PURPOSE Most new mothers return to work soon after childbirth. A need exists to reexamine the defi nition of postpartum health and evaluate employed women's recovery from childbirth in association with such factors as delivery type and breastfeeding.METHODS Using a prospective cohort design, we recruited Minnesota women into the study while they were hospitalized for childbirth in 2001. Telephone interviews were conducted 5 weeks postpartum. Eligible women were 18 years or older, employed, and spoke English. Multivariate models using 2-stage least squares were used to estimate factors associated with physical and mental health and postpartum symptoms.RESULTS A total of 817 women were enrolled (71% response) in the study; 716 women completed interviews at 5 weeks postpartum. On average, women reported 6 postpartum symptoms, most frequently fatigue (64%), breast discomfort (60%), and decreased desire for sex (52%). Findings showed that cesarean (vs vaginal) deliveries were associated with signifi cantly worse physical function, role limitations, and vitality. Multivariate fi ndings showed that the effect of delivery type on physical health was moderately large (␤ = -5.96; P = <.01), and breastfeeding was associated with an increased frequency of postpartum symptoms (␤ = 4.63; P = .01).CONCLUSIONS These mothers experienced several childbirth-related symptoms at 5 weeks postpartum, indicating a need for ongoing rest and recovery. Health concerns were greater for women who were breastfeeding and for those whose babies were delivered by cesarean section, suggesting a need for greater support for these women and a reassessment by the medical community of the progressively growing practice of cesarean deliveries. INTRODUCTIONT he participation of American women in the labor force during the last 20 years has changed most dramatically for mothers of infants. In 2003 their labor force participation rate was at 54%, 1 dipping slightly from a record high of 58% in 1998, but markedly higher than 31% in 1966.2 Many of today' s mothers are established in the marketplace before starting their families and remain employed during their child' s infancy by taking a family or medical leave.3,4 Among fi rst-time mothers employed during pregnancy and giving birth in the United States between 1991 and 1994, 13% had returned to work by 1 month after childbirth, increasing to 30% by 2 months, and 41% by 3 months, for a total of 76% returning within the fi rst year after childbirth. 4 With many new mothers returning to work soon after childbirth, a need exists to reexamine and broaden the definition of postpartum health, particularly for employed women.Traditionally, the medical perspective of the postpartum period refers to the time after childbirth that is required for the reproductive organs to return to their nonpregnant state, a process of about 6 weeks. 160 POSTPARTUM HEALTH OF EMPLOYED MOTHERSthan the single postpartum visit recommended at 4 to 6 weeks after delivery. Yet fi ndings from longitudinal studies suggest that ...

This essay reviews four texts that analyze women in political institutions in order to develop a more general theory of gendered institutions. Scholar ship on women in political institutions will be advanced by continuing to look beyond the confines of the traditional subfields of political science, drawing on interdisciplinary work in feminist theory, critical race theory, and the sociology of work. Gender should be theorized, not as a word that is interchangeable with sex, but as a continuous, variable, and tenacious process that, while usually leading to women's disadvantage, is challenged, negotiated, subverted, and resisted. Such scholarship should explore how masculinity, work, and politics are intertwined.

Why do some issues surge to the forefront of our attention while others languish in obscurity? Feminist scholars have explored the emergence of issues such as rape, battering, no-fault divorce, pay equity, and other women's issues on the public agenda. Despite a burgeoning body of literature on feminist social movements within history, political science, and sociology over the last twenty-five years, scholars of agenda setting, public policy, and American politics more generally have largely ignored this work. Not surprisingly, this research cannot be simply added in to the dominant agenda setting theoretical paradigm; rather, the findings disrupt conventional understandings. This essay critiques two canonical works, Kingdon's Agendas, Alternatives and Public Policies (1995) and Baumgartner and Jones's Agendas and Instability in American Politics (1993), and discusses exemplary feminist research. It argues that if we want to know how norms change we need to broaden our scope beyond political elites and interest groups to include social movements and newly politicized grassroots activists. We must see change as produced by networks of insiders and outsiders rather than exclusively caused by elites in formal positions. Feminist scholarship also takes seriously the discursive and emotional aspects of politics rather than utilizing a narrow pluralist framework. Moreover, it recognizes the important yet neglected role of law as both an arena and a discourse.

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