child, without excessive diversion
or external pressure, can have important consequences...“ (Kamerman
et al., 1983) for child development during the first year of life.
Kamerman et al. (1983), recommend a period of at least three to nine
months for the length of the maternity leave.

[In a survey of 815 two-career families, 36% of the women were back
at their jobs within one to eight weeks, 32% took 9-18 weeks, 19% took
19-33 weeks, and 10% took longer for their maternity leave (Catalyst,
1980). The median time of the leave in this survey was 12 weeks.

The Yale Bush Center in Child Development and Social Policy,
Advisory Committee on Infant Care Leave--whose members include
academics and professionals in child development, business, health,
social welfare and law--recommended that leave be available for a
minimum of six months with 75% income replacement for three months, and
full benefit continuation and job protection for six months (Zigler &
Muenchow, 1983). Zigler and Muenchow (1983) stated that although this
time limit may seem arbitrary and deserves further study, it is based on
family and child health reasons. They state the process by which
parents and infants communicate is a subtle and requires time for

development. The disruption in family routines and sleep patterns are a

75

second reason for a prolonged period of leave available for parents
(Zigler & Muenchow, 1983).

In sum, many recommendations are given to new mothers regarding
when they "should“ return to employment in the postpartum period. These
recommendations continue to be based on personal opinion, social bias',
and child development research. Despite these recommendations for a
longer maternity leave, women with infants are returning to work in
large numbers early in the first postpartum year. Most recommendations
focus on the needs of the infant. Studies on the length of the
maternity leave and its effect on the mother and her adaptation to the
maternal role have not been reported.

Role Strain

According to role theory, role strain during role transitional
periods has been shown to be a universal and "normative“ phenomenon.
Goode (1960) stated that the problem in these role transition processes
is how to make the whole system manageable in order to reduce the
strain. For the new mother who returns to work during the first
postpartum year, balancing multiple roles successfully has been found to
be a source of role strain (Herman & Gyllstrom, 1977; Myers-Wall, 1984;
Van Meter & Agronow, 1982). In this study, management of the
occupational role in such a way as to decrease overall role strain is
the variable under study.

A number of descriptive studies have been done with working women
and families, particularly dual-career families, to determine sources of
strain and stress in these individuals (Gray, 1983; Hall, 1972; Herman &
Gyllstrom, 1977; Johnson 8 Johnson, 1977; Keith & Schafer, 1980;
Majewski, 1986; Mercer, 1985; Miller a Sollie, 1980; Myers-Wall, 1984;

76

Tiedje, 1987). Much of the literature deals with stress and strain as
an inherent aspect of the dual-career lifestyle and attempts to
determine what coping strategies are utilized, mainly by women, in
managing the stain. Those studies that considered a woman's
occupational status as a variable in determining the level of strain
will be reviewed.

In an attempt to develop and explore a model for coping with role
conflict, Hall (1972) nonrandomly sampled 109 college-educated women in
a pilot study, and subsequently, 261 randomly selected college
graduates. When these women were asked to list their most prominent
roles, those mentioned most frequently were wife, mother, volunteer, and
employee. When asked to describe where strains existed between there
roles, the following sources of pressure were identified: home (wife
and mother role), nonhome (employment), self (personal desires to
develop interests), and time. Although ”time" did not involve any
particular role, it was mentioned so frequently it was included.
Finally, the women were asked how they dealt with these conflicts and
16 coping techniques were identified (Hall, 1972).

The 16 techniques were classified into three categories. Type I
coping was labelled structural role redefinition, and involved altering
external, structurally imposed expectations relevant to a person's
position (Hall, 1972). Type II coping was personal role redefinition,
changing one's expectations and perception of one's own behavior in a
given position. For 33 women in this study, this involved quitting
work. Type III coping was referred to as reactive role behavior and

entailed attempting to find ways to meet all role expectations. Some

77

women adapted by demanding more of themselves, while 45 women changed
their work schedule to increase their overall efficiency (Hall, 1972).

In sum, Hall (1972) found that the greatest role problem faced by a
woman was the conflict arising from multiple roles (inter-role
conflict), and was more a matter of role overload and competition for
her time rather than an issue of incompatibility (intra-role conflict).
In this study, role overload was found to be related to the number of
hours a woman works per week. Furthermore, comparing a woman's roles to
a man's roles, showed that men do not have fewer roles than women, but
they tend to produce less conflict as they demand action of the role
holder at different times rather than simultaneously (Hall, 1972).

In 1977, Johnson and Johnson interviewed 28 dual-career families in
a cross-sectional descriptive study in order to describe parental
adaptation to role strain and identify the techniques used to modify the
strain. In this random sample, each family had at least one child under
the age of 12, with a mean age of 5.6 years, and the mean number of
children was 1.7. All the parents were college educated and in
professional positions. No data was given for the age of the parents,
number of hours each parent worked, length of the marriage, or ranges of
ages of the children and numbers of children in each family.

The interviews of the husbands and wives lasted about two hours and
were conducted separately (Johnson a Johnson, 1977). A combination of
Open-ended questions and forced-choice questions were utilized but no
information on the specific data collection tools was made available.

All the women in this study reported major concerns over the
conflict between career and their children, and this conflict was

referred to by the authors as role strain (Johnson & Johnson, 1977).

78

The women reported this role strain 116 times and involved emotional
depletion, guilt and fatigue. The cause of the role strain 64% of the
time centered around child-rearing problems and their guilt and fatigue
related to dealing with these problems. Marital or financial problems
only accounted for 15% of the reports of strain (Johnson & Johnson,
1977).

Husbands, on the other hand, were either vague or unemotional in
their reports of role strain in themselves or their wives (Johnson a
Johnson, 1977). In most cases, the men were reported as minimizing or
denying any perceived role strain as their technique of resolving
strain. A number of techniques were utilized by the women to modify
their perceived level of strain.

The most common technique utilized by the women to modify strain
was to temporarily lower their career ambitions and assign more time to
domestic roles (Johnson & Johnson, 1977). There was no mention made in
this study of modifications made in the occupational role other than to
say that the women had lowered their career aspirations to avoid higher
levels of role strain.

In summary, Johnson and Johnson (1977) interviewed dual career
families with young children and found that the wives and mothers in
particular, experienced difficulties in respect to the proliferation of
role demands in both home and job situations. The greatest strain was
in the maternal role and the most common technique utilized by mothers
to cope with this strain was to lower their career ambitions and assign
more time to the domestic role. Further analysis of how the maternal
and occupational roles of women can be modified to lower role strain is

needed.

79

In another attempt to identify the coping strategies utilized by
first-time mothers who returned to employment, Myers-Wall (1984)
interviewed 42 married women during their postpartum stay and at two
months after delivery using Paloma's Coping Strategies scale and an
adaptation of Steffensmeier's Ease of Transition instrument. The mean
age of the subjects under study was 23.74 years (range 18-33), and all
but three of the subjects had been employed prior to pregnancy. At the
time of the second interview (two months postpartum), 35.7% of the women
had returned to a job outside of the home (Myers-Wall, 1984).

Myers-Wall (1984) identified four role commitments that conflicted
with new parenthood: work, social life, marriage, and housekeeping
roles. Using correlational techniques, it was found that the use of
coping strategies was especially useful in dealing with conflicts
between the woman's social and work roles and eased the transition to
parenthood. It was determined that employment and social life roles
clash with parenthood primarily due to location conflicts and conflicts
in expectations. The coping strategies utilized were holding a positive
view of the situation, establishing a salient role, compartmentalizing
roles, and compromising standards. These strategies seemed to be more
appropriate for dealing with social life and employment role conflicts
than for marital and housekeeping roles and thus accounted for the
stronger correlations (Myers-Wall, 1984).

The use of these coping strategies resulted in less disruption in
one's living pattern, better overall adjustment to parenthood, more
satisfaction with the changes that did occur, and higher marital
satisfaction and harmony (Myers-Wall, 1984). It was recommended that

these strategies be incorporated into instructions for new mothers who

80

intended to return to the labor force while adjusting to the new demands
of parenthood, thus enhancing their effectiveness in both roles.

In 1983, Gray surveyed 232 married, women doctors, lawyers and
professors about their attitudes toward their roles and how they cope
with role conflicts. The women were randomly selected from an urban
area in the East and were administered a 64 item fixed-choice
questionnaire that also included one open-ended and demographic data
questions. More in depth information was obtained through hour long
personal interviews with 15 subjects randomly chosen from various
subgroups of the original sample (Gray, 1983).

The participants in this study were evenly representative of the
three professions, with an average age of 39 years and a range of 25 to
69 years (Gray, 1983). In a typical week, the women averaged 46.0 hours
worked and 23 of the women or 9.9% said they worked part-time. The
average number of children was 1.7 and 68 women or 29.3% had no children
(Gray, 1983).

In this descriptive survey, it was revealed that 77% of the women
often experienced strains between their home and career roles (Gray,
1983). Of the women, 46% felt that their family was more important than
their career, 46% stated it was impossible to rank the relative
importance of these roles, and 8% said their careers definitely came
first. Over 80% said that their husbands, colleagues, and parents were
supportive of their careers (Gray, 1983).

An analysis of the coping strategies used by these women revealed
80% of the women reported family members helped with chores, they had
reduced standards within certain roles, and they rotated their attention

among roles, depending on which need was most pressing (Gray, 1983).

81

Other commonly used strategies were eliminating certain activities
within roles, developing new attitudes to reduce conflicts, and
carefully scheduling and organizing activities. These strategies were
all closely related to satisfaction with these roles. The two
strategies that were rarely used were keeping roles totally separate and
eliminating roles. Nearly 47% of the women stated that had no
"conscious“ strategies for dealing with role strain (Gray, 1983).

Gray's (1983) work documents the presence of role strain in
employed professional women, however, the age of the child or the
presence of the child in the home at the time of the survey was not
reported. Furthermore, the process of role adaptation was not discussed
in this study.

In another report of data from earlier research efforts, Mercer
(1985) asked the 242 first-time mothers she studied to report the amount
of role strain they perceived. A five-point scale ranging from “none“
to "very high" levels of strain was utilized at four, eight, and 12
months postpartum. At four months, 18% of the women reported high or
very high levels of role strain. This increased to 16% at eight months
and 21% at one year. Only 13% did not report any perceived role strain.
Even with increased experience in the maternal role, the perceived
strain did not decrease and Mercer (1985) felt this may be reflective of
the increase in employed mothers from 55% at eight months to 62% at one
year. However, comparisons of levels of role strain in employed versus
nonemployed mothers at the same periods of time showed no difference in
the groups (Mercer, 1985).

Majewski (1986) using a subgroup sample of 86 women from Mercer's

(1984) larger sample, attempted to further correlate and describe the

82

relationship between role conflict and the ease of transition to the
maternal role. Role conflict between pairs of life roles was measured
utilizing the Role Conflict Scale (RCS) developed by Holohan and
Gilbert (1979). The transition to the maternal role was measured with a
seven item scale (Blank, 1964) and Mercer's (1985) 14 item maternal
behaviors scale.

Majewski (1986) found no difference between groups of employed and
unemployed mothers in relation to the extent of perceived role conflict
as measured by the RC5. However, when the employed mothers were
separated according to job versus career, those mothers with careers
experienced significantly more conflict on subscales of the RC5. The
woman who perceives her employment as a career may feel greater
involvement and personal investment in a career, and thus more conflict
between roles (Majewski, 1986).

Another explanation offered for differences in levels of conflict
was related to the personality variables of the women: women with jobs
being more easy-going and less goal oriented than women with careers and
also may have selected less demanding jobs in anticipation of difficulty
with their roles as mothers (Majewski, 1986). However, irregardless of
employment status, those mothers with higher levels of perceived role
conflict had greater difficulty in making the transition to the maternal
role. Thus, role strain and role conflict were found to impede the
transition to the new role (Majewski, 1986).

Tiedje (1987) went beyond the role strain/conflict model for
analyzing the coping effectiveness of employed mothers. Included in the
conceptual framework was the “role enhancement" concept to help explain

a woman's experience in coping with multiple roles. That is, there are

83

potential benefits, satisfactions, or rewards as well as strains, for
women occupying multiple roles. Utilizing 65 faculty women and 93 mid-
level business managerial women who were married and had at least one
child under the age of five, a personal interview and data from a pre-
interview questionnaire provided data for analysis in this study
(Tiedje, 1987).

To measure perceptions of inter-role combinations, Conflict and
Enhancement subscales of the Role Concurrence Perception Scale (RCPS)
(Tiedje, 1987) were utilized. The overall findings of this study
revealed that neither the conflict or enhancement hypothesis alone is an
adequate explanation of a woman's experience in their social roles in
relation to their coping effectiveness (Tiedje, 1987). Rather, role
enhancement and role conflict must be viewed as coexistent and
intermingling (Table 4). Differences in a woman's perceptions of role
conflict and enhancement are also associated with differences in caping
effectiveness (Tiedje, 1987). Although professional women with
preschool children experience conflicts in their roles of wife, mother,
and worker, they also experience satisfactions and rewards that enhance

coping effectiveness (Tiedje, 1987).

Table 4. Inter-role Concurrence Typology: Family & Career Roles

 

 

Enhancement
Low High
High Low enhancement High enhancement
High conflict High conflict
Conflict
Low Low enhancement High enhancement

Low conflict Low conflict

 

84

In summary, role strain during role transition periods has been
shown to be a universal and “normative" phenomenon. In particular, role
strain and conflict exists for working mothers between employment roles
and parenting roles. Women consistently reported more work-family
strain than men in dual career families. Strain was also found to
impede the transition to the maternal role. Numerous coping strategies
have been identified and include lowering role expectations or
compromising standards, compartmentalizing roles, holding a positive
view of the situation, scheduling and organizing activities, utilize
social supports, and lowering career aspirations. Research also
suggests that role enhancement coexists with role conflict/strain to
affect coping effectiveness in women with multiple social roles. More
research is needed to study the relationship between manipulation of the
occupational role as a coping strategy and the maternal role adaptation
process during the first postpartum year.

Interventions With Working Mothers

 

Although this study of the maternal role adaptation process and
occupational variables that may affect the process does not include an
intervention as part of the conceptual framework, a review of
interventions will be included as a basis for recommendations for
interventions with working mothers that will be presented in Chapter VI.

Childbirth education has long been recognized as an important
aspect of the parental preparation for the labor and delivery
experience. Many of these classes do include some anticipatory guidance
for couples regarding postnatal parenting concerns. However, very few

educational programs have been developed that specifically address the

85

working mother and issues pertinent to this now predominant parenting
situation.

Cronenwett (1976) addresses the need for postpartum guidance for
new parents stating that hospital-based maternity nurses are
inconsistent in providing information related to the problems of
parenthood and textbooks on maternity nursing omit or do little to
emphasize this important area. Postpartum support groups were started
in 1975 in Michigan through the LaMaze Association of Ann Arbor
(Cronenwett, 1976). These groups were designed to allow new parents to
share experiences, feelings, and coping strategies as they dealt with
the immediate postpartum period and the transition to parenthood. One
of the major foci of the groups during the first six months was the
problem of role changes. All of the primiparas had returned to work at
least on a part-time basis during the course of the group meetings.
Most of the mothers were intensely searching for a way to integrate
their maternal feelings into their previously established identities
(Cronenwett, 1976). Later discussions focused on other relationships
such as the marital and immediate family (grandparents) interactions.
The groups became a source of information and a means of providing
support for the families involved.

In a retrospective analysis of women who had attended the
postpartum support groups, Cronenwett (1980) attempted to determine the
characteristics of women who had used this form of support, the needs
that were met by participating in this group, the types of discussions
most meaningful to group members, and the factors affecting group

affectiveness in providing support.

86

Questionnaires were returned from 66 married caucasian women who
had participated or were still participating in groups (Cronenwett,
1980). The mean age for the respondents was 27 years, the median
education was that of a college graduate, and the median income was
$15,000 per year. Primiparas accounted for 73% of the group and 70% of
the women had returned to work before participating in the groups. None
of the groups were couple groups but 52% of the women reported being in
groups where babies attended the sessions (Cronenwett, 1980).

When asked why they had joined the postpartum support group, 24 of
the respondents (36%) expressed a desire to talk with other persons in
the same situation (Cronenwett, 1980). The reason mentioned by 27% of
the women was a desire to meet new people with children their child's
age. Over 80% of the women believed all of their initial expectations
and needs had been met by the group experience.

When the women were asked to select topics that had been the most
meaningful to them, negative feelings about parenting were most
important when the baby was less than six months old (Cronenwett, 1980).
Talking about working or not working outside of the home was most
important when the baby was over six months old. Discussing the labor
and delivery experience was important to the women irregardless of the
infant's age. When asked how the topics were chosen for discussion, 73%
of the women mentioned the recognition of the universal nature of their
feelings and the reassurance that their situation was normal
(Cronenwett, 1980).

The length of time a woman remained in the group was significantly
related to whether she was working outside of the home or not

(Cronenwett, 1980). Seventy-seven percent of the mothers who returned

87

to work stayed in the groups for a year or more while 85% of the mothers
who did not return to work were in their group for one year or less.
This was the only variable that significantly affected the length of
time in the group (Cronenwett, 1980).

In sum, postpartum support groups can provide opportunities for new
mothers to “norm“ with other women in similar situations, offer social
contacts, and allow new mothers to discuss their labor and delivery
experiences. Women who worked outside of the home tended to remain in
the groups for longer periods of time. Possibly this was related to the
need of better-educated and older women for a group where the maternal
role is esteemed and validated or the norming aspect of the group
interaction may account for this phenomenon.

In 1985, Collins and Tiedje began a quasi-experimental
intervention study with 35 married primiparas who were planning to
return to work at least 20 hours per week within six months of the birth
of their child. The data used for analysis in this author's research is
from this intervention study. The women responded to advertisements
about a group that would meet six times to discuss issues pertinent to
working mothers. Those women who could not attend the group sessions
were asked to be a part of the control group and answer questionnaires
at four points in time: pretest (pre-intervention), two and four months
after returning to work, and one year after the infant's birth (Collins
& Tiedje, in press).

The primary objective of Collins and Tiedje's research (in press),
was to examine the effects of a pilot intervention on the well-being of
married women resuming employment following the birth of their first

child through comparison of an experimental and a control group. The

measures utilized were Lederman and Weingarten's Postpartum Self-
Evaluation Questionnaire, Osipow and Spokane's Measure of Occupational
Strain, Depuy's General Well-being Schedule, Cohen Perceived Stress
Evaluation Questionnaire, and Pearlin's Role Satisfaction subscales.

The women who participated in this study were on the average 30.4
years old with a range of 24 to 38 years of age (Collins & Tiedje, in
press). The educational background revealed 24.2% had completed high
school and some technical training, 42.4% were college graduates, and
23.3% had attended graduate school or had a graduate degree. After
returning to work, 32.4% of the women worked 20-35 hours per week, 38.2%
worked 36-40 hours, and 29.4% worked more than 40 hours per week. When
asked how important their employment was for economic survival, 15.2%
stated it was “not important or not too important,“ 51.6% answered
“somewhat important,“ and 33.3% felt it was “very important." There
were no initial differences between the control and experimental groups
on demographic, work, or family functioning variables (Collins & Tiedje,
in press).

Collins and Tiedje (in press) reported lower levels of work strain
and higher levels of well-being at work for those mothers who had
attended the group sessions when measured at two and four months after
return to work. However, participation in the sessions did not appear
to influence marital or parental well-being or postpartum adaptation at
the two and four month data collection times. Qualitatively, the
participants were very positive about the opportunity for "norming" in
the group, and appreciated the information and role modeling provided by

the nurse facilitators.

89

A number of authors, as a result of research with new mothers and
parents during the postpartum period have recommended various nursing
interventions for these groups (Hardin & Skerrett, 1981; Kutzner &
Toussie-Weingarten, 1984; Sheehan, 1981). These interventions include
anticipatory guidance, counseling, education, and role modeling by the
professional nurse. However, these interventions were discussed in a
one-to-one nurse-client relationship rather than group interventions.
Research on the effectiveness of these interventions during the
postpartum period is lacking. Nor has research specifically looked at
interventions designed to facilitate maternal role adaptation.

In summary, the literature on interventions during the postpartum
period with new mothers (Parents) has usually given recommendations for
intervention rather than studying the effect of interventions with the
exception of two studies reporting group education and support group
results. More research is needed that documents the outcomes of nursing
interventions during the postpartum period.

Chapter Summary

In this chapter, a review of the literature has been presented
relevant to the variables in this study of maternal role adaptation and
maternal employment from historical and research perspectives. In
addition, role strain literature was reviewed as it pertained to these
variables, and interventions with mothers and parents in the postpartum
period were also examined.

Maternal role adaptation has been defined as a process whereby the
new mother achieves competence in the role and integrates the mothering
behaviors into her established role set so she is comfortable with her

identity as a mother. The endpoint of this process is the achievement

90

of maternal identity and has been observed to occur within three to ten
months after the birth of the baby. Increasingly, women with children
are returning to work during the period of time in which maternal role
adaptation is taking place, yet the relationship between maternal
employment and role adaptation has not been studied.

There are various aspects of a woman's employment situation after
the birth of her first child that can vary and thus may affect maternal
role adaptation. This study is specifically concerned with the length
of a woman's maternity leave, the number of hours that a woman works and
the level of choice about returning to employment. The literature
reveals that little research has been done to study each of these
variables in respect to maternal role adaptation. Currently the issues
being raised about maternity leave deal with the child's growth and
development and business/economic issues of maternity leave rather than
the mother's role adaptation.

Role strain has been shown to be a universal and normative
phenomenon during role transition periods. In working women, role
strain and conflict exists between employment roles and parenting roles
and has been found to impede the transition to the maternal role.
Numerous coping strategies utilized by working women have been
identified. In this study, the employment variables will be analyzed as
precursors or moderators of role strain and the subsequent effects on
maternal role adaptation. Previously this has not been reported in the
literature on role strain.

The intervention literature regarding facilitating maternal role
adaptation in working mothers is also scarce with only two research

efforts reported. Postpartum education, counseling, and anticipatory

91

guidance for working mothers has been lacking in childbirth education
programs, maternity nursing texts, and the clinical practices of
professional nurses. This may be due in part to the lack of research
with contemporary women choosing to combine employment and motherhood.
This study can contribute to this body of knowledge and provide
research-based information to guide health promotion interventions with
a growing segment of the population.

In this chapter the relevant literature pertaining to the study
variables has been reviewed. The methods for examining these variables

and the procedures used are presented in Chapter IV.

CHAPTER IV
Methodology and Procedures
Overview

This study was designed to identify and describe the relationship
between select occupational variables and maternal role adaptation
during the postpartum period for first time mothers who return to work.
Data for this study were collected as part of a grant from the American
Nurses Foundation, "Promoting Positive Well-Being in Employed Mothers,“
conducted by C. Collins and L.B. Tiedje.

The study design for the original project was a quasi-experimental,
repeated measures design with two groups of women. One group of women
was assigned to participate in a six-session, group nursing intervention
designed to promote the well-being of women returning to employment
following the birth of a first child. A second group of women served as
a control group that completed the same measures without attending the
group intervention sessions. Data were collected on both groups at
intake, two and four months after returning to work, and one year after
the birth of the baby.

In this chapter the concepts under study are operationally defined.
In addition, the criteria for selection of the original sample along
with data collection procedures, instrument selection, and human rights
protection from the original project are presented. A discussion of the

methods of statistical analysis for this study concludes this chapter.

92

93

Research Questions

This study will be directed at answering the following research
question: Is there a relationship between 1) length of maternity leave,
2) number of hours worked per week by the new mother, and 3) reasons for
working after the birth of a first baby, and the degree of maternal role
adaptation as measured at two months after return to employment?
Specifically:
I. Is there a relationship between the degree of importance placed on
financial incentives as a reason for returning to work after the birth
of a first baby and the degree of maternal role adaptation as measured
at two months after return to employment?
2. Is there a relationship between the degree of importance placed on
personal motivations as a reason for returning to work after the birth
of a first baby and the degree of maternal role adaptation as measured
at two months after return to employment?

Hypotheses

The following hypotheses are tested in this study:
1. Women who have longer maternity leaves will have a higher degree of
maternal role adaptation at two months after return to employment.
2. Women who work full-time will have lower degrees of maternal role
adaptation at two months after return to employment than women who work
part-time.

SM

In the original study, women who were interested in attending group
nursing intervention sessions were asked to call for dates and times of
group sessions. Those women who called expressing interest in the group

were entered on a contact sheet. They were then called by the one of

94

the principal investigators of the original project, and given
information about the group sessions. The individuals wishing to
participate in the study were entered into the intervention group or
control group based on whether or not the group was starting at the time
the potential participant contacted the Expectant Parent Organization.

A total of 35 control and experimental group participants were
identified for inclusion in the original study. Of these, 17 were
entered into the control group and 18 into the experimental group
subject to a six-session group intervention. Two of the control group
subjects were lost: one subject had not returned to work during the
first postpartum year and one subject was not married and not living
with the father of the baby, and therefore did not meet the study
criteria. One control group participant completed two of the measures
and requested to be dropped from the study as she was moving out of
state. The final sample was voluntary and not randomly selected.

Study Procedures

After a participant had been identified as a control group subject,
they were assigned a code number and sent a packet of information which
included the following:

1. Introductory cover letter

2. Control group consent form

3. Initial pretest questionnaire (Appendix A)

4. Postcard for notification of return to work

5. Preaddressed, stamped return envelope

Records were maintained and dates for administration of successive
questionnaires were calculated. At two and four months after the actual

return to work date, questionnaires were mailed to the control group

95

participants with a cover letter and a preaddressed, stamped return
envelope. The fourth measure was similarly mailed to the subjects at
one year after the birth of the woman's infant.

The experimental subjects participated in one of three groups that
met six times in the postpartum period, prior to the woman's return to
employment. During the first class, the participants signed a consent
form and completed the self-administered pretest questionnaire. Again,
records were maintained and dates for administration of successive
questionnaires were calculated. The two month (Appendix 8), four month,
and one year questionnaires were mailed to the participants at the
appropriate times in a manner similar to the control group participants.

The intervention for the experimental group participants consisted
of flexible sessions at the home of one of the principal investigators,
where individual concerns, discussion, and informality were considered
more important than the content for any particular session. A number of
different concerns were discussed at each session depending on group
concerns and needs.

The final sample for this study included these participants from
both the control and experimental groups. There were no significant
differences between the two groups concerning sociodemographic
variables. Nor were significant differences found between control and
experimental groups on maternal role adaptation (Collins & Tiedje, in
press). But in this study, the focus is not on assessing the effects of
the experimental intervention; rather, the primary interest lies in
correlating attributes and behavioral choices of subjects with an

outcome variable measuring maternal adaptation.

96

Timing of Data Collection

 

The level of maternal role adaptation in the original study was
measured at three distinct points after the participants returned to
employment: two and four months after the return to employment and one
year after the birth of the infant. For this study, the two month
measure was used for data analysis to evaluate maternal role adaptation
in relation to the resumption of the worker role.

Operationalization of the Study Variables
Maternal Role Adaptation

Maternal role adaptation is defined as a process occurring during
the first postpartum year in which the mother achieves competence in the
maternal role and integrates the mothering behaviors into her
established role set (Mercer, 1986a). In this study, maternal role
adaptation was measured by using scores from the subscales of the
instrument, Postpartum Self-evaluation Questionnaire (PSEQ) (Appendix
C). Two of the seven subscales were utilized: The Mother's Confidence
in her Ability to Cope with the Tasks of Motherhood; and The Mother's
Satisfaction with Motherhood and Infant Care. On each of the items in
the subscales, subjects were given five Likert-type response options
ranging from “never or almost never“ to “always or almost always." Both
positively and negatively worded statements were used on the
questionnaire to prevent response bias. Scores on the negatively stated
items were reversed. Higher scores on the subscales are indicative of
poorer maternal role adaptation.

One subscale of the PSEQ, entitled “Mother's Confidence in Her
Ability To Cope with the Tasks of Motherhood“, was operationalized as

the mother's doubts about her ability to parent, specifically as her

97

ability to interpret her infant's behaviors and to meet his or her needs
(Lederman et al., 1981). After distinguishing between confidence in
skills and satisfaction with the mother role, the subscale, “The
Mother's Satisfaction with Motherhood and Infant Care," was developed to
measure the mother's pleasure with the nurturant activities and a
relative preference for a motherhood role versus other roles (Lederman
et al., 1981). The interscale correlations of these two scales were
reported by Lederman et al., (1981) as 0.25 and 0.35 at three days and
six weeks postpartum, respectively. The other subscales of the PSEQ
deal with conceptual issues of maternal support, marital relationships,
and the delivery experience which do not help explain the relationship
between employment and maternal role adaptation within a role theory
perspective.
Validity of Postpartum Self-Evaluation Questionnaire

Validity refers to the degree to which an instrument measures what
it is intended and presumed to measure. Content validity is concerned
with adequate sampling of content. There are no objective methods to
confirm the adequacy of content coverage of an instrument. One way to
establish validity is to rely on experts to determine if items are
representative of the trait to be measured (Polit & Hungler, 1987).
Another type of validity is predictive validity. This type of validity
refers to the adequacy of an instrument in predicting some criterion to
be observed at a future time. Information on the validity of this
instrument has been requested from the authors.

Reliability of Postpartum Self-Evalugtion Questionnaire
Reliability, in the sense of internal consistency of an instrument

refers to the extent to which all items of the instrument are equally

98

good indicators of a concept or attribute in question (Polit & Hungler,
1987). A second meaning of reliability refers to reproducibility of
results: a measure is reliable to the extent that repeated application
of the instrument produces the same results. The less the scores of an
instrument are influenced by error, the greater the reliability of the
instrument. One of the most useful indices of reliability in the first
sense, internal consistency, is the Cronbach's alpha. The range of
values of the alpha coefficient is from 0.00 to 1.00 if the correlations
among the items are, on the average, positive. The higher the
coefficient, the higher the degree of internal consistency (Polit &
Hungler, 1987). Its value depends both on the size of the average
correlation among the items of the scale and the number of scale items.

In the Lederman et al. (1981) study, the reliability coefficients
of the subscales of the Postpartum Self-evaluation Questionnaire range
from .62 to .82 at three days postpartum and .73-.90 at six weeks
postpartum. In that study, reliabilities for the two subscales of
interest here, at three days and six weeks postpartum were as presented
in Table 5. Reliability coefficients for the same two subscales, and
with the present data on 35 subjects, have already been reported: The
two month measure yielded an alpha of .76 on the Satisfaction With
Motherhood subscale and .85 on the Mother's Confidence subscale
(Collins & Tiedje, in press).
Lengthiof the Maternity Leave

The length of the maternity leave is defined as the period of time
from the birth of the baby to the return of the mother to employment
outside the home. This variable was calculated in this study from a

question on the pretest asking the date of birth of the infant and the

99

Table 5. Reliability Coefficients of Specific PSEQ Subscales
(Lederman et al. 1981)

 

Subscale Name 3 daysgpp, 6 weeks pp

Mother's Confidence In Ability to .80 .74
Cope with Tasks of Motherhood

Mother's Satisfaction with Motherhood .62 .78
and Infant Care

 

actual date of return to employment obtained when a card was returned by
the participant. The length of the maternity leave was recorded in
units of weeks.

Number of Hours of Employment

 

The participants were asked on the two month measure to indicate
how many hours they worked per week. Eight categories were provided
ranging from "less than 15 hours per week" to “over 45 hours per week."
Each category of hours worked per week will be correlated with an
indicator of maternal role adaptation.

Mother's Reasons for Working

 

The mother's reasons for working are divided into two major
categories: psychological and social reasons on the one hand, and
financial reasons on the other. To measure these dimensions, seven
questions, formulated by the principal investigators, were asked on the
pretest. These items probed the importance of various reasons for
working to these first time mothers.

Conceptually, three questions of this instrument related to
financial motivations as reasons for working. They were “It is

necessary for economic survival,“ “To get more than basic necessities,"

100

and "To get ahead financially.“ The response choices ranged from "not
at all important“ to "very important.“ In the original study, the
reliability of this subscale was .65 on the pretest measure (Collins &
Tiedje, in press). An attempt was made to improve the reliability
coefficient of this subscale with deletion of the question about getting
ahead financially. These data are presented in Chapter V.

The remaining four questions of this instrument formed another
subscale that addressed various personal motivations and their
importance to the new mother as a reason for working outside of the
home. These questions were related to feelings of independence and
satisfaction, liking one's job, to get out of the house and away from
children, and to have contact with adults. Again, the response choices
ranged from “not at all important“ to “very important.“ In the original
study, the reliability of these four items was .77 when asked on the
pretest (Collins & Tiedje, in press).

Each of the reasons for working subscales were correlated separately

 

with the indicators of maternal role adaptation at two months after
return to employment in order to investigate a relationship between the
independent and dependent variables. Due to the small sample size and
the lack of variability that resulted, no attempt was made to create a
index of the variations in reasons for working between personal and
financial motivations and subsequently investigate correlations.

Extraneous Variables

 

Extraneous variables are defined as independent variables that may
influence the results of the study (Polit & Hungler, 1987). The
sociodemographic data of maternal age, educational level and occupation,

family income, length of employment in same agency, and sex of the

101

infant were obtained on the pretest measure. These items were utilized
as extraneous variables and no attempt was made to control for the
effects of these variables on maternal role adaptation; rather analysis
will be limited to a descriptive level.

Human Subjects Protection

The rights of the respondents were protected through adherence to
standard criteria set forth by the Michigan State University Committee
on Research Involving Human Subjects. Potential subjects contacted the
Principal Investigators who described the intervention and the study.

If the subject agreed to participate in either the control or
experimental groups, they were asked to sign a consent form. The
consent form provided an explanation of the research, including the
purpose of the study, the use of the results, and assurances of
anonymity and confidentiality (Appendix 0). Confidentiality and
anonymity were assured through the use of code numbers on the
instruments used for data collection and analysis.

Statistical Analysis of the Data

Data from both the control and experimental groups at two separate
data collection points were examined for this study: pretest and two
month measure. The subscales and sociodemographic data utilized for
analysis and the measure from which each were obtained are summarized in
Table 6.

Descriptive statistics were used to characterize the sample in terms
of sociodemographic attributes. Descriptive statistical analysis allows
for presentation and summary of quantitative attributes of sample subjects
(Polit & Hungler, 1987). Specifically, means, standard deviations and

ranges were reported for maternal age and length of the maternity leave.

102

Table 6. Location of Data and Subscales on Study Measures

 

Data Pretest Two Month

Hours worked X
Maternal educational level
Maternal age

Maternal occupation

Infant sex

Family income

Length of Employment Agency
Reasons for Working
Maternity leave (calculated)
Subscales of PSEQ X

XXXXXXXX

 

Hours worked, maternal age, educational level, family income,
occupation, length of employment with the same agency, and infant sex
were reported as frequency distributions. Tables summarizing the
sociodemographic and extraneous variables are presented in Chapter V.

In order to describe the respondents' scores on the scales employed
in this study, subscale means, ranges, and standard deviations were
calculated for the Reasons for Working subscales, and for indicators of
maternal role adaptation at two months postpartum. In each case,
Cronbach's alpha was used to determine the internal consistency of all
the subscales and interscale correlations were calculated to ascertain
relationships among the different concepts being measured. Reliabilities
of each of the measures were calculated on the Maternal Role Adaptation
subscales. Tables summarizing the results are reported in Chapter V.

The first hypothesis regarding the length of the maternity leave
and the level of maternal role adaptation was answered by computing a
correlation coefficient using the Pearson Product Moment (Pearson's r).

This procedure is used to describe the relationship between the

103

independent variable (measured at pre-test), length of the maternity
leave (interval variable) and the dependent variable of maternal role
adaptation (measured at post-test). The Pearson r summarizes the
magnitude and direction of a linear relationship between two variables
(Polit & Hungler, 1987). The value ranges from -1.00 to +1.00. All
correlations between -1.00 and 0.00 are indicative of negative
relationships, implying that as the score on one measure increases, the
score on the other measure decreases. Coefficients that range from 0.00
to +1.00 are indicative of positive relationships between the measures
or variables (Polit & Hungler, 1987). The higher the absolute value of
the coefficient, the stronger the relationship.

The second hypothesis concerning the number of hours worked per
week and the level of maternal role adaptation was investigated using a
one-way analysis of variance. This statistical technique is used to
test the significance of the difference between means for two or more
groups (Polit & Hungler, 1987). The one way analysis of variance was
computed to obtain a F-ratio statistic. This statistical value
contrasts variation between treatment groups with variation within
groups. If the variation between groups is large relative to variation
within groups, then the probability that the independent variable does
not affect the dependent variable is correspondingly small (Polit 8
Hungler, 1987). Eight categories of hours of work per week were
investigated in relation to the subscales of the PSEQ at two months
after return to work to compare mean scores of each of the groups with
the indicators of maternal role adaptation.

The two research questions regarding the degree of importance of

financial and personal reasons for working were correlated separately

104

with the indicators of maternal role adaptation using the Pearson r
technique. Again, no attempt was made to create a typology of reasons
for working due to the small sample size utilized for this study.

Finally, multiple linear regression was utilized in an attempt to
describe the combined simultaneous influence of the length of the
maternity leave, the number of hours of employment per week, and the
degree of importance of various reasons for working on the level of
maternal role adaptation at each of the periods of data collection.
When two or more independent variables are used to predict the magnitude
of a relationship, the index of correlation is the multiple correlation
coefficient, symbolized as "R" (Polit & Hungler, 1987). When squared,
this statistic indicates the proportion of variance in the dependent
variable accounted for by the combined simultaneous influence of the
independent variables. This is to say, R2 does not have negative values
and only shows the strength of the relationship between several
independent and a dependent variable, not the direction of a
relationship. The R2 statistic is also referred to as the coefficient
of determination (Polit & Hungler, 1987).

mm

In this chapter the methodology for this research was described and
discussed. Specifically, topics addressed were the research questions,
the sample characteristics, operational definitions of the variables
under study, study procedures, human subjects protection, and data

analysis procedures. In Chapter V an analysis of the data and findings

relevant to the research questions are presented.

CHAPTER V
Data Presentation and Analysis
Overview

A description and analysis of the sample, and an interpretation of
the research findings is discussed in this chapter. Reliability measures
of the subscales and mean scores of each are presented. Data relevant
to each of the research questions are presented to examine the
relationship between the major study variables of employment
characteristics and maternal role adaptation. The findings of this study
in relation to the findings of similar research are also interpreted.

Sample Characteristics

The sample for which data was available and analyzed for this study
consisted of 33 married women who had recently delivered their first
baby and returned to employment outside of the home. The subjects all
completed a pretest measure and a measure timed to two months after
their return to employment.
Sociodemographic Characteristics of the Sample

The sociodemographic variables addressed in this study include:
maternal age, maternal education and occupation, family income, infant
sex, and the length of employment in same agency. Frequency
distributions and percentages of these variables are presented in Table
7. The sample consisted primarily of college educated women, with a
mean age of 30.3 years (S.D.=3.4), reporting a total family income of

over $45,000 per year. The majority of the women reported employment

105

106

in a professional or managerial occupation and over half of the sample

reported at least one to five years in their current position.

Table 7. Sociodemographic Characteristics of Sample

 

Afig x=30.3 years S.D.=3.4 Range=24-38 years
MATERNAL EDUCATION—-Highest grade completed

 

Frequency Percent

 

High School graduate

1-3 years of college

Technical school graduate

College graduate 1
Some graduate school

Graduate degree

NbbbWU-P

OCCUPATION

 

Professional or managerial 72.7
Technical, sales, or administrative support 27.3

FAMILY INCOME

 

$15-19,999
$20-24,999
$25-29.999
$30-34,999
$35-39,999
540-44,999
$45-49,999
$50-54,999
$55-59,999
$60,000 +

o—u—r
O 0 O I O 0 O
AOo—i—NHHOOO

womhmwwHHH
iDOOiNU'IOiOwww
O

H
(A)

INFANT SEX

 

Male=15 (45.5%)
Female=l7 (51.5%)

LENGTH OF EMPLOYMENT IN SAME AGENCY

Less than one year 2
1-5 years 17
6-10 years 10
New job 3

uaai

WOO-fiat
I

hiuiuihi

 

107

Employment Characteristics of Sample

Two of the independent variables analyzed for this study were the
number of hours the mother worked per week and the length of the
maternity leave. The number of hours worked per week was reported on
the measure obtained two months after the return to employment and
consisted of eight categories of hours ranging from “less than 15 hours"
to "greater than 45 hours." The frequency distribution of this variable
is reported in Table 8. Of note, over 72% of the participants were
working more than 35 hours per week at two months after return to

employment.

Table 8. Weekly Hours Worked Two Months After Return to Employment

 

 

Categppy Frequency Percent
Less than 15 hrs/wk 2 6.1
15-20 hrs/wk 3 9.1
21-25 hrs/wk 2 6.1
26-30 hrs/wk 1 3.0
31-35 hrs/wk 1 3.0
36_4O hrs/wk 14 42.4
41-45 hrs/wk 8 24.2
More than 45 hrs/wk _g _§;1
33 100.0

 

The length of the postpartum maternity leave was calculated from
two questions on the pretest requesting the birthdate of the infant and
the date of return to employment. This variable is reported in
intervals of ”weeks“ in Table 9. The mean length of the maternity leave
was 16.19 weeks (S.D.=7.24) with a range of 5.71 to 39.71 weeks. One

third of the participants had returned to work at three months

108

postpartum and by six months postpartum, nearly 85% of the women had
resumed employment. The maternity leave variable is also a measure of
the infant's age at the time of the mother's return to work since it was

calculated from the infant's birth date.

Table 9. Length of the Postpartum Maternity Leave

 

 

Length of Leave Frequency Percent
0-4 weeks 0 0.0
5-8 weeks 2 6.1
9-12 weeks 9 27.2

13-16 weeks 9 27.2
17-20 weeks 5 15.2
21-24 weeks 3 9.1
25-28 weeks 3 9.1
29-32 weeks 1 3.0
33-36 weeks 0 0.0
37-40 weeks _1 3.0

33 99.9

 

The infant's age at the time of data collection for the first
measure of maternal role adaptation (two months after return to
employment) is found in Table 10. One third of the infants were three
months old at the time of their mother's return to work and at least
three-fourths of the infants were over six months of age when their
mothers returned to the work force.

The other independent variables to be investigated in this study
are the importance of financial and social reasons for working. These
variables will be discussed along with the other instrument utilized for
data collection, the PSEQ, in the next section of this chapter dealing
with the reliability of the instruments.

109

Table 10. Infant's Age At Time of Measurement of Maternal Role

 

 

Adaptation

Infant'sAgg Freguency Percent
0-1 month 0 0.0
1-2 months 2 6.1
2-3 months 9 27.2
3-4 months 9 27.2
4-5 months 5 15.2
5-6 months 3 9.1
6-7 months 3 9.1
7-8 months 1 3.0
8-9 months 0 0.0
9-10 months _1 §;Q
33 99.9

 

Reliability of Instruments

Reliability coefficients for each of the scales pertaining to the
research questions were obtained. In this section, a description of the
procedures used to determine the reliabilities and the values obtained
are reported.
Postpartum Self-Evaluation Questionnaire

The Postpartum Self-Evaluation Questionnaire (PSEQ) was used to
measure the dependent variable, maternal role adaptation. The PSEQ
consists of seven dimensions or indicators of postpartum maternal role
adaptation. The statistical procedure used to determine the internal
consistency of the subscales was Cronbach's alpha. The alpha
reliabilities of the subscales ranged from .73 to .89 at two months
following return to employment. The alpha values of all the subscales

are reported in Table 11.

110

Table 11. Coefficient AIphas--PSEQ

 

Subscale 2 Months
Confidence in Parenting .82
Satisfaction with Parenthood .74
Relationship with Spouse .89
Spouse Participation In Child Care .89
Gratification with Labor and Delivery .85
Satisfaction with Life Circumstances .73
Support from Family and Friends .78

 

The interscale correlations for the subscales of the Postpartum
Self-Evaluation Questionnaire were calculated using Pearson's r. They
range from .11 to .55 and are reported in Table 12. The interscale
correlation was .50 (P=<.01) between the Parent Satisfaction subscale
and the Confidence in Parenting subscale used in this study. This is a
moderate level of correlation between the two subscales.

Importance of Reasons for Working

Two subscales were created from seven questions on the pretest
regarding the importance of financial and personal reasons for working
after the birth of a first baby. The financial subscale was composed
of three questions and the remaining four items formed the social
reasons subscale. A Pearson r was calculated yielding an interscale
correlation of .035 between the two subscales. This is low interscale
which indicates separate dimensions or reasons for working are measured
by these items.

The internal consistency of both subscales was ascertained with
Cronbach's alpha. The alpha reliability obtained for the financial
subscale was .63 with three questions included in the analysis.

However, if the question about “getting ahead financial“ was removed

111

Table 12. Interscale Correlations of PSEQ Subscales

 

1 2 3 4 5 6 7
1) Parent 1.000
Satisfaction
2) Confidence .50** 1.000

in Parenting

3) Relationship .33 .23 1.000
with Spouse

4) Spouse .41* .50** .41 1.000
Participation

5) Satisfaction .35* .25 .40* .40* 1.000
with Life

6) Gratification .50** .22 .16 .26 .20 1.000
with L G D

7) Support from .46** .55*** .43* .11 .28 .53** 1.000
Family

 

from the subscale, the alpha could be raised to .70. The two questions
pertaining to "economic survival“ and “basic necessities“ were
considered conceptually similar to one another and for the purpose of
analysis in this study, the financial subscale consisted of two
questions and the question about “getting ahead financially“ was
omitted.

The personal reasons subscale achieved an alpha reliability of .75

with a four item format. The alpha scores could not be improved through

112

further deletions of items. The alpha reliabilities for these subscales

are reported in Table 13.

Table 13. Reasons for Working Subscales-~Alpha Coefficients

 

Subscale Alpha
Financial Reasons: .63

Economic survival
Basic necessities

Get ahead financially .70 if item deleted
Personal Reasons: .75

Independence/Satisfaction

Like job

Out of home/away from kids
Contact with adults

 

Research Questions
The hypotheses and research questions to be answered are:

Qpestion 1. Is there a relationship between the degree of

 

importance placed on financial incentives as a reason for returning to
work after the birth of a first baby and the degree of maternal role
adaptation as measured at two months after a return to employment?
Question 2. Is there a relationship between the degree of
importance placed on personal motivations as a reason for returning to
work after the birth of a first baby and the degree of maternal role
adaptation as measured at two months after a return to employment?

Hypothesis 1. Women who have longer maternity leaves will have a

 

higher degree of maternal role adaptation at two months after return to

employment.

113

Hypothesis 2. As the number of hours worked per week increases,

 

women will have lower degrees of maternal role adaptation at two months
after return to employment.

Study Results

 

In this section, the data analysis procedures used to answer the
hypotheses and research questions of this study are presented. In
addition, the degree and direction of any significant relationships
among the variables are discussed. A probability of .05 has been
chosen to indicate statistical significance for all procedures used in
data analysis.

Mean scores and standard deviations for each of the instruments and
their subscales were calculated and are presented in Table 14. The mean
scores for all the subscales of the PSEQ ranged from 1.72 to 2.11 (range
1-5). Only two of the seven subscales of the PSEQ were used for data
analysis in this study. The subscales that were omitted dealt with
conceptual issues of maternal support, marital relationships, and the
delivery experience which do not help explain the relationship between
employment and maternal role adaptation within a role theory
perspective. The Confidence in Parenting subscale mean was 2.07
(S.D.=.46) and the Satisfaction with Parenthood subscale mean was 1.95
(S.D.=.40). Lower scores on the subscales are indicative of better
maternal role adaptation.

The response options for the PSEQ subscales ranged from “never or
almost never“ (score=l) to “always or almost always" (score=5). Higher
scores on the PSEQ are indicative of poorer maternal role adaptation.

The participants in this study had achieved a fairly high degree of

114

Table 14. Mean Scores and Standard Deviations--PSEQ

 

Scale 2 Months
Confidence in Parenting 2.07
S.D.=.46
Satisfaction with Parenthood 1.95
S.D.=.40
Relationship with Spouse 2.11
S.D.=.62
Spouse Participation in Child Care 1.84
$0003.59
Gratification with Labor and Delivery 2.00
S.D.=.76
Satisfaction with Life Circumstances 2.11
S.D.=.54
Support from Family and Friends 1.72
S.D.=.46

 

maternal role adaptation by two months after return to employment as
measured by the PSEQ.

Mean scores and standard deviations for the two subscales of the
Reasons for Working instrument are included in Table 15. The four
response options ranging from a minimum of one for "not at all
important“ to a maximal score of four for "very important.“ Higher
scores were indicative of greater importance of personal or financial
reasons for working.

Hypothesis 1--Length of Maternity Leave and Maternal Role Adaptation

The first hypothesis regarding the length of the maternity leave
and the level of maternal role adaptation was tested by computing a

Pearson's r between length of maternity leave and the subscales of

115

Table 15. Mean Scores and Standard Deviations--Reasons for Working

 

Subscales
Pretest
Personal reasons 3.26 S.D.=.56
Financial reasons 2.92 S.D.=.81

 

mother's satisfaction with motherhood and mother's confidence in her
ability to cope with the tasks of motherhood. The Pearson correlation
coefficients are reported in Table 16. There were no statistically
significant relationships found between the length of the maternity
leave and subscale scores of maternal role adaptation. Although not
statistically significant, the weak correlation between the length of
the maternity leave and the Satisfaction with Parenthood was in the
hypothesized direction. That is to say, as the length of the maternity
leave increased, the satisfaction with parenthood in the new mother also
increased after returning to employment. However, no unequivocal causal
interpretation can be given for this condition. Longer maternity leave
may increase satisfaction with parenthood. However, it is just as
plausible to assume that satisfaction with parenthood may be a
determinant of the length of the maternity leave for those women who
have some options related to the amount of time they can be away from
their job and maintain a position with the same employer.

Since the maternity leave was an interval variable that ranged
from less than six weeks to over 39 weeks of leave, scatterplots were
obtained of the maternity leave variable correlated with the measure of

the maternal role adaptation to investigate for the presence of a

116

Table 16. Pearson's r For Length of the Maternity Leave and Indicators

of Maternal Role Adaptation

 

 

 

Confidence Satisfaction

2 Months 2 Months
Length of Maternity r=-.0017 r=.1535
Leave (weeks) P=.993 P=.410

 

nonlinear relationship between the variables. No significant patterns
were apparent in the score distributions of the scatterplots.
Hypothesis 2--Hours Worked per Week and Maternal Role Adaptation

A one way analysis of variance was the statistical technique used
to answer the second hypothesis about the number of hours worked per
week by the new mother and the level of maternal role adaptation. There
were eight categories of hours that were investigated with the
parenthood satisfaction and confidence in parenting subscales of the
PSEQ to test the significance of differences between mean scores on the
subscales as the hours worked per week varied. There were no
statistically significant differences between the means of the subscales
as the hours worked per week increased (Table 17). In addition, the
mean scores of each of the subscales as the hours worked per week
varied are reported in Table 18. There was no consistent pattern of
variation in the mean scores as the hours worked per week increased.
Research Question 1--Importance of Financial Reasons for Working_
and Maternal Role Adaptation

The first research question regarding a relationship between the

degree of importance of financial reasons for working and the level of

117

Table 17. Analysis of Variance in Measures of Maternal Role Adaptation

as Hours Worked Per Week Varied

 

 

Subscale F-ratio F Probability
Satisfaction with Parenthood .8102 .5872
Confidence in Parenting .5213 .8099

 

Table 18. Mean Scores of PSEQ Subscales as Hours of Employment Varied

 

 

Category Frequency Satisfaction Confidence
< 15 hours/week 2 1.88 2.31
15-20 hours/week 3 1.82 2.18
21-25 hours/week 2 2.19 2.19
26-30 hours/week 1 1.69 1.31
31-35 hours/week 1 2.23 2.00
36-40 hours/week 14 2.05 2.11
41-45 hours/week 8 1.72 1.97

> 45 hours/week 2 1.95 2.07

 

maternal role adaptation was investigated using Pearson's r correlation.
The results of this analysis are reported in Table 19. There were no
statistically significant relationships between the importance of
financial reasons for working and maternal role adaptation subscale
scores at two months after return to employment. However, both of the
subscales did have a negative correlation with the importance of
financial reasons for working. For the respondents who placed greater
importance on financial reasons for working, both satisfaction with
parenthood and confidence in parenting were somewhat lower. In addition,
the confidence in parenting subscale had a stronger negative correlation

(r=-.23) than did the satisfaction with parenthood subscale (r=-.O4).

118

Table 19. Correlation Coefficients for Reasons for Working and PSEQ

 

 

 

Subscales
Financial Reasons Personal Reasons
Satisfaction with Parenthood r=-.O4 r=.20
P=.83 P=.27
Confidence in Parenting r=-.23 r=.28
P=.20 P=.12

 

Rgsggrch Question 2--Importance of Personal Reasons for Working and
Maternal Role Adaptation

The second research question regarding a relationship between the
degree of importance of personal reasons for working and the level of
maternal role adaptation was investigated using a Pearson's r
correlation. Table 19 contains the correlation coefficients for this
investigation. There were no statistically significant relationships
between personal reasons for working and subscale scores at two months
after return to employment. Both subscales correlated in a positive
direction with the importance of personal reasons for working. For
respondents who placed greater importance on personal reasons for
working, both satisfaction with parenthood and confidence in parenting
were somewhat higher. The Confidence in Parenting subscale had a
slightly stronger correlation (r=.28) than the Satisfaction with
Parenthood subscale (r=.20).
Multiple Regression With Independent Variables

Multiple linear regression was employed to investigate the

combined simultaneous influence of the length of the maternity leave,

119

number of hours worked per week, and the degree of importance of
personal and financial reasons for working on the level of maternal role
adaptation at two months after return to employment. No significant
predictors of maternal role adaptation were found when the total PSEQ
score or the satisfaction with parenthood subscale scores were regressed
on the independent variables. The multiple linear regression of the
confidence in parenting subscale with the independent variables

resulted in 13.8% of the variation predicted by these variables.
Examination of the beta weights in this regression reveal the strongest
predictors to be the importance of personal and financial reasons for
working. The R2 values are reported in Table 20.

Other Finding;

In addition to calculating mean scores and standard deviations for
the subscales of the PSEQ, a total scale score on the PSEQ was computed.
The total PSEQ mean was 1.98 with a standard deviation of 0.36. This
mean score was in the same range as the values for the individual
subscales.

The total PSEQ score was utilized as an indicator of maternal role
adaptation to investigate a relationship between this dependent variable
and the length of the maternity leave. Consistent with the findings
obtained when the subscale scores were utilized, there was no
statistically significant relationship between these variables (r=.05,
P=.81).

Correlation coefficients were also obtained for total PSEQ scores
and financial and personal reasons for working. These values are
reported in Table 21. No statistically significant relationships were

found between these variables. The importance of financial reasons for

120

Table 20. Coefficients of Determination for Independent Variables with
PSEQ Subscales

 

Dependegt Variable: Beta:
Total PSEQ with

Independent Variables:

 

Length of Maternity Leave -.013
Number of Hours Worked per Week -.055
Personal Reasons for Working -.O71
Financial Reasons for Working -.223

R2=.059 F sig.=.778

Dependent Variable:
Satisfaction with Parenthood with

Independent Variables:

 

Length of Maternity Leave .140
Number of Hours Worked per Week .087
Personal Reasons for Working .236
Financial Reasons for Working -.O65

R2=.064 F sig.=.753

Dependent Variable:
Confidence in Parenting Abilities

Independent Variables:

 

Length of Maternity Leave .041
Number of Hours Worked per Week -.043
Personal Reasons for Working .277
Financial Reasons for Working -.239

R2=.138 F sig.=.368

 

Table 21. Correlation Coefficients for Reasons for Working and Total
PSEQ Scores

 

Financial Reasons Personal Reasons

Total PSEQ r=-.23 r=-.06
P=.20 P=.73

 

121

working continued to have a negative relationship when correlated with
the total PSEQ scores. However, the correlation between the importance
of personal reasons for working and the total PSEQ scores became
negative, albeit slight (r=-.06), when previously this correlation was
in a positive direction.

Summary of Data Presentation

 

The first research question did not produce statistically
significant relationships between the financial reasons for working
subscale and indicators of maternal role adaptation at two months after
return to employment. There was a weak, negative relationship between
financial reasons for working and the confidence in parenting subscale
of the PSEQ. The second research question produced weak, positive
relationships between the personal reasons for working subscale and both
of the PSEQ subscales at two months after return to employment although
neither reached statistical significance.

There were no significant relationships found between the length of
the maternity leave and indicators of maternal role adaptation at two
months after return to employment. Thus, the first hypothesis could not
be confirmed. The correlation between the length of the maternity leave
and the satisfaction with parenthood subscale was in the hypothesized
direction (positive). The second hypothesis was also not confirmed as
no significant relationships were found between the number of hours
worked per week and indicators of maternal role adaptation at two months
after return to employment. There also was no discernible pattern of
variation in the mean subscale scores as the hours worked per week

varied.

122

A multiple linear regression including length of the maternity
leave, number of hours worked per week, and personal and financial
reasons for working as independent variables with indicators of maternal
role adaptation revealed a small proportion of variance could be
predicted in the confidence in parenting subscale by these variables.
Similar relationships were not apparent with the satisfaction with
parenthood subscale or the total PSEQ scores.

Interpretation of Results
Sociodemographic Characteristics of Sample

The sociodemographic variables of the participants in this study
will be discussed and compared to those of subjects in related research.
The sociodemographic characteristics of importance for interpretation of
the data include: maternal age, maternal occupation, maternal
education, and family income.

Maternalqug. The range of maternal age of the participants in this

 

sample was 24 to 38 years with a mean age of 30.3 years (S.D.=3.4
years). The mean age of these primiparous women is higher than samples
utilized by other researchers (Curry, 1983: Hock et al., 1984; Jimenez &
Newton, 1982; Lederman et al., 1981; Myers-Wall, 1984; Shereshefsky &
Yarrow, 1973; Walker et al., 1986a). However, this higher age is
consistent with the current trend for delaying childbirth until age 30
or older in order to continue their education and begin a career
(O'Connell & Bloom, 1987).

Maternal Occupation. In this study, 72% of the women were employed in
professional or managerial occupations as categorized by a listing of
job titles in the Dictionary of Occupational Titles (U.S. Department of

Labor, 1977). This predominance of career women is consistent with the

123

higher mean age of the participants in this study and the national trend
of delaying childbirth to begin a career.

Maternal Education. The educational level of the participants revealed
a very homogenous group as 75% of the women were college graduates and
21% had obtained a graduate degree. Only one participant reported
completion of high school as the highest educational level obtained.
Many researchers have utilized similarly well educated samples in
maternal role adaptation research (Behrman, 1982; Curry, 1983; Gilbert
et al., 1984; Gray, 1983; Hall, 1972; Hock et al., 1984; Johnson &
Johnson, 1977; Majewski, 1986; Pickens, 1982; Shereshefsky & Yarrow,
1973; Tiedje, 1987; Walker et al., 1986). However, education was not
discussed as a confounding variable related to maternal role adaptation
except to say that women over 29 years of age who had graduated from
college, and who had attended graduate school had more adaptive
behaviors than younger mothers (Ralph, 1977).

Family Income. Over 39% of the participants in this study reported a
family income of $60,000 or more per year. This is of course well above
the national average but is consistent with the age, occupation, and
education characteristics of this sample. Only three participants
reported a family income less than $30,000 per year. Financial
motivations of the participants for working will be discussed in a later
section.

In summary, the sociodemographic profile of the participants in
this study revealed a homogenous sample related to maternal age,
occupation, education, and family income. Although widely recruited,
members of lower socioeconomic groups did not choose to participate in

this study.

124

Statement of Hypotheses and Research Qpestions
The hypotheses and research questions of this study will be
presented along with a brief review of the findings pertinent to each
question. A discussion of the findings and comparison to the research
literature will also be included.

Hypothesis 1. Women who have a longer maternity leave will have a

 

higher degree of maternal role adaptation at two months after return to
employment. No statistically significant relationships were found
between the length of the maternity leave and total scores or subscale
scores on the instrument (PSEQ) used to measure maternal role adaptation
at two months after returning to employment. This is not surprising,
given the small sample size. It is, therefore noteworthy to report that
the correlation was, at least, in the hypothesized direction.

A review of the literature failed to identify any studies on the
relationship between the length of the maternity leave and subsequent
maternal role adaptation. Hock et al. (1984) did observe a higher
quality interaction between mothers and infants in those dyads where the
mother did not return to work until at least four months after the
infant's birth. Current literature related to recommendations for the
length of the maternity leave and the return to employment is based on
personal opinions and social bias (Brazelton, 1981; Heins et al., 1983:
Kamerman et al, 1983; Zigler & Muenchow, 1983).

Another problem is the lack of variability in the total and
subscale scores on the PSEQ and may help to explain the lack of a
significant relationship between the length of the maternity leave and
maternal role adaptation. The mean score on the total PSEQ at two

months after return to employment was 1.98 reflecting a relatively high

125

level of maternal role adaptation at this time. The coefficient of
variation (standard deviation divided by the mean) was less than one,
reflecting little variation in the overall scores. Similar observations
can be made on the mean scores and standard deviations for the subscales
of Confidence in Parenting and Satisfaction with Parenthood that were
utilized for data analysis. A more heterogeneous sample may yield
different results if research is repeated. Timing the measures to the
date of the return to employment rather than two months after the
resumption of employment may also yield different results.
Theoretically, this may produce a greater variation in the scores
related to role strain that occurs as a new role is added to one's total
set of role expectations.

Another explanation for the lack of significant findings may be
that these women had progressed through most or all of the stages of
maternal role adaptation as described by Thornton and Nardi (1975) and
Rubin (1967). The length of the maternity leave is also a measure of
the age of the infant. The timing of the first measure of maternal role
adaptation was two months after returning to work. For the women in
this study, the infants ranged from 13.71 weeks to 47.71 weeks (over
three months to nearly 12 months) of age at that time. Mercer (1981)
observed that maternal role adaptation usually occurred within three to
ten months after delivery. Therefore, the women in this study may have
already progressed sufficiently through the stages to elude measurement
of major differences in role adaptation.

More research is needed to confirm or deny the existence of a
relationship between the length of the maternity leave and maternal role

adaptation in another sample of first time mothers. Although the

126

correlation between the satisfaction with parenthood subscale and
indicators of maternal role adaptation was in the hypothesized
direction, a longitudinal study is needed to determine if satisfaction
with the parenthood role results in women taking longer maternity leaves
when possible or if a longer leave results in more satisfaction with the
new role.

This research on the length of the maternity leave and indicators
of maternal role adaptation is especially important at the present time
with national interest peaking on the subject of legislating the length
of maternity/parental leaves. A woman's adaptation to her new role must
be considered in order to formulate a holistic policy.

Hypothesis 2. As the number of hours worked per week increases, women
will have lower degrees of maternal role adaptation at two months after
return to employment. There were no significant differences between the
mean scores on the PSEQ subscales as the number of hours worked per week
increased when measured at two months after a return to employment.

The number of hours that a woman works outside the home after the
birth of a first child may indicate general preferences of women. A
majority of employed mothers in the U.S. work full-time (greater than 35
hours per week) (U.S. Department of Labor, 1986) as was characteristic
of the women in this sample. Various reasons have been cited for this
pattern of employment such as loss of seniority and smaller economic
benefits with part-time work, personal or career goals, and perceived
compatibility between occupational and maternal roles (Behrman, 1982).
Moen and Dempster-McClain (1987) found that of all the women in their
study, 53% wished they could work fewer hours per week. Furthermore,

women who worked full-time and preferred to work part-time wanted to do

127

so in order to spend more time with their children (Moen & Dempster-
McClain, 1987). In the current study, desire to work less or more hours
was not measured. This may be an important variable determining the
outcome of maternal role adaptation. The number of hours worked per
week by a new mother may not affect maternal role adaptation, however,
research is lacking that confirms or denies the presence of such a
relationship.

The lack of a significant relationship between the number of hours
worked per week and the indicators of maternal role adaptation in this
study may be a result of the lack of variability in both variables.
Nearly three-fourths of the women in this study reported working more
than 35 hours per week. The lack of variability in the mean scores and
standard deviations on the total PSEQ and subscale scores has already
been discussed. More research is needed on the relationship between the
number of hours a working mother is employed per week and the effect of
increased hours of employment on maternal role adaptation with a more
heterogeneous group. Documentation certainly exists regarding the
desire of many women to work fewer hours in order to spend more time
with their children. Again the issue of measuring role adaptation at a
relatively late time in the postpartum period may have also affected the
variability in the PSEQ scores. Measurement earlier in the postpartum
period may produce different results if more role strain is being
experienced. This also assumes that maternal role adaptation is best
done sequentially (i.e. maternal adaptation first followed by employment
adaptation) rather than simultaneously.

Research Question 1. Is there a relationship between the degree of

importance placed on financial incentives as a reason for returning to

128

work after the birth of a first baby and the degree of maternal role
adaptation as measured at two months after a return to employment?
There were no significant relationships between the importance of
financial reasons for working and maternal role adaptation total or
subscale scores at two months after a return to employment although the
correlations were consistently in a negative direction.

The literature pertaining to reasons for working, consistently
supports the importance of financial reasons as the major motivation for
women returning to work after childbirth (Behrman, 1982; Hoffman, 1979;
Mercer, 1981). It should also be noted that it has been more socially
acceptable for women to cite “financial need" as a reason for returning
to employment. It is unclear how women define “financial need“ and
dimensions of this variable need to be defined in future research.
Studies that have investigated a possible relationship between financial
motivations for working after childbirth and maternal role adaptation
were not identified in the current literature.

The negative correlation between the importance of financial
reasons for working and indicators of maternal role adaptation is
better understood after reviewing the subscale items. The Satisfaction
with Parenthood subscale contains items relating to feeling overburdened
with all the demands made on the mother, too many responsibilities
overall, and dissatisfaction with the amount of time available for other
activities. As the new mother feels a greater financial burden and more
need to work for financial reasons, satisfaction with the parenthood
role may decrease related to feeling overburdened, dissatisfied, and

having too many responsibilities in all the roles assumed.

129

The Confidence in Parenting subscale correlated more strongly in a
negative direction with the financial reasons for working subscale.

Some of the items on the confidence subscale relate to doubts about
being a good mother, wanting to be a better mother, and not giving
enough attention to the baby. The women who feel obligated to work for
financial reasons (and possibly not for personal reasons) may have a
more traditional attitude that women with babies should not work, thus
casting doubt on their ability to be good mothers. Johnson and Johnson
(1977) observed that guilt and anxiety over perceived failures are the
greatest problem for working mothers. This may be reflected in some of
the items of this confidence in parenthood subscale.

A possible explanation for the lack of a significant relationship
identified in this study between financial motivations and maternal role
adaptation, aside from the small sample size, may be the homogeneous
nature of the group of women in this study. The mean score of 2.92
(S.D.=.81) indicated that most of these women felt working for “economic
survival“ or to be able to purchase “nice things“ was at least “somewhat
important." Another explanation may be the interrelationship of
confounding factors that were not identified and investigated in this
study, such as the percent of the total family income produced by the
woman and financial benefits (i.e., health insurance) associated with
the woman's employment.

More research is needed to further investigate the nature of a
relationship between the financial motivations for employment and
maternal role adaptation. The use of a larger sample and a more
heterogeneous group, especially in terms of socioeconomic status, may

enhance research efforts.

130

Research Qpestion 2. Is there a relationship between the degree of
importance placed on personal motivations as a reason for returning to
work after the birth of a first baby and the degree of maternal role
adaptation as measured at two months after a return to employment? The
correlations between personal reasons for working and the Satisfaction
with Parenthood subscale and the Confidence in Parenting subscales were
low and positive but did not reach levels of statistical significance.

An explanation for the correlation in a positive direction between
these variables may be related to some of the characteristics of the
participants in this study: older, well educated women in professional
or managerial positions. These women are more likely to be self-
confident, independent, and satisfied with their career role. This in
turn, may affect their confidence in their mothering abilities
(especially decision- making abilities of which there are at least three
items on this subscale) and their satisfaction with the motherhood role.

Majewski (1986) investigated the relationship between employment
role attitude, or the extent to which an individual reported contentment
or being pleased with her occupation, and the ease of maternal role
transition. No significant correlations were observed between these two
variables in Majewski's (1986) study. (Tables were not available with
data from this analysis to determine the nature of any correlation.)
However, Jimenez and Newton (1982) found that a positive commitment to
work was correlated with a more positive adjustment to a first pregnancy
and early motherhood.

The findings of Jimenez and Newton (1982) related to a more
positive adjustment to early motherhood in women with a positive work

commitment may be particularly relevant to the overall lack of

131

statistically significant findings in this study. As a whole, these
women had a very positive commitment to work and thus may have
progressed through the stages of role adaptation before the PSEQ
instrument was administered. The findings of this study also suggest
that positive maternal role adaptation is possible in working mothers.
Documentation of what are “good“ or “poor“ adaptation scores on the PSEQ
related to the stages of role adaptation has not been determined and are
needed to help identify those mothers experiencing difficulty in role
adaptation.

Multiple Linear Regression Analysis. An investigation of the

 

simultaneous influence of the length of the maternity leave, the number
of hours worked per week, and the degree of importance of personal and
financial reasons for working on the level of maternal role adaptation
failed to identify any significant predictors of adaptation at two
months after return to employment related to the dependent variables of
the total PSEQ scores and the Satisfaction with Parenthood subscale. A
small proportion of variance (13.8%) in the Confidence in Parenting was
explained by the independent variables, with the Personal Reasons for
Working variable having the largest Beta weight in this regression. The
possible explanation for this relationship was previously discussed in
regard to the second research question.

Mercer (1982) found that 38% of the variance in maternal role
adaptation in her study could be predicted by a cluster of variables:
self concept, maternal child-rearing attitudes, negative (bad life
events) stress, and infant-related stress with educational level,
ethnicity, and marital status controlled. It should be noted variables

other than those under investigation in this study were utilized in

132

Mercer's (1982) study. In addition, Mercer (1982) used different
measures of maternal role adaptation. Future attempts to explain
variance in maternal role adaptation should include more variables such
as those used by Mercer and the variables under investigation in this
study.

Summary of Findingg

In sum, there were no statistically significant relationships
identified in this study between 1) length of the maternity leave, 2)
number of hours worked per week, and 3) the importance of financial or
personal reasons for working and the level of maternal role adaptation.
The sociodemographic profile of the sample revealed a homogeneous group
of women participating in this study and very little variability was
observed in total and subscale scores on the instrument used to measure
the level of maternal role adaptation in the postpartum period, and in
the importance of financial or personal reasons for working in this
study sample. Weak, positive relationships were identified between
personal reasons for working and subscales of the PSEQ. Weak, negative
relationships were identified between financial reasons for working and
subscales of the PSEQ.

The research literature related to the hypotheses and research
questions of this study is scarce, indicating a lack of investigation by
other researchers into issues of maternal employment characteristics and
maternal role adaptation.

A description and analysis of the sample, and an interpretation of
the research findings has been discussed in this chapter. Reliability
measures and mean scores of the subscales were presented as well as data

relevant to each of the research questions. An interpretation of the

133

findings of this study in relation to the findings of similar research
was also discussed. Implications for future research along with a
nursing framework for assessment and interventions with working mothers

in primary care settings will be discussed in Chapter VI.

CHAPTER VI
Summary and Conclusions
W

A correlational study was conducted to identify and describe the
relationship between select employmEnt variables and maternal role
adaptation during the postpartum period for first time mothers who
return to work. Data for this study had been collected as part of a
grant from the American Nurses' Foundation, ”Promoting Positive Well-
Being in Employed Mothers,“ conducted by C. Collins, PhD, and L.B.
Tiedje, PhD.

Select aspects of role theory were used to guide the investigation.
The concept of role strain as conceived of by Goode (1960) and the
stages of maternal role adaptation occurring in new mothers during the
postpartum period as formulated by Thornton and Nardi (1975) were
utilized. The research questions and hypotheses were generated from
these role theory frameworks.

The thirty-three participants were first time mothers who
completed one measure prior to returning to work and the a second
measure of indicators of maternal role adaptation timed at two months
after their return to work. There were no statistically significant
findings indicative of a relationship between the length of the
maternity leave, the number of hours worked per week, personal and

financial reasons for working and the level of maternal role adaptation.

134

135

Although conclusive findings did not result from this
investigation, trends in the data were observed. Weak, positive
relationships were identified between the importance of personal reasons
for working and subscales of the PSEQ. Weak, negative relationships
were identified between the importance of financial reasons for working
and subscales of the PSEQ. These trends can provide guidance for future
research on the relationship between employment and maternal role
adaptation.

The research literature related to the hypotheses and research
questions of this study is scarce. Implications for future research
will be presented in this chapter. In addition, a nursing framework for
assessment of and interventions with first time mothers returning to
work will be discussed. Implications for the Clinical Nurse Specialist
in primary care settings will be identified from this nursing framework.

Recommendations for Further Research

A number of recommendations for future research can be suggested
based on this study. The recommendations are based on the limitations
suggested in interpreting the findings of this research as well as the
lack of research previously done on maternal role adaptation. Use of
the role theory perspective for further inquiries will also be presented.

A methodological limitation of this study was the small sample size
available for data analysis. There were too few participants to allow
for much variation in the scores on the instruments and subscales. As a
result, statistically significant findings were not observed. Future
research on the relationships between select employment variables and

maternal role adaptation should have a sample of about 100 or more women.

136

Another limitation in this research effort was the homogenous
sample that was obtained in relation to the educational level,
occupational position, and socioeconomic status of the participants.
Greater effort must be made to include women with lower family incomes,
less education, and other than professional or managerial employment
positions. It may have been possible for those participating in this
research to buy household and childcare assistance to reduce total role
responsibilities and thus reduce role strain.

An additional methodological concern in this research was the
timing of the measure to two months after the return to employment.
Future efforts should consider administration of the maternal role
adaptation measure nearer the date of return to work. Two months after
a return to employment may have allowed time for renegotiation or
reorganization of role responsibilities in an attempt to lessen role
strain. A measure timed to the date of return to employment or one to
two weeks after resuming the worker role, may produce more variation in
the indicators of maternal role adaptation.

More data should also be collected on how the length of the
maternity leave was determined (i.e. personal choice versus company
dictated policy). This could provide more information for the financial
and personal reasons for working variable.

The scarcity of maternal role adaptation research related to
occupational characteristics of the mother has previously been noted.
Current legislative efforts aimed at mandating maternity and parental
leave benefits in the United States lack a strong research foundation
upon which to base recomnendations. The reconInendations of social and

political forces are based on personal opinions, social bias', and child

137

development research. Studies on the effect of the length of maternity
leave on maternal role adaptation have not been reported. Federally
funded grants should be sought to study maternity/paternity leave with
worker productivity as the dependent or outcome variable.

Similarly, research on full-time versus part-time employment in
working mothers is also lacking except to document personal preferences.
No research has been attempted to longitudinally document the effects of
varying work hours on maternal role adaptation. This is especially
important as the profiles of women working in the United States have
changed so rapidly in the last ten years.

Finally, more experimental research is needed on nursing
interventions designed to facilitate maternal role adaptation in working
women. Documentation exists of strong support from working mothers who
have benefited from attendance in postpartum support groups (Collins &
Tiedje, in press). Only one study has been reported that evaluated the
effectiveness of a nurse-facilitated postpartum support group designed
to enhance well-being in working mothers (Collins & Tiedje, in press).

Aspects of role theory were chosen to guide this study that
focused on the role strain present when multiple roles were assumed by
the new mother. This framework was adequate to explain the presence of
role strain when considering the resumption of the worker role for new
mothers. In retrospect, redefining role strain to include both positive
(rewards and satisfactions) and negative outcomes may provide a more
balanced perspective. Measures of personal strain/well-being may
provide more detailed information about the various types of role strain

present when a new mother returns to work.

138

Furthermore, role expectations were not measured in this study
within the role theory framework. Role expectations were defined as the
duties, obligations, rights, and privileges of any occupant of a role
(Sarbin & Allen, 1968). Social and psychological adjustment followed by
adaptation to a role were described as the reactions to role
expectations. To better understand variations in adaptation when
multiple roles are assumed, a measure of perceived role expectations
should be included in future research. When role expectations are
measured, specific causes of role strain can be ascertained and better
guide interventions with working mothers or dual-career families.

To summarize, many suggestions for methodological changes have been
proposed to improve the quality of research efforts on maternal role
adaptation. Research on maternal role adaptation and maternal
employment characteristics in general is also lacking and deserves more
study. Recommendations for future research within an enhanced role
theory perspective were given. In the next section of this chapter a
conceptual framework will be presented as a basis for nursing assessment
and interventions with working mothers to facilitate maternal role
adaptation. I

Conceptual Framework for Nursing Assessment and Interventions

Although select aspects of role theory were used to generate
hypotheses and research questions for this study, inadequate guidance
for assessment and interventions is provided by this framework alone. A
framework that is specific to the nursing process and the nursing
perspective is better suited to guide nursing endeavors with clients.

Sister Callista Roy's (1981, 1984, 1986) nursing theory, "An Adaptation

139

Model,” will be presented to serve as a guide for nursing assessment and
interventions with working mothers.

In Roy's (1986) model the focus is on the individual, who is viewed
as an adaptive system, and on stimuli from the environment acting on
this individual to affect the level of adaptation. The goal of Nursing,
according to Roy, is to promote adaptation. It is this concept of
adaptation which links the person and nursing (Fitzpatrick & Whall,
1983).

According to Roy (1981), adaptation is a response to the
environment that results in survival. Adaptation is a process that
consists of the adaptive system, the individual, responding to the
external (environmental) stimuli and the internal (self) stimuli. These
stimuli are mediated by focal, contextual, and residual stimuli which
together form the adaptation level of the individual. These stimuli lead
to activation of the coping mechanisms and produce the outcomes of
either adaptive or ineffective responses (Figure 3).

A person's ability to respond positively, or to adapt, depends on
the degree of change taking place and the state of the person coping
with the change. Nurses aim to increase the adaptive responses and
decrease ineffective responses thus promoting adaptation (Roy, 1984).

In this study, the focus of nurses would be the mother, and she becomes
known as the adaptive system in the Roy (1986) model.

According to Roy there are three classes of stimuli which provide
input to the adaptive person and form their adaptation level. These are
focal, contextual, and residual stimuli. The fgggl stimuli are those

which are confronting the person immediately. The contextual stimuli

 

are all other environmental influences. Finally, the residual stimuli

140

«NS! u>.hadn<

co..m.amu< m.om .eccmpmz use .meo: co....aee<

'
‘

 

 

 

 

0.0...0 .000.....o.0

0:0 .23....

6.300.... 0.0..
00:00.3 .0. .302:

4m>m4 u>.hs<o<

V

 

 

000....000
.0030 .o no.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

m.>om .m o.:m.m

 

Imhw>m k w>.....<n<

 

 

 

 

 

 

 

0.3. .0008 0033000033. 0350... 9.3.2..
32.0 0.0000:
00.0 0 0033.00.33. 0.0. .3
. . I .o 02.00.093.00: .350... .00....
2500.3 .3090 0.0-00:
0000. 3.00202230:
0.00. 0.53.5 44:032.
I 0.00 .00.... 8:020:00:
"00.3000: .0 00.00 0.000: 0:...00. 0 .233 _
. 0.050 0..
253.1 .0003 02.0.30 0.0.. fldgmgm :02. .0 25.2.3.0:
>530: .330 3
>330 00.3 .0...
0. .33....30: 00.28000 .3. 5.! 00.30.0000:
I 00. .. 3.. .2. 2.... 0...... 153.5
alga, 8090' # II a u chug bl
0900050 0350 230.33! b i 2.00. i
.02. 0.3.00: T 0.1.0.0... .0 52.0.7 3:33
800.00 .30. 8.3.500: :30. .0 05.23.. 45.0.0th
.0003 300083.30 0.0.2.3338: .
0.0.. 00.3.3.0..0000.
fin 30.0.08 .3300. 30.02... 0.2.0030..-
333.5 a<ahxu§o
o. .3833.
cos-.303 00.0.00... 0.... :00) o. 2.53..
2500.3 .00. .0. .302 33.1.5 .300.
000.. ”0.3! 0,-3.0»:
9 .
9.250002 0.002050 .0 .300 .v m...0...zu>..u...z.
.x=0¢:z iv .;=0¢:z azaucaz .:=0¢:z
5000mm". » L -
7 If

141

are beliefs, attitudes, and experiences which have an indeterminate
effect on the present situation (Roy, 1984).

In this study, the fggql stimulus is the event which most attracts
the mother's attention. This stimulus is judged to have the strongest
effect on the person and has also been referred to as a stressor (Roy,
1981). The return to work after the birth of a baby is the focal
stimulus for the new mother who may still be in the process of adapting
to the mothering role (Figure 3). Learning how to manage the role
responsibilities of a job/career in addition to the duties she has
assumed as a mother will command her attention and consume most of her
energy.

The contextual stimuli are the other environmental influences that
contribute to the effect of the focal stimulus (Figure 3). They can be
present either from within or without, but are not the center of
attention or focus of one's energy expenditure. These factors will
however, influence how the individual will deal with the focal stimulus
(Roy, 1986). The mother who is returning to work may have a decision to
make about when to return to work after the birth of her child. Will
her maternity leave be six weeks, three months or even six months in
duration? A second decision may be how many hours per week to work.
Will she work part-time or full-time?

Impacting on both of these decisions is the economic status of the
family and whether the mother needs to return to work for the income
gained through her employment. Is the income necessary for the economic
survival of the family or is it to enhance the financial situation of

the family? Is she desirous of a job outside of the home to satisfy a

142

personal need? The personal need could be a feeling of independence,
self-satisfaction, socialization, or career advancement.

Yet another contextual stimuli will be the support the mother will
receive from her partner, relatives, and friends when she returns to
work. Will she be responsible for all the child care activities and
household tasks as well as her occupational responsibilities? Will her
partner be available to feed and bathe the baby, get up with the baby at
night, do the shopping, and clean their home?

The residual stimuli are another group of factors whose effect is
not always apparent or measurable. They are only possible influences on
the situation (Roy, 1986). In the mother returning to work, a residual
stimulus may be her beliefs about what constitutes an “ideal mother“ or
whether mothers should work outside the home after having a baby.
Another group of residual stimuli might be the mother's feelings about
her job/career. Is her career equally or even more important than the
mothering role to her? How much is she willing to "sacrifice" of her
career for her new baby (Figure 3)?

These three classes of stimuli which form the mother's environment
are constantly changing and the significance of any stimulus can change.
What is focal at one time may become contextual and later even slip far
enough into the background to become residual (Roy, 1986). Whatever
category the stimuli fall into, they pool to form the adaptation level
of the mother.

Roy's (1986) model of adaptation also describes two internal
processes of the person known as the regulator and the cognato . These
mechanisms for c0ping receive input from the environment and from

changes in the person's internal state and produce responses. The

143

responses are carried out through the effectors. The four effectors are
the physiolpgic, self-concept, role function, and interdependence modes
(Roy, 1986). It is through these categories that responses of the
individual can be carried out and the adaptation level can be observed.

The physiological mode is associated with the way a person

 

physically responds to stimuli from the environment. Stimuli activate
the coping mechanisms which in turn produce physiologic behaviors. The
five basic needs are oxygenation, nutrition, elimination, activity and
rest, and protection (Roy, 1986). The working mother will need to meet
these basic physiological needs in order for adaptive status to be
achieved. The degree to which these physiologic needs were being met
was not measured in this study.

The self-concept mode is one of three psychosocial modes of
functioning in this model. The self-concept mode is the manifestation
of behavior and the level of adaptation relative to a person's beliefs
and feelings about one's self at a given time. The self-concept mode is
viewed as having two subareas: the physical self and the personal self.
One component of the personal self is the self-ideal and this relates to
what one would like to be or is capable of doing (Roy, 1986). For the
new mother, the self-ideal may relate to being a good mother and having
confidence in her abilities to understand her baby's needs and provide
for her infant adequately (Figure 3).

The role function mode consists of the performance of duties based
on positions in society and is the mediator between the internal and
external worlds of the person. The goal of this mode is social
integrity: the need to know who one is so that one can act (Roy, 1986).

The mother will have the developmental tasks of her age group to achieve

144

and also the need to attain the basic skills to carry out her maternal
role such as infant care skills (Figure 3). The developmental tasks of
this age group would be such things as learning to be interdependent
with partner, assisting the child to gradually become independent,
building and maintaining a mutually satisfying marriage relationship,
learning to be a competent wife, and becoming a good parent (Duvall,
1977). In addition, the return to employment adds role responsibilities
associated with the worker role.

The interdependence mode is concerned with one's relations with
significant others and is the mode in which affectional needs are met.
The relationships in this mode differ from those in the role function
mode in that they serve the purpose of providing nurturing relationships
for personal growth (Roy, 1984). The mother will have a need for
affection from her significant others: partner, mother, father, and
baby. The mother's support systems, such as colleagues at work,
relatives, and friends will form another group that can provide love and
respect, although it usually would be in a less intense form (Figure 3).
This mode, although important to the overall adaptation process, was not
investigated in this study.

In the new mother who is in the process of adapting to the
maternal role and then returns to work, there are many changes taking
place at one time. The potential exists for many ineffective responses
or behaviors to be present which would make it difficult for her to meet
all of her role obligations, thus disrupting the process of goal
achievement. This may result in inadequate functioning in one or more
adaptive modes and would lead to less effective adaptation to the

maternal role.

145

Adaptive responses of individuals are those responses that

promote the integrity of the person in terms of the goals of survival,
growth, reproduction and mastery. These responses act as feedback or
further input into the system, allowing the person to decide whether to
increase or decrease efforts to cope with the stimuli. In this study,
the healthy adaptive response is adaptation to and internalization of
the maternal role by the mother. The healthy adaptive response would be
observed in the working mother who demonstrates adaptive behaviors in
the role function, interdependence and self-concept modes.

Roy's Adaptation Model (1986) states that nursing intervention
begins with an assessment of the behavior in each of the four adaptive
modes: physiologic, self-concept, role function, and interdependence.
The nursing assessment is then focused on determining the focal,
contextual, and residual stimuli contributing to each behavior (Figure
3).

Nursing intervention is aimed at managing the person's internal and
external stimuli configuration by removing, increasing, decreasing, or
altering the focal, contextual, and residual stimuli. The outcomes are
evaluated and modifications made as necessary (Roy, 1984).

In summary, the adaptive system in this model is the mother who is
returning to employment after the birth of her baby. There are numerous
stimuli called the focal, contextual, and residual stimuli which
activate the mother's coping mechanisms resulting in adaptive behaviors.
These adaptive behaviors are carried out in four categories known as the
physiologic, self-concept, role function, and interdependence modes.

The outcomes of the adaptive modes in this study are either the healthy

adaptive response, the adaptation to the maternal role, or an

146

ineffective adaptation to the maternal role secondary to role strain
(Roy, 1984, 1986).

Nursing intervention begins with assessment of the adaptation level
and the adaptive modes. Interventions are aimed at managing the
mother's adaptation level stimuli. The outcomes of the intervention are
evaluated and modifications made if the healthy adaptive response of
maternal role adaptation has not been achieved (Roy, 1984, 1986). In
the next section of this chapter nursing implications based on Roy's
(1986) Adaptation Model and the research findings of this study will be
presented.

Implications for Nursing Interventions

This section of the chapter will describe the implications for
nursing practice based on the research findings of this study focusing
on the role of the Clinical Nurse Specialist in a primary care setting.
Based on the literature, in general, nursing interventions during the
postpartum period with new mothers are lacking. However, opportunities
for intervention are certainly not lacking.

The Clinical Nurse Specialist (CNS) in certain primary care
settings would have the opportunity to begin assessment and
interventions during the prenatal period as contact is made by working
women for prenatal care. Anticipatory guidance for potential
problematic situations (eg. finding childcare, delegating tasks) should
be provided to working women who plan to return to employment after
delivery.

Although conclusive findings were not found in this study, the
conceptual framework suggests the potential for role strain exists in

those women attempting to combine the wife, mother, and worker roles.

147

Prenatal counseling about the length of the maternity leave should be
based on the time needed for physiological healing after delivery as
well as the time needed to learn the skills associated with the maternal
role which will vary with the individual's past experiences with child
care activities.

Anticipatory guidance should also be provided to working women
about the number of hours they will work per week after delivery.
Again, conclusive findings about the number of hours worked per week and
the effect on maternal role adaptation are lacking. It is suggested by
role theory that the potential for role overload and strain exists as
the total number of role responsibilities increases. Documentation of
women's preferences for working fewer hours per week in order to spend
more time with their children does exist (Moen & Dempster-McClain, 1987)
and these findings can be presented for discussion with the client.

Postpartum assessment by the CNS of first time mothers planning to
return to employment can be based on the framework suggested by Roy
(1986). Initial assessment by the CNS begins with the four adaptive
modes of the new mother. Physical examination can be used to assess the
status of the physiological mode related to the nutritional,
elimination, and activity and rest patterns of the mother. The role
function mode would include an assessment of the new mother's
perceptions of her ability to meet her role demands. Observations of
mother-child interactions would provide an assessment of the level of
mother-infant attachment and the mother's ability to perform childcare
activities.

The self-concept mode may also be assessed through observation of

the mother's ability to care for her infant and the congruence of this

148

assessment with the mother's stated confidence in performing various
tasks. The interdependence mode can be evaluated through observations
of the new family unit for evidence of developing nurturing
relationships. The mother's perception of adequate support from family,
friends, and her spouse would be an indicator of a satisfactory response
in the interdependence mode.

If effective responses by the new mother are observed in all of the
adaptive modes, the nursing assessment would be that of a healthy
adaptive response. In this study, the healthy adaptive response is
adaptation to and internalization of the maternal role by the new mother
who has returned to employment. If a healthy adaptive response is not
observed, a second level of assessment by the CNS must be initiated.

The second level of assessment according to Roy's (1986) model
involves evaluation of the focal, contextual, and residual stimuli
contributing to the behaviors exhibited in the four adaptive modes. The
CNS through interviews with the working mother can determine if the
return to employment has become the focal stimulus triggering
maladaptive responses. Questions about the woman's employment situation
can provide information on the contextual stimuli and whether such
factors as the hours worked per week, the financial status of the
family, and the length of the maternity leave are contributing to
strain. Although not confirmed in this study as impacting on maternal
role adaptation, theory does suggest a relationship between these
variables and maternal adaptation behaviors.

Finally, evaluation of feelings or beliefs in the working woman
about more traditional motherhood behaviors may identify residual

stimuli that are impacting on the adaptive mode behaviors of the working

149

mother. Assessment of personal reasons for working such as feelings of
independence and satisfaction derived from employment may be additional
residual stimuli that affect the adaptive modes.

Nursing interventions with the working mother begin after an
assessment of the adaptive modes and the environmental stimuli
confronting the woman has been completed. The nursing interventions are
designed to help the working mother manipulate environmental stimuli in
both home and work roles in order to reduce strain and promote
adaptation.

Specific interventions with working mothers would be derived based
on theory and advanced clinical judgment of individual situations.
Role-playing with the working mother to enhance role negotiation and
role bargaining skills may be indicated for the woman who does not
perceive adequate support from her spouse or co-workers. Time and
stress management strategies may be indicated if a working mother is
experiencing role overload and cannot decrease the number of hours spent
in her home and work roles.

The findings of this study revealed a negative correlation between
the importance of financial reasons for working and both satisfaction
with parenthood and confidence in parenting. On the other hand, those
women who place greater importance on personal reasons for working had
somewhat higher levels of satisfaction and confidence. For those women
who report a need to work out of economic necessity rather than for
personal reasons, the CNS in anticipation of lower levels of
satisfaction and confidence may initiate discussion with the working
mother related to these areas of adaptation. The CNS would allow the

working mother to express and explore any concerns or problems in a non-

150

judgmental atmosphere. Facilitation of problem-solving through helping
the mother identify and describe problems, generate possible solutions,
evaluate all the possible outcomes, and determine the alternatives to be
implemented is a major intervention for the CNS in this situation.

Strategies to manipulate the environmental stimuli of the working
mother would be designed, implemented, and reassessment of the adaptive
response would determine the need for further intervention. If the
healthy adaptive response, maternal role adaptation, is observed the
goals of the nursing intervention have been achieved. If maladaptive
responses are observed, alternative management strategies are designed
and implemented until maternal role adaptation has been facilitated.

To summarize, nursing interventions with working mothers begin in
the early prenatal period with anticipatory guidance for potentially
problematic situations in the postpartum period. Postpartum
interventions begin with an assessment of the adaptive mode behaviors to
determine the level of maternal role adaptation achieved. If
maladaptation is observed, further assessment and manipulation of the
environmental stimuli is indicated until a more healthy adaptive
response is observed in the working mother. Interventions could
include anticipatory guidance, role playing, counseling sessions, and
time and stress management techniques. Areas that should be addressed
with women through pregnancy and the postpartum period have been
summarized in Table 22. Examples of questions are included that would
allow nurses to assess the stimuli confronting women and the resources

available.

151

Table 22. Nursing Assessment of Working Women Through Pregnancy and

Postpartum

 

EartytPregnancy
Occupational Safety
“Tell me about your job and describe a usual day."

Postpartum Return to Work
”What are your plans for working after the baby comes?“
“What arrangements have you made for childcare?“

Late Pregnancy
Maternity leave
”How long will you continue to work?“
"What are your expectations about returning to work?“
"What are agency policies for maternity leave and do
you have any choice in the matter?“

Breastfeeding
“Are you planning to breastfeed your baby?“

“What are your plans for breastfeeding after going back
to work?”

Childcare
“What arrangements have you made for childcare?"
“What are your expectations for a care provider?“

Partner and family support

“What are the feelings of significant others about your
decisions to go back to work?“

Early Postpartum (delivery to two weeks postpartum)
General adaptation
“How are you managing?“
“Are your expectations being met?“

Childcare

“What arrangements have you made for childcare after
your return to work?“

Six Weeks Postpartum
Maternity leave
“What are your plans for returning to work?“
"What are the expectations of significant others
related to your return to work?“

Childcare

"How are arrangements for childcare progressing?“
“What problems do you anticipate?“

152

Table 22 (cont'd).

After Return to Employment and Throgghout First Postpartum Year
General adaptation
“How are you managing?“
“How are things at home? at work?"
“Is there anything you want to do differently?”
“What is (has been) most troublesome for you?“

Childcare
"How are your childcare arrangements working out?"

Breastfeeding (if appropriate)
"How is breastfeeding going? Any problems/concerns?“

 

Clinical Nurse Specialist Education and Practice

Various role characteristics of the CNS in primary care have been
identified. The role characteristics that may be most important to the
CNS engaged in maternal role adaptation research or clinical practice
will be described.

The CNS in an assessor role has been highlighted throughout the
assessment process with the working mother. Continued assessment of
progress made toward healthy maternal role adaptation will be necessary
throughout the intervention phase of the client-CNS relationship.

As a clinician, the CNS formulates the nursing diagnosis when an
adaptation problem is identified and formulates the nursing
interventions based on theory and advanced clinical judgment, promoting
client participation in modifying the environmental stimuli to reduce
strain. The counselor and educator roles of the CNS are highlighted as
the client is assisted to identify those contextual stimuli presenting
the most difficulties. As a pquqg; and collaborator, strategies would

be designed in conjunction with the working mother to reduce the strain

153

experienced as increased role responsibilities are encountered with the
resumption of the worker role.

The CNS as an advocate, leader, and consultant with expertise in
the area of maternal employment issues may be involved in formulating
legislative policy for maternity/parental leave by providing expert

testimony to legislators. The researcher role for the CNS would involve

 

further investigation into the effects of employment on maternal role
adaptation. Until the time that more evidence is available, the CNS may
also serve as a role model to clients attempting to combine many roles
simultaneously.

Expanded roles for nurses in primary care settings are becoming
more prevalent. Extended contact with the new mother and family unit
exists as comprehensive and continuous care is provided in this setting.
As a result,iin the educational preparation of Clinical Nurse
Specialists the trend for increasing numbers of mothers with young
children in the work force must be considered. While most advanced
nursing education programs address normal pregnancy and prenatal
preparation of the new mother, little attention has been given to
postpartum adaptation especially in regard to employment considerationsI.

, The CNS must be prepared to provide anticipatory guidance for women
considering a resumption of employment and have a repertoire of stress
and time management techniques. The CNS should also be knowledgeable
about issues and concerns of working mothers and be prepared to function
as a facilitator of group sessions with working mothers as the situation
warrants. J

The CNS whose focus is on families should be prepared with family

interventions designed to support the dual worker/career lifestyle.

154

From a research and theory based perspective, the nurse prepared at the
graduate level should understand the implications for potential family
and individual health problems as a result of the multiple roles
lifestyle. The CNS must be aware that the manifestations of
mothering/parenting difficulties may be subtle and identified only after
a thorough and focused assessment of the family unit. This type of
assessment is beyond the scope of the medical model of practice that is
focused on disease recognition and treatment. This assessment is also
beyond basic nursing educational programs.

In summary, a number of role characteristics of the CNS have been
identified that are pertinent to primary care practice and facilitation
of maternal role adaptation. These include assessor, clinician,
planner, collaborator, educator, counselor, researcher, leader,
advocate, consultant, and role model. In addition, the educational
preparation of the CNS should include advanced knowledge and skills for
assessment and interventions with working mothers and dual worker/career
families in support of the changing work force trends in the United
States today.

ML!

Aspects of role theory were used to generate hypotheses and
research questions to guide this correlational study to identify and
describe the relationships between employment characteristics and
maternal role adaptation in first time mothers who returned to work.
Literature support and previous research on the existence of such
relationships is lacking. Thirty-three primiparous women completed one

measure prior to returning to work and a second measure of indicators of

155

maternal role adaptation timed at two months after a return to
employment.

The length of the maternity leave and the number of hours worked
per week after the return to employment were hypothesized to have an
effect on the maternal role adaptation of the new mother. Although
there was no evidence to support these hypotheses in this study,
methodological problems may have been a contributor. Therefore, these
variables should not be abandoned as assessment and intervention with
new mothers occurs.

Importance of personal and financial reasons for working
were found to have weak although not statistically significant
relationships with indicators of maternal role adaptation related to
confidence in parenting and satisfaction with parenthood. The
importance of personal reasons for working correlated positively with
the subscales while the importance of financial reasons for working were
negatively correlated with the same subscales.

Roy's (1986) model of adaptation provided the framework for
assessment of behaviors of the working mother in four modes: role
function, physiologic, interdependence, and self-concept. If the
healthy adaptive response, adaptation to the maternal role is not
apparent, nursing assessment is then focused on the environmental
stimuli of the new mother. The nursing intervention is directed at
managing these focal, contextual, and residual stimuli until the
adaptive response has been facilitated. Interventions suggested for the
Clinical Nurse Specialist within the primary care setting were
anticipatory guidance, role-playing, counseling sessions, and time and

stress management techniques. Early and continued nursing intervention

156

may enhance well-being and role adaptation in new mothers facing
multiple role obligations.

Further research on maternal role adaptation both by nurses and
professionals in other disciplines is needed as the number of employed
mothers with young children and infants is increasing. Currently this
research is lacking. Legislative policy decisions related to maternity
and parental leave during the postpartum period must also focus on
maternal role adaptation issues when these benefits are being

considered.

LIST OF REFERENCES

List of References

American Nurses' Association (1986). ANA outlines 'top ten'
legislative priorities. Capital Update, 5(11), 7-8.

Behrman, D. (1982). Family and/or career: Plans of first-time
mothers. Ann Arbor, MI: UMI Research Press.

 

Blank, M. (1964). Some maternal influences on infant's rates of
sensorimotor development. Journal of the American Academy of
Child Psychiatry, g, sea-6877‘

 

Brazelton, T.B. (1981). On becoming a family: The growth of
attachment. New York: Delacorte Press/Seymour Lawrence.

 

Brazelton, T.B. (1985). Working and caring. Reading, MA: Addison-
. Wesley Publishing Company.

 

Bureau of National Affairs (1987). BNA gpecial report on pregnangy and
employment: The cgmplete handbook on discrimination, health, and
safety. Rockville, MD: Author.

 

Burr, W.R. (1972). Role transitions: A reformulation of theory.
Journal of Marriage and the Family, 35, 407-416.

Burr, W.R., Leigh, G.K., Day, R.D., & Constantine, J. (1979). Symbolic
interaction and the family. In W.R. Burr, R. Hill, F.I. Nye, and
I.L. Reiss (Eds.), Contemporary theories about the family: Vol. 2
(pp. 42-111). New York: Free Press.

Catalyst (1980, June). Research project on corporate leave policies.
Perspective, 1. '

 

Catalyst (1983, March). Introduction to career and family: Maternal
and parental leave. Perspective, 3.

 

Catalyst (1984, June). Preliminary report on a nationwide survey of
maternal/parental leave. Perspective, 11.

Collins, C.E. (1987). Combining employment with motherhood. In J.

Griffith-Kenney (Ed.), Contemporary women's health (pp. 324-338).
California: Addison-Wesley Publishing Company.

157

158

Collins, C.E. & Tiedje, L.B. (in press). A program for women returning
to employment after childbirth. Journal of Obstetric and
Gynecolpgic Nursing.

Cronenwett, L.R. (1976). Transition to parenthood. In L.K. McNall &
J.T. Galeener (Eds.), Current practigq in obstetric and
gynecologic nursipg (pp. 179-187). St. Louis: C.V. Mosby
Company.

 

Cronenwett, L.R. (1980). Elements and outcomes of a postpartum support
group program. Research in Nursing and Health, 2, 33-41.

 

Curry, M.A. (1983). Variables related to adaptation to motherhood in
“normal“ primiparous women. Journal of Obstetric and Gynecolpgic
Nursing, 12(2), 115-121.

Ouvall, E. (1977). Family development (4th ed.). Philadelphia: J.B.
Lippincott Company.

Fitzpatrick, J. & Whall, A. (1983). Conceptual models of nursing;_
Analysis and application. Bowie, MD: Robert J. Brady Company.

 

Gray, J.D. (1983). The married professional woman: An examination of
her role conflicts and coping strategies. Psychology of Women

Qqarterly, 1(3), 235-243.

Gilbert, L.A., Holohan, C.K., & Manning, L. (1981). Coping with
conflict between professional and maternal roles. Family
Relations, 29, 419-426.

Gold, 0. & Andres, D. (1978). Developmental comparisons between
adolescent children with employed and nonemployed mothers.
Merrrill-Palmer Quarterly, 23, 243-254.

 

Goode, W.J. (1960). A theory of role strain. American Sociolpgical
Review, gg, 488-496.

 

Hall, D.T. (1972). A model of coping with role conflict: The role
behavior of college educated women. Administrative Science

Qqarterly, 22(4), 471-486.

Hardin, S.B. & Skerrett, K. (1981). Counseling working mothers.
Journal of Nurse-Midwifery, 26(4), 19-29.

 

Hardy, M. & Conway, M. (1978). Role theory perspective for health
professionals. New York: Appleton-Century-Crofts.

 

 

Harris, 8. (1979). Careers, conflict, and children: The legacy of the
cult of domesticity. In A. Roland & 8. Harris (Eds.), Career and
motherhood: Struggles for a new identity (pp. 55-86). New York:
Human Sciences Press.

159

Hayghe, H. (1982). Marital and family patterns of worker: An update.
Monthlprabor Review, 195, 53-56.

Heins, M., Stillman, P., Sabers, 0., Mazzeo, J. (1983). Attitudes of
pediatricians toward maternal employment. Pediatrics, 22(3), 283-
290.

Herman, J.B. & Gyllstrom, K.K. (1977). Working men and women: Inter-
and intra-role conflict. Psychology of Women Quarterly, 1(4),
319-333. '

Hock, E., Gnezda, M.T., & McBride, S.L. (1984). Mothers of infants:
Attitudes toward employment and motherhood following the birth of a
first child. Journal of Marriage and the Family, 46(5), 425-431.

Hoffman, L.W. (1974). Psychological factors. In L.W. Hoffman & F.I.
Nye (Eds.), Working mothers (pp. 32-62). San Francisco: Jossey-

 

Bass Publishers.

Hoffman, L.W. (1979). Maternal employment: 1979. American
Psychologist, 24(10), 859-865.

 

Hoffman, L.W. (1984). The study of employed mothers over a half
century. In M. Lewin (Ed.), In the shadow of the past: Psycholpgy
portrays the sexes (pp. 296-319). New York: Columbia University
Press.

 

Holohan, C.K. & Gilbert, L.A. (1979). Conflict between major life
roles: Women and men in dual career couples. Human Relations,
22(6), 451-467.

 

Howell, M.C. (1973). Employed mothers and their families. Pediatrics,
52(2), 252-260.

Jimenez, M.H. & Newton, N. (1982). Job orientation and adjustment to
pregnancy. Birth, 9(3), 157-163.

Johnson, C.L. & Johnson, F.A. (1977). Attitudes toward parenting in
dual-career families. American Journal of Psychiatry, 223(4),
391-3950

Kamerman, S.B., Kahn, A.J., Kingston, P. (1983). Mgternity policies and
working women. New York: Columbia University Press.

 

Keith, P.M. & Schafer, R.B. (1980). Role strain and depression in two-
job families. Family Relations, 22, 483-488.

Kutzner, S.K. (1984). Adaptation to motherhood from postpartum to early
childhood. Unpublished doctoral dissertation, University of
Michigan, Ann Arbor, MI.

’l

160

Kutzner, S.K. & Toussie-Weingarten, C. (1984). Working parents: The
dilemma of childrearing and career. Topics in Clinical Nursing,
2(3), 30-37.

Lederman, R.P. & Lederman, E. (1984). Psychosocial aspects of
pregnancy. Englewood Cliffs, NJ: Prentice-Hall.

Lederman, R.P., Weingarten, C., & Lederman, E. (1981). Postpartum self-
evaluation questionnaire: Measures of maternal adaptation. Birth
Defects: Original Article Series, 22(6), 201-231.

Leifer, M. (1980). Psychological effects of motherhood: A study of
first pregnancy. New York: Praeger Scientific.

Majewski, J.L. (1986). Conflicts, satisfactions, and attitudes during
transition to the maternal role. Nursipg Research, 22(1), 10-14.

Mercer, R.T. (1981). A theoretical framework for studying factors that
impact on the maternal role. Nursing Research, 29(2), 73-77.

Mercer, R.T. (1982). Factors havigg an impact on maternal role
attainment the first year of motherhood (Final report MC-R-060435-
03). Springfield, VA: U.S. Department of Commerce.

Mercer, R.T. (1985). The process of maternal role attainment over the
first year. Nursing Research, 23(4), 198-203.

Mercer, R.T. (1986a). First-timemgtherhood experiences from teens to
forties. New York: Springer Publishing‘Company.

Mercer, R.T. (1986b). Predictors of maternal role attainment at one
year postbirth. Western Journal of Nursing Research, 2(1), 9-32.

Mercer, R.T. (1986c). The relationship of developmental variables to
maternal behavior. Research in Nursing and Health, 2, 25-33.

Merton, E. (1957). Social theogypand social structure. New York: Free
Press.

Miller, B.C., & Sollie, D.L. (1980). Normal stresses during the
transition to parenthood. Family Relations, 22, 459-465.

Moen, P. & Dempster-McClain, 0.1. (1987). Employed parents: Role
strain, work time, and preferences for working less. Journal of
Marriage and Family, 32(8), 579-590.

 

Myers-Wall, J.A. (1984). Balancing multiple role responsibilities
during the transition to parenthood. Family Relations, 22, 267-
271.

 

O'Connell, H. & Bloom, O.E. (1987). Juggjing jobs and babies:
America's child care challeng . New York: Population Reference
Bureau, Inc.

 

161

Pickens, 0.5. (1982). The cognitive processes of career—oriented
primiparas in identity reformulation. Maternal Child Nursing
Journal, 22(3), 135-164.

Polit, D.F. & Hungler, B.P. (1987). Nursing research: Principles and
methods (3rd ed.). Philadelphia: J.B. Lippincott Company.

Poloma, M.M. (1972). Role conflict and the married professional woman.
In C. Safilius-Rothschild (Ed.), Toward a psycholggyof women (pp.
539-552). Lexington, MA: Xerox Publishing.

Ralph, K.C.S. (1977). Maternal ability to adapt to infant cues of
temperament. Unpublished doctoral dissertation, Arizona State
University, Tempe, AR.

 

Roy, C. (1981). The Roy adaptation model. In J.P. Riehl & C. Roy
(Eds.), Conceptual models for nursing practice (2nd ed.). New
York: Appleton-Century-Crofts.

Roy, C. (1984). Introduction toggrsing: An adaptation model (2nd
ed.). Englewoodeliffs, NJ: Prentice-Hall, Inc.

Roy, C. (1986). Introduction to ngrsing; An adaptation model (3rd
ed.). Englewood Cliffs, NJ: Prentice-Hall, Inc.

Rubin, R. (1967). Attainment of maternal role: Processes. Nursing
Research, 22(3), 237-245.

Rubin, R. (1977). Binding-in in the postpartum. Maternal Child
Nursing Journal, 2(2), 67-75.

Rubin, R. (1984). Maternal identity and maternal experience. New York:
Springer.

Sarbin, T. (1968). Role theory. In G. Lindzey (Ed.), Handbook of
social psycholpgy (pp. 223-258). Reading, MA: Addison-Wesley
Publishing Company.

 

Sarbin, T. & Allen, V.L. (1968). Role theory. In G. Lindzey (Ed.),
Handbook of social psychology (pp. 488-549). Reading, MA:
Addison-Wesley Publishing Company.

Scott, R.W. (1970). Professionals in bureaucracies: Areas of
conflict. In H. Volmer & 0. Mills (Eds.), Professionalization.
Englewood Cliffs, NJ: Prentice-Hall.

Sekaran, U. (1986). Dual career families. San Francisco: Jossey-Bass
Publishers.

 

Sheehan, F. (1981). Assessing postpartum adjustment. Journal of
Obstretric andfiynecologic Nursing, 29(1), 19-23.

162

Shereshefsky, P.M. & Yarrow, L.J. (1973). Psychological aspects of a
first pregnancy and early postnatal adaptation. New York: Raven
Press, Publishers.

Skinner, D.A. (1980). Dual-career stress and coping: A literature
review. Family Relations, 22, 473-480.

Thomas, E.J. 8 Biddle, B.J. (1966). Basic concepts for classifying the
phenomena of role. In B.J. Biddle & E.J. Thomas (Eds.), Role
Theory: Concepts and research (pp. 23-29). New York: John Wiley
E_Sons, Inc.

Thornton, R. & Nardi, P.M. (1975). The dynamics of role acquisition.
American Journal of Sociolpgy, 22(4), 870-885.

Tiedje, L.B. (1987). Multiple role women: Interrole compatibility
perceptions. Unpublished doctoral dissertation, University of
Michigan, Ann Arbor, MI.

U.S. Bureau of Census (1983). Statistical abstracts of the Ugited
States (101st ed.). Washington, D.C.: U.S. Government Printing
Office.

U.S. Department of Labor (1977). Dictignary of Occupational Titles.
Washington D.C.: U.S. Government Printing Office.

U.S. Department of Labor, Bureau of Labor Statistics (1986). Handbook
of labor statistics (Vol. 33). Washington, D.C.: U.S. Government
Printing Office.

U.S. Department of Labor, Bureau of Labor Statistics (1987). News
(August 12). Washington, D.C.: U.S. Government Printing Office.

Van Meter, M.S. & Agronow, S.J. (I982). The stress of multiple roles:
The case for role strain among married college women. Family
Relations, 22, 131-138.

Walker, L.0., Crain, H., 8 Thompson, E. (1986a). Maternal role
attainment and identity in the postpartum period: Stability and
change. Nursing Research, 22(2), 68-71.

Walker, L.0., Crain, H., & Thompson, E. (1986b). Mothering behavior and
maternal role attainment during the postpartum period. Nursing
Research, 22(6), 352-355.

Zambrana, R. (1979). The working mother in contemporary perspective.
Pediatrics, 23, 862-870.

 

Zigler, E. & Muenchow, S. (1983). Infant day care and Infant-care
leaves: A policy vacuum. American Psychologist, 22(1), 91-94.

 

APPENDIX A

Pretest Questionnaire

163

PLEASE ANSWER THE FOLLOWING QUESTIONS ABOUT.YOU AND YOUR FAMILY.

1)

2)

3)

h)

5)

6)

7)

8)

9)

ID)

What was your age at your last birthday?

What is your marital status:

Single, never married Widowed
Married Divorced
Separated

Are your currently living with the father of your baby?

<

ES M0

What is the highest level of education you completed?

Some elementary school (grades i-7)

Completed elementary school (8th grade)

Some high school (9-ll years)

Graduated from high school

Some college or technical training beyond high school (1-3 years)
Graduated from technical program

Graduated from college

Some graduate school beyond bachelor's degree

 

 

Graduate degree (please specify )
Other (please specify 1
What is your occupation?

 

What is the date of birth of your baby?

 

(month) (dateli ($3.6)
What is the sex of your baby? ___ Male ___ Female

When do you expect to return to work (list the specific date
when you plan to go back to work)?

(month) (date) (Year)

 

 

When you return to work, how many hours per week do you plan to
work? Please include work you do at home for your job.

Less than 20 hours per week 36 - ho hours per week
21 - 25 hours per week hi - #5 hours per week
26 - 30 hours per week over #5 hours per week

31 - 35 hours per week
How long have you been employed In the job you will be returning
to after your baby's birth?

less than one year 6 - ID years
i - 5 years this will be a new job for me

164

11) Taking into consideration all sources of income, which of the
10" ranges includes your total fgmily income before taxes last year?

Less than $10,000 $35,000 - $39,999
$10,000 - $19,999 $00,000 - $99,999
$15,000 - $19,999 $45,000 - $49,999
$20,000 ' $29,999 $50,000 - $5h,999
$25,000 - $29,999 555.000 - 559.999
$30,000 - $39,999 $60,000 and above

PEOPLE HAVE DIFFERENT REASONS FOR WORKING. BELOW ARE SOME OF THESE REASONS.
PLEASE INDICATE HOW IMPORTANT EACH OF THESE REASONS IS TO YOU.

( I ) (2) (3 ) (‘0)
nor AT ALL NOT TOO SOMEWHAT Alveav
iHPORTANT IMPORTANT iMPORTANT lMPORTAMT

i2) it is necessary for economic
V110 survival

13) To get a little more than the

vmz: basic necessities: to buy
nice things

Ih) To get ahead financially

15) it gives a feeling of indepen-
“33 dence and self-satisfaction

16) I like what I do on my job

\fii?
17) To get out of the house and
fi'fi' away from children from a
while

18) To have contact with adults
1"“ and thel r ideas

I9) if you were to get enough money to live as comfortably as you'd like

‘57? the rest of your life, would you continue to work?
YES NO Undecided
IT) 17) T5)

PEOPLE HAVE DIFFERENT KINDS OF FLEXIBILITY IN THEIR JOBS. PLEASE CIRCLE THE
RESPONSE THAT BEST DESCRIBES YOUR JOB.

m 20) How much choice would you say you have over which days you work?
a "

GREAT DEAL QUITE A an some A LITTLE none AT ALL
(5) (Ii) (3) (2) (I)

1655

-3-

21) How much choice would you say you have over which hours you work on a
was particular day?

GREAT DEAL QDITE A BIT sane A LITTLE HOME AT ALL
(5) (h) (3) (2) (i)

__ 22) How much choice would you say you have over where (at office or home) you
vuo do you work?

GREAT DEAL QUITE A BIT SOME A LITTLE HOME AT ALL
(5) (h) (3) (2) (I)

PLEASE ANSWER THE FOLLOWING QUESTION ABOUT YOUR RELATIONSHIP AS A COUPLE.
INDICATE £9! OFTEN EACH STATEMENTS APPLIES TO YOUR RELATIONSHIP.

 

(i) (21 (3) (h) (ST '-
ALMOST NEVER ONCE iN AWHILE SOMETIMES FREQUENTLY ALMOST ALWAYS

23) We ask each other for help.
24) When problems arise, we compromise.

v": __ 25) We approve of each other's friends.
m __ 26) We are flexible in how we handle our differences.
W 27) We like to do things with each other.
\Tfii _.
__ 28) Different persons act as leaders in our relationship.
J: __ 29) We feel closer to each other than to people outside our family.
vuz _ 30) We change our way of handling tasks.
v”. __ 31) We like to spend free time with each other.
:1: __ 32) We try new ways of dealing with problems.
‘2: _ 33) We feel very close to each other.
1': __ 3h) We Jointly make the decision in our relationship.
vuz __ 35) We share hobbies and interests together.
was _ 36) Rules change in our relationship.
was __ 37) We can easily think of things to do together as a couple.
was __ 38) We shift household responsibilities from person to person.
‘2: _ 39) We consult each other on our decisions.
‘1‘: __ 100) it is hard to identify who the leader is in our relationship.
‘1‘: __ iii) Togetherness is a top priority.
‘1': __ ‘02) it is hard to tell who does which household chores.
Vise

THANK 2222 £25 COMPLETING THIS QUESTIONNAIREIII

APPENDIX B

Two-Month Questionnaire

166

EMPLOYMENT

Please answer the following questions about your job.

i. What is your present job title?

 

2. How many hours per week do you work?

___ less than 15 hours per week ___ 31-35 hours per week
___ 15-20 hours per week ___ 36-90 hours per week
___ 21-25 hours per week ___ 01-95 hours per week

I 26-30 hours per week ___ over 95 hours per week

3. Has your job position, or the number of hours you work per week
changed since the last time you completed a questionnaire for us?
YES NO

If yes, please explain what has happened:'

 

 

 

 
 
  

A. Please think about your employment situation during
the past month. Taking everything into consideration
during the past month, how often did you... ‘1 y ,L

3‘

Feel happy in your job?

Feel satisfied in your job?

Feel frustrated or angry in your job?
Enjoy yourself in your job?

Feel insecure in your job?

Feel unhappy in your job?

Feel unable to get much done at work?
Dread going to work?

Feel bored with your work?

Find yourself getting behind at work
Have accidents on the job?

Feel the quality of your work was good?

S.

167

Found your work interesting or exciting?
Make errors or mistakes?

Feel able to concentrate on the things you
needed to do at work?

 

Miss work?

i'd like you to think about all the pleasures and
problems that go into daily life with your husband.
Taking everything into consideration, during the 1?
past month, how often have you... 4' j?
z

 

   

   

  
    
 
  

.f

k

if
S

     
 

       
  

  
  
 

5"

g
c?
I
3‘

‘3‘
B

   

Felt happy in your marriage?

Felt satisfied in your marriage?

Felt frustrated or angry in your marriage?
Enjoyed yourself in your marriage?

Felt insecure in your marriage?

Felt unhappy in your marriage?

The statements below have been made by mothers of
young infants. Read each statement and decide which
response best describes your feelings. Then check
the appropriate square next to each statement. 3%?

i know what my baby likes and dislikes.
My husband participates in the care of the baby.
it bothers me to get up for the baby at night.

My husband is understanding (calms me) when i get
upset.

This baby is a financial burden for us.
Childbirth left me with a feeling of accomplishment.

My husband feels that caring for the baby is not
his responsibility.

We need more things that we can afford to buy.
i am proud of my last delivery.
I feel close to my husband.

it is boring for me to care for the baby and do the
same things over and over.

i wonder whether i make the right decisions for my
baby.

   
 
 

168

My husband helps with child care.

When the baby cries, i can tell what she/he wants.
Friends or relatives reassure me as a mother.

My husband spends time with the baby.

My patience with the baby is limited.

1 am satisfied with the amount of time we spend
together as a family.

My parents criticize me as a mother.

I am dissatisfied with the amount of time i have
for activities other than child care.

My husband gets annoyed when i ask him to help with
the care of the baby.

I enjoy taking care of the baby.
'1 am angry about having too many responsibilities
as a mother.

it is hard to talk to my husband about problems i
have.

.When feeding, diapering, and bathing the baby, i
wish i could be doing something else.

i have doubts about whether i am a good mother.
would like to be a better mother than I am.

i think about unpleasant and frightening things
that happened during labor and delivery.

i can talk to some of my friends or relatives about
questions i have concerning motherhood.

My home seems too cramped for my child(ren) to play
in.

My husband criticizes me as a wife.

My husband wants to share in the care of the baby.
i am glad i had this baby now.

I lose my temper when i am with the baby.

There is hope for a steady income for my family.

i feel that i know my baby and what to do for him]
her.

My husband would rather spend time at work or a
hobby than be with me.

My husband cares about how i feel.
My husband makes me feel i am a burden to him.

i have friends or relatives who encourage me to
care for the baby in my own way.

 

,I .. .i
(iii: if

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

169

I am pleased with my home life as it ls.~
I enjoy being a mother.

When i am feeling down or depressed, my husband
reassures me.

i like to hold and cuddle the baby after a feeding
or bath.

My husband and i have problems with our marriage.
My parent(s) are interested in the baby.
I feel joyful when I remember the birth of the baby.
I feel bad about the way i reacted to the pain of

a

I can share my thoughts and feelings with my
I am nervous when i hold the baby.

There is enough money for all my family's basic
needs.

The baby seems like a stranger to me.

Since I have become a mother this time, I feel
depressed and lonely.

My husband shows an interest in the baby.
Discussions with my husband end in arguments.

My husband lets me down when I need him.

When the baby cries, my husband ignores him/her.

I feel satisfied with the care I received In labor
and delivery.

i trust my own judgement In deciding how to care
for my baby.

Our home seems too small for all of us.
I know what my baby wants.

1 can rely on friends or relatives to help me with
the baby when necessary.

I worry that i am not giving enough attention to
the baby.

i feel overburdened with the many demands made on
s a mother.

My husband dislikes caring for the baby.
My parent(s) make me feel like there is little I
can do right.

i feel my labor and delivery was a good experience.

 

i feel disappointed in the delivery experience I

170

 

 

My husband helps at home when he can.

i worry about how we will manage on our present
income.

My husband enjoys holding the baby.

My parent(s) think i should take better care of the
baby.

i feel gratified about giving birth.
My husband avoids helping with child care.

 

 

 

 

 

 

I would prefer to go to work or classes and have
someone else care for the baby.

 

i am unsure of what to do for the baby when s/he
cries.

 

My parent(s) seem to like the way i care for the
baby.

 

Friends or relatives think I am a good mother.

 

i feel good about how i handled myself during labor
and delivery.

My parent(s) show little interest in the baby.
i feel relaxed and secure about my future.

 

 

 

 

 

 

 

 

 

7. Please think about all the pleasures and problems
that go with parenting. Taking everything into
consideration, during the past month, how often has

parentigg made you...

 

Feel happy?

Feel satisfied?

Feel frustrated or angry?
Enjoy yourself?

Feel insecure?

Feel unhappy?

THANK YOU FOR COMPLETING THIS QUESTIONNAIRE!
h/lB/Bb

 

APPENDIX C
PSEQ Subscales

171

POSTPARTUM SELF-EVALUATION QUESTIONNAIRE SCALES

QUALITY OF RELATIONSHIP WITH SPOUSE

My husband is understanding (calms me) when I get upset.

I feel close to my husband.

It is hard to talk to my husband about the problems I have.
My husband criticizes me as a wife.

My husband would rather spend time at work or a hobby than be with me.
My husband cares about how I feel.

My husband makes me feel I am a burden to him.

My husband and I have problems with our marriage.

I can share my thoughts and feeling with my husband.
Discussions with my husband end in arguments.

My husband lets me down when I need him.

When I am feeling down or depressed, my husband reassures me.

My husband helps at home when he can.

 

PERCEPTION
My husband
My husband
My husband
My husband

My husband
baby.

My husband
My husband

172

POSTPARTUM SELF-EVALUATION QUESTIONNAIRE SCALES

OF SPOUSE'S PARTICIPATION IN CHILD CARE

participates in the care of the baby.

feels caring for the baby is not his responsibility.
helps with child care.

spends time with the baby.

gets annoyed when I ask him to help with the care of the

wants to share in the care of the baby.

shows an interest in the baby.

When the baby cries, my husband ignores him/her.

My husband
My husband

My husband

dislikes caring for the baby.
enjoys holding the baby.

avoids helping with child care.

 

173

POSTPARTUM SELF-EVALUATION QUESTIONNAIRE SCALES

GRATIFICATION FROM THE LABOR AND DELIVERY EXPERIENCE
Childbirth left me with a feeling of accomplishment.
I am proud of my last delivery.

I think about unpleasant and frightening things that happened during
labor and delivery.

I feel joyful when I remember the birth of the baby.

I feel bad about the way I reacted to the pain of labor.

I feel satisfied with the care I received in labor and delivery.
I feel my labor and delivery was a good experience.

I feel disappointed in the delivery experience I had.

I feel good about how I handled myself during labor and delivery.

174
POSTPARTUM SELF-EVALUATION QUESTIONNAIRE SCALES

SATISFACTION WITH LIFE SITUATION AND CIRCUMSTANCES

The baby is a financial burden for us.

I am satisfied with the amount of time we spend together as a family.
My home seems too cramped for my child(ren) to play in.

There is hope for a steady income for my family.

I am pleased with my home life as it is.

There is enough money for all my family's basic needs.

Our home seems to small for all of us.

I worry about how we will manage on our present income.

I feel relaxed and secure about my future.

We need more things than we can afford to buy.

175

POSTPARTUM SELF-EVALUATION QUESTIONNAIRE SCALES

CONFIDENCE IN ABILITY TO COPE WITH TASKS OF PARENTHOOD

I know what my baby likes and dislikes.

I wonder whether I make the right decisions for my baby.
When the baby cries, I can tell what he/she wants.

My patience with the baby is limited.

I have doubts about whether I am a good mother.

I would like to be a better mother than I am.

I feel that I know my baby and what to do for him/her.

I am nervous when I hold the baby.

The baby seems like a stranger to me.

I trust my own judgment in deciding how to care for my baby.
I know what my baby wants.

I worry that I am not giving enough attention to the baby.

I am unsure of what to do for the baby when s/he cries.

176

POSTPARTUH SELF-EVALUATION QUESTIONNAIRE SCALES

SATISFACTION WITH PARENTHOOD AND INFANT CARE

It is boring for me to care for the baby and do the same things over and
over.

I am dissatisfied with the amount of time I have for activities other
than childcare.

I enjoy taking care of the baby.
I an angry about having too many responsibilities as a mother.

When feeding, diapering, and bathing the baby, I wish I could be doing
something else.

I am glad now that I had this baby.

I lose my temper when I am with the baby.

I enjoy being a mother.

I like to hold and cuddle the baby after a feeding or bath.

Since I have become a mother this time, I feel depressed and lonely.
I feel overburdened with the many demands made on me as a mother.

I would prefer to go to work or classes and have someone else care for
the baby.

It bothers me to get up for the baby at night.

177

POSTPARTUH SELF-EVALUATION QUESTIONNAIRE SCALES

SUPPORT FOR PARENTAL ROLE FROM FAMILY AND FRIENDS
Friends or relatives reassure me as a mother.
My parents criticize me as a mother.

I can talk to some of my friends or relatives about questions I have
concerning motherhood.

I have friends or relatives who encourage me to care for the baby in my
own way.

My parent(s) are interested in the baby.

I can rely on friends or relatives to help me with the baby when
necessary.

My parent(s) make me feel like there is little I can do right.
My parent(s) think I should take better care of the baby.

My parent(s) seem to like the way I care for the baby.

Friends or relatives think I am a good mother.

My parent(s) show little interest in the baby.

APPENDIX D

Consent Form

178

CONSENT FORM

The program in which we are asking your participation is designed to learn
more about how health care professionals can assist women who combine

employment and parenthood. if you agree to participate in this program, you
will be asked to complete a questionnaire about your well-being at two and four
months following your return to employment and one year after your baby's
birth. Each of the questionnaires will require about one-half hour to

complete.

if you agree to participate in this study, please sign the following
statement:

I) l have freely consented to take part in a study of women returning to
employment following the birth of a baby, being conducted by the College of
Nursing at Michigan State University and the Expectant Parents Organization
of Lansing. ,

2) The study has been described and explained to me and I understand what my
participation will involve.

3) i understand that I can withdraw from participating in this study at any
time. Withdrawal from this study will not change the availability of
services to me through the Expectant Parent Organization of Lansing.

A) i understand that the results of this study will be treated in strict
confidence and, should they be published, my name will remain anonymous. I
understand that within these restrictions, results can, upon request, be
made available to me.

5) i understand that no beneficial results can be guaranteed as a result of
participating in the study.

I , state that i understand what is required

 

9
(print name)

as a participant and agree to take part in this program.

Signed Date
(signature of participant)

 

 

l’lICHIGRN STATE UNIV. LIBRARIES
illllllll"Ill”Ill"|||l||llllillHIIIIHIHIIIIHHI
31293005393271