Wellbeing at work: The difficulties, stress, and adjustment strategies of female junior doctors returning to work after maternity leave in Ghana

Abstract

This study explores the challenges to wellbeing that female junior doctors face in their return to work after maternity leave and the strategies they use to cope with the combined pressures of being a new mother and returning to work. Employee wellbeing is a subject of keen interest among scholars and practitioners given its significant role in the long-term wellbeing of the workforce and sustainability of the organisations. In all sectors and disciplines, numerous factors determine the state of employees’ wellbeing, one of which may relate to the ability of individuals to take a break from work in order to attend to pressing social or other concerns. Maternity leave in the context of the healthcare sector (which is at the centre of this study) is one of such instances, whereby female employees take a break from work in order to give birth and spend time breastfeeding and bonding with their new-born babies before they must return to work. This life event comes with much joy and social prestige, and it gives females a sense of balancing their work and their non-work lives. However, for new mothers – especially female junior doctors who must return to work barely after three months post-maternity leave – their joy is short lived because of the nuances and various challenges that they face when returning to work. Although the extant literature does deal with the positive effects and the challenges associated with maternity leave, there is a lack of scholarship on the mechanisms adopted by the female workers for coping with the challenges they face upon their return to work – especially in developing economies, such as Ghana’s, where female junior doctors must simultaneously play the roles of a breastfeeding mother, a housewife, and a doctor. In shedding light on this apparent gap in the literature, the present study examines the difficulties, stressors, and readjustment strategies of junior female doctors returning to work after maternity leave in Ghana. In order to do so, the study uses Verta Taylor’s (2016) Rock-a-bye, Baby and the job demands and resources model, and the researcher carries out a thematic analysis of empirical data gathered by means of semi-structured interviews with 36 female junior doctors in Ghanaian public and private medical hospitals who have had the experience of returning to work after maternity leave. Using NVivo 12 software and thematic analysis, the researcher establishes a rage of themes and subthemes to address the research objectives, which examine the difficulties (1), evaluate the stress (2) that junior female doctors face when returning to work after maternity leave and explore their readjustment and coping strategies (3). In terms of Objective 1, the researcher identifies ‘adaptation difficulties’, ‘motherhood penalty’, ‘work-life balance issues’, ‘structural constraints’, ‘unmet exclusive breastfeeding requirements’, ‘over-labouring - high-volume workloads and long working-hours’ along with the challenge of maintaining good WLB, which are the key themes of difficulties faced by female junior doctors upon their return to work after maternity leave. Regarding objective 2, the researcher establishes the stress of competing demands (domestic chores; motherhood; competing attention and time; further studies), general motherhood-related stress (the timing of feeding a baby; stress of calming a baby) and emotions (mixed feelings; mothers missing their babies; engorgement pain; worries about babies and nannies), which are the key themes of stress and the concomitant emotions faced by these returning female doctors, due to those difficulties. With respect to objective 3, the researcher identifies different strategies that they used in coping with the difficulties and stress they face upon return from maternity leave – using themes of management planning (short sleeping time; enrolling children in preschools, storing breastmilk), personal development and other necessary adjustment (on-the-job training, self-learning, flexible working arrangement, personal downgrading) and social (relatives/non-relatives), religious and professional support (counselling services). This study thereby makes both theoretical and empirical contributions to the extant literature. In terms of theory, the study extends Rock-a-by, Baby theory by combining it with the job demands and resources model to both deepen our understanding of the difficulties and stressors facing female doctors as well as shed light on the strategies they use to cope with those challenges. Rock-a-by, Baby theory has largely been deployed in studies investigating experiences of motherhood challenges post-maternity leave, but not many studies consider the potential coping mechanisms that may be used, especially in a non-Western environment such as Ghana Thus, by integrating the job demands and resources model into Taylor’s (2016) Rock-a-by, Baby, the researcher brings the complex interplay of job demands, personal demands, and the availability of job resources into the spotlight (including the need for job control and balance; essential training; sufficient coaching; and relevant social support), which deepens extant scholarship on the challenges and coping strategies of female junior doctors returning to work after maternity leave. By analysing the experiences of female junior doctors in Ghanaian hospitals, which mirror the experiences of others in similar developing countries, this study also makes an important empirical contribution to the field. The implications and limitations of the study are discussed as well as the potential future direction of research on the topic area.