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‘Negotiating the tensions of having to attach and detach concurrently’: A qualitative study on combining breastfeeding and employment in public education and health sectors in New Delhi, India
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
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2015 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 31, no 4, 473-481 p.Article in journal (Refereed) Published
Abstract [en]

Objective: the aim of this study was to explore the factors involved in combining breastfeeding and employment in the context of six months of maternity leave in India.

Design: qualitative semi-structured interviews were conducted and analysed using a Grounded Theory approach.

Setting: Health and Education sectors in New Delhi, India,

Participants: 20 first-time mothers with one 8-12 month-old infant and who had returned to work after SIX months maternity leave.

Measurements and findings: the interviews followed a pre-tested guide with a vignette, one key question and six thematic areas; intentions, strategies, barriers, facilitators, actual experiences and appraisal of combining breastfeeding and employment. Probing covered pre-pregnancy, pregnancy, maternity leave, the transition and return to work. This study revealed a model of how employed women negotiate the tensions of concurrently having to attach and detach from their infant, work, and family. Women managed competing interests to ensure trusted care and nutrition at home; facing workplace conditions; and meeting roles and responsibilities in the family. In order to navigate these tensions, they used various satisficing actions of both an anticipatory and troubleshooting nature.

Key conclusion: in spite of a relatively generous maternity leave of six months available to these women, several individual, familial and workplace factors interacted to both hinder and facilitate the process of combining breastfeeding and employment. Tension, negotiation and compromise are inherent to the process.

Implications for practice: antenatal and postnatal interventions providing information and support for working mothers need to address factors at the individual, family and workplace levels in addition to the provision of paid maternity leave to enable the successful combination of breastfeeding and employment.

Place, publisher, year, edition, pages
2015. Vol. 31, no 4, 473-481 p.
National Category
Nutrition and Dietetics
URN: urn:nbn:se:uu:diva-247658DOI: 10.1016/j.midw.2014.12.008ISI: 000353526100011PubMedID: 25660847OAI: oai:DiVA.org:uu-247658DiVA: diva2:797172
Available from: 2015-03-23 Created: 2015-03-23 Last updated: 2015-07-07Bibliographically approved
In thesis
1. Mothers’ Agency in Managing Breastfeeding and Other Work in Dar es Salaam, Tanzania and New Delhi, India
Open this publication in new window or tab >>Mothers’ Agency in Managing Breastfeeding and Other Work in Dar es Salaam, Tanzania and New Delhi, India
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Combining breastfeeding and other forms of work is desirable from both public health and labour productivity perspectives. This is often challenging, especially in low- or middle-income fast-growing urban settings. The aim of this thesis was to gain a deeper understanding of mothers’ perspectives on combining breastfeeding and other work in the urban contexts of Dar es Salaam, Tanzania, and New Delhi, India. Individual semi-structured interviews were conducted with community mothers (n=8) and health worker mothers (n=12) in Dar es Salaam, and mothers working in the health (n=10) and education sectors (n=10) in New Delhi. The methods of analysis were:  qualitative content analysis, grounded theory approach, and directed and general inductive content analyses. Mothers’ agency manifested in several ways. Striving to integrate or segment the competing domains of home and work was a goal of these mothers to reduce conflicts in managing breastfeeding and other work. Spatial and time constraints led mothers to engage in an array of carefully planned actions and troubleshooting tactics that included ways of ensuring proximity between them and their baby and efficient time managing. The timing of these strategic actions spanned from pregnancy, over maternity leave, to the return to employment. Managing breastfeeding and work triggered emotions such as stress, frustration and guilt, but also satisfaction and joy. Mothers negotiated with family, employers, colleagues and informal networks to gain support for their strategies, displaying both individual, collective and proxy agency. Changing family structures and roles highlight the potentially greater supportive role of the partner/husband. Work/Family Border Theory and Bandura’s agency constructs provided frameworks for a deeper understanding of mothers’ perspectives, but using existing family relationship constructs would better diffentiate between various modes of agency. Workplaces and maternity protection conditions were generally inadequate. Interventions are required: to strengthen the breastfeeding mother’s own agential capacity using an individual approach; to provide information to families and communities; to improve regulatory, structural and attitudinal conditions at workplaces, and to strengthen health and social services to adequately support mothers in managing breastfeeding and other work.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 68 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1086
Breastfeeding, Women, Mothers, Work, Employment, Agency, Tanzania, India
National Category
Research subject
urn:nbn:se:uu:diva-247759 (URN)978-91-554-9208-3 (ISBN)
Public defence
2015-05-26, Room IX, Universitetshuset, Biskopsgatan 3, Uppsala, 13:00 (English)
Available from: 2015-05-04 Created: 2015-03-23 Last updated: 2015-07-07

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