Maternity leave is associated with positive health and cognitive outcomes for children, especially when paid and longer than six weeks, and may also contribute to maternal physical and mental health. Currently, U.S. women are guaranteed access to maternity leave only through the Family and Medical Leave Act (FMLA), which requires employers to offer eligible employees up to 12 weeks of unpaid job-protected leave to care for family members, including newborn children. However, as many as 40% of women are either ineligible or cannot afford to take extended leaves of absence from work without pay. In addition, findings on the association between maternity leave and women's physical and mental health are mixed, with most existing research using either international or small, regional samples that are difficult to generalize to the U.S. population. The last comprehensive study on maternity leave in the U.S. was conducted over two decades ago. This study will use two new, nationally-representative datasets to identify trends in the availability, use, and duration of pai and unpaid maternity leave in the U.S. and to explore the association between leave and health. Listening to Mothers III is a survey conducted among a national sample of childbearing women ages 18-45 who gave birth in a U.S. hospital in 2011-12 (N=2,400). It includes unique measures for women's employment experiences during pregnancy and postpartum; maternity leave availability, use, and duration; and women's and infants' health status, healthcare utilization, and health-related behaviors postpartum. The National Survey of Family Growth 2006-2010 was conducted by the Centers for Disease Control and Prevention (CDC) via household interviews; its Pregnancy Supplement includes responses from 4,579 women who gave birth within the last 5 years. It is one of the only datasets containing detailed information on employment and maternity leave with a large enough sample size to conduct comparative analyses of maternity leave availability, use, and duration by respondents' state of residence at the time of birth. The expected outcomes of this research include new information on: 1) associations between maternity leave and health for U.S. women and infants, differentiating between paid and unpaid leave; 2) whether women residing in states that have implemented policies expanding on the minimum provisions of the FMLA have significantly more access to maternity leave in terms of availability, use and duration; and 3) whether these policies are associated with significant differences in maternal and child health across states, via their impact on access to leave. This project addresses issues highly pertinent to the AHRQ priority populations of Women and Children, Low-Income Populations, and Minority Health. The results of this research will be of interest to women, children, and families; to employers seeking to balance the costs and benefits of offering maternity leave benefits to employees; and to policymakers seeking to use research evidence in their decision- making processes, especially as paid family leave enters the national policy agenda.
This project will use new, nationally-representative survey data to examine the effects of paid and unpaid maternity leave on health outcomes in women and infants, as well as trends in the availability, use, and duration of maternity leave by state and socio-demographic characteristics. The project is expected to produce research evidence relevant to state- and federal-level policymakers, health services researchers, employers, and others working in the area of maternal and child health.
