Our major reflection on these data must be that what we know about the effects of the paid employment of mothers does not warrant the simplistic assumption that family life, and the well-being of children, are thereby endangered. The nature of the summary conclusions that follow demonstrates how little we do know with assurance. As indicated earlier, however, the weight of the prevailing myth requires that we proclaim what is known; the finding of "no effect" is important information.

Patients who consult their physicians for assistance in making a decision about a change in maternal employment status, need first of all to be reminded that the entire issue is fogged by deep-seated beliefs and prejudices that are not easily understood or even expressed. Our views on spouse relations and parent-child relations are strongly determined by our own early experiences and by the pervasive societal myth. To the extent that families can plan felicitous changes in the course of their lives together, an earnest effort to untangle myth, prejudice, and belief must be made on all sides.

This effort can, however, be aided by an understanding of whatever objective information can be marshalled from an examination of the research literature. The physician's responsibility, as always, is to convey all of the relevant data, privately acknowledging his or her personal position without allowing it to color the presentation of the data. The decision, in the long run, must be made by those who will live with the consequences. To guide them, we might offer from this review the following conclusions:

1. Re working conditions:

a. The mother is likely to feel comfortable and enhanced by her employment situation if the job is consonant with her skill and training, if she is rewarded (by recognition and promotion) for accomplishment, and if pay is competitive with other paid jobs.

b. If these conditions are not met, her valuation of herself may be diminished in the employment situation, and her family relations altered accordingly. (The situation is thus analogous to that of the father.)

c. If she must work for pay, but would rather not (or vice versa, if she wishes to be employed but is not), her position in family relations is likely to be stressed.

2. Re family function:

a. The opinion of other important persons in the mother's life (including especially her husband but also her relatives and friends) about the value of her employment will strongly influence her satisfaction with employment.

b. Maternal employment per se has little demonstrated long-term effect on family dynamics; if a change in ideology about the family (e.g., from traditional toward egalitarian) is brought about in conjunction with or as a consequence of maternal employment, family relations may be altered accordingly.

c. There are many options for the accomplishment of domestic chores; the family's choice will be affected by ideology, financial means, and the availability of resources in the community. It is unrealistic to expect that there will be no change in the performance of domestic responsibilities when the mother enters paid employment.

d. Major changes in family life, such as the gain or loss of employment by either parent, may bring about some change in all family relations; the period of adjustment, which is usually experienced as somewhat stressful, is of limited duration. The ultimate effect on the family cannot be reliably assessed during this adjustment period.

3. Re the children:

a. Satisfactory child-care arrangements are essential, expensive, and may be difficult to find at this time. It is impossible to generalize about "ideal" child care (with or without a full-time homemaker-mother) since needs vary by family and by age and personality of the child. A variety of options exists.

b. For the child, a major component of the changes associated with change in parental employment status may be new circumstances in caretaking. New circumstances may be temporarily stressful, and should therefore be avoided, if possible, at points of rapid and saltatory development, e.g., when attachments are forming (in third quarter of the first year), when symbolic use of language is almost but not quite attained (at about the second birthday), and at any point when the child's adjustment capacity is under stress.

c. Children are likely to be positively affected by maternal employment, and attendant changes in family function, if the mother finds satisfaction in work outside the home and if she is supported by family members.

d. The children of employed mothers are likely to attain a nonstereotyped view of the nature and value of male and female abilities.

e. Other specific direct effects of maternal employment on children have not been demonstrated. It is probable that intervening variables (such as child-rearing style) are critical, and that maternal employment per se should not be expected to have single and uniform effects on the lives of children.

Finally, it is impressive that a number of studies report that the families of nonemployed mothers (husbands, children, and the mothers themselves) are strongly opposed to maternal employment, principally on the grounds that the family may be harmed.208, 260, 279, 280 When mothers are successfully and enthusiastically employed, however, the changes reported by their families, if any, tend to be in a positive direction. The myth dies hard.

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