To Work Outside or Not

Dr. Spock On Parenting
by Benjamin Spock, M.D.

(Page 2 of 4)

Whether a mother of a baby or preschool child should go back to an outside job (caring for a baby can be a full-time inside job) is a complicated matter, as everyone who has tried can tell you. There are many factors to be considered. How important to the mother is the job, financially, emotionally, or psychologically? Could mother and father dovetail their working hours so that between them they can cover most of the child's waking hours? Is there a grandmother, aunt, or other relative whom both parents like who could care for their child?

Has the mother worked before, in her chosen field, long enough and successfully enough that she has confidence that she could always find work at her former job or at another, if she decided to quit her job for now? What's the local situation as to quality and availability of day care? Would the mother prefer to stay home for one or several years, perhaps until the youngest child is in first grade or three years old at the least and able to attend a good day-care center or nursery school? (There should be government subsidies for such parents who can't afford to stay home.)

A few professionals in the child development field believe that only a mother or father can give a baby or small child ideal care, because of the intimacy of that relationship and its permanence. But a majority feel, as I do, that a well-trained teacher in a high-quality day-care center, or a woman providing excellent day care in her home, or a compatible grandparent, aunt, or uncle, or a full-time sitter can do a satisfactory job during the parents' workday. It is essential, however, that his or her personality and attitude are good.

The substitute caregiver should be able to give a parental kind of care, by which I mean loving each child with real warmth, appreciating each child's individual makeup, showing pleasure in the child's tiny achievements (which will encourage the child to keep on developing), and being able to manage the child with a kind touch (without severity and without oppressiveness).

In the three-to-five-year-old day-care situation, there should not be more than seven children in the care of one adult. And there shouldn't be more than three children per adult when the children are under three. The latter situation is called family day care when it is provided in the care-giver's home.

If you are considering day care or family day care, you should visit the places under consideration for several hours on two or more occasions to be sure that the spirit of the care as well as the physical situation fits with your ideas. A good question to keep in mind is whether the teachers are spending most of their time giving general directions to the group or whether they are keeping their eyes open for children who are having difficulties. Is a child getting frustrated with a plaything and in need of tactful help; is he getting into tugs-of-war or fights and in need of help to learn the fun of cooperative play; is he getting hurt and in need of comforting?

Of course there should be enough constructive playthings. For the three-to-five-year-olds there should be blocks, dolls, doll's equipment, housekeeping equipment, easel and finger paints, modeling clay, toy cars, tricycles, wagons, a jungle gym, a sandbox. For children under three the playthings and activities will be simpler, but they must be available.

In past decades women who expected to have outside jobs tended to have their babies relatively soon after marriage and then they went to work when their children were one to six. But in recent years increasing numbers of women have gotten well started on their working careers first and then had their babies in their late twenties or thirties. In this way they have first settled any inner doubts about whether they are capable of holding good jobs. And when the babies have come, the mothers have been in a better position to decide whether to get back soon to the outside job on a full- or part-time basis, or whether to take off a year or more for full-time care, until the child was ready for day care at three, kindergarten at five, or school at six. By then the father might be earning more, thus making it more financially possible for the mother to quit temporarily.

Studies have shown that the old adage "Have your children when you are young, strong, and flexible" is not necessarily sound. On the average, older parents are more flexible, tolerant, understanding, and happy in child care.

Babies and children up to three years are highly sensitive to separation from the person who has been their principal caregiver. Babies as young as six months will go into a depression if abruptly separated from their mother and left with an unfamiliar person. At two or two and a half they will become subdued if the mother abruptly leaves them with an unfamiliar caregiver. The depth of the child's despair only shows when the mother returns. Then the child, let's say it's a girl, will rush to the mother and cling to her. She will cry in alarm when her mother goes into the next room. She will bat away the sitter, whom she accepted while the mother was gone. When her mother tries to leave her in her crib at bedtime, she will cling with a viselike grip. If her mother can pry herself loose and head for the door, a two-year-old who has never climbed out of her crib before will unhesitatingly vault over the side and race after her. It will take months to reassure a child who has been frightened in this way.

The answer is to prepare thoughtfully for the separation over a period of at least two weeks by introducing the sitter or substitute gradually. She can come to the home for increasing periods of time for a week without trying to do anything directly for the child, just making friends at a distance. When she is accepted, she can try helping the child to dress or bringing her some food. When this step goes smoothly, the mother can leave the home for not more than half an hour, the next day for an hour, and so on, gradually. At any sign of panic, the sitter should back off and proceed more slowly.

If the young child is going out to family day care, the same principles should apply: several brief visits with the mother until the child feels at home; then the mother can leave the child for half an hour and gradually increase the length of her absences. This may all seem expensive — in time and money. But it is well worthwhile to prevent a separation panic that could affect the child for months and perhaps make the mother's outside job impossible.

After they reach the age of three years, children are much less likely to develop a severe separation anxiety. But I'd still recommend a gradual introduction to a day-care center, at least for the first few days, to see how fast the child takes to it. Then proceed, slowly or fast.

FULL-TIME OR PART-TIME WORK?

For many women the best compromise, when it is possible, is to start with part-time work. This gives the mother much of the closeness to the child that she wants during the most formative years, yet keeps her hand in the work she wants to pursue. Furthermore it gives her the sense of escape from the confinement of home that many women feel they need, especially with the first child, the one who ends the mother's freedom.

In fairness, a father should be willing to cut down to a part-time job so that the mother won't have to sacrifice so much of her outside work time. But some fathers are still not ready to think of themselves as caregivers, and even in families where the father is willing to assume such a role, this may not be practical. The fact is that, unfairly, men earn much more than women for equal work, so when a father goes on part-time it usually means a greater financial sacrifice for the family than when the mother does all the cutting down. And when companies do provide long leaves for infant care, it's almost always maternity leave, not paternity leave.

Good day care and family day care are expensive, more expensive than families on modest incomes can afford. Most European countries have gone a lot further than the United States in subsidizing day care through contributions of government or industry or both. Our country is the richest the world has ever known and there is no good reason why it should be shortchanging our children — except, of course, for our obscene defense budget.

In past generations and centuries most women felt that the family was the most important aspect of existence. (I myself have felt that it is.) But in their crusade for equality and justice, particularly in the women's liberation movement beginning in the 1970s, many feminists have thought of equality primarily in terms of equal pay and equal access to the prestigious jobs, which they are certainly entitled to. But pay and prestige have been two of men's highest aims, in our excessively competitive, materialistic society. So, in a sense and to a degree, many women are now accepting men's values. Or, to put it in harsher terms, many women are joining the rat race. Incidentally, they are getting more stomach ulcers and heart attacks, once considered particular diseases of tense, ambitious men.

This issue — what values we should emphasize in America in the future — is one that is very close to my heart on several scores. All through my career as a medical school teacher, one of my main jobs has been to try to help students to be sensitive to the feelings of their patients, because these feelings have close connections with their diseases. In other words, I was trying to counteract the tendency in the upbringing of so many boys in America to suppress their feelings and to depersonalize their relations with other people, in their family life and in their work. This tendency is particularly handicapping in the work of physicians, who will misdiagnose many conditions if they fail to recognize emotional factors.

In my pediatric practice and in writing Baby and Child Care I've been trying to persuade fathers to get involved in the care of their children — for the sake of the children and for the sake of the fathers themselves.

And as a peace activist I am dismayed by the encouragement of aggressiveness and violence by television, movies, and war toys.

It would have been so much better if, instead of women's taking on men's excessively competitive values, men had had the sense to see that they have been pursuing harmful ideals and to recognize that family life; participation in neighborhood affairs; and warm, cooperative relationships — at home, in the community, and at work — are the vital aspects of existence and that both sexes should demote the outside job to third priority.

What does all this have to do with women's outside work? I'm trying to encourage women, whether they work by choice or necessity, to avoid falling into the male fallacy of thinking of outside work as more important, more challenging than family.

Late Parenting

In the past it was usually believed that a couple should have their children while they are young. Parents are thus more resilient, nearer to their children in spirit (somewhat as if this were an athletic contest that went to the side with more endurance). Parenting takes endurance all right. But a study a generation ago showed that, even more, it takes understanding and tolerance, and that these qualities are in greater supply on the average in parents in their thirties than those in their twenties. And the parent child relationship and the child's adjustment are on the average judged to be better when the parents are in their thirties.

In trying to explain this outcome to myself, I conclude that younger parents are still so close to childhood themselves but so proud of having outgrown it that they don't want to admit any connection. I'll give two examples of this intolerance. When I was interviewing a fourteen-year-old girl and asked her what her ten-year-old brother was like, she was so irritated by his crudeness, his lack of sophistication, that she was able only to give a loud, disgusted grunt. If she were a few years older she might have been able to cast her eyes to heaven and smile indulgently at his uncouthness. Another example of intolerance: A sixteen-year-old mother, asked how her new baby was doing, scowled and declared, "He's bad!" Questioning brought out that what she was disapproving of so indignantly was just the usual amount of fretfulness in a young baby.

In other words, you may enjoy your babies more and they may enjoy you more if you have them in your thirties.

In reading about and listening to young women who are going to work for the first time, I've learned that in our discriminating society, where they've often heard such remarks as "Women are not good as engineers" or not good as physicists, or not good as executives, many of them have self-doubts about whether they will be able to succeed in their chosen fields, especially if their ambitions are high. From this point of view, it may work out better for such women to start their careers early, advance through several levels, establish a reputation, and convince themselves that they have what it takes. Then they can more comfortably take off a period for full-time or part-time child care, with the idea of going back to the full-time career later. I'm not saying that starting a career first and postponing children till later will prove best for all women. But I've known a number for whom it turned out to be quite satisfying. It fits, too, with the recent tendency to postpone marriage until the later twenties.

Parents in their thirties are more secure in their adulthood. They aren't so self-centered. They can see and feel what a baby is and what he needs.

I don't want to emphasize the difference between parents in their twenties and thirties so much that I discourage couples who want their babies in their twenties. I only want to overcome the belief that the twenties are always better.

Copyright © 1988 by Benjamin Spock

About the Author

Benjamin Spock, M.D., practiced pediatrics in New York City from 1933 to 1947. He then became a medical teacher and researcher at the Mayo Clinic, the University of Pittsburgh, and Case Western Reserve University in Cleveland. The author of eleven books, he was a political activist for causes that vitally affect children: disarmament, day care, schooling, housing, and medical care for all. He had two sons, a stepdaughter, and four grandchildren. Dr. Spock, who died March 15, 1998, at age ninety-four, was married to Mary Morgan. Dr. Spock's Baby and Child Care has been translated into thirty-nine languages and has sold fifty million copies worldwide since its first publication in 1946.