Perinatal work characteristics and postpartum depression among employed women

Introduction
Postpartum depression is a debilitating mental disorder that affects around 13% of women after childbirth. This study identifies the psychosocial work and family factors associated with maternal postpartum depression five weeks after childbirth.

Methods
The study utilized a prospective cohort design, recruiting women from three Minneapolis and St. Paul hospitals while hospitalized for childbirth in 2001. 817 women were enrolled (71% response rate) and 716 women completed five-week telephone interviews. Eligible women were 18 years or older, employed, and spoke English. Independent variables included demographics, preconception general health, perceived control, prenatal job characteristics (perceived job stress, job satisfaction, supervisor and coworker support, job flexibility, number of work hours per week), pregnancy and delivery characteristics, infant sleep problems, social support, and leave status 5 weeks after childbirth.

Results
The women averaged 30 years, 74% were married, 86% were white, and 46.5% were primiparas. These women worked an average of 38 hours per week pre- delivery and 7.1% returned to work by 5 weeks postpartum. Multiple linear regression showed higher postpartum depression scores (Edinburgh Postnatal Depression Scale) to be associated with: poorer preconception general health, prenatal moods, fewer children, a male infant, a planned pregnancy, an infant with sleep problems, less perceived control, less social support, higher perceived job stress, lower number of hours worked per week, and returning to work by 5 weeks postpartum. The regression model explained 28.6% of the variance in depression scores.

Discussion
Findings most relevant to the workplace and to employed women include issues of job stress and timing of return to work after childbirth. Employers should examine their childbirth-related leave policies to ensure they accommodate the needs of women who may be at increased risk of depression if they take short leaves. Future research should investigate the factors that exacerbate or alleviate perceived job stress.