Abstract
Background. Despite significant demographic and societal shifts in Iran, including a threefold increase in women's workforce participation over recent decades, the specific challenges faced by employed mothers with young children remain largely under-recognized. This policy brief addresses the issues and difficulties encountered by pregnant women and mothers with young children employed at Tabriz University of Medical Sciences. This policy brief examines these challenges and proposes recommendations to improve maternal and child support policies and services within the university's workplace. The research aims to provide actionable insights for developing more supportive and effective policies for working mothers and their families.
Methods. This policy brief is based on evidence from a previously approved research project titled "Investigating the Challenges of Pregnant Women or Mothers with Young Children Working at Tabriz University of Medical Sciences." The research employed a mixed-methods approach, including qualitative and quantitative phases. In the qualitative phase, a semi-structured questionnaire was administered via telephone interviews to a sample of pregnant women or mothers with children working at Tabriz University of Medical Sciences. Participants, representing women aged 15 to 54 with prior marital history, were recruited based on their willingness to participate. Data collection continued until data saturation was achieved. The quantitative phase involved completing a relevant questionnaire for the participants in the cohort study of the staff.
Results. The research identified several key policy options for improving the working conditions of employed mothers or mothers with young children, including: development of workplace support programs through establishing designated breastfeeding spaces and offering flexible working hours, enhancing awareness through educational programs, facilitating access to healthcare services, conducting pilot projects and experiments, ensuring full implementation of the Population Growth Law and mandating the private sector to comply with it and modifying some of the existing laws.
Conclusion. This policy brief highlights the critical need for supportive policies that foster individual capabilities, particularly for mothers and children. A capability-based approach, emphasizing choice and opportunity, is recommended. Specifically, it is proposed that maternity leave benefits be fully funded and that government support for parents be significantly strengthened.
Extended Abstract
Background
Working mothers experience a higher incidence of preterm birth, low birth weight, and fetal mortality compared to stay-at-home mothers. Furthermore, the rates of preterm birth and low birth weight are demonstrably elevated among mothers who experience unfavorable working conditions, as opposed to those with favorable conditions. Working mothers often encounter challenges such as fatigue and burnout, stemming from reduced opportunities for rest and self-care, alongside limited access to necessary medical care. The demands of balancing work and childcare significantly contribute to increased stress, anxiety, and a heightened risk of mental health disorders among employed mothers. Furthermore, unfavorable workplace conditions, job insecurity, or inadequate job support further exacerbate the risk of postpartum mental health problems. Studies indicates that several work-related factors pose significant challenges for working mothers, including full-time employment, inadequate paid maternity leave, the absence of dedicated breastfeeding rooms, and inflexible work schedules.
Methods
The preparation of this policy brief is based on evidence derived from an approved research project, "Investigating the challenges of Pregnant Women or Mothers with Children Working at Tabriz University of Medical Sciences." This research employed both qualitative and quantitative methodologies, spanning two phases. The qualitative component utilized a semi-structured questionnaire, administered via telephone interviews. The study sample comprised a cohort of pregnant women or mothers with children employed at the university (specifically, women of reproductive age, 15 to 54 years, with marital history), who had indicated their willingness to participate. Interviews continued iteratively until data saturation was achieved. In the quantitative phase, the relevant questionnaire was completed for the participants in the cohort study of the staff. Demographic information including age, education, marital status, history of chronic non-communicable diseases, fertility and infertility history, and anthropometric values were previously collected and available in the staff cohort study file.
Results
The primary finding of this study underscores the urgent need to improve the physical and mental health of employed mothers, alleviate their concerns regarding infant and child care (under 6 years), and promote continuous breastfeeding in the workplace. The absence of comprehensive support and effective policies contributes to a decline in the quality of pre- and postnatal care, increases job-related stress, and negatively impacts maternal and newborn health. Addressing these challenges necessitates the development of well-aligned and efficient policies to protect mothers' rights, ensure their well-being, and safeguard the health of the future generation.
Policy Recommendations and Solutions
1. Implementing workplace support programs, specifically the creation of appropriate breastfeeding spaces and flexible working hours:
This solution offers the potential for increased employee satisfaction and productivity. However, this solution also entails financial and managerial costs for employers and may encounter resistance. To facilitate implementation, mothers should be granted the flexibility to adjust their work schedules and break times to minimize conflict between work and family responsibilities. Furthermore, offering part-time work arrangements, providing dedicated rest time for feeding and breastfeeding, and establishing childcare centers or facilities near the workplace are additional strategies to alleviate mothers' concerns and reduce mental preoccupation related to childcare. The implementation of an extensive, government-funded system of low-cost, high-quality childcare enables parents, particularly mothers, to return to the job market more quickly, thereby enhancing their productivity and job satisfaction.
2. Enhancing knowledge through educational programs:
Enhancing knowledge among both employers and mothers regarding their rights and the relevant supporting legislation through educational programs involves upfront costs associated with the implementation of workshops and training initiatives. However, these investments yield long-term benefits, leading to improved parenting behaviors and increased job efficiency.
3. Facilitating access to the healthcare services:
Providing affordable or free healthcare services, including reducing waiting times for clinical and para-clinical services, and establishing specialized maternal health facilities, presents potential costs for the healthcare system and the government. However, this approach can contribute to a reduction in maternal health concerns and an overall improvement in public health
4. Conducting pilot projects and experiments:
Implementing policies on a limited scale to evaluate cost-effectiveness before widespread adoption may initially incur higher costs, but if successful, this approach ensures the effectiveness and sustainability of the policies.
5. Full implementation of the Population Growth Law and mandating the private sector to comply with it:
Despite the incentives and support outlined in the Population Growth Law, there are instances where these provisions are not effectively implemented, particularly within the private sector where employers are not obligated to comply. This lack of enforcement results in dissatisfaction among employed women. Therefore, the full implementation of the provisions of the Population Growth Law, coupled with mandatory compliance for private sector employers, can play a significant role in enhancing job satisfaction, increasing the efficiency of employed mothers, and encouraging childbearing.
6. Modify some existing laws:
In the Civil Service Management Law currently provides family and child allowances exclusively to men, while acknowledging the significant role of mothers in childcare. This creates a sense of inequity and dissatisfaction among employed mothers, who perceive this provision as discriminatory. Modifying these laws to extend family and child allowances to both parents, including mothers, would be an effective strategy for increasing job satisfaction and promoting childbearing among employed women.
Conclusion
This policy brief underscores the critical need to foster individual capabilities, particularly among mothers and children, through the implementation of supportive policies. A capability-based approach, centered on providing opportunities for choice, is recommended. It is recommended that maternity leave benefits be fully funded, and that government support for parents be strengthened. Evidence suggests that increased financial support for families encourages mothers to care for infants and enhances their financial security, ultimately promoting childbearing. A significant challenge is the limited availability of childcare services and facilities for children under six. To address this, it is proposed that, following the end of parental leave, additional leave be considered for childcare in unforeseen circumstances (such as child illness) to alleviate the stress on parents, particularly mothers, enabling them to provide stress-free care. Providing at least 24 months of unpaid parental leave would be highly beneficial. The policies implemented in Sweden, particularly the approval and implementation of child-bearing incentives, including the allocation of non-transferable leave rights for fathers, serve as a valuable model for developing similar policies.
Practical Implications of Research To ensure effective implementation, the recommended policies should be developed and implemented through coherent and phased plans, which should include:
• Formulation and approval of protective regulations within labor laws.
• Allocation of resources and financial facilities to employers for the provision of supportive environments.
• Continuous training and regular information dissemination to both employees and employers.
• Continuous monitoring and periodic evaluation of the implementation of existing policies and laws, with necessary reforms implemented as needed.
• The provision of flexible and part-time work opportunities until a certain age of the child, ensuring access to early care and education.
These recommendations should be implemented through close inter-sectorial collaboration involving employers, non-governmental organizations (NGOs), to ensure their effectiveness and contribute to the well-being of mothers and newborns.