Women in paid employment have better outcomes in pregnancy and improved lifestyle behaviours during it compared to homemakers, major new Irish research has found.
Women who were unemployed or homemakers had higher incidences of low birth weight and size, and their babies were more likely to be admitted to the neonatal unit, than women in paid employment, according to the study of over 62,000 Irish women.
In addition, women who were homemakers had an increased incidence of neonatal death, while among unemployed women the rate of stillbirth was higher, compared to women in paid work.
The unemployed and homemaker cohorts were less likely to plan their pregnancy and to take folic acid before conception, and more likely to continue smoking and use illicit drugs during pregnancy, the researchers from UCD and the Coombe Women and Infants University Hospital found.
Observational study
Even after adjusting for continued adverse lifestyle behaviours during pregnancy, the association with adverse outcomes persisted.
The observational study was based on the outcomes for more than 62,000 women who gave birth at the Coombe between 2010 and 2017. One of the largest maternity hospitals in Europe, the Coombe sees a diverse mix of patients in terms of socio-economic background.
The authors say their study challenges previous results and assumptions that homemakers provide the best scenario for desired foetal development.
“In some cases, such as those working in factories, mining and construction this may be true, however we found that when comparing women in paid employment as a whole to homemakers, these women had not only improved pregnancy outcomes but also improved lifestyle and pregnancy-related behaviours.”
Maternal employment
While the link between unemployment and poorer pregnancy outcomes is well-established, the Irish research sheds new light on outcomes for homemaker women.
"It does suggest that, depending on the type, work can be good for you, in terms of pregnancy outcomes," says Prof Michael Turner of UCD's Centre for Human Reproduction. "It brings in income to provide for you and your family; you eat better, exercise more and may be able to employ carers for other children."
“Society may need to see what it can do to increase maternal employment,” Prof Turner says, adding that this question is particularly relevant during the Covid-19 pandemic, as unemployment, including female unemployment, increases again.
However, he acknowledges the homemaker group is a diverse one that includes women who were on social welfare benefits before their pregnancy and women who are well-supported financially and who consciously chose to stop working before having children.
A possible weakness of the study is that information on employment status from women is self-reported, the authors acknowledge.
