Georgia Tech Scholar Publishes First-Ever Study of Paid Family Leave’s Impact on Maternal Mental Health

Posted June 3, 2019

By Michael Pearson

California’s paid parental leave law appears to have improved the mental health of mothers and the overall welfare of their infant children, according to a new Georgia Institute of Technology study that is the first to assess the impact of paid family leave on maternal well-being.

Using data from the National Survey of Children’s Health and the Behavioral Risk Factor Surveillance System, the study finds a 5.5% to 9% improvement in self-reported ratings of mental health among California mothers after the 2004 implementation of paid family leave, as compared to women who gave birth in California before the law went into effect and to those who live in other states.

The study also found improvements in overall infant health and reduced rates of asthma among children born after the law’s implementation, according to Lindsey Bullinger, an assistant professor in Georgia Tech’s School of Public Policy. She conducted the study.

“So much of the focus on paid family leave is on the employment implications. But paid time off to recover from childbirth and bond with a child could also have effects on the health of both parents and children. Some research has explored the health effects for children, but nearly no research has looked at the health of those who take the leave in the U.S.” Bullinger said.

The study did not find any improvement as a result of the law in how new fathers reported their mental health status, or in measures of respiratory or food allergies in children. But it did find improvements in how parents felt like they were coping with the day-to-day demands of parenting.

The improvements in maternal mental health and overall child well-being may be the result of children spending more time at home after birth instead of in daycare, increased opportunities for parents to care for their children, reductions in parental stress and anxiety, and improved economic outcomes, all of which have been shown to have a positive effect on child health, according to the study.

The results were particularly strong in low-income households, Bullinger said.

“Many families do not have paid leave through their employers and cannot afford to take unpaid leave after the birth of a child,” Bullinger said. “Relative to higher-income families who can, paid family leave could be more impactful for poorer families, since the jump between what leave they could afford to take before the law compared to after the law is larger. And that’s what we see in the study. Paid leave in California had stronger effects for children and parents from lower income families.”

Results Could Help Guide Policy

Paid family leave is a perennial issue across the United States, and the results contained in the new paper could prove useful to state and federal lawmakers considering implementation of such policies, Bullinger said.

“Most of the research on paid family leave is from Europe and Canada. But there, leave lengths are much longer, in the range of 25 to 52 weeks, so it is not clear if that research is helpful in the U.S. where leaves are typically much shorter. These findings can help policymakers in both designing programs and evaluating the costs and benefits of those programs in the U.S.”

Previous studies have documented positive implications from paid family leave on job prospects for mothers, the length of parental leave taken, and child hospitalizations. Bullinger’s paper is the only one to look at the impact on parental mental health, and among the first to look at overall infant well-being.

The study, “The Effect of Paid Family Leave on Infant and Parental Health in the United States,” will be published in print in the July edition of the Journal of Health Economics.

Two Previous Studies Focused on Impact of Affordable Care Act

Bullinger, who focuses on the impact of public policies on the health and well-being of children and their families, also recently had two articles published examining impacts of the Affordable Care Act (ACA).

In the most recent paper, published in May in Maternal and Child Health Journal, Bullinger, along with co-author Kosali Simon of Indiana University, found that the ACA increased sales of injectable contraceptives, but had no significant impact on sales of many other forms of prescription contraceptives, such as intrauterine devices, implants, pills, or patches.

Bullinger also co-authored a paper in JAMA Pediatrics examining reimbursement changes for breast pump medical equipment.

The law’s provisions covering the cost of breast pumps for new mothers increased the number of women who attempted breastfeeding, as well as the period those mothers breastfed their children. That paper found that recent reductions in reimbursement of breast pumps by insurers are unlikely to yield health care costs savings.

Kandice A. Kapinos of the RAND Corporation and Tami Gurley-Calvez of the University of the Kansas Medical Center co-authored that article with Bullinger. It was published in November 2018.

The School of Public Policy is a unit of the Ivan Allen College of Liberal Arts.