A recent study by Linda Luecken and her colleagues at Duke University Medical Center in North Carolina provides the first solid evidence of the physical impact of "role overload" among working mothers-- evidence that the increased demands on working moms often result in physiological changes associated with ill health.

The study examined 109 women with full-time clerical and customer-service jobs. Some had children at home, some did not. Urine samples were collected over 2 days to measure levels of stress hormones. The women were also asked to rate their jobs and their home lives in terms of these questions: How hectic is the pace? How psychologically demanding is it? How much privacy do you have? How much control do you have over how to spend your time? How much freedom do you have to make decisions?

The results: Employed women with children at home, when compared to employed women with no children at home, have:

• higher levels of cortisol excretion. Cortisol is a stress hormone that is thought to reflect "distress," lack of personal control, and increased risk for cardiovascular disease.
• similar levels of work strain but higher levels of home strain including both greater demands and less control

Another factor is that working mothers seldom have a chance to "unwind," so they have increased sympathetic nervous system arousal both during and after work. While many husbands may be pitching in more at home, they often finish their assigned tasks and then relax. A working mom is virtually always on call and responsible for managing the details of home. There's always something unexpected to cope with-- spilled milk, lost homework, a sick child, the search for new child care.

Does marriage or social support at home protect working mothers? Apparently not. The presence of a spouse or significant other at home did not buffer the physiological and psychological consequences of stress in working mothers. Higher income, ethnicity, or the number of children at home also did not influence the levels of stress.

Rx: Self-Care Tips
Here are a few suggestions for working moms to help balance the demands of job and home:

• Set limits. Schedule and honor your own time to relax, put your feet up, and play. Learn to say no.
• Cultivate a mental picture of the many sides of "you" besides your "other-centered" roles at home or at work--e.g. artist, lover, poet, gardener, runner.
• Make frequent written lists of your own priorities, from the largest (spend time with my children, go to work) to the smallest (take out the recycle boxes). Put them in the order you want and match up your activities and commitments to make sure you're getting the things done that are truly most important to you. Let the rest go.
• Ask for help: Say exactly what you want from your spouse, significant other, or children; then negotiate to share responsibilities at home.
• Remember that perfection is the enemy of happiness. Be willing to accept less than perfect performance on household chores.
• Team up with other parents to share the load -- child care, dinner clubs, or shuttling.
• Celebrate the healthy pleasures of parenting. Pay attention to the moments of joy that make all the effort worthwhile. Plan regular, specific activities-- no matter how small or trivial-- to connect with your spouse, child and significant other.

Light KC: Stress in Employed Women: A Women's Work Is Never Done If She's a Working Mom. Psychosomatic Medicine 59:360-61, 1997.

Excerpted with permission from the Quarterly Newsletter, Mind/Body Health Newsletter. For subscription information call 1-(800)-222-4745 or visit the Institute for the Study of Human Knowledge website.