Paid maternity leave associated with mental and physical health benefits for mothers, children

Paid maternity leave has major mental and physical health benefits for mothers and children - including reduced rates of postpartum depression and infant mortality, according to a report in the March/April issue of Harvard Review of Psychiatry. The journal is published in the Lippincott portfolio by Wolters Kluwer.

Given the substantial mental and physical health benefits associated with paid leave, as well as favorable results from studies on its economic impact, the United States is facing a clear, evidence-based mandate to create a national paid maternity leave policy. We recommend a national paid maternity leave policy of at least 12 weeks for all mothers."

Maureen Sayres Van Niel, MD, lead author, reproductive psychiatrist in Cambridge, Mass

Studies show range of public health benefits of paid maternity leave

The authors analyzed recent national and international studies on the effects of paid maternity leave on the health of mothers and children. "For decades, national paid maternity leave policies of 12 weeks or more have existed in every industrialized country except the United States," according to Dr. Van Niel. "In this review, we show that serious health consequences can occur for women and children in this country without such a policy."

Focusing on 26 experimental or quasi-experimental studies, the review highlights the public health benefits of paid maternity leave in several areas:

• Mothers' mental health. Paid maternity leave has been linked to significantly lower rates of postpartum maternal depression, a common disorder with serious repercussions for both the mother and child. Other reported benefits include reduced psychological distress, improved mood, and in one study a sharply reduced risk of intimate partner violence.
• Children's mental health. Maternity leave has positive effects on infant mental health and development - including reducing the risk of postpartum depression and its inherent adverse effects on maternal-infant bonding. Duration of maternity leave has also been linked to the quality of mother-child interactions, which affects the development of attachment, empathy, and later academic performance in the child.
• Physical health. Paid maternity leave is "directly correlated with decreased infant and child mortality." It is also associated with improved attendance at pediatric well-baby visits, more timely immunizations, and a markedly reduced risk of infant rehospitalizations in the first year of life. In addition, paid leave is associated with improved measures of physical health in postpartum women.
• Breast-feeding. Strong evidence has shown that paid maternity leave increases the likelihood of both breastfeeding initiation and duration among mothers who choose to and are able to breastfeed. Paid leave also provides women with a greater opportunity to breastfeed exclusively for six months, consistent with current recommendations.

The authors also cite economic impact studies showing "no substantial negative economic or employment consequences of paid maternal leave." Paid leave also has individual and societal benefits, including labor force attachment, wage stability, and decreased use of public assistance.

The review also highlights a "troubling" disparity: "The United States has a two-tiered system of paid maternity leave: women with moderate-to-high family incomes can more often afford to stay at home with their infants for 12 or more weeks, whereas women with low family incomes cannot afford to do so and must often return to work shortly after giving birth."

"In light of the increasing data that paid leave offers substantial benefits to the health of mothers and children, we recommend that the United States develop a national paid maternity leave policy that would allow all mothers sufficient time to be home with their infants after the birth or arrival of the child, regardless of their employer or socioeconomic status," states Dr. Van Niel. The authors hope the evidence in their review will support ongoing efforts to enact a national paid family leave policy, such as the proposed Family and Medical Insurance Leave Act currently in Congress.

"Many businesses recognize that paid family leave helps to retain talent," says Dr. Christina Mangurian, senior author and Professor and Vice Chair for Diversity and Equity at the UCSF Department of Psychiatry. "Available data now also shows that paid maternity leave is good for the physical and mental health of mothers and their children. So now we know it's not just good for business, it's also good for the health of working families."