Screening
An important piece in the new policy is screening as
a condition of return to work after maternity leave.
Return-to-work screening may be done by primary
care providers, obstetric care providers, pediatric
care providers, or occupational health professionals.
Professional experience as a nurse midwife and nurse
practitioner combined with the “lived experience” of
patients and colleagues enabled this APN to identify
the often ignored mental health needs of working
mothers. This nursing knowledge fueled interest in
searching the literature for research on working
women and perinatal depression and helped this
APN to create a policy that would provide services to
this vulnerable population.
A careful review of the literature showed that
working women with young infants experience a
great deal of stress from work and family life. According
to the Bureau of Labor Statistics, working
women are much more likely than men to be
responsible for care of children and the home in
addition to workplace responsibilities.30 This type
of family life spillover and the added difficulty in
balancing competing roles may lead to mental distress
in vulnerable individuals, which can be identified by
screening as a condition for return to work.28
In an effort to determine the population impact
for a perinatal mental health policy, the APN
searched for demographic information on US
workers. Over the past 40 years, the demographics of
the US worker have changed and now more women
who are pregnant or who have young infants are
in the workplace. Approximately 49% of the US
workforce is female and a majority of these women
are of reproductive age.25 Of these working women,
80% who become pregnant while actively employed
will return to work during the first year of the infant’s
life.30 These factors, combined with societal
expectations to balance competing needs of the
workplace and parenting responsibilities, may leave
women unable to practice mental wellness activities
(such as exercise and socializing), and therefore
vulnerable to mental illness.27 The societal changes
and the incidence rate of perinatal depression are the
reasons that perinatal depression screening in working
women is specifically addressed in the new policy.