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. 2000 Mar;54(3):185–191. doi: 10.1136/jech.54.3.185

Unemployment and psychological distress one year after childbirth in France

M Saurel-Cubizolles 1, P Romito 1, P Ancel 1, N Lelong 1
PMCID: PMC1731633  PMID: 10746112

Abstract

STUDY OBJECTIVE—To analyse the relation between unemployment and the psychological distress of mothers one year after childbirth.
DESIGN—Multicentric survey concerning births occurring between September 1993 and July 1994.
SETTING—In France: two maternity units in the Parisian area and one in Champagne-Ardennes, in the east of France, comprising both urban and rural areas.
PARTICIPANTS—Primipara and secondipara women were interviewed three times: at birth by a face to face interview, five months and 12 months after the birth, by postal questionnaires, with a 83% response rate for the two postal questionnaires. The analysis includes 632 women who answered all three stages of the survey.
MEASUREMENTS—Psychological distress was mainly assessed one year after birth by the 12-item General Health Questionnaire.
RESULTS—After adjustment for unwanted pregnancy, marital conflicts, marital status, hospitalisation of the baby during the last year, lack of confiding relationship, depressive or anxious troubles before pregnancy, age, educational level and parity, unemployed women had an excess of psychological distress compared with employed women (OR = 1.87; 95%CI = 1.12, 3.13). The ratios for housewives were very close to those of employed women. Among the unemployed women, 60% had recently been without a job, since a few months before or after the birth. An excess of psychological distress among unemployed compared with employed women was observed in all social groups defined by the current or last occupation, but with various extents. Psychological distress was specially linked to the employment status in the group of women with the more qualified occupations.
CONCLUSION—Even after a birth, when women are very much involved in their maternal role, those seeking a job have worse mental health than those in a stable situation, either employed or housewives. In France, the unemployment rate among young women is high. It is specially important that social regulations protecting employment during and after pregnancy are adequately applied. Employers, legislators, such as medical doctors, have to be aware to this situation.


Keywords: psychological distress; unemployment; childbirth; women's health

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Selected References

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  1. Arrow J. O. Estimating the influence of health as a risk factor on unemployment: a survival analysis of employment durations for workers surveyed in the German Socio-Economic Panel (1984-1990). Soc Sci Med. 1996 Jun;42(12):1651–1659. doi: 10.1016/0277-9536(95)00329-0. [DOI] [PubMed] [Google Scholar]
  2. Blondel B., Bréart G., du Mazaubrun C., Badeyan G., Wcislo M., Lordier A., Matet N. La situation périnatale en France. Evolution entre 1981 et 1995. J Gynecol Obstet Biol Reprod (Paris) 1997;26(8):770–780. [PubMed] [Google Scholar]
  3. Brenner M. H., Mooney A. Unemployment and health in the context of economic change. Soc Sci Med. 1983;17(16):1125–1138. doi: 10.1016/0277-9536(83)90005-9. [DOI] [PubMed] [Google Scholar]
  4. Brown G. W., Moran P. M. Single mothers, poverty and depression. Psychol Med. 1997 Jan;27(1):21–33. doi: 10.1017/s0033291796004060. [DOI] [PubMed] [Google Scholar]
  5. Claussen B., Bjørndal A., Hjort P. F. Health and re-employment in a two year follow up of long term unemployed. J Epidemiol Community Health. 1993 Feb;47(1):14–18. doi: 10.1136/jech.47.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dew M. A., Bromet E. J., Penkower L. Mental health effects of job loss in women. Psychol Med. 1992 Aug;22(3):751–764. doi: 10.1017/s0033291700038198. [DOI] [PubMed] [Google Scholar]
  7. Ensminger M. E., Celentano D. D. Gender differences in the effect of unemployment on psychological distress. Soc Sci Med. 1990;30(4):469–477. doi: 10.1016/0277-9536(90)90349-w. [DOI] [PubMed] [Google Scholar]
  8. Ezzy D. Unemployment and mental health: a critical review. Soc Sci Med. 1993 Jul;37(1):41–52. doi: 10.1016/0277-9536(93)90316-v. [DOI] [PubMed] [Google Scholar]
  9. Goldberg D. P., Gater R., Sartorius N., Ustun T. B., Piccinelli M., Gureje O., Rutter C. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997 Jan;27(1):191–197. doi: 10.1017/s0033291796004242. [DOI] [PubMed] [Google Scholar]
  10. Hammarström A. Health consequences of youth unemployment--review from a gender perspective. Soc Sci Med. 1994 Mar;38(5):699–709. doi: 10.1016/0277-9536(94)90460-x. [DOI] [PubMed] [Google Scholar]
  11. Hopton J. L., Hunt S. M. Housing conditions and mental health in a disadvantaged area in Scotland. J Epidemiol Community Health. 1996 Feb;50(1):56–61. doi: 10.1136/jech.50.1.56. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Janlert U. Unemployment as a disease and diseases of the unemployed. Scand J Work Environ Health. 1997;23 (Suppl 3):79–83. [PubMed] [Google Scholar]
  13. Kumar R. Postnatal mental illness: a transcultural perspective. Soc Psychiatry Psychiatr Epidemiol. 1994 Nov;29(6):250–264. doi: 10.1007/BF00802048. [DOI] [PubMed] [Google Scholar]
  14. Lahelma E. Unemployment and mental well-being: elaboration of the relationship. Int J Health Serv. 1992;22(2):261–274. doi: 10.2190/LKDE-1E0K-TANM-HQUY. [DOI] [PubMed] [Google Scholar]
  15. Lahelma E. Unemployment and mental well-being: elaboration of the relationship. Int J Health Serv. 1992;22(2):261–274. doi: 10.2190/LKDE-1E0K-TANM-HQUY. [DOI] [PubMed] [Google Scholar]
  16. Leeflang R. L., Klein-Hesselink D. J., Spruit I. P. Health effects of unemployment--II. Men and women. Soc Sci Med. 1992 Feb;34(4):351–363. doi: 10.1016/0277-9536(92)90295-2. [DOI] [PubMed] [Google Scholar]
  17. Lelong N., Saurel-Cubizolles M., Romito P. Réponses à une enquête postale sur la santé des femmes après une naissance: importance des relances et caractéristiques des non-répondantes. Rev Epidemiol Sante Publique. 1997 Sep;45(4):305–314. [PubMed] [Google Scholar]
  18. Lewis G., Araya R. I. Is the General Health Questionnaire (12 item) a culturally biased measure of psychiatric disorder? Soc Psychiatry Psychiatr Epidemiol. 1995 Jan;30(1):20–25. doi: 10.1007/BF00784430. [DOI] [PubMed] [Google Scholar]
  19. Lewis G., Sloggett A. Suicide, deprivation, and unemployment: record linkage study. BMJ. 1998 Nov 7;317(7168):1283–1286. doi: 10.1136/bmj.317.7168.1283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Montgomery S. M., Bartley M. J., Cook D. G., Wadsworth M. E. Health and social precursors of unemployment in young men in Great Britain. J Epidemiol Community Health. 1996 Aug;50(4):415–422. doi: 10.1136/jech.50.4.415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Platt S., Micciolo R., Tansella M. Suicide and unemployment in Italy: description, analysis and interpretation of recent trends. Soc Sci Med. 1992 Jun;34(11):1191–1201. doi: 10.1016/0277-9536(92)90312-e. [DOI] [PubMed] [Google Scholar]
  22. Reijneveld S. A., Schene A. H. Higher prevalence of mental disorders in socioeconomically deprived urban areas in The Netherlands: community or personal disadvantage? J Epidemiol Community Health. 1998 Jan;52(1):2–7. doi: 10.1136/jech.52.1.2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Romito P., Saurel-Cubizolles M. J. Fair law, unfair practices? Benefiting from protective legislation for pregnant workers in Italy and France. Soc Sci Med. 1992 Dec;35(12):1485–1495. doi: 10.1016/0277-9536(92)90051-q. [DOI] [PubMed] [Google Scholar]
  24. Romito P., Saurel-Cubizolles M. J., Lelong N. What makes new mothers unhappy: psychological distress one year after birth in Italy and France. Soc Sci Med. 1999 Dec;49(12):1651–1661. doi: 10.1016/s0277-9536(99)00238-5. [DOI] [PubMed] [Google Scholar]
  25. Turner J. B. Economic context and the health effects of unemployment. J Health Soc Behav. 1995 Sep;36(3):213–229. [PubMed] [Google Scholar]
  26. Viinamäki H., Kontula O., Niskanen L., Koskela K. The association between economic and social factors and mental health in Finland. Acta Psychiatr Scand. 1995 Sep;92(3):208–213. doi: 10.1111/j.1600-0447.1995.tb09570.x. [DOI] [PubMed] [Google Scholar]
  27. Viinamäki H., Niskanen L., Pesonen P., Saarikoski S. Evolution of postpartum mental health. J Psychosom Obstet Gynaecol. 1997 Sep;18(3):213–219. doi: 10.3109/01674829709080690. [DOI] [PubMed] [Google Scholar]
  28. Viinamäki H., Rastas S., Tukeva L., Kuha S., Niskanen L., Saarikoski S. Postpartum mental health. J Psychosom Obstet Gynaecol. 1994 Sep;15(3):141–146. doi: 10.3109/01674829409025639. [DOI] [PubMed] [Google Scholar]
  29. Weich S., Lewis G. Poverty, unemployment, and common mental disorders: population based cohort study. BMJ. 1998 Jul 11;317(7151):115–119. doi: 10.1136/bmj.317.7151.115. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. de Mont-Marin F., Hardy P., Lépine J. P., Halfon P., Féline A. Validation d'une version française du General Health Questionnaire (GHQ-28) dans une population de diabétiques. Encephale. 1993 Jul-Aug;19(4):293–301. [PubMed] [Google Scholar]

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