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The Price of Productivity

Op-Med is a collection of original articles contributed by Doximity members.

With the recent passing of Ruth Bader Ginsburg, I cannot help but reflect on my experience as a woman in this country, especially on the time I was pregnant while working as an NP, and the period of motherhood that followed. 

I became pregnant in October of 2014. My pregnancy began smoothly and I continued working full time as an NP and part-time as a nurse consultant. At 26 weeks, however, I was diagnosed with gestational diabetes. I needed to walk for 15 minutes after lunch and check my blood sugars during work. It was tough to fit into my hectic schedule, but the tasks eventually became part of my routine. Then, at 32 weeks, I felt irregular contractions and cramping, followed by cervical changes at 33 weeks. I was placed on modified bed rest for preterm labor risks, and was forced to take time off from work earlier than I had planned. My daughter was soon delivered via an emergency C-section.

When it was time for me to return to work, I realized I wanted more time with my daughter. I struggled over the fact that I had needed a C-section and suffered from postpartum depression. I met with my employers and told them I would not be returning to work. I was nervous and felt guilty, but taking time off from work was one of the best (and difficult) decisions I have ever made in my life.

As a career-oriented woman, taking time to focus on just motherhood was difficult. Despite the tasks of breastfeeding my daughter every two hours, changing diapers, doing laundry, bathing, tummy time, and play time, I felt unaccomplished each day. I missed, at that time, what I considered “real work.” Why did I feel so unproductive as a mother? Fortunately, my time off gave me the opportunity to explore these thoughts and emotions. 

I found myself wondering why productivity is valued so highly in our culture. Certainly, productivity creates more profit, and thus has tremendous economic value in a capitalist system. In fact, in medicine, clinicians are rewarded for being more efficient and productive while providing quality care for our patients. But it was difficult for me to turn off the ethic of productivity as all-important when it came to motherhood. I suddenly felt unproductive because I was not working in a paid profession. 

In “The Price of Motherhood,” economist Ann Crittenden, states that the devaluing of women’s work started during the Industrial Revolution, with the introduction of the cash economy and the concept of individual wages. During this period, men were able to work outside the home more, while women were more tied to the home and taking care of household responsibilities. This shift in the economy eventually defined women’s work, including child rearing as a “labor of love.” Crittenden proposed that the feminist movement failed to advocate for mothers, placing mothers in an economically disadvantaged position, especially when they choose to take time off to care for their child.

By contrast, in the book, “Feminism’s Forgotten Fight,” Kirsten Swinth applauds the different groups of women from different ethnicities, social classes, and genders within the second wave feminist movement in the 1960s–70s, who had a vision and fought for women’s issues (such as gender equality in the workplace and at home, maternity rights, welfare reform, universal childcare, universal income, and the advancement of women in civil service). The movement led to several legislative changes. For example, in conjunction with the Civil Rights Act of 1964, employment discrimination on the basis of gender, race, pregnancy, disability and religion was prohibited. Additionally, the organization, Federally Employed Women (FEW) advocated for advancement of women in civil service, as well as part-time work for mothers. Lastly, as an amendment to the Civil Rights Act, as defined by the U.S. Equal Employment Opportunity Commission, the Pregnancy Discrimination Act of 1978 prohibits employment discrimination based on pregnancy, childbirth, or medical conditions related to pregnancy. 

According to Swinth, the feminist movement did not fail to advocate for women’s issues related to work and family. Nor did it propagate the distorted idea that “women can have it all,” which only created male clones. Instead, the second wave feminists redefined “female selfhood” and “normalized working motherhood, and it set the foundation upon which a broad edifice of changes in personal lives, workplaces, and society could be built.”

As a woman, mother, and worker in a capitalist system, I believe it is important to question and talk about our feelings and opinions about family and work. It is also good to know the historical context of where we are today. According to Crittenden, “although women have been liberated, mothers have not.” Is this true? As mothers, as women, and as parents, do we even stop and think about the status of mothers and of fathers in this country today and the repercussions on our children? Or are we so busy being productive in our work that we just accept what is? The U.S. is the richest country in the world, and yet it is the only developed country in the world which does not have federally mandated parental leave. Are we OK with this?

These are questions feminists should not have to tackle alone. We are in the midst of a pandemic, a climate crisis, and an upcoming election that will determine our future. Perhaps we can all take a little time from our productive days to stop and ask ourselves: what do I want? How do I envision my daily life and the lives of those in the next generations to come? And if what I want is not present in my current reality, what steps can I take? As Mahatma Gandhi once said, “in a gentle way, you can shake the world.” What would you shake?

Joanne is a mother and NP from San Francisco, CA. She loves to write about the intersection of health, spirituality, feminism, and motherhood. A story's ability to inspire wisdom and self-reflection in others is what motivates her to write. She is a 2020–2021 Doximity Op-Med Fellow. Joanne has no conflicts of interest to disclose.

Illustration Collage by Jennifer Bogartz / Ralf Hiemisch / gettyimages

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