A woman's work is never done: Women's work and pregnancy outcome in Albania

Albania has undergone extreme social and political changes during the past five years. Conditions regarding women's work and its effect on reproductive health have been unknown. During 1993 and 1994, a cohort of 1199 pregnant women were followed to identify how work factors related to spontaneous abortion, infant low birth weight, gestation length, and perinatal mortality. A small subgroup was interviewed to examine qualitative issues including motivation, attitudes, and personal experiences regarding working and raising a family. Results reveal that certain work factors directly correlated with low birth weight, miscarriage, and/or perinatal death. The significant factors included: fewer household helpers, standing, working in a hot environment, commuting, walking and carrying, and lifting heavy weights on the job. Most women were unemployed, and virtually all were deeply concerned about employment and poverty. Their challenge is to maintain an equilibrium between satisfaction of economic needs and physical needs during pregnancy. International aid programs working in Albanian maternal and child health must consider the physical repercussions from increased work on the job and little or no decrease in work at home.