Paid Maternity Leave Improves Health, Mental Health for Both Mothers and Infants

Paid maternity leave benefits the mental and physical health of both mothers and children, a review in the Harvard Review of Psychiatry has found. The benefits include a decrease in postpartum depression and mother and infant rehospitalizations and improved infant attachment.

“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,” said lead author Maureen Sayres Van Niel, M.D., a reproductive psychiatrist in Cambridge, Mass. She is the APA Assembly’s representative to the Caucus of Women Psychiatrists and chair of the Assembly Committee of Representatives of Minority/Underrepresented Groups.

Van Niel and colleagues reviewed 26 studies about the relationship between maternity leave and health outcomes in mothers and their children. Key findings among the studies in the review include the following:

• Significantly higher scores for maternal depression and increased diagnoses of major depressive disorder among women who took fewer than 12 weeks of paid leave.

• An increased risk of postpartum depression among women who took less than six months of maternity leave in general (paid or unpaid).

• A 58% lower chance of reporting physical and psychological intimate partner violence in the year following birth for women who took paid maternity leave compared with those who were not working or were not eligible for paid leave.

• A 51% lower chance of being rehospitalized in the year after birth among women who took paid leave of any duration.

• A 46% reduced likelihood of infant rehospitalization in the first year among infants born to mothers who took paid leave compared with those whose mothers took no leave or unpaid leave.

“The United States is one of [very few] developed countries to lack a national policy on paid family leave,” said review coauthor Nicholas Riano, M.A.S., an assistant clinical research coordinator in the Department of Psychiatry at the University of California, San Francisco (UCSF). “This review substantially adds to the literature. It is important for policymakers to consider the benefits of paid maternity leave and what policies should be enacted.”

In conducting their review, the authors also found disparities among women of differing socioeconomic backgrounds: Women with higher incomes were more likely to take eight to 12 weeks of leave, including unpaid leave, whereas women with lower incomes were more likely to return to work as early as 10 days after giving birth.

University of California San Francsico

“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 home with their infants for 12 or more weeks, whereas women with low family incomes cannot afford to do so. They must go to work in order to pay their bills,” Van Niel explained. “Yet it’s very important for all women and their babies to have time together to create a more secure attachment.”

Although psychiatrists do not typically interact with women during the postpartum period unless the women were established patients before their pregnancies or are grappling with postpartum depression, there is still an opportunity to help, said senior author Christina Mangurian, M.D., M.A.S., former chair of APA’s Council on Minority Mental Health and Health Disparities and professor and vice chair of diversity and health equity at the UCSF Department of Psychiatry.

“My wish is that we [psychiatrists] advocate for paid maternity leave as a profession because of the mental health benefits,” Mangurian said. “We know how important bonding is early in an infant’s life. It’s important for us to use our scientific and clinical expertise to advocate for paid leave to promote this bonding and mental health wellbeing.”

The authors reported no outside funding for their review. ■