Women lawyers working more than 45 hours a week are five times as likely to feel high stress at work and three times more likely to experience a miscarriage in the first trimester than women who work less than 35 hours a week, say occupational health epidemiologists at UC Davis School of Medicine and Medical Center. The findings are reported in the June issue of the Journal of Occupational and Environmental Medicine. "Women traditionally have had to juggle the responsibilities of both work and home, putting in extra hours to meet the demands," says Marc B. Schenker, professor and chair of the Department of Epidemiology and Preventive Medicine at UC Davis School of Medicine and Medical Center. "While women have managed to raise families and to make tremendous progress in nearly all fields of work, our study shows that there are negative health effects of working long hours on the job rather than at home. "Working more than 45 hours per week on the job was a strong predictor of stress and was associated with a three-fold higher rate of miscarriage, even after taking into account other factors such as age, smoking, alcohol intake and previous miscarriage. Women need to be aware of the impact that long hours at work can have on their reproductive health, and we as a society need to address the issue of women having to choose between having a career and a family." The study was based on a survey of 584 women who graduated from UC Davis School of Law from 1969 through 1985. Researchers used a mail-in questionnaire to examine the association between job stress and place of employment, legal specialty, work hours (job and domestic), job tenure, age and marital status. They also examined lifestyle factors, including smoking and alcohol use and the association between work conditions and pregnancy outcomes, such as patterns of childbirth, contraceptive failures, spontaneous abortions and low birth weight. Self-perceived stress at work was determined by response to the question, "When working, how often do you feel tense, stressed or high strung?" Answers were characterized as occurring "all," "most," "much," "some," "a little," or "none" of the time. Forty-eight percent of respondents reported feeling stressed at work much, most or all of the time, with the highest percentage (63 percent) reported by those who work more than 45 hours a week. Long hours and high stress were most commonly associated with women who achieved partnership and associate status, specialized in criminal law and litigation, and worked between one and five years at their current job. "Work overload is a well-known and well-documented stressor in the law profession," says Schenker. "After graduation from law school, young lawyers typically spend the first five years of their careers working to achieve associate status. It is a highly competitive work environment, especially for women." A 1990 study of 3,248 male and female lawyers by the American Bar Association found that nearly half of respondents worked over 50 hours a week, and another 34 percent worked between 40 and 50 hours. While women tended to work slightly fewer hours than their male counterparts, female lawyers were twice as likely to feel stress in the workplace when compared to men. The ABA study identified political intrigue, back-biting, sexual harassment, lack of opportunity for advancement, advancement not determined by quality of work and lack of respect by superiors as some of the negative aspects of the work environment that affect women's coping skills more than men's. "To accomodate the work schedule, women tend to postpone childbearing until after school or after the early years of work," says Schenker. "In our study, 60 percent of those reporting high stress at work believed it would be 'impossible' or 'very difficult' to have a child in their current position, and 50 percent of all respondents said it would be 'somewhat' to 'very difficult' to do so. Only 26 percent of those in low stress jobs reported such difficulty. Moreover, 27 percent of respondents had no knowledge of their employer's policies on maternity leave, suggesting that career issues take precedence over family." Finding the best time to have a child and raise a family while pursuing professional goals is an important issue for many career women. The UC Davis study shows that for certain careers in law, childbirth may not be as easy to fit in. "This study documents how difficult our current timetable is for women who want to pursue a career and raise a family," says Martha West, a professor of law who specializes in gender issues and employment discrimination at UC Davis School of Law. "So many women are postponing childbirth until their late 30s and early 40s because the current male model of professional training and career development does not accommodate women's role as childbearers." The UC Davis survey also supports the view that women are responsible for the majority of domestic work and child care. Nearly half of all married women spent more than 20 hours a week on domestic work, and 41 percent spent more than 70 hours a week on all work. Yet, the researchers found no evidence that domestic work hours contributed to perceived stress on the job. In fact, married women reported less stress on the job (46 percent) when compared to 56 percent of never-married women who tended to spend fewer hours a week on domestic work. This study was supported by a grant from the March of Dimes. UC Davis Study on Female Lawyers and Stress -- Respondent profile: Of 794 female law school graduates who were sent a mail-in questionnarie, 584 answered the survey (74 percent ). Median age of respondents was 35. Fifty-three percent graduated between 1969 and 1980 and 47 percent graduated between 1980 and 1985. Sixty-nine percent graduated before age 30, 27 percent between age 30 and 39 and 3 percent between age 40 and 52. -- Full-time verus part-time work: Ten percent worked less than 35 hours a week on the job (part time), and 42 percent worked more than 45 hours a week. -- Single versus married women: Single women worked more hours than married women, but married women did more domestic work. Forty-nine percent of married women spent more than 20 hours a week on domestic work while 41 percent spent more than 70 hours a week on all work. Although marriage added considerably to the total hours of work, researchers found no evidence that marriage added to perceived stress on the job. -- Number of work hours per week: Fifty-nine percent of associates and 54 percent of partners worked more than 45 hours a week. Sixty percent of women working in litigation law, 58 percent of corporate/business law workers, and 53 percent of real estate lawyers worked more than 45 hours a week. -- Stress: High stress at work was reported by 48 percent of respondents, with 63 percent of those working more than 45 hours a week reporting high stress. -- Balancing work and childbirth: Sixty percent of those reporting high stress said that it would be impossible or very difficult to have a child versus 26 percent of those in low stress jobs. Fifty percent of all respondents said it would be "somewhat" to "very difficult" to raise a child in their current position. Moreover, 27 percent had no knowledge of their employer's policies on maternity leave. -- Maternal age at birth: The majority of women tend to postpone childbirth until after graduation from law school. Fifty-four percent of births were to women who graduated from law school between 23 and 29 years of age. Eighty-eight percent of births occurred after graduation. Thirty-six percent of births to 30-34 year olds occurred after graduation. -- Spontaneous abortions: Long work hours significantly increases the risk of spontaneous abortion by women who worked long hours during the first trimester. Women working longer than 45 hours a week experienced spontaneous abortion three times as often, even after researchers adjusted for age, smoking, alcohol intake and previous miscarriage. -- Alcohol use: Having seven drinks a week increased the spontaneous abortion rate fivefold. Nature of employment and legal specialty also was associated with spontaneous abortion rate.