Skip to main content

Advertisement

SpringerLink
Log in

Maternity Leave Access and Health: A Systematic Narrative Review and Conceptual Framework Development

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Background Maternity leave is integral to postpartum maternal and child health, providing necessary time to heal and bond following birth. However, the relationship between maternity leave and health outcomes has not been formally and comprehensively assessed to guide public health research and policy in this area. This review aims to address this gap by investigating both the correlates of maternity leave utilization in the US and the related health benefits for mother and child. Methods We searched the peer-reviewed scholarly literature using six databases for the years 1990 to early 2015 and identified 37 studies to be included in the review. We extracted key data for each of the included studies and assessed study quality using the “Weight of the Evidence” approach. Results The literature generally confirms a positive, though limited correlation between maternity leave coverage and utilization. Likewise, longer maternity leaves are associated with improved breastfeeding intentions and rates of initiation, duration and predominance as well as improved maternal mental health and early childhood outcomes. However, the literature points to important disparities in access to maternity leave that carry over into health outcomes, such as breastfeeding. Synthesis We present a conceptual framework synthesizing what is known to date related to maternity leave access and health outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. Internationally, the US is conspicuous for its meager maternity leave protections. Among the five largest developed countries, the US offers the shortest and only unpaid federal leave policy. Likewise, even among less-developed nations, the US is in the minority for its limited maternity leave protections both in terms of length and compensation. Given the US’s idiosyncrasy in this area, this paper focuses on studies specific to the US context and comparative conclusions are beyond the scope of this paper.

References

  1. Aday, L. A., & Andersen, R. (1974). A framework for the study of access to medical care (pp. 208–220). Fall: Health Services Research.

    Google Scholar 

  2. Aday, L. A., & Andersen, R. (1981). Equity of access to medical care: a conceptual and empirical overview. Medical Care, 19(12S), 4–27.

    Article  CAS  Google Scholar 

  3. Andersen, R. M. (1968). A behavioral model of families’ use of health services. Research series no. 25. Chicago: Center for Health Administration Studies, University of Chicago.

  4. Andersen, R. M., Yu, H., Wyn, R., Davidson, P. L., Brown, E. R., & Teleki, S. L. (2002). Access to medical care for low income families: How do communities make a difference? Medical Care Research and Review, 59(4), 384–411.

    Article  PubMed  Google Scholar 

  5. Arthur, C. R., Saenz, R. B., & Replogle, W. H. (2003). The employment-related breastfeeding decisions of physician mothers. Journal of the Mississippi State Medical Association, 44(12), 383–387.

    PubMed  Google Scholar 

  6. Baum, C. L. (2003). The effect of state maternity leave legislation and the 1993 family and medical leave act on employment and wages. Labour Economics, 10(5), 573–596.

    Article  Google Scholar 

  7. 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, F29–F47.

    Article  Google Scholar 

  8. Berger, L. M., & Waldfogel, J. (2004). Maternity leave and the employment of new mothers in the United States. Journal of Population Economics, 17(2), 331–349.

    Article  Google Scholar 

  9. Chatterji, P., & Frick, K. D. (2005). Does returning to work after childbirth affect breastfeeding practices? Review of Economics of the Household, 3(3), 315–335.

    Article  Google Scholar 

  10. Chatterji, P., & Markowitz, S. (2005). Does the length of maternity leave affect maternal health? Southern Economic Journal, 72(1), 16–41.

    Article  Google Scholar 

  11. 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), 61–76.

    PubMed  Google Scholar 

  12. Chatterji, P., Markowitz, S., & Brooks-Gunn, J. (2013). Effects of early maternal employment on maternal health and well-being. Journal of Population Economics, 26(1), 285–301.

    Article  PubMed  PubMed Central  Google Scholar 

  13. 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.

    CAS  PubMed  Google Scholar 

  14. Dagher, R. K., McGovern, P. M., & Dowd, B. E. (2014). Maternity leave duration and postpartum mental and physical health: Implications for leave policies. Journal of Health Politics, Policy and Law, 39(2), 369.

    Article  PubMed  Google Scholar 

  15. Davidson, P. L., Andersen, R. M., Wyn, R., & Brown, E. R. (2004). A framework for evaluating safety-net and other community-level factors on access for low-income populations. Inquiry, Spring, 41, 21–38.

    Google Scholar 

  16. Donath, S. M., Amir, L. H., & Team, A. S. (2003). Relationship between prenatal infant feeding intention and initiation and duration of breastfeeding: A cohort study. Acta Paediatrica, 92(3), 352–356.

    Article  CAS  PubMed  Google Scholar 

  17. Family and Medical Leave Act of 1993, 29 U.S.C. §§ 2601–2654 (2006).

  18. Fein, S. B., & Roe, B. (1998). The effect of work status on initiation and duration of breastfeeding. American Journal of Public Health, 88, 1042–1046.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Feldman, R., Sussman, A. L., & Zigler, E. (2004). Parental leave and work adaptation at the transition to parenthood: Individual, marital, and social correlates. Journal of Applied Developmental Psychology, 25(4), 459–479.

    Article  Google Scholar 

  20. Gennaro, S. (1996). Leave and employment in families of preterm low birthweight infants. Image—The Journal of Nursing Scholarship, 28(3), 193–198.

    Article  CAS  PubMed  Google Scholar 

  21. Gerstel, N., & McGonagle, K. (1999). Job leaves and the limits of the family and medical leave act. Work and Occupations, 26(4), 510–534.

    Article  Google Scholar 

  22. Gjerdingen, D. K. (1994). The relationship of women’s postpartum mental health to employment, childbirth, and social support. The Journal of Family Practice (0094-3509), 38(5), 465.

    CAS  Google Scholar 

  23. Gjerdingen, D. K., Chaloner, K. M., & Vanderscoff, J. A. (1995). Family practice residents’ maternity leave experiences and benefits. Family Medicine, 27(8), 512–518.

    CAS  PubMed  Google Scholar 

  24. Gjerdingen, D. K., McGovern, P. M., Chaloner, K. M., & Street, H. B. (1995). Women’s postpartum maternity benefits and work experience. Family Medicine, 27(9), 592–598.

    CAS  PubMed  Google Scholar 

  25. Gough, D. (2007). Weight of Evidence: A framework for the appraisal of the quality and relevance of evidence. Research Papers in Education, 22(2), 213–228.

    Article  Google Scholar 

  26. Grice, M. M., Feda, D., McGovern, P., Alexander, B. H., McCaffrey, D., & Ukestad, L. (2007). Giving birth and returning to work: The impact of work-family conflict on women’s health after childbirth. Annals of Epidemiology, 17(10), 791–798.

    Article  PubMed  Google Scholar 

  27. Guendelman, S., Goodman, J., Kharrazi, M., & Lahiff, M. (2014). Work-family balance after childbirth: The association between employer-offered leave characteristics and maternity leave duration. Maternal and Child Health Journal, 18(1), 200–208.

    Article  PubMed  Google Scholar 

  28. Guendelman, S., Kosa, J. L., Pearl, M., Graham, S., Goodman, J., & Kharrazi, M. (2009). Juggling work and breastfeeding: Effects of maternity leave and occupational characteristics. Pediatrics, 123, e38–e46.

    Article  PubMed  Google Scholar 

  29. Hamilton, A. R., Tyson, M. D., Braga, J. A., & Lerner, L. B. (2012). Childbearing and pregnancy characteristics of female orthopaedic surgeons. Journal of Bone and Joint Surgery—Series A, 94(11), e77.1–e77.9.

    Google Scholar 

  30. Han, W. J., Ruhm, C., & Waldfogel, J. (2009). Parental leave policies and parents’ employment and leave-taking. Journal of Policy Analysis and Management, 28(1), 29–54.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Han, W. J., & Waldfogel, J. (2003). Parental leave: The impact of recent legislation on parents’ leave taking. Demography, 40(1), 191–200.

    Article  PubMed  Google Scholar 

  32. Heymann, J., Raub, A., & Earle, A. (2011). Creating and using new data sources to analyze the relationship between social policy and global health: The case of maternal leave. Public Health Reports, 126(SUPPL. 3), 127–134.

    PubMed  PubMed Central  Google Scholar 

  33. Hyde, J. S., Klein, M. H., Essex, M. J., & Clark, R. (1995). Maternity leave and women’s mental health. Psychology of Women Quarterly, 19, 257–285.

    Article  Google Scholar 

  34. International Labour Organization. (2010). Maternity at work. Geneva: International Labour Organization, 2010. http://www.ilo.org/wcmsp5/groups/public/@dgreports/@dcomm/@publ/documents/publication/wcms_124442.pdf. Accessed 27 April 2015.

  35. Johnston, M. L., & Esposito, N. (2007). Barriers and facilitators for breastfeeding among working women in the united states. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 36(1), 9–20.

    Article  PubMed  Google Scholar 

  36. Kamerman, S., & Kahn, A. (1995). Starting right: How America neglects its youngest children and what we can do about it. New York: Oxford University Press.

    Google Scholar 

  37. Killien, M. G., Habermann, B., & Jarrett, M. (2001). Influence of employment characteristics on postpartum mother‘s health. Women and Health, 33(1–2), 63–81.

    Article  CAS  PubMed  Google Scholar 

  38. Kim, S. (2001). Perceived impacts of family leave policy: Do organizational factors matter? Public Personnel Management, 30(2), 221–239.

    Article  Google Scholar 

  39. Kimbro, R. T. (2006). On-the-job moms: Work and breastfeeding initiation and duration for a sample of low-income women. Maternal and Child Health Journal, 10(1), 19–26.

    Article  PubMed  Google Scholar 

  40. Klerman, J., & Leibowitz, A. (1997). Labor supply effects of state maternity leave legislation. In F. Blau & R. Ehrenberg (Eds.), Gender and family issues in the workplace. New York: Russell Sage.

    Google Scholar 

  41. Klerman, J., & Leibowitz, A. (1998). FMLA and the labor supply of new mothers: Evidence from the June CPS. Santa Monica: RAND.

    Google Scholar 

  42. Lindberg, L. D. (1996). Women’s decisions about breastfeeding and maternal employment. Journal of Marriage & The Family, 58, 239–251.

    Article  Google Scholar 

  43. Mandal, B., Roe, B. E., & Fein, S. B. (2010). The differential effects of full-time and part-time work status on breastfeeding. Health Policy, 97(1), 79–86.

    Article  PubMed  Google Scholar 

  44. Mays, N., Pope, C., & Popay, J. (2005). Systematically reviewing qualitative and quantitative evidence to inform management and policy-making in the health field. Journal of Health Services Research & Policy, 10(Suppl 1), 6–20.

    Article  Google Scholar 

  45. McGovern, P., Dowd, B., Gjerdingen, D., Moscovice, I., Kochevar, L., & Lohmann, W. (1997). Time off work and the postpartum health of employed women. Medical Care, 35(5), 507–521.

    Article  CAS  PubMed  Google Scholar 

  46. McGovern, P., Dowd, B., Gjerdingen, D., Moscovice, I., Kochevar, L., & Murphy, S. (2000). The determinants of time off work after childbirth. Journal of Health Politics, Policy and Law, 25(3), 527–564.

    Article  CAS  PubMed  Google Scholar 

  47. McGovern, P. M., Gjerdingen, D. K., & Froberg, D. G. (1992). The parental leave debate: Implications for policy relevant research. Women and Health, 18(1), 97–118.

    Article  CAS  PubMed  Google Scholar 

  48. McKinley, N. M., & Hyde, J. S. (2004). Personal attitudes or structural factors? A contextual analysis of breastfeeding duration. Psychology of Women Quarterly, 28(4), 388–399.

    Article  Google Scholar 

  49. Mirkovic, K. R., Perrine, C. G., Scanlon, K. S., & Grummer-Strawn, L. M. (2014). In the United States, a mother’s plans for infant feeding are associated with her plans for employment. Journal of Human Lactation, 30(3), 292–297.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Mirkovic, K. R., Perrine, C. G., Scanlon, K. S., & Grummer-Strawn, L. M. (2014). Maternity leave duration and full-time/part-time work status are associated with us mothers’ ability to meet breastfeeding intentions. Journal of Human Lactation, 30(4), 416–419.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Murtagh, L., & Moulton, A. D. (2011). Working mothers, breastfeeding and the law. American Journal of Public Health, 101(2), 217–223.

    Article  PubMed  PubMed Central  Google Scholar 

  52. National Conference of State Legislatures. (2013). State and family medical leave laws. Retrieved from http://www.ncsl.org/research/labor-and-employment/state-family-and-medical-leave-laws.aspx#2

  53. 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, e1414–e1427.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Popay, J., Arai, L., Petticrew, M., & Roen, K. (2003). Narrative synthesis in systematic reviews. Methods Briefing 22, The Economic and Social Research Council. http://www.ccsr.ac.uk/methods/projects/posters/documents/Popay.pdf

  55. Popay, J., Roberts, H., Sowden, A., Petticrew, M., Arai, L., Rodgers, M, et al. (2006). Guidance on the conduct of narrative synthesis in systematic reviews. Final report, Institute of Health Research, Lancaster: ESRC Methods Programme.

  56. Pregnancy Discrimination Act (“PDA”), 42 U.S.C. § 2000(e) et seq., 1978.

  57. Roe, B., Whittington, L. A., Beck, S. F., & Teisl, M. F. (1999). Is there competition between breast-feeding and maternal employment? Demography, 36(2), 157–171.

    Article  CAS  PubMed  Google Scholar 

  58. Rossin, M. (2011). The effects of maternity leave on children’s birth and infant health outcomes in the United States. Journal of Health Economics, 30(2), 221–239.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Rossin-Slater, M., Ruhm, C. J., & Waldfogel, J. (2013). The effects of California’s paid family leave program on mothers’ leave-taking and subsequent labor market outcomes. Journal of Policy Analysis and Management, 32(2), 224–245.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Ruhm, C. J. (2000). Parental leave and child health. Journal of Health Economics, 19(6), 931–960.

    Article  CAS  PubMed  Google Scholar 

  61. Sattari, M., Serwint, J. R., Neal, D., Chen, S., & Levine, D. M. (2013). Work-place predictors of duration of breastfeeding among female physicians. Journal of Pediatrics, 163(6), 1612–1617.

    Article  PubMed  Google Scholar 

  62. Schott, W. (2012). Going back part-time: Family leave legislation and women’s return to work. Population Research and Policy Review, 31(1), 1–30.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Shepherd-Banigan, M., & Bell, J. F. (2014). Paid leave benefits among a national sample of working mothers with infants in the United States. Maternal and Child Health Journal, 18(1), 286–295.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Staehelin, K., Bertea, P. C., & Stutz, E. Z. (2007). Length of maternity leave and health of mother and child—A review. International Journal of Public Health, 52, 202–209.

    Article  PubMed  Google Scholar 

  65. Tanaka, S. (2005). Parental leave and child health across OECD countries. Economic Journal, 115(501), F7–F28.

    Article  Google Scholar 

  66. U.S. Department of Health and Human Services. (2000). Healthy people 2010: Understanding and improving health (2nd ed.). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  67. U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. (2011). “Maternity Leave.” Women’s Health USA 2011. Rockville, Maryland: US Department of Health and Human Services.

  68. Visness, C. M., & Kennedy, K. I. (1997). Maternal employment and breast-feeding: Findings from the 1988 National Maternal and Infant Health Survey. American Journal of Public Health, 87(6), 945–950.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Waldfogel, J. (1999). The impact of the Family and Medical Leave Act. Journal of Policy Analysis and Management, 18(2), 281–302.

    Article  Google Scholar 

  70. Wiese, B. S., & Ritter, J. O. (2012). Timing matters: Length of leave and working mothers’ daily reentry regrets. Developmental Psychology, 48(6), 1797–1807. (not U.S. study).

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. George Washington University, 3/F, 5G Bowen Road, Mid-Levels, Hong Kong

    Ellie Andres

  2. George Washington University, 950 New Hampshire Ave, NW, 4th Floor, Washington, DC, 20052, USA

    Sarah Baird

  3. George Washington University, 950 New Hampshire Avenue, NW, 3rd Floor, Washington, DC, 20052, USA

    Jeffrey Bart Bingenheimer

  4. George Washington University, 950 New Hampshire Ave, NW, Suite 600, Washington, DC, 20052, USA

    Anne Rossier Markus

Authors
  1. Ellie Andres
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sarah Baird
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jeffrey Bart Bingenheimer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anne Rossier Markus
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ellie Andres.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Andres, E., Baird, S., Bingenheimer, J.B. et al. Maternity Leave Access and Health: A Systematic Narrative Review and Conceptual Framework Development. Matern Child Health J 20, 1178–1192 (2016). https://doi.org/10.1007/s10995-015-1905-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-015-1905-9

Keywords

Search

Navigation