Parental leave is defined as a job-protected leave of absence for parents after childbirth in order to take care of their baby. The federal Family and Medical Leave Act (FMLA) allows up to 12 weeks of unpaid leave for new parents; however, only about half of all working women are eligible for FMLA benefits. (Those who have been working for less than a year or for an employer with less than 50 employees are not covered by FMLA.) It is also important to note that women of color are less likely than white women to have access to maternity leave. In addition, women with less education and those working for lower pay are less likely to take maternity leave.

While 11 states have passed paid family and medical leave laws, the United States has no federal law protecting the right to paid family or medical leave. In fact, the United States is the only nation in the developed world that lacks paid parental leave (Pew Research Center).

Lack of Parental Leave and Its Impact on Parental Mental Health

In a recent systematic review, researchers reported on the literature examining the impact of parental leave on parents’ mental health. The studies included in this review took place in high-income countries, and they examined generosity of leave policies according to several measures: any parental leave (n=5), benefit amount (n=13), and leave duration (n=31). 

Overall, the evidence suggests that improved mental health was observed among mothers with more generous parental leave policies, especially those with paid leave of at least 2–3 months. More specifically, increased duration of leave was associated with reduced risk of depressive symptoms, less psychological distress, lower rates of burnout, as well as lower use of mental health services. This finding was observed despite significant heterogeneity across the studies.

In contrast, the association between fathers’ leave and paternal mental health outcomes was less conclusive. Nor could the study determine whether more generous parental leave for fathers had a beneficial effect on mothers’ well-being. 

The United States Lags Behind Other Developed Countries

This review indicates that more generous parental leave policies are associated with improved mental health and decreased risk of postpartum depression in women. While the study did not specify what the minimal amount of parental leave should be, the authors noted the greatest benefits in women who were offered paid leave of at least 2–3 months.

The transition to parenthood is inevitably stressful as it entails a major life occurring over a short period of time. In addition, women, as well as their partners, are particularly vulnerable to postpartum depression and anxiety after the birth of a child. Parental leave might help alleviate symptoms and risk of depression and/or anxiety by preventing or reducing stress.

Among developed countries, the United States has the least generous maternity leave policies. More than 50 countries around the world offer at least six months of paid maternity leave, with many countries offering paid leave for fathers as well. How much time is allowed for maternity leave has significant financial implications for the family, but it also affects maternal and infant health outcomes.  

One might look to the experiences of Norway as an example of the beneficial effects of paid maternity leave. Prior to 1977, Norway had a parental leave policy which was similar to the current policy in the United States: 12 weeks of unpaid leave. After 1977, Norway changed the law such that women would receive 18 weeks of fully paid maternity leave. When researchers compared the long-term outcomes for children born to Norwegian women after the law was changed, they discovered that the children born after 1977 had higher IQ scores and higher academic achievement than the children born to the mothers who had the shorter maternity leave.

Today, only 21% of US workers have access to paid family leave through their employers, even though, according to the Pew Research Center, both parents work full-time in almost half of all two-parent families. Earlier this month the Biden administration announced that it would be undertaking actions to support and advance women’s economic security. One key element of this plan is a national paid family and medical leave program which would give all workers up to 12 weeks of paid leave.

Ruta Nonacs, MD PhD

Heshmati A, Honkaniemi H, Juárez SP. The effect of parental leave on parents’ mental health: a systematic review. Lancet Public Health. 2023 Jan;8(1):e57-e75.