By Steven Reinberg
Tuesday, August 5, 2008 12:00 AM
TUESDAY, Aug. 5 (HealthDay News) -- Many new mothers in the United States struggle with chronic emotional and physical problems, often with little or no support from their husbands or partners, all the while trying to meet the needs of their newborns, and in some cases the pressure to return to work, a new report finds.
"Mothers of young children in the United States are in a rather untenable situation," said Carol Sakala, an author of the report and director of programs for Childbirth Connection, a national not-for-profit organization that works to improve the quality of maternity care.
"Mothers are so isolated in our society. There is not an appreciation for the extent to which this is a very challenging time for this large population," she said.
The report, calledNew Mothers Speak Out, National Survey Results Highlight Women's Postpartum Experiences, surveyed 903 new mothers, ages 18 to 45, who gave birth in 2005.
Among the findings: After six months, 43 percent of the women still felt stressed; 40 percent reported problems controlling their weight; 34 percent had trouble sleeping; 26 percent had no sexual desire; and 24 percent suffered from chronic backaches.
During the first two months after giving birth, 44 percent of the women said that their physical or emotional condition interfered with taking care of their baby.
What's more, many women didn't feel they got the support they needed from their spouse or partner, with 73 percent saying they provided more of the child care than their husband or partner.
Even the 49 percent of women who had full-time jobs said they provided most of the child care, with just 3 percent of husbands or partners providing most of the child care, according to the report.
Twenty percent of the women with a husband or partner said their mate provided little, if any, affectionate, emotional, enjoyment or practical support.
"We were surprised at how quickly the women were back to employment -- over 80 percent by 12 weeks postpartum," Sakala said. "They didn't get the maternity leave that they wanted. They felt they had to be back at work earlier than they wanted. They weren't able to achieve their breast-feeding goals.
"They are trying to do the right thing, but they are not getting the support they need in terms of time to recover and the financial support they need to be at home with their babies," Sakala added.
Just 40 percent of working mothers said they received paid maternity leave benefits. Among those receiving paid maternity leave, 50 percent said they received 100 percent of their pay. Among full-time workers, 23 percent got at least six weeks of full pay, and 38 percent received six weeks at half pay.
More than one-third of the working women were back on the job six weeks after giving birth, and 84 percent were back working after 12 weeks of maternity leave.
Almost half of the women -- 48 percent -- said they hadn't remained at home as long as they wished. The main reason they went back to work was that they couldn't afford more time off, the report found.
Most of the working women said the ideal amount of time off would be seven months. Only 1 percent of the women had fully paid leave for four months or more.
Once the women returned to work, many challenges still remained. Seventy-nine percent described being away from their baby as a challenge. Problems making child-care arrangements affected 50 percent of the new mothers; breast-feeding issues affected 37 percent; 36 percent struggled with issues of support from their partner or spouse; and 29 percent said they experienced lack of support in the workplace.
"There is a major awareness challenge. We aren't really aware of the situation that mothers are in," Sakala said. "We need to extend the supports we have offered to mothers. We need to build awareness among women that they are not alone. These are common issues, issues for which they can get help. They are entitled to help."
Dr. Ruta Nonacs is a staff psychiatrist with Massachusetts General Hospital's Perinatal and Reproductive Psychiatry Clinical Research Program. She thinks the new survey is another piece of evidence that more attention needs to be paid to help new mothers.
Part of the problem, Nonacs said, has been changes in society that leave new mothers more isolated. "Most women don't exist within extended families and need other forms of support, because there is not an extended family that can pick up the extra responsibility," she said.
Longer maternity leaves and more flexible return-to-work policies would be one way of helping new mothers, Nonacs said. "That would be very helpful in reducing the level of stress," she said.
Also, new mothers expect more of themselves than they did in the past, Nonacs said. "With all the emphasis on 'appropriate parenting,' there is pressure on women to be 100 percent available, which is simply not possible. Women's expectations have increased dramatically," she said.
These heightened expectations add to the stress of new motherhood, Nonacs said. "Especially, when there is a disconnect between how one thinks a mother is supposed to behave and how grueling it actually is. That sets up people for disappointment and feelings of inadequacy. It does create stress," she said.
"Throw away your parenting books," Nonacs advised. "Get all the support you can muster -- if you pay for it or recruit various family members and friends. The first year in a child's life is very demanding. One needs a lot of support, and one also needs to take care of oneself," she said.
To see the full report, visit the Childbirth Connection.
SOURCES: Carol Sakala, Ph.D., director of programs, Childbirth Connection; Ruta Nonacs, M.D., Ph.D., Center for Women's Mental Health, Massachusetts General Hospital, Boston; Aug. 5, 2008, Childbirth Connection report,New Mothers Speak Out, National Survey Results Highlight Women's Postpartum Experiences