National Paid Maternity Leave Makes Sense for Mothers, Babies and Maybe the Economy

New mothers who are entitled to paid maternity leave beyond a few weeks’ duration are more likely to have better mental and physical health. In turn, their offspring have a slightly reduced likelihood of infant death and an increased chance of secure maternal attachment, breastfeeding and keeping up to date with vaccinations, according to a multi-institution study co-authored by UC San Francisco researchers.

While the United States offers qualifying parents up to 12 weeks of unpaid leave after a birth or adoption, just 16 percent of private industry employees have access to paid leave, according to the study, which publishes in Harvard Review of Psychiatry on March 9, 2020. More contentiously, close to one in four new mothers who are not eligible for paid leave return to work within 10 days of giving birth.

In contrast, nations like the United Kingdom and Mexico offer 12 weeks’ paid leave, versus 36 weeks in Japan and up to 85 weeks in Estonia, said senior author Christina Mangurian, MD, MAS, of the UCSF Department of Psychiatry and the UCSF Weill Institute for Neurosciences.

In their review, researchers evaluated 26 national and international studies that examined the impact of paid maternity leave and duration of leave. Among their findings:

• A 2000 study from nine Western European countries showed that adding 10 weeks of paid maternity leave to the average paid leave in each country was linked to an approximate 5 percent drop in the number of infant deaths.
• A 2012 U.S. study of 3,350 mothers showed that less than eight weeks of paid maternity leave was linked to poorer health and increased depression.
• A 2011 Australian study of 1,507 mothers showed that women who took paid maternity leave were subject to 58 percent lower incidence of emotional and physical violence from their partners.
• A 2005 study of 1,907 U.S. mothers found that those who had more than 12 weeks of paid maternity leave were more likely to have infants who were up to date on their vaccinations, had fewer behavioral issues, had breastfed and had done so for longer periods.
• A 2018 U.S. study of 3,850 mothers revealed that the duration of paid maternity leave significantly correlated to positive mother-child interactions, leading to secure attachment, empathy and later academic success.

Additionally, the authors said that paid-leave policies frequently reveal a “troubling” two-tiered system in which those with higher incomes can afford to stay at home for 12 weeks or more, while lower-income women return to work. Among employees who made less than $30,000 per year, 62 percent did not receive paid leave, compared to 26 percent of their peers who made more than $75,000 annually.

“In the U.S., women in higher-paid households are often able to stay home with their infants for 12 weeks or more because many of them have access to paid maternity leave, or are able to take unpaid leave without significantly impacting their families,” said Mangurian. “On the other hand, lower-income women frequently need to return to work earlier because they can’t afford to take unpaid leave. This is a problem because data suggest that at least 12 weeks of paid maternity leave has a beneficial effect on the mental and physical health of both the mother and baby.”

The authors stated that paid maternity leave could help, rather than hurt, the economy, pointing to population studies indicating that it results in “substantial individual and societal benefits, notably labor force attachment, wage stability and decreased use of public assistance.”

First author Maureen Sayres Van Niel, MD, a reproductive psychiatrist in Cambridge, Mass., said that the U.S. is facing an evidence-based mandate to create a national paid leave policy. “For decades, national paid maternity leave policies of 12 weeks or more have existed in every industrialized country except the United States. We recommend that the United States develop a national paid policy that would allow all mothers sufficient time to be home with their infants, regardless of their employer or socioeconomic status.”

Co-Authors: Richa Bhatia, MD; Nicholas Riano of UCSF; Ludmila de Faria, MD, of Florida State University College of Medicine; Lisa Catapano-Friedman, MD, of Massachusetts College of Pharmacy and Health Sciences; Simha Ravven, MD, and Kristin Budde, MD, of Yale University School of Medicine; Barbara Weissman, MD, of San Mateo Country Psychiatry Residency Training Program; Carine Nzodom, MD, of Columbia University School of Medicine; Amy Alexander, MD, of Stanford University School of Medicine.

The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health, which serves as UCSF’s primary academic medical center, includes top-ranked specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area.