The trajectory of health and quality of life for employed women upon return to work after childbirth is unknown. The effects of stress and role conflict from total workload on women's postpartum health are not well established. Yet, mothers of infants represent one of the fastest growing segments in the US labor market. The purpose of this project is to estimate a function relating total workload (i.e., hours of paid and unpaid work), use of family medical leave, job stress, and work-family conflict to maternal health at critical points in time after childbirth. The research model is adapted from economic models of health and household production function theory, and integrates elements of the biopsychosocial approach to stress and health. The study employs a prospective design with panel data collection at 6 weeks, 3 months, 6 months, 12 months and 18 months after childbirth. Selected intervals reflect critical times in women's postpartum recovery and employment patterns that have implications for maternal workload and well-being. Potential subjects will be recruited from selected hospitals and screened for eligibility. Upon hospital discharge following childbirth, 782 women will be surveyed at intervals described above using both telephone and mailed administration of survey instruments depending on the timing of data collection. A system of equations will be estimated for women's total workload, use of family medical leave, job stress, work-family conflict, health status and quality of life at each time period. Consistent with this theoretical approach an analytic procedure called two-stage least squares will be employed. This approach permits cross-sectional analyses that estimate the impact of explanatory variables (e.g., job stress) on the dependent variables of interest (e.g., maternal health) at one specific point in time (e.g., six months after childbirth). In addition, the use of panel data permits longitudinal analyses that will allow us to estimate alternative models such as distributed lag models. This latter approach will enable us to estimate current values of the dependent variable (e.g., maternal health at 18 months after childbirth) as a function of both current and past values of the explanatory variables (e.g., total workload at 12 months and 18 months after childbirth). Results from the study will provide important information on maternal health and quality of life at a vulnerable time in the life cycle of women and their families. The study findings will identify workplace and job characteristics and family and personal choices that support women's health and quality of life. Knowledge of these factors will facilitate the design and testing of policy and programmatic interventions relevant to employers, policy makers and occupational health providers.
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