“You’re Left to Fend for Yourself”: Navigating Maternity Care, Employment Barriers, and Postpartum Well-being in Florence, Italy

Authors

• Sophie E. Shank, Purdue UniversityFollow
• Honor Fuchs, Purdue UniversityFollow
• Nicole A. Stepp, Purdue UniversityFollow
• Andrea L. DeMaria, March of DimesFollow

Abstract

This qualitative study explores how maternity care systems, workplace policies, and sociocultural norms shape pregnancy and postpartum experiences among women in Florence, Italy, a context characterized by declining fertility, low maternal employment, and persistent gender inequities. Twenty-four women aged 25–62 participated in 60-minute, in-person interviews conducted in May and June 2023. Reflexive thematic analysis identified four interrelated themes: (1) mixed experiences with Italy’s public healthcare system, (2) employment challenges shaped by gender discrimination and workplace pressures surrounding maternity benefits, (3) impacts on postpartum well-being amid limited support and follow-up care, and (4) women’s recommendations for improving maternity policies and support systems. Participants described dissatisfaction with fragmented public healthcare services, limited communication with providers, and insufficient attention to postpartum mental health. Workplace narratives revealed wage disparities, hiring discrimination toward women of reproductive age, pressure to return to work early, and barriers to accessing maternity protections among self-employed workers. These structural challenges were reinforced by cultural expectations that mothers assume primary caregiving roles, contributing to isolation, maternal shame, and identity loss during the postpartum period. Participants advocated for longer paid maternity and paternity leave, improved postpartum education and mental health support, community-based programs for new mothers, and more affordable childcare. Collectively, these findings highlight a disconnect between maternity policy design and women’s lived experiences and showcase the need for culturally responsive, gender-equitable reforms that integrate maternal health care, workplace protections, and social support systems to promote maternal well-being and workforce participation.

Author ORCID Identifier

Authors ORCIDID: 0009-0000-1153-4049, 0009-0007-0435-4032, 0009-0007-2725-1140, 0000-0002-5450-0444

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

Recommended Citation

Shank, Sophie E.; Fuchs, Honor; Stepp, Nicole A.; and DeMaria, Andrea L. (2026) "“You’re Left to Fend for Yourself”: Navigating Maternity Care, Employment Barriers, and Postpartum Well-being in Florence, Italy," Health Behavior Research: Vol. 9: No. 1.