The Impact of Paid Maternity Leave on the Mental and Physical Health of Mothers and Children: A Review of the Literature and Policy Implications

Abstract

For decades, national paid maternity leave policies of 12 weeks or more have been established in every industrialized country except the United States. Despite women representing 47% of the current U.S. labor force, only 16% of all employed American workers have access to paid parental leave through their workplace. As many as 23% of employed mothers return to work within ten days of giving birth, because of their inability to pay living expenses without income. We reviewed recent studies on the possible effects of paid maternity leave on the mental and physical health of mothers and children. We found that paid maternity leave is associated with beneficial effects on (1) the mental health of mothers and children, including a decrease in postpartum maternal depression and intimate partner violence, and improved infant attachment and child development, (2) the physical health of mothers and children, including a decrease in infant mortality and in mother and infant rehospitalizations, and an increase in pediatric visit attendance and timely administration of infant immunizations, and (3) breastfeeding, with an increase in its initiation and duration. 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.

In Their Own Words: A Qualitative Investigation of the Factors Influencing Maternal Postpartum Functioning in the United States

“…Moreover, programs such as Listening Visits (a nondirective counseling intervention which originated in the United Kingdom) could be enacted in the United States to provide mothers with additional emotional support in the context of home visits [ 89 ]. Additionally, paid parental leave initiatives [ 88 , 90 , 91 ] take the onus off of mothers for balancing work and financial concerns with postpartum adjustment. Implementing similar initiatives in the United States would address critical gaps and could begin to cultivate an environment around mothers that predisposes to higher levels of postpartum function.…”

The yearly financing need of providing paid maternity leave in the informal sector in Indonesia

“…The total financing need of both our estimate for informal sector, and the other estimate from previous study on formal sector [30] shows that the combined financing need of providing MCT to eligible WRA in both the formal and informal sectors at 100% coverage based on minimum wage amount to be around US$2 billion per year, roughly 4.5 times lower than the estimate of the cost of not breastfeeding in Indonesia. This indicates the value of investing in MCT, in addition to its benefits in terms of alleviating the costs of sickness, cognitive losses and deaths due to not breastfeeding and improve maternal-child physical and mental health and family wellbeing, and also to potentially increase women's participation in the labour market [4][5][6]8,11,12,[14][15][16]66]. However, the proposed MCT approach would require, among other things, sound monitoring to ensure that breastfeeding actually took place, consistency in the best timing of delivery of cash distribution and breastfeeding counselling visits, recognizing that many mothers receiving the cash transfer face major social determinants of health challenges.…”

“…Such benefits include alleviating the costs of sickness, cognitive losses and deaths due to not breastfeeding [4][5][6]14]. Providing paid maternity leave entitlement for working women may also be useful to improve maternal-child physical and mental health and family wellbeing, and also to potentially increase women's participation in the labour market [8,11,12,15,16]. Studies have indeed shown that paid maternity leave may improve breastfeeding outcomes; mothers receiving paid leave for more time, breastfeed longer [9,11,[17][18][19][20].…”

The annual cost of providing paid maternity leave in the informal sector in Indonesia 

“…The total cost of both our estimate for informal sector, and the other estimate from previous study on formal sector [30] shows that the combined cost of providing MCT to eligible WRA in both the formal and informal sectors at 100% coverage based on minimum wage amount to be around US$2 billion per year, roughly 4.5 times lower than the estimate of the cost of not breastfeeding in Indonesia. This indicates the value of investing in MCT, in addition to its benefits in terms of alleviating the costs of sickness, cognitive losses and deaths due to not breastfeeding and improve maternal-child physical and mental health and family wellbeing, and also to potentially increase women's participation in the labour market [4][5][6]8,11,12,[14][15][16]67]. However, the proposed MCT approach would require, among other things, sound monitoring to ensure that breastfeeding actually took place, consistency in the best timing of delivery of cash distribution and breastfeeding counselling visits, recognizing that many mothers receiving the cash transfer face major social determinants of health challenges.…”

“…Such benefits include alleviating the costs of sickness, cognitive losses and deaths due to not breastfeeding [4][5][6]14]. Providing paid maternity leave entitlement for working women may also be useful to improve maternal-child physical and mental health and family wellbeing, and also to potentially increase women's participation in the labour market [8,11,12,15,16]. Studies have indeed shown that paid maternity leave may improve breastfeeding outcomes; mothers receiving paid leave for more time, breastfeeding longer [9,11,[17][18][19][20].…”