Paid Maternity Leave in the United States: Associations with Maternal and Infant Health


Objectives The United States is one of only three countries worldwide with no national policy guaranteeing paid leave to employed women who give birth. While maternity leave has been linked to improved maternal and child outcomes in international contexts, up-to-date research evidence in the U.S. context is needed to inform current policy debates on paid family leave. Methods Using data from Listening to Mothers III, a national survey of women ages 18–45 who gave birth in 2011–2012, we conducted multivariate logistic regression to predict the likelihood of outcomes related to infant health, maternal physical and mental health, and maternal health behaviors by the use and duration of paid maternity leave. Results Use of paid and unpaid leave varied significantly by race/ethnicity and household income. Women who took paid maternity leave experienced a 47% decrease in the odds of re-hospitalizing their infants (95% CI 0.3, 1.0) and a 51% decrease in the odds of being re-hospitalized themselves (95% CI 0.3, 0.9) at 21 months postpartum, compared to women taking unpaid or no leave. They also had 1.8 times the odds of doing well with exercise (95% CI 1.1, 3.0) and stress management (95% CI 1.1, 2.8), compared to women taking only unpaid leave. Conclusions for Practice Paid maternity leave significantly predicts lower odds of maternal and infant re-hospitalization and higher odds of doing well with exercise and stress management. Policies aimed at expanding access to paid maternity and family leave may contribute toward reducing socio-demographic disparities in paid leave use and its associated health benefits.

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    Respondents were coded as having depressive symptoms if they indicated feeling “little interest or pleasure in doing things” or “down, depressed, or hopeless” either “More than half the days” or “Nearly every day” during the two weeks prior to the survey.


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This project was supported by a Health Services Research Dissertation Award from the Agency for Healthcare Research and Quality (1R36 HS023950-01). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.

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Correspondence to Judy Jou.

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Jou, J., Kozhimannil, K.B., Abraham, J.M. et al. Paid Maternity Leave in the United States: Associations with Maternal and Infant Health. Matern Child Health J 22, 216–225 (2018).

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  • Maternity leave
  • Family and Medical Leave Act
  • Maternal health
  • Infant health
  • Health behavior