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The results of a Duke University study on stress in working moms will come as no surprise to any working mother: it’s more stressful to be a working mom than to be a working woman without children at home.
But supportive dads and significant others may be chagrined to learn that their supporting role has little apparent mitigating effect on mom’s stress as measured by common physiological and psychological markers.
The study’s lead author was psychologist Linda Luecken, M.A., who worked under the guidance of internist Redford Williams, M.D., a 25-year veteran of the department of psychiatry at Duke University Medical Center in Durham, N.C. It was published in the July/August issue of Psychosomatic Medicine.
The authors defined the objective of the study as evaluating the "biological and psychological effects of role overload." They measured daily excretion of cortisol and the urinary catecholamines epinephrine and norepinephrine, all of which are key physiological markers of stress, and assessed "work and home strain" and social support in a sample of 109 women employed full time.
"Strain" was defined as the degree to which subjects were exposed to high demand with low control, Williams explained.
Working women with at least one child at home excreted significantly more cortisol than working women without children at home, regardless of marital status or social support. Urinary catecholamines, however, increased equally during the workday in both women with children and those without and did not decline after work in either group. Catecholamine levels were unrelated to marital or parental status or social support.
Earlier Studies
Most earlier studies of the effect of job stressors on health have focused on men, the authors observed. But such studies may not be valid for women, for whom the perception and consequences of work are often quite different. One striking example of this was revealed by an earlier study of men and women managers. It found that after work the norepinephrine levels of the men dropped sharply, while those of the women increased.
Despite the inevitable conflicts that arise for working women with children at home, some studies have reported that parental status per se was not a significant predictor of psychological distress. Studies have found that employment outside the home is associated with improved psychological and physical health for women, and that work-related stress alone is a poor predictor of health risk. One study, however, found that the positive psychological benefits of employment for women were reduced for mothers with children at home.
In light of this complex picture, the authors commented, it is necessary to weigh the multiple roles occupied by women, since it "may be the interaction of these roles that is relevant to the health benefits or risks of employment."
The current study’s finding of increased home strain in working mothers is consonant with other studies showing that despite outside, full-time employment, women usually continue to bear the brunt of childrearing and other household responsibilities, resulting in what some have termed the "second shift" phenomenon. Many studies have shown that working women with children carry a far heavier total workload than men.
While the current study could not elucidate the clinical significance of increased cortisol levels in working mothers, it was inspired in part by a study that did focus on that issue, the famous Framingham study, according to Williams.
In the Framingham study of several thousand women, researchers found that working women in clerical jobs with three or more children had a significantly higher risk of developing cardiovascular disease than women with fewer or no children. The current study did not look at variable effects based on the number of children due to the small sample size, said Williams.
The study is somewhat limited because the sample of women worked in clerical and customer service positions. The quality of work and the socioeconomic context may have an impact on both psychological and physical stress in the workplace, and different outcomes might occur with women in higher status positions, the authors speculated.
Deborah Cross, M.D., chair of the APA Committee on Women, spoke with Psychiatric News about the new study. It is significant in part simply because it focuses on women, observed Cross.
"So much research has been done on men. But as we’re learning, it is not always generalizable to women. Having research like this, in which we clearly see differences, helps us begin to single out risk factors," said Cross.
Welfare Reform
This study should have "broad implications" for the welfare reform debate, said Cross. "The intent of welfare reform is to put everyone, including mothers of very young children, to work," she noted. In New York, for example, any woman with a child more than 1 year old must seek employment. This study suggests that forcing women into work prematurely will create additional stress and perhaps exacerbate social and psychological problems.
Women, in contrast to men, may see work as "less hectic and less stressful than home," said Cross. This may be related to a sense that they have more control over what happens at work than at home.
Even among women with social support, the tendency is to remain vigilant to children despite the presence of a husband or partner, she noted.
The study suggests that there are accommodations needed in the workplace to allay the added stress of working mothers, according to Cross. This includes providing access to psychotherapy. Women "often feel they can’t ask for help anywhere, that they are responsible for everything," said Cross.
Stress is "a common denominator, a common pathway," said Cross. "So stress, no matter how you define it, may end up being expressed in a number of different ways," be it cardiovascular disease or mental illness.
The study suggests that "there is something about being a mother, per se, that is a constant source of stress," said Williams.
The finding that home strain was a predictor of elevated cortisol suggests that it is the uncontrollable environment created by children that is particularly stressful for women. "The idea is that there are a lot of psychological demands on you and you do not have control over how you meet those demands," said Williams.
Although the Duke team was not sure why urinary catecholamines were unaffected by parental status, catecholamine levels "tend to reflect work, per se, while cortisol levels tend to reflect distress," according to Williams.
Stress puts working mothers at higher risk, not only for cardiovascular disease, but for depression or any other condition to which they might be predisposed, Williams commented. "To the extent that working mothers are under more stress, and I don’t think anybody will disagree that they are, there are some practical implications."
Employers should consider not only providing access to therapy, as suggested by Cross, but also a variety of other options.
Programs such as flex-time and on-site day care may make a critical difference. Working at home may be another useful option with the advent of sophisticated home computers.
And, of course, added Williams, women can try to get their partners to take more responsibility for caretaking of children at home. Perhaps if "husbands could not only share some of the chores, but decide with the mother what needs to be done at home, it might take some of the load off," he said.
Finally, working mothers themselves could benefit by learning how to modify their reactions to unavoidable stress. For example, research has shown that meditation actually lowers cortisol excretion, he noted. Meditating when stressed "gives [working mothers] a time out and helps them to center." Other kinds of cognitive behavioral training that increase coping skills can help, since most people never realize they can learn better coping techniques. Even if a mother’s natural feelings of constant vigilance at home cannot be changed, "maybe she could learn to cope with it a little more effectively," Williams said.