Challenges of working mothers: balancing motherhood and profession

Abstract

Background: Females contribute to 48.5% of population of India. Shouldering dual responsibilities of house and work can eventually take toll on women’s physical and mental health. The work and family commitments are likely to be influenced by parity, duration of breastfeeding, work environment and social support. This study is conducted to assess the stress levels among working professional mothers and their associated risk factors.Methods: It was a cross sectional study conducted in working professional mothers of India. Data was collected using structured questionnaire and perceived stress scale (PSS-4) for assessing stress. The form was made available on internet so as to approach wide spectrum of professionally working mothers.Results: Moderate to severe stress was perceived by 63.04% women. Severity of stress increases with shift duties (p=0.05), lack of family support (p=0.08) and inability to exclusively breastfeed child for 6 months (p=0.09). Only 1/3rd (31.88%) working mothers could exclusively breastfeed their child for 6 months. Exclusive breastfeeding was more observed in mothers with higher socio-economic status (OR=2.39) and also among those who had shift duties (OR=5.23).Conclusions: In spite of family support for childrearing, most of the professional working mothers are experiencing perceived stress. Work environment flexibility and efficient social support to reduce stress is recommended.

Full text

International Journal of Community Medicine and Public Health | July 2018 | Vol 5 | Issue 7 Page 2905
International Journal of Community Medicine and Public Health
Kadale PG et al. Int J Community Med Public Health. 2018 Jul;5(7):2905-2910
http://www.ijcmph.com
pISSN 2394-6032 | eISSN 2394-6040
Original Research Article
Challenges of working mothers: balancing motherhood and profession
Prajakta G. Kadale, Aastha N. Pandey*, Swati S. Raje
INTRODUCTION
Woman is an integral part of the society. According to
census 2011, females contribute to 48.5% of the Indian
population.1 Traditionally, Indian women had been home
makers. In late decades, with the spread of education and
better awareness, along with increasing cost of living,
women have shifted from home to career. Like many
other countries, India has provided a stage for growth and
development for women. However, women in India are
still seen as the family manager back home. This attitude
of the society has put dual responsibilities on women.
Although the literature is not conclusive, parental
employment has been found to have a beneficial effect on
many of children's health and developmental outcomes,
including higher self-esteem, fewer social and emotional
problems, reduced risk of being uninsured, higher
vaccination rates and greater academic achievement.2
However, women are wrapped in two equally exacting
roles: pursuing a career and economic independence,
while continuing, to bear the stress of household work. It
can eventually take a toll on women’s physical and
mental health.
A working mother can be defined as a woman with an
ability to combine a career with added responsibility of
raising a child.3 The problems might be different in
mothers from low socio-economic status for whom, doing
a job may be essential due to economic reasons.
ABSTRACT
Background:
Females contribute to 48.5% of population of India. Shouldering dual responsibilities of house and
work can eventually take toll on women’s physical and mental health. The work and family commitments are likely to
be influenced by parity, duration of breastfeeding, work environment and social support. This study is conducted to
assess the stress levels among working professional mothers and their associated risk factors.
Methods:
It was a cross sectional study conducted in working professional mothers of India. Data was collected using
structured questionnaire and perceived stress scale (PSS-4) for assessing stress. The form was made available on
internet so as to approach wide spectrum of professionally working mothers.
Results:
Moderate to severe stress was perceived by 63.04% women. Severity of stress increases with shift duties
(p=0.05), lack of family support (p=0.08) and inability to exclusively breastfeed child for 6 months (p=0.09). Only
1/3rd (31.88%) working mothers could exclusively breastfeed their child for 6 months. Exclusive breastfeeding was
more observed in mothers with higher socio-economic status (OR=2.39) and also among those who had shift duties
(OR=5.23).
Conclusions:
In spite of family support for childrearing, most of the professional working mothers are experiencing
perceived stress. Work environment flexibility and efficient social support to reduce stress is recommended.
Keywords: Working professional mothers, Perceived stress, Breastfeeding, Childrearing
Department of Community Medicine, M.I.M.E.R. Medical College, Talegaon (D), Pune, Maharashtra, India
Received: 29 March 2018
Revised: 07 May 2018
Accepted: 09 May 2018
*Correspondence:
Dr. Aastha N. Pandey,
E-mail: aasthapandeypathak@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20182620

Kadale PG et al. Int J Community Med Public Health. 2018 Jul;5(7):2905-2910
International Journal of Community Medicine and Public Health | July 2018 | Vol 5 | Issue 7 Page 2906
However, in women who are in professional field,
balancing career and family life, even when they have a
choice of selecting only one, might be facing emotional,
psychological and physical burdens while effectively
juggling between professional and child rearing
responsibilities. Hence, it is important to understand the
challenges that professional working mothers are facing
in coping with the stress of handling multiple roles.
One of the crucial aspects in early child rearing is
breastfeeding. WHO recommends exclusive
breastfeeding for six months and a diet with
complementary foods up to two years and beyond.4
Breastfeeding contributes to well-being of both mother
and child. But, for employed women, who have to get
back to work, after the end of maternity leave,
breastfeeding becomes a challenging task.
Recovery of women from childbirth stress and their
resumption of work and family responsibilities are
mainly influenced by factors like pre-existing health
status, parity, breastfeeding, the accessibility of social
help from family and companions and work related
variables, e.g., timing of return to work, work pressure,
and working environment. Lack of social support
increases the job stress, which in turn, affects the mental
health of the employed working mother.5,6 It is also
reported that professional working mothers either had to
cease or conceal the breastfeeding practices when
employed.7 However, there is paucity of studies in Indian
population to explore the problems of working mothers.
This paper is an attempt to assess the stress levels among
working professional mothers from India, from various
geographical area and various fields, and to identify the
risk factors of their perceived stress. The study also aims
to identify problems faced by working mothers in child
rearing especially breastfeeding, while maintaining a
balance between their career and motherhood.
METHODS
It was a cross sectional study conducted in working
professional mothers of India. A structured questionnaire
was used to assess the socio-demographic data, work
environment, child rearing problems and perceived stress.
The Perceived Stress Scale (PSS) measures the level to
which a respondent considers his or her life stressful.
perceived stress scale 4-item version (PSS-4) was used to
assess working mothers’ perceived stress.8,9
The study population consisted of working mothers
ranked above semi-professionals, with the work
experience of more than one year.10 Mothers from socio-
economic class below upper middle class (B. G. Prasad’s
classification-2016) were excluded from the study.11
Mothers whose children were greater than 18 years of age
were excluded from the study, as most of the child-
rearing responsibilities are over by this time. Considering
the prevalence of medium to high stress levels among
employed women as reported to be 75.66%, the sample
size was calculated to be 136.12
The form was made available on internet so as to
approach a wide spectrum of professionally working
mothers. Attempts were made to cover various
professions such as teaching, doctors, IT professionals,
banking and finance professionals and business women.
The approval was obtained from institutional ethical
committee. Data was collected by convenient sampling
(type of nonprobability sampling) during July 2017 to
December 2017.
RESULTS
In all, 152 working mothers from various states of India,
working in different occupational fields, participated in
the study. Out of these, 138 mothers fulfilled the
inclusion criteria. Maximum responses were from
Maharashtra, followed by Karnataka (Figure 1).
Figure 1: Distribution of study participants according
to place of work.
Figure 2: Perceived stress among study participants.
Distribution of study participants with respect to their
occupation is depicted in Figure 2 It was observed that,
most of the participants were from health and medical
sector, followed by computer and technology.
4 1
1
1
1
2
2 6 3
110
4 1 2
Andhra Pradesh
Assam
Chhattisgarh
Delhi
Goa
Gujarat
Jammu and Kashmir
Karnataka
Madhya Pradesh
Maharashtra
Punjab
Tamil Nadu
Telangana
4%
33%
56%
7% No stress
Mild stress
Moderate stress
Severe stress

Kadale PG et al. Int J Community Med Public Health. 2018 Jul;5(7):2905-2910
International Journal of Community Medicine and Public Health | July 2018 | Vol 5 | Issue 7 Page 2907
Table 1: Demographic characteristics of the study
participants.
Variables
Number
Percentage
(%)
Age in
years
18-30
23
16.67
31-40
77
55.80
41-50
38
27.54
Education
Graduate
23
16.67
Post-graduate
69
50
Professional
or honours
46
33.33
Socio-
economic
status
Upper class
122
88.41
Upper middle
class
16
11.59
Marital
status
Married
123
89.13
Divorced
5
3.62
Separated
5
3.62
Widowed
5
3.62
Type of
family
Nuclear
95
68.84
Joint
43
31.16
Total
number of
children
1
75
54.35
2
62
44.93
3
1
0.72
Table 1 shows the demographic characteristics of
working mothers in the study. Most of them were in
reproductive age group. More than half of the participants
had only one child at the time of the study. Nearly 1/3rd
of the working mothers were highly qualified. 68.84%
mothers belonged to nuclear family.
Almost all (96.38%) of participants were found to be
stressed as per perceived stress scale. A mild level of
stress is considered to be an important motivating factor
and thus is considered normal and necessary. If the stress
is intense, continuous, and repeated, it can lead to
physical illness and psychological disorders. Thus, in
order to study severity of stress, perceived stress score
was divided into quartiles. We observed that, 63.04%
women experienced moderate to severe perceived stress.
Further analysis was done to see the factors associated
with severity of stress (Table 2).
Severity of stress was found significantly more in the
mothers who had shift duties (p=0.05). Inability to spend
enough time with children and inadequate social support
in child rearing were found marginally significant with
severity of stress levels. Mothers who could not
exclusively breastfeed their youngest child till 6 months,
were found to have high level of stress (p=0.097).
However, duration of working hours and reasons for
working was not associated with high stress levels.
Table 2: Association of severity of the perceived stress with various factors.
Mild
Moderate
Severe
Total
P value
Age in years
18-30
13
8
2
23
0.094038949
31-40
24
46
4
74
41-50
9
23
4
36
Total work experience in years
1-5
19
21
3
43
0.471631191
6-10
13
23
2
38
>11
14
33
5
52
Duration of working hours (including
travel timing)
<8 hours
27
40
5
72
0.739879972
>8 hours
19
37
5
61
Do you have shift duties?
Yes
7
17
5
29
0.054024318
No
39
60
5
104
Were you given easier jobs or
concession during pregnancy?
Yes
27
43
5
75
0.871617207
No
19
34
5
58
Do you think you spend enough time
with children?
Yes
18
18
1
37
0.071753471
No
28
59
9
96
How long was your youngest baby
given exclusive breastfeeding?
<6 months
20
35
8
63
0.097127111
≥6 months
26
42
2
70
Total duration of breastfeeding to
youngest baby
≤ 6 months
14
9
3
26
0.10018087
≤ 1 year
22
42
5
69
≤ 2 years
10
26
2
38
Do you get enough time (7-8 hrs) to
sleep?
Yes
19
21
2
42
0.192529805
No
27
56
8
91
Do you think, you are doing justice to
both your work and your motherhood?
Yes
14
22
0
36
0.14561961
Injustice to work
9
7
1
17
Injustice to
motherhood
18
31
7
56
No
5
17
2
24
Continued.

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International Journal of Community Medicine and Public Health | July 2018 | Vol 5 | Issue 7 Page 2908
Mild
Moderate
Severe
Total
P value
Who is effectively helping you in child
rearing?
Spouse and
relative
29
48
2
79
0.086253531
Maid at home
and day care
14
27
7
48
None
3
2
1
6
Main reason for working
Financial need
8
19
3
30
0.800633187
Self- esteem &
self-respect
20
38
4
62
Career oriented
14
15
2
31
Other
4
5
1
10
Table 3: Association of breastfeeding with various factors.
Exclusive breastfeeding for 6 months
Odd’s ratio
Given
Not given
Working hours
<8
45
28
0.524781341
>8
49
16
Shift duties
Yes
26
3
5.225490196
No
68
41
Easier jobs or concession
during pregnancy
Given
41
18
1.117400419
Not given
53
26
BG Prasad SES
Upper class
86
36
2.388888889
Upper middle class
8
8
Type of family
Nuclear
68
27
0.995693368
Joint
26
17
Study of various factors at work environment pointed out
that, 47.1% women spend >1/3 of their day at workplace
including travel time. 42.73% mothers feel that they were
not given any concession or easier jobs during pregnancy.
21.01% working mothers have to work in shift duties.
Main reason for working was found to be self-esteem &
self-respect (44.93%).
Out of 138 participants, 70.29% (97) mothers felt that
they were doing injustice either to motherhood, or work,
or both. Among them, most of the women felt injustice
towards motherhood than towards work.
Analysis of factors related to child-rearing revealed that,
only 31.88% mothers could exclusively breastfeed their
youngest child till 6 months. Nearly half of the mothers
faced problems during lactation (44.93%). Most common
problem reported was early lactational failure. More than
2/3rd of the mothers felt that, they were not able to spend
enough time with their children (70.29%). Inadequate
sleep was reported by 69.57% mothers.
Data was further analysed to identify factors associated
with exclusive breastfeeding (Table 3). Shift duties at
work are positively associated with exclusive
breastfeeding. (OR=5.23). Exclusive breastfeeding is
more observed in mothers from higher socio-economic
class. (OR=2.39). Mothers who were given easier jobs or
concession during pregnancy could complete exclusive
breastfeeding for 6 months effectively (OR=1.17).
DISCUSSION
Dual responsibilities of working mothers lead to a need
of balance between the work and family life. Their
attempt to justify the different roles simultaneously puts
them under tremendous pressure. The extent of stress and
the factors responsible to it needs evaluation.
There are a few studies which address the work place
stressors in specific occupations such as health workers
or IT industry.6,13 However stress of working mothers is
rarely reported.
Mishra et al reported the prevalence of psychiatric
morbidity as 58.9% in working women, with 49.5%
moderate and 9.3% severe morbidity. Profession wise
doctors recorded the highest prevalence of psychiatric
morbidity followed by skilled manpower at 61.8% and
unskilled at a low value of 48.5%. There was significant
difference in psychiatric morbidity between professionals
and skilled groups vs. unskilled groups (p<0.05).13 In our
study, most of the participants were working in medical
and health sector, prevalence of stress is found to be
comparable.
In a study, by Chandraiah et al, age was found to be
negatively correlated with occupational stress and
positively with job satisfaction.14 As against this, we
found a positive association of age with severity of stress.
This might be because of increase in work experience,

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International Journal of Community Medicine and Public Health | July 2018 | Vol 5 | Issue 7 Page 2909
leading to increased responsibility, in turn, resulting in
high levels of stress among working mothers.
Exclusive breastfeeding upto 6 months is reported to be
54.9% as per NFHS- 4 data.15 In a similar population of
Pakistan, it is reported to be 41.5%.16 However, it was
much less in the present study. An improvement in this
regard might be expected due to The Maternity Benefit
(Amendement) Bill, passed in 2017, by Government of
India. Women will be entitled to 26 weeks of paid
maternity leave (up from 12 weeks) for their first two
children. Breastfeeding beyond this period can be a
difficult task. According to the Bill, companies with 50 or
more employees will now have to mandatorily provide a
day care facility, or crèche.17 This may help the working
mother to continue breastfeeding for longer duration.
A literature review study in U.S. states that, breastfeeding
at work moves an intimate interpersonal relationship into
a broader socio-physical ecosystem. Breastfeeding at
work is mainly affected by type of work, social support
from family as well as workplace, work flexibility,
instrumental support at workplace in the form of on-site
lactation rooms, on-site child care.18 In the present study,
the ODD’s ratio shows positive association of shift duties
and socio-economic status with exclusive breastfeeding.
In India, though social conditions provide social support
to the working mother, no association was seen between
exclusive breastfeeding and type of family.
Shift work is considered necessary to ensure continuity of
work in many occupations such as health care, production
and IT. However, it can cause significant alterations of
sleep and biological functions that can affect physical and
psychological well-being of a person resulting in
disturbing his or her work life balance. In a study among
nurses Ferri et al, reported statistically significant
decrease in quality and quantity of sleep, with more
frequent chronic fatigue, psychological, and
cardiovascular symptoms in nurses doing night duties in
comparison with the day shift workers.19 Similarly,
proportion of mothers having higher perceived stress was
more among mothers doing shift duties in the present
study.
It has been researched in past that, a minimum of 6 to 8
hours of sleep is required for sound health. But ever
increasing demands of modern day professional lives
have taken tolls on the personal lives of mothers.
Conclusion of different researches has also proposed that
the majority of mothers throughout the world today suffer
from chronic sleep deprivation, which affects every area
of their lives.20 In our study also, more than 2/3rd of the
mothers reported to have inadequate sleep.
A study conducted among working mothers by Sandra
Mary Travasso et al, reported that, lack of adequate
support for child care appear to be more susceptible to
severe and prolonged periods of depression.21 The finding
is similar to our study.
Limitations
The study findings should be interpreted in the light of its
limitations. There may be a tendency of those with strong
opinions to participate, which may bias the responses. A
sampling frame could not be generated as there is no
database available for married professional working
mothers. Further, factors associated with stress levels
could be better explored with the help of qualitative type
of study. But, this study can be further expanded on a
large scale, with a better study design, to explore the
problems of working mothers in detail.
CONCLUSION
Most of the married working women could not breastfeed
their child for 6 months. In spite of social support for
childrearing, most of the professional working mothers
are having perceived stress. Health care providers can use
the findings of this study, to promote breastfeeding in this
population, by using tactics geared toward the mother,
her social network, and her entire community. Work
environment flexibility for breastfeeding mothers is need
of the hour to achieve effective exclusive breastfeeding.
At the same time, need of stress buster measures is
essential for effective balance of motherhood and
profession.
ACKNOWLEDGEMENTS
We express our sincere thanks to Dr. S. V. Chincholikar,
Head of the department of Community Medicine,
M.I.M.E.R. Medical College, Talegaon (D) for his
support and guidance.
Funding: No funding sources
Conflict of interest: None declared
Ethical approval: The study was approved by the
Institutional Ethics Committee
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Cite this article as: Kadale PG, Pandey AN, Raje
SS. Challenges of working mothers: balancing
motherhood and profession. Int J Community Med
Public Health 2018;5:2905-10.