More than half of new moms in the U.S. work outside the home, and researchers suggest that many are returning to work before their bodies have fully recovered from childbirth.

Nashville teacher Andrea da Silva is one of them. Da Silva returned to her classroom of 18 kindergarteners in January, just five weeks after the birth of her first child -- daughter Isabel.

She says it was clear that her body was still healing and she was constantly fatigued early on.

“I lived off caffeine those first few weeks back,” she tells WebMD. “I’m a coffee drinker anyway, but I was drinking five or six cups in the morning just to stay awake. It was at least three weeks after I got back before I began to feel like I could wake up and deal with the day.”

The number of new mothers working outside the home almost doubled between the mid-1960s and the late 1990s. According to the latest government figures, 54 percent of women with infants were employed in 2003.

“Most of these women are returning to work anywhere from six to 12 weeks after giving birth,” says Pat McGovern, PhD, of the University of Minnesota. “There isn’t a lot of research out there on women’s general postpartum health, and almost nothing specifically looking at working women.”

Postpartum Symptoms

In an effort to remedy this, McGovern and colleagues surveyed 716 Minnesota moms when their babies were about five weeks old.

They found that the women still had an average of six postpartum symptoms, including fatigue, not feeling rested upon waking in the morning, breast discomfort, headaches, back or neck pain, and decreased sexual desire.

All of the women in the study were employed, although most had not returned to work when they were interviewed.

The mothers of infants delivered by cesarean section were more likely than women who delivered vaginally to report decreased physical function and pain after five weeks.

Moms who breastfed reported more symptoms than those who didn’t. As expected, these women had more breast discomfort and nipple soreness. But they also were more likely to report continuing fatigue five weeks after delivery, as well as constipation, hemorrhoids, and a decreased desire for sex.

The researchers will continue to follow the women as they return to work. The ongoing study is funded by the National Institute for Occupational Safety and Health. The early findings were published in the March/April issue of the Annals of Family Medicine.

Recovery Takes Time

Postpartum recovery has traditionally been defined as the period after childbirth that is required for the reproductive organs to return to their nonpregnant state. This usually takes about six weeks.

But McGovern says findings from her study and others highlight the importance of considering many more factors when assessing a woman’s health following childbirth.

She says new moms should be evaluated for fatigue during routine postpartum visits to their doctor, along with other common physical and mental symptoms.

Women and their doctors should also explore creative options for returning to work, such as intermittent leave, she adds.

The Family and Medical Leave Act requires covered employers to grant the parent of a newborn 12 weeks of unpaid leave. McGovern says most women don’t know that they can spread that leave out and work part time when they return to their jobs, if their doctor certifies that it is medically necessary.

”Most women are not completely recovered at five or six weeks,” she says. “If they are working or about to go back to work it is especially important that they understand this and that they discuss all of their symptoms with their physician.”

By Salynn Boyles, reviewed by Louise Chang, MD

SOURCES: McGovern, P. Annals of Family Medicine, March/April 2006; vol 4: pp 159-167. Pat McGovern, PhD, associate professor, School of Public Health, University of Minnesota, Minneapolis. Andrea da Silva, teacher and new mom, Nashville, Tenn.