Family leave after childbirth and the mental health of new mothers.

BACKGROUND Recent studies indicate that short maternity leave, and, more generally, full-time maternal employment during the first year of life, detract from children's health, cognitive development, and behavioral outcomes. Much less is known, however, about how early parental employment affects the mental and physical health of the mothers themselves. AIMS OF THE STUDY The purpose of this paper is to examine the association between short family leave length (less than 12 weeks of total leave after childbirth, less than 8 weeks of paid leave) and mental and physical health outcomes among new mothers. METHODS Data come from the Early Childhood Longitudinal Study--Birth Cohort (ECLS-B), a nationally representative sample of 14,000 children born in 2001 and followed until kindergarten entry. We focus on a sample of ECLS-B mothers from the first wave of the survey who had worked during pregnancy and who had returned to work by the time of the first follow-up interview, which was conducted about 9 months after childbirth. When examining the effects of paternal leave, we further restrict this sample to mothers who were married at the time of the first follow-up interview. The maternal health outcomes of interest are measures of depression and overall health status. We use standard OLS and ordered probit models, as well as two-stage least squares and two-stage residual inclusion methods which address the potential endogeneity of family leave with respect to maternal health. RESULTS Our findings from the OLS and ordered probit models indicate that, for mothers who worked prior to childbirth and who return to work in the first year, having less than 12 weeks of maternal leave and having less than 8 weeks of paid maternal leave are both associated with increases in depressive symptoms, and having less than 8 weeks of paid leave is associated with a reduction in overall health status. Findings from models that address the potential endogeneity of maternal leave generally support these results, and suggest that longer leave may improve the health of new mothers. DISCUSSION Our findings suggest that longer leave after childbirth may benefit families. However, one potential drawback of using cross-sectional variation in state policies and community characteristics for identification is that these measures may be correlated with other unmeasured factors that directly influence family leave and maternal health. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE The mother's mental and physical health can be an important route through which infants are affected by parents' employment decisions. Our findings suggest that post-partum health services that target mothers' mental and physical health, and its effects on infants, may be useful. IMPLICATIONS FOR HEALTH POLICIES Our findings suggest that policies that support longer family leave may benefit maternal mental health. IMPLICATIONS FOR FURTHER RESEARCH Future research should examine how workplace and public policies related to maternal employment can be used to improve families' health outcomes.