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A Longitudinal Analysis of Total Workload and Women's Health After Childbirth

McGovern, Patricia PhD, MPH; Dagher, Rada K. PhD, MPH; Rice, Heidi Roeber MD, MPH; Gjerdingen, Dwenda MD; Dowd, Bryan PhD; Ukestad, Laurie K. MS; Lundberg, Ulf PhD

Journal of Occupational and Environmental Medicine: May 2011 - Volume 53 - Issue 5 - p 497–505
doi: 10.1097/JOM.0b013e318217197b
Original Articles

Objectives: To examine the association of women's postpartum health with total workload (TWL), work and personal factors in the year after childbirth.

Methods: Employed women from Minneapolis and St Paul, Minnesota, were recruited while hospitalized for childbirth. Longitudinal analyses, using fixed effects regression models, estimated the associations of TWL, job satisfaction and stress, social support, perceived control, breastfeeding and infant characteristics with women's health at 5 weeks, 11 weeks, 6 months, and 12 months postpartum.

Results: Increased TWL over time was associated with significantly poorer mental health and increased symptoms.

Conclusions: High TWL–including reduced time for rest, recovery, and sleep–is a risk factor for women's mental health and symptoms 12 months after childbirth. Women's postpartum health was positively associated with social support, which may help to decrease the negative effects of excess work.

From the Division of Environmental Sciences (Dr McGovern and Ms Ukestad) and Division of Health Policy and Management (Dr Dowd), School of Public Health; and Department of Family Medicine & Community Health, Medical School (Dr Gjerdingen), University of Minnesota, Minneapolis, Minn; Department of Health Services Administration (Dr Dagher), School of Public Health Building, University of Maryland, College Park, Md; Center for Occupational Environmental Health Promotion (Dr Rice), Family Practice Center, Albuquerque, NM; and Department of Psychology (Dr Lundberg), Stockholm University, Sweden.

Address correspondence to: Patricia McGovern, PhD, MPH, Division of Environmental Sciences, School of Public Health, University of Minnesota, 420 Delaware St SE, Mayo Building MMC 807, Minneapolis, MN 55455 (

This study was not supported by any of the following institutions: National Institutes of Health (NIH), Wellcome Trust, Howard Hughes Medical Institute, or other institutions.

©2011The American College of Occupational and Environmental Medicine