Postpartum Health of Employed Mothers 5 Weeks After Childbirth

Pat McGovern; Bryan Dowd; Dwenda Gjerdingen; Cynthia R. Gross; Sally Kenney; Laurie Ukestad; David McCaffrey; Ulf Lundberg

doi:10.1370/afm.519

Abstract

PURPOSE Most new mothers return to work soon after childbirth. A need exists to reexamine the definition of postpartum health and evaluate employed women’s recovery from childbirth in association with such factors as delivery type and breastfeeding.

METHODS Using a prospective cohort design, we recruited Minnesota women into the study while they were hospitalized for childbirth in 2001. Telephone interviews were conducted 5 weeks postpartum. Eligible women were 18 years or older, employed, and spoke English. Multivariate models using 2-stage least squares were used to estimate factors associated with physical and mental health and postpartum symptoms.

RESULTS A total of 817 women were enrolled (71% response) in the study; 716 women completed interviews at 5 weeks postpartum. On average, women reported 6 postpartum symptoms, most frequently fatigue (64%), breast discomfort (60%), and decreased desire for sex (52%). Findings showed that cesarean (vs vaginal) deliveries were associated with significantly worse physical function, role limitations, and vitality. Multivariate findings showed that the effect of delivery type on physical health was moderately large (β = −5.96; P = <.01), and breastfeeding was associated with an increased frequency of postpartum symptoms (β = 4.63; P = .01).

CONCLUSIONS These mothers experienced several childbirth-related symptoms at 5 weeks postpartum, indicating a need for ongoing rest and recovery. Health concerns were greater for women who were breastfeeding and for those whose babies were delivered by cesarean section, suggesting a need for greater support for these women and a reassessment by the medical community of the progressively growing practice of cesarean deliveries.

Footnotes

Conflicts of interest: none reported
“Preliminary Findings from the Minnesota Postpartum Health Study: Women’s Health 6 Weeks after Childbirth,” P. McGovern with B. Dowd, D. Gjerdingen, T. Rockwood, C. Gross, S. Kenney, L. Ukestad, D. McCaffrey, U. Lundberg, After Birth: Policies for Healthy Women, Families, and Workplaces. A Signature Study and Conference of the Humphrey Institute of Public Affairs conducted in collaboration with the School of Public Health and Consortium on Law and Values in Health, Environment, and the Life Sciences Colloquia Program, Humphrey Institute of Public Affairs, University of Minnesota, Minneapolis, October 1, 2004.
“The Health of Employed Women at 6 Weeks after Childbirth: Preliminary Findings,” P. McGovern with B. Dowd, D. Gjerdingen, T. Rockwood, C. Gross, S. Kenney, L. Ukestad, D. McCaffrey, U. Lundberg, at the Women’s Health Research Conference, National Center for Excellence in Women’s Health, University of Minnesota, Minneapolis, September 13, 2004.
“The Health of Employed Women at 6 Weeks after Childbirth: Preliminary Findings, “ P. McGovern with B. Dowd, D. Gjerdingen, T. Rockwood, C. Gross, S. Kenney, L. Ukestad, D. McCaffrey, U. Lundberg, at the National Occupational Research Agenda (NORA) Symposium: Health and Safety Priorities for the 21st Century, Midwest Center for Occupational Health and Safety, University of Minnesota, Minneapolis, May 27, 2004.
“The Minnesota Women’s Postpartum Health Study: Design, Implementation and Preliminary Findings,” P. McGovern with B. Dowd, D. Gjerdingen, T. Rockwood, C. Gross, L. Ukestad, D. McCaffrey, U. Lundberg, at the School of Social Work, Wayne State University, Detroit, Mich, June 9, 2004.
Funding support: This publication was supported by grant # 5 R18 OH003605-05 from the National Institute for Occupational Safety and Health (NIOSH).
Disclaimer: The contents of this study are solely the responsibility of the authors and do not necessarily represent the official views of NIOSH.
Parts of this study were previously presented in the following formats: “The Health of Employed Women at 6 Weeks after Childbirth,” P. McGovern, with B. Dowd, D. Gjerdingen, S. Kenney, L. Ukestad, D. McCaffrey, U. Lundberg, a poster presentation at the Academy Health Annual Research Meeting, 2005, Hynes Convention Center, Boston, Mass, June 27–28, 2005.