Child Psychiatry Perspectives

Women, Work, and Children

Carol Nadelson, M.D., and Malkah Notman, M.D.

Abstract: The authors begin by discussing the changes in patterns of family life that have
occurred over recent years. They cite the increase in the number of working mothers and
the change in what has been considered a traditional family structure. They point out that
most women work out of economic necessity and that they add their job responsibilities to
their traditional ones. Recent literature on maternal attachment has made it necessary to
consider how the separation of mother and child related to the mother working affects the
child. The authors review some of the recent literature in this area and point out that not
only is it the quality of care that is most critical to the child but that there is evidence that in-
fants can form more than one attachment. They cite the mutuality of the relationship be-
tween mother and child and point out the lack of evidence for a relationship between
maternal employment and maternal deprivation. They also review the literature on the im-
pact on older children of mothers' working and report that it appears that maternal employ-
ment has a positive effect, particularly on daughters. Although all of the data is not yet clear,
they conclude that there may be benefits for mothers, children, and families in terms of the
quality of relationships and identifications when mothers work.
Journal of the American Academy of Child Psychiatry, 20: 863-875, 1981.

The past few decades have seen substantial changes in patterns of

family life, including changes in relationships within the family as
well as in those outside it. One of these changes, the increase in the
numbers of working mothers, has aroused considerable concern
about the effects of working on children and family life. In this de-
bate many old prejudices, some new simplistic assertions, and a
good deal of confusion have appeared due to the complexity of the
problem, the many variables involved, and the shifting focus of
much of the argument.

Dr. Nadelson is Professor and Vice-Chairman, Tufts University School of Medicine, Director of
Training and Education, Department of Psychiatry, Tufts New England Medical Center (171
Harrison Avenue, Boston, MA 02111), where reprints may be requested. Dr. Notman is Clinical Pro-
fessor of Psychiatry, Tufts University School ofMedicine, Director of Psychotherapy Training, Depart-
ment of Psychiatry, Tufts New England Medical Center.
0002-7138/81/2004-0863 $01.16 © 1981 American Academy of Child Psychiatry.

863
864 Carol Nadelson and Malkah Notman

At this time only 6% of American families fit the traditional

model of the husband working and the wife caring for children at
home. Furthermore, approximately one half of all women 16 years
of age or older are in the work force or actively seeking employ-
ment. Forty-one percent of these women have children under 18
years of age and 31 % of children under six have working mothers.
The number of women in the work force has increased by 60% in
the past decade (Moroney, 1978; Pifer, 1978).
The 'traditional' pattern of a full-time, life-time mother has actu-
ally been traditional for only one or two generations. It evolved as
a product of modern historical development, including industriali-
zation and relative affluence. In the past, women who were in the
lower classes had always filled many roles and shared the burden
of work in order to sustain their families. However, they remained
legally and financially dependent on their husbands.
Responses to the changing role of women have varied. There are
those who herald a new era of freedom while others cite mothers
and wives who are out of the home as the cause of divorce, teenage
pregnancy, delinquency, violence, homosexuality, and other "ills" of
society. This view reflects both anxiety about change and inability
to realistically assess its impact. In many instances the assumption
that women all have a choice does not take into account the realistic
pressures for women to work and the lack of alternatives. In this
paper, we will focus our discussion on the implications for children
and families of the increase in the number of working mothers.

THE WORKING AND NONWORKING MOTHER

The working mother has become an increasingly more frequent

maternal model and marital status no longer determines whether a
mother works. Although currently most working mothers are mar-
ried, live with their husbands, and have school age children, a large
number (more than 15 million) are single, separated, widowed, or
divorced. A substantial proportion of this group have young chil-
dren. In the past decade, the number of families headed by women
have grown 10 times as rapidly as two-parent families (Pifer, 1978).
Most women work out of economic necessity; they remain in low-
status jobs with limited personal goals (Pearce, 1978). Moreover,
they add their job responsibilities to their traditional roster of activ-
ities, and often think of their work as an extension of their
nurturant, maternal, providing role rather than as an independent
Women, Work, and Children 865

activity about which they may have some choice and from which
they may obtain personal gratification (Bardwick, 1971). These
women often experience role strain as a result of proliferation of
areas of responsibilities (johnson and Johnson, 1976).
Any comparison of the impact on children of working and
nonworking mothers must take into account the actual amount of
time a full-time mother spends with her children. This is important
longitudinally (that is, the years of life taken up by caring for chil-
dren) and horizontally (that is, the amount of time each day spent
in child care). Childbearing and rearing occupy only a small
portion of a woman's lifetime and she is often not prepared for
what will later become a major part of her life, if she prepared pri-
marily for a role as a mother and a caretaker of small children.
Rossi (1972) estimated that the average woman marries at age 22,
has two children two years apart and dies at 74, seven years after
the husband's death at age 67. She thus has 56 years of adulthood
(starting at age 18), of which:
(1) 23% (13 years) are without a husband;
(2) 41 % (23 years) are with a husband but not with children un-
der 18; and
(3) 36% (20 years) are with a husband and at least 1 child under
18.
H we assume that parenting is full-time up to school age (6), then
only 12% of a woman's adulthood (or 7 years) consists of full-time
mothering of preschool children. While these figures continue to
change, it is clear that even the nonworking woman in contempo-
rary society will spend almost 2 times as many years with neither
husband nor dependent children than she will spend carrying re-
sponsibility for preschool children.
Another important consideration is the impact of divorce on
mothers and children, since this has resulted in an increase in the
number of working mothers. The rising divorce rate makes it a dis-
tinct possibility that many women will be alone for an even longer
time than in the past and that they will have to support themselves
and often their children, too. Divorced women suffer greater eco-
nomic difficulty than married women and often cannot maintain
an adequate standard of living. One third of female-headed house-
holds (resulting from divorce or from women never having mar-
ried) have incomes below the poverty level (Pearce, 1978). The
impact of divorce, then, may be greate~ because economic depriva-
tion often accompanies the emotional turmoil, A child may thus ex-
866 Carol Nadelson and Malkah Notman

perience the loss of both parents, one who leaves and the other
who may begin to work, as well as a change in life style.

MATERNAL DEPRIVATION AND ATTACHMENT

There has been a great deal of concern about how to integrate

emerging data on the importance of mother-infant attachment
with the fact that a growing number of women are leaving their
children, including young infants, in the care of others. The im-
pact of this behavior of mothers on their children is not clear. Nei-
ther is the role and relationship of the father or other important
figures clear, in terms of the eventual developmental outcome.
Klaus and Kennell (1976), in their report on their work on the
effects of close contact between a mother and infant at birth, found
that, on follow-up from one to five years later, positive effects
from the intimate contact could be observed in a number of areas.
They reported greater attachment behavior, weight gain, greater
duration of breast feeding, and fewer illnesses in the first year.
There was greater language development at five years of age.
Fraiberg (1977), drawing on the work of Spitz, Bowlby, and oth-
ers, stresses in her book the importance of the child's first attach-
ment to the mother for later cognitive development and for the
ability to form relationships and maintain controls later in life. She
decries the inadequacy of the substitute arrangements provided for
children and the system that forces mothers to be employed when
they wish to care for their children. She also stresses the greater
problem for the poor, who cannot afford adequate substitute care
and who often find that they have little choice but to make inade-
quate arrangements.
Unfortunately, however, Fraiberg generalizes and implies that
maternal working in itself leads to attachment failure and that this
degree of separation is linked with failure to thrive in infancy or
with sociopathy in adulthood. Maternal absence through employ-
ment can thus be seen as risking attachment failure and its devel-
opmental consequences.
The implication is that any maternal employment risks serious
consequences. This assessment does not consider data indicating
that day care is a positive developmental experience when the
mother is depressed, exhausted, or for other reasons unable to
provide adequate stimulation (Murray, 1975). Fraiberg's argument
Women, Work, and Children 867

poses two polarized and unrealistic alternatives-the loving mother

on the one hand and the impersonal, inadequate day-care facility
on the other. Furthermore, she does not consider in this argument
the evidence, cited by Murray (1975), that indicated that family sta-
bility and adequacy of stimulation and of relationships are
overriding variables in children's development, even when the day
care is not ideal.
Kenniston (1977) in his review of her book holds that the link be-
tween maternal employment and failure of bonding and develop-
ment is not supported. He also adds that "research suggests that
children of mothers who freely choose to work outside the home
are better off, other things equal, than the children of mothers
who stay home but are discontented with full-time mothering and
homemaking. Barring truly catastrophic (but fortunately, rare)
deprivations of early human contact, the fulfillment of the
caretaking parents is usually reflected in the well-being of their
children." This argument is not taken up by Fraiberg. What hap-
pens to the mother-child relationship when the mother feels that
she must not work in order to be a good mother must also be con-
sidered. Weisman and Paykel's (1974) report on the impact of
maternal depression on children adds a sobering note to this
oversimplified view of mother-child interaction.
Furthermore, the implications of the data that Fraiberg cites on
maternal deprivation can be questioned because they were drawn
from studies of institutionalized children and from retrospective
studies of adults who had been institutionalized. The reconstruc-
tion of case histories has enormous potential for distortion. In ad-
dition, the findings are difficult to extrapolate to the situations of
middle-class families that make adequate provisions and to those
cases in which the pressures of poverty, isolation, and deprivation
may not interfere with parent-child relationships.
Fraiberg's point is dependent upon Bowlby's (1969) view that in-
fants are monotrophic, i.e., form attachments with one, primary
caretaking person. This idea has been widely accepted, despite con-
tradictory evidence (Murray, 1975; Rutter, 1974; Casler, 1961).
There is considerable evidence to support the view that multiple at-
tachments can form and that the strength of attachments depends
upon the amount and quality of attention received from care-
takers. In his review of the literature in this area, Rutter (1974) em-
phasizes that the quality of mothering is the more critical variable.
868 Carol Nadelson and Malkah Notrnan

He argues that the term "maternal deprivation" covers a range of

responses and experiences not solely related to the absence of the
mother.
Schaeffer and Emerson (1964) report that fathers are also se-
lected for attachment. They challenge the assumption that the
child's preference is inevitably for mother because of her nurturant
relationship with the child. Other researchers agree that multiple
caretakers per se are not harmful, provided there is stability and
predictability in the child's environment (Moss, 1967; Rutter, 1974;
Casler, 1961).
Thus, while there is evidence that the caretaker does indeed
have to be available and consistent in the early period, there is no
clear evidence to support the conclusion that there are negative ef-
fects of sharing the caretaking among consistent, responsive indi-
viduals. Certainly this is the pattern in many cultures in which a
grandmother, older sibling, or other relatives or friends regularly
do part of the caretaking (Whiting and Edwards, 1975).
Another basic issue to consider is how one decides what consti-
tutes a "good" or "bad" outcome in a child. The connections be-
tween early patterns and later developmental outcomes are unclear
and there are important cultural variations. Since children are
reared to produce adaptive adults, clearly there are no absolute an-
swers as to what must be provided in every instance. Many models
may be applicable as long as basic needs for stable care and contact
are met.
The data on attachment are further difficult to interpret be-
cause of the complexity of parent-child interactions, the role of
constitutional factors, and the failure of investigators or clinicians
to include alternative models. Rutter (1974) concludes that "it
seems to be incorrect to regard the person with whom there is the
main bond as necessarily and generally the most important person
in the child's life. That person will be most important for some
things, but not for others. For some aspects of development, the
same sexed parent seems to have a special role, for some, the per-
son who plays and talks most with the child and for others, the per-
son who feeds the child. The father, the mother, brothers and
sisters, friends, school-teachers and others all have an impact on
development, but their influence and importance differs for dif-
ferent aspects of development. A less exclusive focus on the
mother is required" (p. 125).
Brazelton and Keefer (in press) decry the competitive standards
Women, Work, and Children 869

that permeate child rearing and indicate that this competitiveness

leads to an expectation of the equation "perfect mother = perfect
child" and encourages the idea that the baby will thus be molded
directly by his/her mother without regard to the contribution made
by the child or any sense of the importance of the interaction.
Thus, the mother is seen as omnipotent and totally responsible,
which implies the omnipresent threat of potentially causing irre-
versible psychopathology if she fails. The father, the family, and
social context are not fully considered.
Moreover, the importance of looking at the development of
attachment as a mutual interaction has repeatedly been reem-
phasized. Fries (1977), who in her studies of constitutional traits
recognized as early as 1931 that in the initial month of a child's life
the child's development involves a mutual interaction with the
caretaker, questions the idea of the mother as the person responsi-
ble for shaping the development of a plastic, uniform individual.
The mother learns and responds to her infant while the child is
learning the mother (Brazelton and Keefer, in press; Lichtenberg,
1981).
One must also consider the implications of data, such as that of
Coutrot and Ormezzano (1974), which indicate that children also
want their parents to be satisfied and fulfilled. A "new image of
children" emerges, one that emphasizes their capacity for inde-
pendence and cooperation rather than their psychological fragility
(Rapoport and Rapoport, 1978).

MOTHER-CHILD RELATIONSHIPS

An analysis of mother-child relationships and subsequent devel-

opment of children is crucial in assessing the impact of maternal
employment. The issues are complex and have often been
confounded. Many authors emphasize that it is necessary to look at
multiple variables in context, since to consider the effect of mater-
nal employment alone is simplistic and limited in its applicability
(Warshaw, 1976; Cox, 1975; Marantz and Mansfield, 1977). Some
studies have begun to delineate these issues. Cox (1975), for exam-
ple, found that the effect of maternal employment was negative in
father-absent families but not in families with two parents. Resch
(1975), Johnson and Johnson (1976), Murray (1975), Hoffman
(1972), and Moss (1967) have reported that observed distress in
children in substitute-care arrangements was eliminated or mod-
870 Carol Nadelson and Malkah Notman

Hied depending upon familiarity with the substitute-care setting,

consistency and caring in relationships with caretakers and other
children, and emerging play interests. Marantz and Mansfield
(1977) suggest that the cognitive stage of the child and other devel-
opmental variables are also important.
In a review of studies of the effect of substitute care on infants,
Murray (1975) concluded that developmental progress in the in-
fant appears to be related to the strength of the mother-infant at-
tachment and the level of stimulation in the home, regardless of
the setting of rearing. Separations do not in themselves appear to
be harmful, particularly after the first year, as long as they are
accompanied by predictable substitute care. Emotional disturb-
ances do result when mothers put children, especially those under
one year, in unstable care. Moore (1963) found that children in
early day care, before the age of one year, showed more dependent
attachment to parents and more fear than those who went into day
care later. Comparing all children receiving substitute care with ex-
clusively home-reared infants, he found that home-reared infants
were less aggressive, more obedient, more docile and more con-
cerned with approval.
In assessing these findings, therefore, one must emphasize that
the reasons for any observed differences are multidetermined. In
addition to the work and care situations, the effects of substitute
care are related to the nature of the early mother-child contact, the
personality characteristics of the mother prior to the birth of the
child, her concept of her role, the age of the child, his/her emo-
tional cognitive state, and a variety of family variables. Further-
more, these factors in turn affect the mother's relationship to the
child and her decisions about work. Additional evidence suggests
there may be sex differences in responses of children to maternal
employment; boy's development has been reported to be enhanced
by a stimulating environment outside the home, whereas girls may
benefit more from close contact with the mother (Yarrow, 1964).
These findings are also related to the age of the children when
mothers are less available. The interpretation of these data must
also address the values involved in these reports concerning what is
considered a desirable personal outcome for boys as compared
with girls.
The impact of sociocultural factors--especially poverty-in addi-
tion to psychological factors in the lives of their families is also an
important concern. Bronfenbrenner (1970) points out that depri-
vation and poverty interfere with parent-child relationships, as do
W omen, Work, and Children 871

social forces undermining the confidence and motivation of par-

ents to be good parents. Poverty and limitations in real options and
opportunities can contribute to a limited view of life and to depres-
sion. Furthermore, deprivation and abandonment are not only the
result of the physical absence of a parent, but. of preoccupation or
depression and emotional unavailability.
If the mother is already depressed, full-time employment can
further sap her energy. Bronfenbrenner (1970), Lamb (1975), and
Brim (1975) also call attention to the effects on children of the ab-
sences of fathers, whether by virtue of working many hours or of
divorce. Absence of adults increased a child's susceptibility to
group and peer influences, which may in some cases intensify anti-
social tendencies.
An additional way in which adults are absent from meaningful
participation in children's lives derives from discontinuity between
generations and the instability of many families with physical scat-
tering of family members. Intergenerational bonds are often
lacking or diffused and parents and grandparents do not have op-
portunities for contact.
As noted, those who are concerned about maternal involvement
outside the home often generalize and draw conclusions from stud-
ies of maternal deprivation. Not only is maternal employment not
synonymous with maternal deprivation, but the day-care centers
studied as examples of substitute care have been among the
poorest examples of such facilities (Murray, 1975; Yarrow, 1964;
Nadelson, 1979; Notman, 1977). Studies in these centers show that
infants reared in inadequate settings, without any stable one-to-one
relationship with an adult, appear to suffer affective and cognitive
deficits. The conclusions from these data, however, cannot pro-
vide automatic condemnation of all day care centers or other
alternative childcare arrangements. The connection between the
sterile, understaffed institutional environment and the setting pro-
vided by good day care, or other arrangements made by the
middle-class working mother with adequate resources, seems
remote.

THE CHILDREN OF WORKING MOTHERS

Concern and conflict about the care of their children is a promi-

nent feature in working women's lives. If children develop physical
or emotional problems, women are usually quick to be blamed and
872 Carol Nadelson and Malkah Notman

also blame themselves, although the etiological factors may not be

at all clear (Nadelson and Notman, 1973). The working woman
herself often believes that her work is not in the best interest of her
family. She may, in fact, overcompensate by asking for less help
from other family members than the woman who is at home (Nye
and Hoffman, 1963).
As noted, the data on effects of maternal employment have been
confused with the data on maternal separation and maternal depri-
vation. Thus, it is often difficult to delineate etiological factors
when problems do develop. A growing body of data, however, sup-
ports the idea that there are benefits for mothers, children, and
families when the mother works, even if it is out of necessity rather
than desire (Howell, 1973a, 1973b; Murray, 1975; Al-Timimi,
1976; Warshaw, 1976). Hoffman (1972) found that the working
mother feels less hostility and more empathy toward her children,
expresses more positive affect, uses less coercive discipline, and
may be somewhat over indulgent. Birnbaum (1975) studied the at-
titudes of professional women toward their children and compared
them with nonworking mothers. She found that the professional
mothers experienced greater pleasure in children's growing inde-
pendence, were less overprotective, and placed less stress on self-
sacrifice.
There is considerable additional evidence to support the view
that having a working mother has a particularly positive effect on
her daughters (Nye and Hoffman, 1963). The daughters of work-
ing mothers were more likely to choose their mothers as models
and as the people they most admire. Adolescent daughters of
working mothers particularly in middle and upper socioeconomic
groups were active and autonomous and admired their mothers,
but were not unusually tied to them. For girls of all ages, having a
working mother contributed to their concept of the female role as
less restricted and as having a wider range of activities, and their
self-concept reflected these views. They usually approved of ma-
ternal employment and planned to work when they grew up and
became mothers. Unlike those of nonworking mothers, these girls
did not assume that women were less competent than men. These
findings were obtained in a period when working mothers were
less the norm than at present. In the current context we might ex-
pect that there might be other women than their mothers who
would provide this alternate view of women. However, the point
that work was not perceived as detrimental, but enhancing, is im-
portant.
 Women, Work, and Children 873

Studies of daughters' academic and career achievements pro-

vide additional evidence of the positive effects of having a mother
with career interests. A number of investigators have found that
achieving women and women who have aspired to careers that are
less conventionally feminine have been more likely to be the
daughters of educated and employed women (Nye and Hoffman,
1963; Birnbaum, 1975; Tangri, 1969; Levine, 1968; Almquist and
Argrist, 1971).
Data on the husbands of working women indicate that they are
more actively involved in the care of the children and that the ac-
tive involvement of the father has a positive effect on both male
and female children (Young, 1975; Lamb, 1975). Furthermore, the
husbands of professional women are more likely to respect compe-
. tence and achievement in women (Rapoport and Rapoport, 1971;
Maccoby, 1966; Nye and Hoffman, 1963; Birnbaum, 1975; Tangri,
1969; Levine, 1968; Almquist and Argrist, 1971; Dizard, 1968;
Garland, 1972).

CONCLUSIONS

We have considered the implications of some of the societal

changes of the past two decades on family patterns, particularly the
impact of the increasing number of working mothers. The litera-
ture on maternal deprivation and mother-infant attachment raises
questions about the effects of early separation. While investigations
in this area are not conclusive, there is evidence that multiple at-
tachments for infants are possible and, thus, fathers and others can
be important attachment objects early in development. Further-
more, separation itself is perhaps not the major factor responsible
for attachment failure, but depression, fatigue, overwork, etc., are
important in distancing mother and child. The problem of con-
founding deprivation with separation related to employment con-
fuses the picture. Substitute care, which is predictable, caring, and
satisfies the needs of infants, does not appear to endanger mother-
infant attachment, particularly when the relationship with mother
and family is solid.
Additional data from studies of the children of working mothers
suggest that there are also benefits for mothers, children, and
their families, in terms of the quality of relationships and iden-
tifications, when mothers work. While there has been considerable
research on mother-daughter interaction, less is known about
mother-son interactions when mothers work. The impact of work-
874 Carol Nadelson and Malkah Notman

ing wives on husbands appears to support the idea that husbands

of working wives are more involved with their children and may
provide important sources of support and nurturance as well as
models for identification.

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