When to Return to Work? Maternity Leave and Mental Health
Authored by:
Anna Glezer, M.D.
Maternity leave is an invaluable period of bonding time for a new mom and her baby and a time of recuperation after delivery.
But how long does it need to be? Patients and practitioners alike ask me about when the right time is to return to work from maternity leave. Does mental health suffer when a woman goes back too soon? Can postpartum depression worsen or onset by a premature return to the work place?
These questions, of course, assume that a woman has had the opportunity to go on leave after delivering, which is not always guaranteed. In 1993, the United States adopted the Family Medical Leave Act of 1993, which allowed for 12 unpaid weeks of leave. In 2002, California became the first state to guarantee 6 weeks of paid leave, and a number of states have followed suit. Otherwise, parental leave is dependent upon your employer’s policies.
The answer of when to return to work varies depending on individual circumstances, but the data do consistently show that longer (usually more than 12 weeks) maternity leave means better mental health for a woman in the immediate weeks and months after the transition. Perhaps more surprising is that adequate maternity leave during the reproductive years is actually associated with improved mental and physical health for women later in life.
Maternity leave and postpartum mental illness
If you are a woman struggling with postpartum mental health issues, whether it is postpartum depression, anxiety, or another condition, maternity leave is even more important. It can take time for a woman to recognize and begin treatment for postpartum depression. Fortunately, it is a condition that is treatable and many feel better.
See my article Baby Blues or Beyond to learn more.
However, a number of women have told me, once feeling better, that they feel they missed out on early bonding time with their infant because of the illness, and therefore are later grateful for a longer time away to be able to work on that attachment.
Postpartum mental health conditions can also take time to surface. For some women, the symptoms of postpartum depression emerge 3-6 months postpartum (and occasionally even later), by which time many women are expected to have returned to work. Additionally, it can take time for treatment to become effective.
It is difficult to find exact numbers of how long a woman with postpartum depression might need to be off work. However, one study found that increasing maternity leave by one week led to a 6-7% decline in depressive symptoms. One way to think about the right time is to consider function. That is, given how you are feeling right now, would you be able to complete the tasks you need to accomplish at work? Or would ongoing symptoms of depression interfere?
Other factors affecting return to work
#1 – Finances
One of the most common reasons to return to work, sometimes sooner than a woman would like to, is due to financial strain. Unfortunately, medications and similar therapies would not help with this particular stressor, but psychotherapy can help a family re-evaluate their priorities, including their financial needs.
#2 – Marital Relationship
Marital conflict also influences the ease of the transition. Research has shown that mood symptoms worsen during the transition back to work when there is tension and conflict in the parental relationship. Couples counseling is quite effective in helping guide communication and easing tension.
#3 – Social Support
One woman recently told me she felt out of place in her mother’s group because she was the only one returning to work. She felt alone and unable to share her story to get feedback and support. I advised she consider changing her social support network to include mothers who are undergoing the same transition back to work. Some companies even have mentorship programs to aid with this transition.
Why return to work?
There are a number of reasons to return to work. The one often cited by my patients (apart from the practical reason of a financial need) is the desire to feel productive and re-engage with one’s industry, co-workers, and sense of career accomplishment; to re-engage the brain in a way that does not involve infant care.
The job to which you are returning also makes a difference. If prior to maternity leave you were at a job where you enjoyed your work and your accomplishments were rewarded, it is much easier to consider returning than to a job without those benefits. Many women explain that if they are going through the difficult emotional task of separating from their baby, they want it to be for a worthwhile reason. If you dislike your job to begin with, this separation will feel more burdensome. If you are in this category, it could mean it is the right time to re-evaluate your job for the sake of your mental health.
How to return to work
For some women, the answer is: gradually. This may mean beginning to work part-time or working from home if those are options for you. I recommend speaking with your employer or colleagues to learn more about what your specific options might be. I also recommend speaking with your physician (or therapist if you have one) about what specific medical accommodations you might need to ensure positive wellbeing once you are back at work. Your clinician’s office may be able to assist you with the necessary paperwork to allow for a more gradual transition.
References:
Chatterji, P. & Markowitz, S. Does the length of maternity leave affect maternal mental health? Southern Economic Journal 72 (2005): 16-41.
Avendano, M. et. al. The long-run effect of maternity leave benefits on mental health: Evidence from European countries. Social Science and Medicine 132 (2015): 45-53.
