Even in families with supportive husbands who endorse an equal role in parenting, mothers have been noted to do 75% of the maintenance of the family and house. This role discrepancy can be accepted or it can be a source of significant discontent. Asking "How do you [and your partner, husband, mother-in-law, etc.] work as a team?" can open the subject for discussion, if needed. Helping mothers negotiate tasks with whomever the other adults may be can ease tensions that could adversely affect the children. I recommend weekly family meetings to keep roles and responsibilities on the table for negotiation, making a trade of tasks as needed.
I remember being amazed by a dynamic friend who had children and a career that involved many presentations at night and on weekends. I asked her how she did it. She replied without hesitation, "I don’t sleep." Lack of sleep is epidemic in the United States, but it has extra potential impact on mothers. It can lead to irritability, depression, lack of sexual interest, inefficiency in every setting, and even car crashes. Asking how much sleep the parents are getting may not seem like a pediatric question, but it can reveal unnecessary stresses.
One thing you may discover is that the mother is up cleaning the house at 11 p.m. I hate Martha Stewart. What real mother can make little costumes for her candlesticks, which Martha advertises as "Easy Decorating for the Holidays"? Yet some women have trouble lowering their standards for "housekeeping" to a feasible level when they have children, much less children and outside employment. You can help provide the perspective that dust kittens in the living room and an occasional frozen dinner are a small price to pay for having family fun and maintaining sanity.
Did you hear about the father of two young girls who was told he had 1 year to live after his cancer diagnosis? He thoughtfully took on the project of aligning eight of his friends with different personal strengths to be godparents for his children, knowing that he would not be there. It struck me that this is an excellent idea for all of us. We can’t be everything to our children, whether we are home full time or working out of the house, but we can use our good judgment to arrange supplementary positive relationships for them. Asking a good friend to sign up as godmother tends to bring a commitment and involvement as well as support for the mother herself. If a family does not have friends for this role, it is time to make some. A religious community is often a good place to start. Finding a few people with whom you can exchange favors, borrow the jumper cables, or stand at the bus stop, turns out to be the best and most lasting way to way establish social support.
I was once in a work group on child development that included leaders in the field of relationship theory. One professor in his 60s revealed that his best friends now were the parents of his children’s preschool friends. Keeping up such a support system for parents of friends and relatives is a key protective factor, not only to prevent adult depression, but for child behavior outcomes as well. Often, work outside the home provides extra social support through colleagues and friends, but it is not inevitable and needs to be fostered. Mothers may be encouraged to have a "mother’s night out" and one for dad, also, to maintain this without feeling guilty. In fact, giving the other parent a chance for a regular "Dad’s night with the kids" is a gift. New adventures, play, a deepened relationship, and more confidence as a parent are wonderful side effects of mom’s absence and vice versa.
Many mothers are caught up in their present dilemma and may not see these two things:
• Part-time work may be a compromise they could negotiate, if feasible financially.
• The 20 or so years of staying home with children still allow for another phase of life in which mothers could accomplish their career goals.
After our discussions, a number of the mothers of my patients have chosen to stop working for a period of time, and they, their children, and their husbands all have benefitted from the decision.
The most important thing affecting your ability to support working mothers may be your own situation! It may be harder to be compassionate with the whining of mothers of your patients if you are giving up precious family time to practice medicine. Their pain may cause enough conflict in you to interfere with your ability to support them. It is important to examine your own thinking, ambivalence, satisfaction, or pain in the choices you have made so that you can respond objectively to theirs.