Maternal and Child Health Journal

, Volume 22, Issue 10, pp 1470–1476 | Cite as

The Effect of Paid Leave on Maternal Mental Health

  • Bidisha MandalEmail author


Objectives I examined the relationship between paid maternity leave and maternal mental health among women returning to work within 12 weeks of childbirth, after 12 weeks, and those returning specifically to full-time work within 12 weeks of giving birth. Methods I used data from 3850 women who worked full-time before childbirth from the Early Childhood Longitudinal Study—Birth Cohort. I utilized propensity score matching techniques to address selection bias. Mental health was measured using the Center for Epidemiologic Studies Depression (CESD) scale, with high scores indicating greater depressive symptoms. Results Returning to work after giving birth provided psychological benefits to women who used to work full-time before childbirth. The average CESD score of women who returned to work was 0.15 standard deviation (p < 0.01) lower than the average CESD score of all women who worked full-time before giving birth. Shorter leave, on the other hand, was associated with adverse effects on mental health. The average CESD score of women who returned within 12 weeks of giving birth was 0.13 standard deviation higher (p < 0.05) than the average CESD score of all women who rejoined labor market within 9 months of giving birth. However, receipt of paid leave was associated with an improved mental health outcome. Among all women who returned to work within 12 weeks of childbirth, those women who received some paid leave had a 0.17 standard deviation (p < 0.05) lower CESD score than the average CESD score. The result was stronger for women who returned to full-time work within 12 weeks of giving birth, with a 0.32 standard deviation (p < 0.01) lower CESD score than the average CESD score. Conclusions The study revealed that the negative psychological effect of early return to work after giving birth was alleviated when women received paid leave.


Paid leave Maternal mental health Propensity score matching 



There is no funding to be reported for this study.

Compliance with Ethical Standards

Conflict of interest

There is no conflict of interest for any of the contributors.

Ethical Approval

License to use the restricted ECLS-B data was approved by the Institute for Education Sciences Data Security Office of the U.S. Department of Education, National Center for Education Statistics. The research was conducted in accord with prevailing ethical principles.


  1. Aitken, Z., Garrett, C. C., Hewitt, B., Keogh, L., Hocking, J. S., & Kavanagh, A. M. (2015). The maternal health outcomes of paid maternity leave: A systematic review. Social Science & Medicine, 130, 32–41.CrossRefGoogle Scholar
  2. Andres, E., Baird, S., Bingenheimer, J. B., & Markus, A. R. (2016). Maternity leave access and health: A systematic narrative review and conceptual framework development. Maternal and Child Health Journal, 20(6), 1178–1192.CrossRefPubMedGoogle Scholar
  3. Baum, II, C. L. (2003). Does early maternal employment harm child development? An analysis of the potential benefits of leave taking. Journal of Labor Economics, 21(2), 409–448.CrossRefGoogle Scholar
  4. Baydar, N., & Brooks-Gunn, J. (1991). Effects of maternal employment and child-care arrangements on preschoolers’ cognitive and behavioral outcomes: Evidence from the Children of the National Longitudinal Survey of Youth. Developmental Psychology, 27(6), 932.CrossRefGoogle Scholar
  5. Berger, L. M., Hill, J., & Waldfogel, J. (2005). Maternity leave, early maternal employment and child health and development in the US. The Economic Journal, 115(501), F29–F47.CrossRefGoogle Scholar
  6. Blau, F., & Grossberg, A. (1992). Maternal labor supply and children’s cognitive development. The Review of Economics and Statistics, 74(3), 474–481.CrossRefGoogle Scholar
  7. Brooks–Gunn, J., Han, W. J., & Waldfogel, J. (2002). Maternal employment and child cognitive outcomes in the first three years of life: The NICHD study of early child care. Child Development, 73(4), 1052–1072.CrossRefPubMedGoogle Scholar
  8. Calnen, G. (2007). Paid maternity leave and its impact on breastfeeding in the United States: An historic, economic, political, and social perspective. Breastfeeding Medicine, 2(1), 34–44.CrossRefPubMedGoogle Scholar
  9. Cantor, D., Waldfogel, J., Kerwin, J., Wright, M. M., Levin, K., Rauch, J., Hagerty, T., & Kudela, M. S. (2001). Balancing the needs of families and employers: Family and medical leave surveys. Report submitted to the US Department of Labor. Washington, DC: Westat.Google Scholar
  10. Chatterji, P., & Markowitz, S. (2012). Family leave after childbirth and the mental health of new mothers. Journal of Mental Health Policy and Economics, 15(2), 61.PubMedGoogle Scholar
  11. Clark, R., Hyde, J. S., Essex, M. J., & Klein, M. H. (1997). Length of maternity leave and quality of mother-infant interactions. Child Development, 68(2), 364–383.PubMedGoogle Scholar
  12. Huang, R., & Yang, M. (2015). Paid maternity leave and breastfeeding practice before and after California’s implementation of the nation’s first paid family leave program. Economics & Human Biology, 16, 45–59.CrossRefGoogle Scholar
  13. Kamerman, S. (2000). Parental leave policies: An essential ingredient in early childhood education and care policies. Social Policy Report, 14, 3–15.CrossRefGoogle Scholar
  14. Klerman, J. A., & Leibowitz, A. (1994). The work-employment distinction among new mothers. Journal of Human Resources, 21(2), 277–303.CrossRefGoogle Scholar
  15. Mandal, B., Roe, B. E., & Fein, S. B. (2014). Work and breastfeeding decisions are jointly determined for higher socioeconomic status US mothers. Review of Economics of the Household, 12(2), 237–257.CrossRefGoogle Scholar
  16. National Conferences of State Legislatures. Employee Leave. Retrieved November 10, 2016, from
  17. Ogbuanu, C., Glover, S., Probst, J., Liu, J., & Hussey, J. (2011). The effect of maternity leave length and time of return to work on breastfeeding. Pediatrics, 127(6), e1414–e1427.CrossRefGoogle Scholar
  18. Radloff, L. S. (1977). The CES-D scale: the self-reported depression scale for research in the general population. Applied Psychological Measurement, 3, 385–401.CrossRefGoogle Scholar
  19. Roberts, R. E., Lewinsohn, P. M., & Seeley, J. R. (1991). Screening for adolescent depression: A comparison of depression scales. Journal of the American Academy of Child & Adolescent Psychiatry, 30(1), 58–66.CrossRefGoogle Scholar
  20. Rosenbaum, P. R., & Rubin, D. B. (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70(1), 41–55.CrossRefGoogle Scholar
  21. Rosenbaum, P. R., & Rubin, D. B. (1984). Reducing bias in observational studies using subclassification on the propensity score. Journal of the American Statistical Association, 79(387), 516–524.CrossRefGoogle Scholar
  22. Rosenbaum, P. R., & Rubin, D. B. (1985). Constructing a control group using multivariate matched sampling methods that incorporate the propensity score. The American Statistician, 39(1), 33–38.Google Scholar
  23. Rubin, D. B. (1973). The use of matched sampling and regression adjustment to remove bias in observational studies. Biometrics, 29, 185–203.CrossRefGoogle Scholar
  24. Rubin, D. B. (1978). Using multivariate matched sampling and regression adjustment to control bias in observational studies. ETS Research Report Series, 1978(2):1–10.Google Scholar
  25. Rubin, D. B., & Thomas, N. (2000). Combining propensity score matching with additional adjustments for prognostic covariates. Journal of the American Statistical Association, 95(450), 573–585.CrossRefGoogle Scholar
  26. Ruhm, C. J. (2004). Parental employment and child cognitive development. Journal of Human Resources, 39(1), 155–192.CrossRefGoogle Scholar
  27. Schroeder, M. C. (2011). The economics of mandated paid leave. Doctoral dissertation, Emory University.Google Scholar
  28. Spriggs, A. L., & Halpern, C. T. (2008). Sexual debut timing and depressive symptoms in emerging adulthood. Journal of Youth and Adolescence, 37(9), 1085–1096.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Stearns, J. (2015). The effects of paid maternity leave: Evidence from temporary disability insurance. Journal of Health Economics, 43, 85–102.CrossRefPubMedGoogle Scholar
  30. Waldfogel, J. (2001). Family and medical leave: Evidence from the 2000 surveys. Monthly Labor Review, 124, 17.Google Scholar
  31. Waldfogel, J., Han, W. J., & Brooks-Gunn, J. (2002). The effects of early maternal employment on child cognitive development. Demography, 39(2), 369–392.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Economic SciencesWashington State UniversityPullmanUSA

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