Work and Family-related Stressors and Postpartum Depression: A Longitudinal Analysis

Background: Prior research on maternal employment has focused on its consequences for the child-parent relationship but scant research has addressed the role of the psychosocial work environment in the etiology of postpartum depression.

Objective: To investigate the determinants of postpartum depression over the first year after childbirth focusing on work and family-related stressors.

Methods: The study employed a prospective cohort design, recruiting women from three Minneapolis and St. Paul hospitals while hospitalized for childbirth in 2001. Data were collected in-person at enrollment; telephone interviews were conducted at 5 weeks, 11 weeks, 6 months, and 12 months after delivery with response rates of 88% (N=716), 81% (N=661), 76% (N=625), and 70% (N=575), respectively. Postpartum depressive symptoms (Edinburgh Postnatal Depression Scale) were measured at each time period. Investigators used econometric methods specific to panel data analyses to estimate the effects of leave duration, job strain, and work-family conflict.

Results: Two Stage Least Squares analysis showed an additional day of leave from work after childbirth until 6 months postpartum decreases depressive symptoms. Fixed effects regression analyses revealed that psychological demands, work-family conflict, infant sleep problems, and infant fussy behavior increase depressive symptoms. Increased schedule control, perceived control over work and family, and social support decrease depressive symptoms.

Conclusions: There is an interdependent relationship between stress from paid work and stress from unpaid tasks at home that affects postpartum depressive symptoms. This study identified factors amenable to change that can inform healthcare providers, leave policy discussions, and workplace policies to positively influence mothers' health.