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Occupational Medicine Advance Access originally published online on July 30, 2008
Occupational Medicine 2008 58(7):468-474; doi:10.1093/occmed/kqn090
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Flexible work arrangements and work–family conflict after childbirth

Mira M. Grice1, Patricia M. McGovern2 and Bruce H. Alexander2

1 Division of Environmental and Occupational Health Sciences, Graduate Program in Public Health, SUNY Downstate Medical Center, Brooklyn, NY, USA
2 Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA

Correspondence to: Mira M. Grice, Graduate Program in Public Health, SUNY Downstate Medical Center, 450 Clarkson Avenue, Box 43, Brooklyn, NY 11203-2098, USA. Tel: +1 718 270 1790; fax: +1 718 221 5154; e-mail: mira.grice{at}downstate.edu


   Abstract
Top
 Abstract
Background
 Methods
 Results
 Discussion
 Conflicts of interest
 References
 
Background Previous research has revealed that work–family conflict negatively influences women’s health following childbirth.

Aim To examine if flexible work arrangements were associated with work–family conflict among women, 1 year after childbirth.

Methods Employed women, aged ≥18, were recruited while hospitalized for childbirth. Flexible work arrangements were measured at 6 months and work–family conflict was measured at 12 months. General linear models estimated the association between flexible work arrangements and work–family conflict.

Results Of 1157 eligible participants, 522 were included in this analysis giving a 45% response rate. Compared to women who reported that taking time off was very hard, those who reported it was not too hard (β = –0.80, SE = 0.36, P < 0.05) and not at all hard (β = –1.08, SE = 0.35, P < 0.01) had lower average job spillover scores. There was no association between taking time off and home spillover. The ability to change hours was associated with greater home spillover (β = 0.46, SE = 0.18, P < 0.05) but not with job spillover. The ability to take work home was associated with increased home spillover (β = 0.35, SE = 0.14, P < 0.05) but not with job spillover.

Conclusions The ability to change work hours and the ability to take work home were associated with increased home spillover to work. The ability to take time off was associated with decreased job spillover to home. Additional research is needed to examine the intentional and unintentional consequences of flexible work arrangements.

Keywords      Occupational health; pregnancy; women; workplace


   Background
Top
 Abstract
 Background
Methods
 Results
 Discussion
 Conflicts of interest
 References
 
In the USA, workforce demographics have changed dramatically over the past 30 years as women of childbearing age have increased their participation in the workforce. In the mid-1990s, ~75% of women aged 25–54 were employed compared to 43% in the 1960s [1]. In 1975, 34% of women with children <3 years of age participated in the labour market compared to 57% in 2005 [2]. Though decreasing slightly after reaching a peak of 59% in 1997, women with infants (children <1 year of age) continue to record high levels of labour force participation with rates levelling off to ~54% [3]. The slight decline in women’s participation rates has been attributed to many factors, including decreased opportunities in the labour market and fewer companies offering family friendly policies [3].

Today’s workforce comprises a large number of single mothers and dual-earner couples who are faced with the challenging task of balancing both work demands and family obligations. Gaining a comprehensive understanding of the reasons behind and consequences of work–family conflict is important, particularly when potential negative outcomes to employees and employers are considered. At the organizational level, work–family conflict has been associated with increased absenteeism, increased employee turnover, decreased career involvement and decreased job satisfaction [4–6]. At the individual level, work–family conflict has been associated with depression, substance abuse, hypertension and overall poor physical health [7–9].

Flexible work practices are often considered to be an essential component of ‘family friendly policies’ and are widely seen as an ideal means to achieving a more balanced work and home life [10–12]. Much of the research previously conducted involved studying workers in the USA. These studies have provided insight into how flexible policies are utilized, in addition to describing worker attitudes and preferences [10,11,13]. Recent reports estimated that ~55% of companies allowed employees to complete work from home or the office and that employees ranked flexibility as one of the most beneficial family friendly policies available at the company [11].

Availability of flexible work schedules has the potential to lead to both positive and negative outcomes for companies and their workforce. Positive outcomes include retention of talented employees, increased employee loyalty, decreased operating costs, increased productivity, increased job satisfaction and decreased work–family conflict [10,11,14–16]. Possible negative outcomes for employees and employers include reduced contact with the workplace, a possible loss of managerial control and the potential for increased interference between work and home domains [13]. Increased interference between work and home can contribute to decreased quality time with family, increased workload and role conflict which can lead to reduced physical and psychological well-being—both being associated with diminished productivity [17].

Most studies have examined flexible work arrangements in populations consisting of both men and women, with or without children. Few have focused exclusively on women’s experiences balancing work and family after childbirth [18–20]. This study was designed to examine if various work flexibility measures, such as the perceived ability to take time off, take work home and change work hours, were associated with work–family conflict among women, 1 year after childbirth.


   Methods
Top
 Abstract
 Background
 Methods
Results
 Discussion
 Conflicts of interest
 References
 
Data for this analysis originated from a study designed to investigate women’s post-partum health [21]. The target population included all women, ≥18 years, who resided in the seven county metropolitan Minneapolis and St Paul area in Minnesota, gave birth to a live, singleton infant with no serious health complications and worked for a minimum of 3 continuous months (20 h/week) in the year preceding childbirth. Additionally, the women had to plan on returning to work following childbirth and, because the survey was conducted in English, participants had to be English speaking.

Three community hospitals were selected from the Minneapolis and St Paul, Minnesota metropolitan area. The study was a prospective cohort study. Participants were recruited between April 2001 and November 2001 while in hospital for childbirth. Perinatal nurses were employed to enrol new mothers into the study. Nurses reviewed the hospital’s birth log to identify all women delivering during the study period. This study was approved by the University of Minnesota’s Institutional Review Board (IRB) as well as the IRBs from each of the three participating hospitals.

Once identified, each woman’s medical record was reviewed for preliminary sample selection criteria (e.g. maternal age, county of residence and infant health status). If initial criteria were met, nurses then interviewed the woman for additional study selection criteria (e.g. employment), reviewed the study protocol, consent forms and invited eligible women to enrol in the study. Demographic and baseline infant and maternal health information was collected from hospital records. Interviews were used to gather personal, family and employment information from the mothers while in the hospital. Eligible women were asked to consent to a 45-min telephone interview 11 weeks, 6 months and 12 months following childbirth. Women unable to complete the full interview at any point were invited to complete the mini-interview, which collected basic information on health status and employment.

Three job flexibility items (i.e. the ability to take time off, the ability to change work hours and the ability to take work home, if temporarily needed) were adapted from the Quality of Employment Survey [22] and validated in post-partum women [23]. Likert-type responses ranged from ‘(1) very hard’ to ‘(4) not at all hard’. The outcome variables, job spillover and home spillover, were measured using four items adapted from Frone et al. [24]. Two questions assessed job spillover which was defined as the encroachment of work roles, obligations and expectations on family roles and obligations (e.g. needing to work late). Home spillover was defined as the encroachment of family roles and obligations on work duties (e.g. leaving work early to pick up a sick child from day care) and assessed with two questions. Likert-type responses for each item ranged from ‘(1) rarely or never’ to ‘(5) most or all of the time’. Responses were added to produce a total score ranging from 2 to 10 for each type of spillover. The questions read as follows:

Job spillover: (i) ‘How often does your job or career interfere with your responsibilities at home (e.g. childcare, cooking, cleaning?)’ and (ii) ‘How often does your job or career keep you from spending the amount of time you would like with your family?’
Home spillover: (i) ‘How often does your home life interfere with your responsibilities at work (e.g. getting to work on time or accomplishing daily tasks, working overtime?)’ and (ii) ‘How often does your home life keep you from spending the amount of time you would like to spend on job or career-related activities?’

Covariates in this analysis were measured 6 months following childbirth, when 94% of the study population had returned to work. Both job and home spillover were measured 12 months following childbirth to ensure that participants had a minimum of 6 months exposure balancing the demands of both work and family, in addition to sufficient opportunity to utilize flexible work arrangements.

Six general linear models were constructed to estimate the associations between the job flexibility items and work–family conflict outcomes. A priori causal models and directed acyclic graphs guided selection of potentially confounding variables. This method is described by Greenland et al. [25] and illustrated by Hernán et al. [26]. Covariates included in each model are provided in table footnotes. Mental and physical health was measured using the Short Form 12 Version 2 Mental Component and Physical Component Summaries [27].

For multivariate analyses, multi-level variables were coded as categorical. Job title was categorized as white-collar, clerical and manual labour. Race was categorized as white, black and other. Imputation was used to estimate variables with missing data (~7% of 817 responses were missing for income and <2% of 817 for the remaining covariates). For example, observations with missing values for income were imputed by averaging the reported family incomes of women by marital status.


   Results
Top
 Abstract
 Background
 Methods
 Results
Discussion
 Conflicts of interest
 References
 
Of the 1157 eligible participants among the 2736 women giving birth at study hospitals during the enrolment period, 817 enrolled in the study (response rate: 71%). Among the excluded participants (N = 1579), 581 (37%) were ineligible because of sample selection or health characteristics (e.g. lived outside of the metropolitan area and baby had serious neonatal complications) and 998 (63%) were ineligible because of employment-related criteria (e.g. not employed at birth and not planning to return to work). Of the 817 women enrolled, a total of 522 women completed the full interview 6 months after childbirth. Demographic information is given in Table 1.


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  		Table 1. A comparison of participant characteristics by interview type

 
Table 2 provides results from the two models analysing the ability to take time off with job and home spillover. When examining the job spillover model, there was a decrease in job spillover as women reported an increased ability to take time off. Compared to women who reported that taking time off was ‘very hard’, those who reported it was ‘somewhat hard’ (β = –0.47, SE = 0.36), ‘not too hard’ (β = –0.80, SE = 0.36) and ‘not at all hard’ (β = –1.08, SE = 0.35) had lower average job spillover scores. Also of note, women who worked in clerical jobs (β = –0.39, SE = 0.19) and manual labour jobs (β = –0.71, SE = 0.28) also reported lower job spillover when compared to women working in white-collar or professional roles.


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  		Table 2. Job spillover and home spillover models and their association with the ability to take time off

 
Although there is no evidence supporting an association with the ability to take time off in the home spillover model, availability of social support from family and friends was associated with lower average home spillover scores (β = –0.06, SE = 0.02) as was working in a manual labour versus white-collar job (β = –0.55, SE = 0.21).

The ability to change hours was not associated with lower job spillover scores but was associated with increased home spillover (Table 3). Women who reported that changing hours was not at all hard reported higher home spillover scores, on average, compared to women who believed it was very hard to adjust their work hours (β = 0.46, SE = 0.18). Availability of social support (β = –0.07, SE = 0.02) and working in manual labour jobs (β = –0.52, SE = 0.20) were again associated with lower average home spillover scores.


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  		Table 3. Job spillover and home spillover models and their association with the ability to change hours

 
Similar results were found when modelling the association between the ability to take work home and job and home spillover (Table 4). Again, there was a significant association with home spillover. Women who reported that it was not too hard (β = 0.52, SE = 0.23) and not at all hard to take work home (β = 0.35, SE = 0.14) had home spillover levels that were, on average, higher than women who reported it was very hard. As with the previous models, availability of social support and working in a manual labour job were all associated with significantly lower home spillover scores.


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  		Table 4. Job spillover and home spillover models and their association with the ability to take work home

 

   Discussion
Top
 Abstract
 Background
 Methods
 Results
 Discussion
Conflicts of interest
 References
 
Our study found that the ability of post-partum women to take time off work was associated with reduced job spillover into the home. These findings are consistent with previous studies [11,13]. Perhaps, more notable were the findings that suggest two work flexibility items (ability to change hours and the ability to take work home) were associated with increased home spillover into the job. Similar findings have been reported in other studies and suggest that employees working from home may be more susceptible to increased interruptions from family members [17]. While interference between work and home may increase, the result would not necessarily be negative. By being in closer proximity to her child, a mother would be better able to manage an emergency or crisis should one arise. For example, if a child becomes ill in day care, mothers with flexible schedules and work locations would be better positioned to leave work to care for their baby. Women who work in inflexible environments may instead experience stress when trying to find alternative childcare arrangements or be forced to use vacation days or sick time to care for their children.

Previous studies exploring workers in the UK reported that employees from non-manual or white-collar jobs were more likely to work at home than those in manual labour work [17]. This may help explain the findings produced in this study that suggest women working in professional roles consistently experience more work and home spillover than women working in clerical and manual labour jobs. White-collar or professional workers typically have the type of work that is amenable to completion at home, while manual labour and clerical workers are more often limited to work demands that must be completed in a work, or office, setting.

Flexible work schedules may increase interference between work and home leading to potentially positive as well as negative outcomes [17]. However, given that many employees rank job flexibility policies as the most beneficial in managing both work and family demands [13], the value of these programmes should not be underestimated. As mentioned previously, workers may be better positioned to manage emergencies but they could also experience increased conflict and stress. Whether or not flexibility results in positive or negative outcomes is likely to depend on the worker’s preferences or personal situation. While work at home may be preferred by some employees, it may not be appropriate, or possible, for others. A variety of flexible work arrangements that are accessible to all job types should be considered. Examples of benefits that white-collar, manual labour and clerical workers could utilize include onsite day care or working 40 hours in less than 5 days.

A strength of this study was the focus on post-partum women and their experiences with flexible workplace policies after childbirth. Previous studies included populations that consisted of both men and women who may or may not have had children. Workers with children, particularly infants, may require additional flexibility to better manage both work duties and family demands during this unique time in women’s life cycles. Another strength of this study was the relatively large sample size. With the exception of Hill et al. [11], other studies had sample sizes that generally ranged from 120 to 450 participants. A final strength of the study was the availability of individual-level data from multiple time points: at childbirth, 11 weeks, 6 months and 12 months post-partum enhancing the ability to investigate associations over time.

Several limitations in this study should also be noted. First, the women in this population were predominantly white, highly educated and lived in a relatively large metropolitan area. In addition, these women were English speakers. For these reasons, the findings cannot be generalizable to women in other communities. Future studies should examine the experiences of diverse populations, including non-English speakers and women in rural communities. Though 817 women enrolled in the study, only 522 completed the interview at 6 months. Bias may have been introduced if women who did not respond were experiencing more or less work–family interference than those who did respond. Given the lack of information on women who did not complete the survey, we were unable to assess the potential magnitude of this bias.

Another potential limitation was the 6-month time lag between when the exposures and outcomes were measured. The 6-month time lag may be too long to capture short-term outcomes or effects. Generally, missing data were few, with the exception of household income. While imputation was based on the mean income of women by marital status, a more precise imputation could have been possible if other variables, such as education and age, were included in the estimation. Finally, use of self-reported data limits the ability to assess the influence of personal outlook and perceptions, such as negative affectivity. However, the exposures and outcomes of interest in this study are inherently subjective. Further, lack of a gold standard or objective measure increases the difficulty in addressing this concern.

Additional research is needed to better understand which underlying circumstances result in flexible arrangements and positive outcomes for workers, their families and employers. Whether or not flexible arrangements lead to increased availability with the family or instead result in increased overtime work and a decrease in quality time with family remains unclear. Further, simply having family friendly policies available does not necessarily mean that employees are utilizing the programmes. Future studies should also consider ways of investigating how often these programmes are being utilized and whether or not they are achieving their intended goals.

In summary, study findings revealed that the ability to take time off was associated with lower job spillover, and the ability to change work hours and the ability to take work home were associated with increased home spillover to work. Whether or not spillover is positive or negative likely depends on the worker’s preferences or personal situation.


Key points
  • The ability to take time off was associated with lower job spillover.
  • The ability to change work hours and the ability to take work home were associated with increased home spillover to work.
  • Whether or not spillover is positive or negative likely depends on the worker’s preferences or personal situation.

 


   Conflicts of interest
Top
 Abstract
 Background
 Methods
 Results
 Discussion
 Conflicts of interest
References
 
None declared.


   Acknowledgements
 
This research was supported by the grant 5 R18 OH003605-05 from the National Institute for Occupational Safety and Health (NIOSH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIOSH. Gratitude is extended to the doctoral training program in occupational health services research and policy made possible through the Midwest Center for Occupational Health and Safety and Educational Research Center supported, in part, by NIOSH (T42OH008434).


   References
Top
 Abstract
 Background
 Methods
 Results
 Discussion
 Conflicts of interest
 References
 

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