SOURCE: Childbirth Connection

August 05, 2008 08:00 ET

"New Mothers Speak Out" Report Paints a Troubling Picture of American Women in Postpartum Period

Many Mothers Face a Broad Range of Social, Emotional and Physical Health and Workplace Challenges, Often With Little or No Support

NEW YORK, NY--(Marketwire - August 5, 2008) - Childbirth Connection, a leading national not-for-profit organization that works to improve the quality of maternity care, today released "New Mothers Speak Out, National Survey Results Highlight Women's Postpartum Experiences." The report is based on new data from the national "Listening to Mothers II Postpartum" survey, and includes relevant results from the national "Listening to Mothers II" survey, which was conducted six months earlier and focused on childbearing experiences of the same women. Combined survey results from these landmark surveys provide an in-depth look at women's postpartum experiences during the first eighteen months after giving birth.

Persistent Physical and Emotional Health Problems

Many mothers grappled with ongoing physical and emotional health problems while caring for their baby. The women reported high rates of newly experienced problems in the first two months after birth. At six or more months after birth, substantial proportions of mothers were still feeling stressed (43%), had problems with weight control (40%), experienced sleep loss (34%), lack of sexual desire (26%) and backache (24%). Among those who had a cesarean birth, 31% reported numbness and 18% reported continued pain at the incision site after at least six months. One-third of mothers reported that during the first two months after birth, their postpartum physical health (33%) or emotional health (30%) interfered at least "some" with their ability to care for their baby, with 44% of all mothers reporting that physical and/or emotional health impairment had interfered with the care of their babies. A year after giving birth mothers reported a net weight gain of six pounds from their pre-pregnancy weight.

The survey utilized validated tools to screen for postpartum depression and traumatic stress associated with childbirth, and found that notable portions of mothers experienced symptoms of depression and of traumatic stress many months after giving birth.

"Postpartum mothers experience a troubling burden of physical and emotional health challenges after giving birth. Although many of these problems abate over time, far too many women were still experiencing them from 6 to 18 months after birth. With more than 4.3 million births each year in the United States, it is an urgent priority to better understand the reason for these challenges, their implications for women and their families, ways to prevent distress and morbidity, and ways to help women and families before they experience detrimental effects," stated Maureen Corry, MPH, Executive Director of Childbirth Connection.

Breastfeeding Experiences

Although 61% of the mothers had intended to exclusively breastfeed as they neared the end of their pregnancies, just 51% were doing so a week after the birth. Those mothers had experienced high rates of hospital practices that can disrupt breastfeeding such as water or formula supplementation and formula samples or offers. Fewer than half (46%) of the mothers who were breastfeeding at one week and not breastfeeding at the time of the "Listening to Mothers II Postpartum" survey reported that they had breastfed as long as they wanted. One-third or fewer of black non-Hispanic women, younger women and women with lower incomes breastfed as long as they wished.

Co-sleeping and Demographic Variation

The study reveals significant disparities in experiences across major U.S. race/ethnicity subgroups in a practice that has been the subject of considerable attention -- infants sleeping in the same bed as their parents. Overall 18% of mothers reported that their baby "always" slept in bed with them and another 10% reported their infant "often" did in the first six months after birth. Among black non-Hispanic mothers more than a third (36%) reported their baby slept with them "always" compared to 30% of Hispanic mothers and 12% among white non-Hispanic mothers. Dr. Eugene Declercq of Boston University School of Public Health and lead author of the report stated, "Co-sleeping was one of the many areas, including breastfeeding, pregnancy intention and circumcision rates, in which we found postpartum experiences of mothers varying widely by race/ethnicity. These variations merit further research."

Nonexistent or Insufficient Social Support from Husbands, Partners and Others

Having a spouse or partner did not necessarily ensure that women received various forms of support. Overall, most of the mothers (73%) said that they provided more of the childcare than their husband or partner. Even among mothers who were employed full time, 49% reported they provided most of the childcare, in contrast to just 3% of husbands or partners who provided most of the childcare and 48% who shared it equally. About 20 percent of women with a husband or partner reported that person provided affectionate, emotional, enjoyment or practical support "none" or "little" of the time.

Meager Paid Maternity Leave Benefits and Multiple Employment Challenges

Of those mothers who had been employed by someone else during pregnancy, 40% said that their employer provided paid maternity leave benefits, with 50% of those working full-time and 14% working part-time receiving these benefits. Among mothers who received paid maternity benefits, 50% indicated they received 100% of pay. Thus for the entire survey sample, the results indicate that of those women employed full-time outside of their home while pregnant, 23% received at least six weeks of their full pay as a maternity benefit and 38% received at least six weeks of half-pay or more as a maternity benefit.

Almost 3 in 10 (29%) of the mothers in the postpartum survey said they were currently employed full-time. Another 14% were employed part-time. Those mothers currently employed were more likely to have one child rather than two or more and be unmarried with a partner rather than married. Among formerly employed mothers more than a third had returned to work by 6 weeks, and most (84%) were back to work by 12 weeks. About half (48%) of mothers who had returned to work by the time of the survey said they had not stayed home as long as they wanted. The leading reason cited for returning to work prematurely (81%) was because they could not afford more time off. When we asked employed mothers and mothers on maternity leave what would be the ideal amount of time off with their baby, the overall average was seven months, with 60% of mothers naming six months or more as the ideal maternity leave. By contrast, just 1% of mothers who had been employed outside the home during pregnancy had fully paid leave of four or more months.

Mothers returning to work reported facing numerous challenges. For example, 79% reported that being apart from their baby was a major or minor challenge in their transition to employment, followed in frequency by childcare arrangements (50%), breastfeeding issues (37%), amount of support by partner/spouse (36%) and lack of support in the workplace as a new mother (29%).

"This important new study underscores the urgent need to improve maternity and pregnancy-related benefits for women in the United States," said National Partnership for Women & Families President Debra L. Ness. "While nearly every other economically competitive nation provides paid maternity leave and stronger supports for working mothers, women here struggle to cobble together the time off, income and childcare they need. This survey shows the toll that is taking on mothers and families. We can and must do better."

"The overall picture is of recent mothers engaged in a juggling act, carrying multiple and sometimes conflicting responsibilities while experiencing high levels of social, physical and emotional health challenges. There are concerns about whether large segments of this population have access to adequate health and social services and social support. We are letting our mothers and babies down at one of the most critical and vulnerable times in their lives. These survey results are a clarion call to action for programs, policies, clinical services, and research to better understand and improve the experiences of new mothers and their families," said Corry.

About New Mothers Speak Out

"New Mothers Speak Out, National Survey Results Highlight Women's Postpartum Experiences," is based on new data from the national "Listening to Mothers II Postpartum" survey and includes relevant results from the national "Listening to Mothers II" survey, which was conducted six months earlier and focused on women's childbearing experiences. Combined survey results from these landmark surveys provide an in-depth look at women's postpartum experiences during the first eighteen months after giving birth.

The "Listening to Mothers Postpartum" survey reached 903 U.S. women, ages 18-45, who gave birth in a hospital to a single infant in 2005, with the infant still living at the time of the survey. The survey was carried out in partnership with Lamaze International and conducted by Harris Interactive®.

The "New Mothers Speak Out" report, along with survey questionnaires, details about the survey methodology and related documents, are available at www.childbirthconnection.org/newmothersspeakout/

About Childbirth Connection

Childbirth Connection is a national not-for-profit organization that was founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection is a voice for the needs and interests of childbearing families. More information about Childbirth Connection may be obtained at www.childbirthconnection.org

About Lamaze International

Since its founding in 1960, Lamaze International has worked to promote, support and protect normal birth through education and advocacy through the dedicated efforts of professional childbirth educators, providers and parents. An international organization with regional, state and area affiliates, its members and volunteer leaders include childbirth educators, nurses, nurse midwives, physicians, students and consumers. More information about Lamaze International may be obtained at www.lamaze.org

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