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Women, Work and Care: A Challenge for the 21st Century

Women, Work and Care: A Challenge for the 21st Century

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Women, Work and Care: A Challenge for the 21st Century

Women, Work and Care: A Challenge for the 21st Century

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Published by: The Royal Society of Edinburgh on Nov 14, 2013
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SummaryRecommendations
RecommendationstotheScottishGovernment
 Alifecourseapproachtowomen’shealthcare:
TheScottishGovernmentshouldworktodevelopalifecourseapproachtowomen’sreproductiveandpost-reproductivehealthwhichraisesitsvisibilityasaconcern.
 Agenderedapproachtopolicymaking:
TheScottishGovernmentshouldcommittotakingagenderedapproachtopolicymaking,toensurethatpolicywithrelevanceforthewholeofsocietyisresponsivetotheexperiencesofmenandwomen.
RecommendationstotheScottishandUKGovernments
 Increasedprovisionforhigh-quality,flexibleandaffordablechildcare:
TheScottishandUKGovernmentsshoulddevelopastrategywhichisfocusedonenablingmenandwomentobalancetheircaringroleswiththeirprofessional/workinglives,andwhichplacestheavailabilityandaffordabilityofhighquality,flexiblechildcareforpre-schoolandschool-agechildrenatitscentre.
Recommendationstoemployersandtertiaryeducationproviders
 Educationalandearlycareertrajectoriesthatarecompatiblewithchildbearing:
Employersandtertiaryeducationprovidersshouldworktowardsanenvironmentinwhichchildbearingismadecompatiblewithfurtherandhighereducation,andcontinuedprofessionaldevelopment,thusfacilitatinglessconstrainedreproductivechoice.
 Employerssupportwomenandmenintheircaringroles:
Public,private,andthirdsectoremployersshouldworktofacilitateanenvironmentinwhichwomenandmenaresupportedintheircaringroles;andinwhichwomenandmenfeelthatthevalueoftheircaringrolesisrecognised.
 Advice Pape
October 2013
1
 Women, work and care; a challenge for the 21st centur
(13–1
1
)
InFebruary2013,theRoyalSocietyofEdinburghhostedatwo-dayinter-disciplinaryconferenceon
WomensReproductiveHealthAcrosstheLifecourse
.Thisconferencebroughttogetherclinicians,policymakers,scientists,socialscientistsandotherstakeholderstoconsideranddebatewomen’sreproductivehealth.Thepurposeofthisconferencewastoconsiderevidence,fromdiverseperspectives,relatingtoreproductivehealth,andtodiscussthewiderimplicationsofthisforhealthandsocialpolicygenerally,andforthemedical,clinicalandacademicworkforceoftheUKspecifically.
 
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 Advice Pape
 13–1
1
Achallengeforthe21stCentur
WomenplayavitalroleintheworkforceoftheUK,andconstitutealargerproportionofthatworkforcethaneverbefore
1
.Thecontributionmadebywomeninallsectorsiscrucial,notonlyforwomensowncareersandprofessionaldevelopment,butalsofortheeconomyasawhole.Equalitylegislationhassoughttoensurethatwomenareprovidedwithopportunitiesintheiremploymentequaltothoseofmen.However,itremainsthecasethatwomensworkplaceparticipationhasyettobefullyincorporatedandsupportedfromapolicyperspective.Womenexperienceauniquesetofcountervailingpressuresrelatedtotheirreproductivehealthandwellbeingwhich,untilrecognisedandmitigatedbyeffectivepolicyandpractice,willremaininvisible.
Thepolicylandscape:whatneedstochange?
Approachestowomen’shealthcareneeds
Atpresent,women’sreproductivehealthisunderstoodprimarilyintermsofmaternalhealth,withthemajorityofavailablesupportandinterventionoccurringinamedicalsetting,atthetimewhenawomanfirstbecomespregnantorbeginstryingtobecomepregnant.Asaresult,manyofthehealthissuesaffectingwomenintheworkplacehavebecomeinvisible.Thesehealthissuesincludemenstrualcycle-relatedproblemssuchasheavybleeding,endometriosis,andfibroids,whichcanleadtopainfulperiodsandnegativelyaffectqualityoflifeandworkplaceactivity
2
.Therelevanceofcycle-relatedproblemsforwomen’squalityoflifeandworkplaceactivityisbecomingincreasinglyapparentintheUKandotherdevelopednations,duetothefactthatwomenarenowtypicallyhavingfewerpregnanciesandmoreperiods.Thereisaneedforagreatermedicalunderstandingofcycle-relatedproblems,andmoreoptionsforthemanagementoftheseproblemsbywomen.Atpresent,themosteffectivetreatmentsforcycle-relatedproblemsareoftensurgicalandirreversibleandmayhaveunacceptableconsequencesforwomen,especiallyforthosewhohaveyettostartafamily.Asaresult,manywomenmustmanagecycle-relatedproblemsalongsidetheirworkinglivesandothercommitments;thischallengeislargelyinvisiblefromapolicyperspective.Furthermore,asageatfirstsexdeclines,ageatfirstchildbirthincreasesandsmallerfamilysizebecomesthenorm;mostwomenspendthirtyormoreyearsoftheirlifetryingtoavoidunwantedpregnancy.Whilstmoderncontraceptioniseffectiveandeasytouse,theneedforitdoesimposeanotherburdenonwomenwhostillhavetoattendtheirdoctoronaregularbasisforcontraceptivesuppliesandfollow-up.Becausewomenarenowworkinguntillaterinlife,healthissuesrelatingtothemenopausearealsobecomingincreasinglyrelevantforwomenintheworkplace.Symptoms(ofperi-menopause)impactinguponlifestyleincludehotflushesandnightsweats;achingjoints;urinaryproblemsandmoodchanges
3
.Forwomenwithseveremenopausalsymptoms,theremaybeasignificantimpactonwellbeingandlifestyleaswellasontherisksofseriousdiseaseinlaterlife.Thereisaneedforgreaterrecognitionofwomensreproductivehealthacrossthewholelifecourseandnotjustinrelationtomaternalhealth.Thereisalsoaneedtofocusonthework-placeasasiteforpromotingwomen’shealthandwellbeing.
Recommendation:
TheScottishGovernmentshouldworktodevelopalifecourseapproachtowomen’sreproductiveandpost-reproductivehealththatraisesitsvisibilityasaconcern.Thisshouldincludetakingadvantageofopportunitiesforsign-postingearlyindicatorsofhealthrisks,andtakingmitigatingaction
4
.Anemphasisonpromotingwomenshealthatworkshouldunderpinsuchanapproach.
Educationalandcareertrajectories
Contemporaryeducationalandcareertrajectoriesstillfollowatraditionallinearpathway,withperiodsofcontinuousformaleducationandtrainingbeingfollowedbygradualprofessionalprogression.Forwomenpursuingtertiaryeducationfollowedbyprofessionalcareers,theperiodofeducationandearlycareertrainingoftenlastsintothelatetwentiesorearlythirties.Careerandfinancialsecurityisunlikelytobereacheduntilawomanisinhermidtolatethirties,meaningthatmorewomenarenowdelayingpregnancydecisionsandchildbearinguntiltheirthirtiesandearlyforties.
1
 Accordingtoa2011reportbytheUKGovernment
‘Womenonboards’ 
,womennowform51%oftheUKpopulationand46%oftheeconomicallyactiveworkforce;https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/31480/11-745-women-on-boards.pdf
2
 Women’sReproductiveHealthAcrosstheLifecourseimplicationsforpublicpolicy 
,RoyalSocietyofEdinburgh,ISBN:9780902198968
3
 Women’sReproductiveHealthAcrosstheLifecourseImplicationsforPublicPolicy 
,RoyalSocietyofEdinburgh,2013
4
 Alifecourseapproachtowomen’shealthcareisendorsedbytheRCOGintheirexpertadvisorygroupreport
HighQualityWomen’sHealthcare:aproposalfor change
,andbytheMRClifecourseepidemiologyunit.
 
Althoughthismightbeunderstoodasamatterofactivechoice,suchreproductivedecisionsaremadeinthecontextofspecificconstraintsthatlimitavailableoptions.Itistakinglongerforwomen,especiallythosepursuingcareers,toreachastageofsecuritytypicallydeemednecessaryforstartingafamily(beinginasettledrelationshipandahomeowner).Theeconomicrecessionandtheassociatednegativeimpactuponhousing,employment,income,publicspendingonchildcare,andmobilityarelikelytohaveexacerbatedthis.Analternativetrajectorytowardsearlierchildbearingrequiresgreatersocietalsupport,facilitatingfurtherandhighereducationandjobprospectsinthecontextofraisingafamily.Thisshouldincludeashiftawayfromlinearcareertrajectories,wherebysolidperiodsofeducation,trainingandworkoccurinconsecutiveblocks,andchildbearingonlyseemsfeasibleonceacertainlevelofseniorityisreached.Analternativeapproachwithgreaterfocusonlife-longlearningandcontinuedtrainingshouldbeadopted.Greaterflexibilitytomapperiodsofstudyandtrainingaroundperiodsofchildbearingandchildrearingshouldalsobeactivelypromoted,formenandforwomen.
Recommendation:
Employersandtertiaryeducationprovidersshouldworktowardsanenvironmentinwhichchildbearingandchildrearingismadecompatiblewithfurtherandhighereducation,andcontinuedprofessionaldevelopment,thusfacilitatinglessconstrainedreproductivechoice. Placegreateremphasisonpart-time/flexiblestudy,toallowmenandwomentomanagestudyandearlycareertrainingaroundperiodsofchildrearing; Ensuretertiaryeducationalinstitutionsare‘familyfriendly’towardsstudents,withappropriatefacilitiesandsupport.
Workplacepolicyandpractice
Equalitylegislationdesignedtoremovegenderinequalitiesnegativelyaffectingwomen’saccesstoworkdoesnotalwaystranslateintoeffectiveworkplacepolicyandpractice.Womencontinuetotakegreaterresponsibilityfordomesticworkandcaringrolesthanmen,whethertheyaresimultaneouslyengagedinworkornot.Thisisparticularlythecaseinrelationtochildcare,butalsoappliestothecareofelderlyrelatives.Asaresultofpressurestobalancecaringroleswithprofessionallife,womensparticipationintheworkplaceisstilldisproportionatelyconstitutedbypart-timework,ascomparedwithmen.Interruptionstolinearcareertrajectoriesexperiencedbywomenasaresultofmaternityleaveorperiodsofpart-timeworkingmeanthattheyarelesslikelytoprogresstothehighestpaidpositionswithintheirchosencareers.Asaresult,the
genderpaygapremainsintractable.Inequityofaccesstolongermaternityleaveandaffordablechildcaremeanthatsomewomenaremorenegativelyaffectedthanothersbytheircaringroles.Womeninhigherpaidandmanagerialpositionsarelikelytohaveaccesstobettermaternitypackages.Theyarealsomorelikelytotakeadvantageofformalchildcare,meaningtheirworkforceparticipationislessheavilypenalisedbymotherhoodthanthatofwomenwhocannotaffordthisoption.
Workingmenandwomenneedtobeenabledtomanagetheircaringrolesbethisasparentsorascarersforelderlyrelativesalongsidetheirworkinglives.Thereisaneedformuchgreateravailabilityofflexibleandlessthanfull-timeworkingpackages,sothatworkingmenandwomencanbalancetheirdualrolesascarersandprofessionals/workers.Thisneedstooccuralongsideagreatersocietalrecognitionoftheimportanceofcaringrolesforsocietyasawhole,especiallygiventhedemographicpressureofanageingpopulationthattheUKcurrentlyfaces.Workplaceethosshouldrecognisethetensionsandintersectionsbetweenpeople’sprofessional,civicandfamilycommitments,andworkingmenandwomenshouldnotfeelunderpressuretominimisetheimportanceoftheircaringrolesinordertoappearcommittedandprofessional.Bothmenandwomenintheworkplaceshouldfeelconfidentabouttakingupflexibleandlessthanfull-timeworkingpackages,withoutthefearthatthiswillundulyhindertheircareerprogression.
Recommendation:
Public,privateandthirdsectoremployersshouldworktofacilitateanenvironmentinwhichwomenandmenaresupportedintheircaringroles;andinwhichwomenandmenfeelthatthevalueoftheircaringrolesisrecognised. Providegreaterflexibilityaroundworkinghours,includingmorepart-timeandflexibleroles,andmoreopportunitiesforremoteworking; Providesupport,suchasrefreshercourses,toreintegratemenandwomenreturningtoworkaftermaternity/paternityleaveandothercareerbreaks.
3
 Advice Pape
 13
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