'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.

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.