Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perspective
  • Published:

The neonatal perspective of paid family medical leave (PFML)

Abstract

Paid family medical leave (PFML) offers infants, parents, and society at large numerous health and economic benefits. It has been shown to improve neonatal and maternal outcomes, breastfeeding rates, familial relationships, and decrease gender inequalities in the workplace. Though the economic feasibility of PFML has been well established in many countries, the USA lacks a cohesive and comprehensive federal PFML policy. Neonatal healthcare providers play a critical role in impacting neonatal health and should actively advocate for the development and promotion of a federal PFML policy, particularly one that is inclusive of both mothers and fathers and is at least 12 weeks in duration.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Jou J, Kozhimannil KB, Abraham JM, Blewett LA, McGovern PM. Paid maternity leave in the United States: associations with maternal and infant health. Matern Child Health J. 2018;22:216–25.

    Article  PubMed  Google Scholar 

  2. Nandi A, Jahagirdar D, Dimitris MC, Labrecque JA, Strumpf EC, Kaufman JS, et al. The impact of parental and medical leave policies on socioeconomic and health outcomes in OECD countries: a systematic review of the empirical literature. Milbank Q. 2018;96:434–71.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Gault B, Hartmann H, Hegewisch A, Mili J, Reichlin L. Paid parental leave in the United States; what the data tell us about access, usage, and economic and health benefits. Institute for Women’s Policy Research, Washington D.C., USA; 2014.

  4. A better balance: the work and family legal center. Comparative chart of paid family and medical leave laws in the United States. 2021. https://www.abetterbalance.org/resources/paid-family-leave-laws-chart/.

  5. Ro C. Parental leave: how rich countries compare. 2019. https://www.bbc.com/worklife/article/20190615-parental-leave-how-rich-countries-compare).

  6. Chzhen Y, Gromada A, Rees G. Are the world’s richest countries family friendly? Policy in the OECD and EU. UNICEF Office of Research, Florence, Italy; 2019.

  7. Chatterji P, Markowitz S. Does the length of maternity leave affect maternal health? South Econ J. 2005;72:16–41.

    Google Scholar 

  8. Chatterji P, Markowitz S. Family leave after childbirth and the mental health of new mothers. J Ment Health Policy Econ. 2012;15:61–76.

    PubMed  Google Scholar 

  9. Avery ME. A 50-year overview of perinatal medicine. Early Hum Dev. 1992;29:43–50.

    Article  CAS  PubMed  Google Scholar 

  10. Mathews TJ, MacDorman MF, Thoma ME. Infant mortality statistics from the 2013 period linked birth/infant death data set. Natl Vital- Stat Rep. 2015;64:1–29.

    Google Scholar 

  11. Ely DM, Driscoll AK. Infant mortality in the United States, 2018: data from the period linked birth/infant death file. Natl Vital- Stat Rep. 2020;69:1–17.

    PubMed  Google Scholar 

  12. Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet. 2008;371:261–9.

    Article  PubMed  Google Scholar 

  13. Korja R, Latva R, Lehtonen L. The effects of preterm birth on mother-infant interaction and attachment during the infant’s first two years. Acta Obstet Gynecol Scand. 2012;91:164–73.

    Article  PubMed  Google Scholar 

  14. Stearns J. The effects of paid maternity leave: evidence from temporary disability insurance. J Health Econ. 2015;43:85–102.

    Article  PubMed  Google Scholar 

  15. Heymann J, Raub A, Earle A. Creating and using new data sources to analyze the relationship between social policy and global health: the case of maternal leave. Public Health Rep. 2011;126:127–34.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Tanaka S. Parental leave and child health across OECD countries. Econ J. 2005;115:F7–F28.

    Article  Google Scholar 

  17. Weber A, Harrison TM, Steward D, Ludington-Hoe S. Paid family leave to enhance the health outcomes of preterm infants. Policy Polit Nurs Pract. 2018;19:11–28.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Burtle A, Bezruchka S. Population health and paid parental leave: what the United States can learn from two decades of research. Healthcare. 2016;4:1–16.

    Article  Google Scholar 

  19. Greenfield JC, Klawetter S. Parental leave policy as a strategy to improve outcomes among premature infants. Health Soc Work. 2016;41:17–23.

    Article  PubMed  Google Scholar 

  20. Burris HH, Lorch SA, Kirpalani H, Pursley DM, Elovitz MA, Clougherty JE. Racial disparities in preterm birth in USA: a biosensor of physical and social environmental exposures. Arch Dis Child. 2019;104:931–5.

    Article  PubMed  Google Scholar 

  21. Christensson K, Cabrera T, Christensson E, Uvnas-Moberg K, Winberg J. Separation distress call in the human neonate in the absence of maternal body contact. Acta Paediatr. 1995;84:468–73.

    Article  CAS  PubMed  Google Scholar 

  22. Raffray M, Semenic S, Osorio Galeano S, Ochoa, Marin SC. Barriers and facilitators to preparing families with premature infants for discharge home from the neonatal unit. Perceptions of health care providers. Invest Educ Enferm. 2014;32:379–92.

    Article  PubMed  Google Scholar 

  23. Flacking R, Lehtonen L, Axelin A, Ahlqvist S, Moran VH, Ewald U. Closeness and separation in neonatal intensive care. Acta Paediatr. 2012;101:1032–7.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Mörelius E, Ortenstrand A, Theodorsson E, Frostell A. A randomized trial of continuous skin-to-skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding. Early Hum Dev. 2015;91:63–70.

    Article  PubMed  Google Scholar 

  25. Conde-Agudelo A, Díaz-Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2016;8:1–118.

    Google Scholar 

  26. Mörelius E, Theodorsson E, Nelson N. Salivary cortisol and mood and pain profiles during skin-to-skin care for an unselected group of mothers and infants in neonatal intensive care. Pediatrics. 2005;116:1105–13.

    Article  PubMed  Google Scholar 

  27. Gray PH, Edwards DM, O’Callaghan MJ, Cuskelly M, Gibbons K. Parenting stress in mothers of very preterm infants—influence of development, temperament and maternal depression. Early Hum Dev. 2013;89:625–9.

    Article  PubMed  Google Scholar 

  28. Treyvaud K. Parent and family outcomes following very preterm or very low birth weight birth: a review. Semin Fetal Neonatal Med. 2014;19:131–5.

    Article  PubMed  Google Scholar 

  29. Kim THM, Delahunty-Pike A, Campbell-Yeo M. Effect of fathers’ presence and involvement in newborn care in the NICU on mothers’ symptoms of postpartum depression. J Obstet Gynecol Neonatal Nurs. 2020;49:452–63.

    Article  PubMed  Google Scholar 

  30. Feeley N, Waitzer E, Sherrard K, Boisvert L, Zelkowitz P. Fathers’ perceptions of the barriers and facilitators in their involvement with their newborn hospitalized in the neonatal intensive care unit. J Clin Nurs. 2012;22:521–30.

    Article  PubMed  Google Scholar 

  31. Rossin M. The effects of maternity leave on children’s birth and infant health outcomes in the United States. J Health Econ. 2011;30:221–39.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Bullinger LR. The effect of paid family leave on infant and parental health in the United States. J Health Econ. 2019;66:101–16.

    Article  PubMed  Google Scholar 

  33. Feldman R, Sussman AL, Zigler E. Parental leave and work adaptation at the transition to parenthood: individual, marital, and social correlates. J Appl Dev Psychol. 2004;25:459–79.

    Article  Google Scholar 

  34. Plotka R, Busch-Rossnagel N. The role of length of maternity leave in supporting mother-child interactions and attachment security among American mothers and their infants. Int J Child Care Educ Policy. 2018;12:1–18.

    Article  Google Scholar 

  35. Weinfield NS, Ogawa JR, Egeland B. Predictability of observed mother-child interaction from preschool to middle childhood in a high-risk sample. Child Dev. 2002;73:528–43.

    Article  PubMed  Google Scholar 

  36. De Wolff MS, van Ijzendoorn MH. Sensitivity and attachment: a meta-analysis on parental antecedents of infant attachment. Child Dev. 1997;68:571–91.

    Article  PubMed  Google Scholar 

  37. Feldman R. Maternal versus child risk and the development of parent-child and family relationships in five high-risk populations. Dev Psychopathol. 2007;19:293–312.

    Article  PubMed  Google Scholar 

  38. Raikes HA, Robinson JL, Bradley RH. Developmental trends in self-regulation among low-income toddlers. Soc Dev. 2007;16:128–49.

    Article  Google Scholar 

  39. Gregory A, Rimm-Kaufman S. Positive mother-child interactions in kindergarten: predictors of school success in high school. Sch Psych Rev. 2008;37:499–515.

    Article  Google Scholar 

  40. Kozak K, Greaves A, Waldfogel J, Angal J, Elliot AJ, Pifier WP, et al. Paid maternal leave is associated with better language and socioemotional outcomes during toddlerhood. Infancy. 2021;26:536–50.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Berger LM, Hill J, Waldfogel J. Maternity leave, early maternal employment, and child health and development in the US. Econ J. 2005;115:F29–F47.

    Article  Google Scholar 

  42. American Academy of Pediatrics Section on Breastfeeding. Policy statement: breastfeeding and the use of human milk. Pediatrics. 2012;129:e827–841.

    Article  Google Scholar 

  43. Victora CG, Bahl R, Barros AJD, Franca GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387:475–90.

    Article  PubMed  Google Scholar 

  44. Ware JL, Chen A, Morrow AL, Kmet J. Associations between breastfeeding initiation and infant mortality in an urban population. Breastfeed Med. 2019;14:465–74.

    Article  PubMed  Google Scholar 

  45. Hamad R, Modrek S, White JS. Paid family leave effects on breastfeeding: quasi-experimental study of US policies. Am J Public Health. 2019;109:164–6.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Mirkovic KR, Perrine CG, Scanlon KS. Paid maternity leave and breastfeeding outcomes. Birth. 2016;43:233–9.

    Article  PubMed  Google Scholar 

  47. Brown CRL, Dodds L, Legge A, Bryanton J, Semenic S. Factors influencing why mothers stop breastfeeding. Can J Public Health. 2014;105:e179–e185.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Aitken Z, Garrett CC, Hewitt B, Keogh L, Hocking JS, Kavanagh AM. The maternal health outcomes of paid maternity leave: a systematic review. Soc Sci Med. 2015;130:32–41.

    Article  PubMed  Google Scholar 

  49. Zigler E, Hall N. Child development and social policy: theory and application. New York: McGraw-Hill Companies; 2000

  50. Horn WF. Fathering infants. In: WAIMH handbook of infant mental health. New York: John Wiley & Sons, Inc; 2000. p. 271–97.

  51. Sarkadi A, Kristiansson R, Oberklaid F, Bremberg S. Fathers’ involvement and children’s developmental outcomes: a systematic review of longitudinal studies. Acta Paediatr. 2008;97:153–8.

    Article  PubMed  Google Scholar 

  52. Rolle L, Gullotta G, Trombetta T, Curti L, Gerino E, Brustia P, et al. Father involvement and cognitive development in early and middle childhood: a systematic review. Front Psychol. 2019;10:1–18.

    Article  Google Scholar 

  53. Bartel AP, Rossin-Slater M, Ruhm CJ, Stearns J, Waldfogel J. Paid family leave, fathers’ leave-taking, and leave-sharing in dual-earner households. J Policy Anal Manag. 2018;37:10–37.

    Article  Google Scholar 

  54. Boesch D. Rhetoric vs. reality: not all paid proposals are equal. Center for American Progress. 2019. https://www.americanprogress.org/issues/women/reports/2019/10/10/475625/rhetoric-vs-reality-not-paid-leave-proposals-equal/

  55. Hegewisch A, Gornick JC. The impact of work-family policies on women’s employment: a review of research from OECD countries. Community Work Fam. 2011;4:119–38.

    Article  Google Scholar 

  56. Grunberg VA, Geller PA, Bonacquisti A, Patterson CA. NICU infant health severity and family outcomes: a systematic review of assessments and findings in psychosocial research. J Perinatol. 2019;39:156–72.

    Article  PubMed  Google Scholar 

  57. Linsell L, Malouf R, Morris J, Kurinczuk JJ, Marlow N. Prognostic factors for poor cognitive development in children born very preterm or with very low birth weight: a systematic review. JAMA Pediatr. 2015;169:1162–72.

    Article  PubMed  PubMed Central  Google Scholar 

  58. De Graff JP, Steegers EAP, Bonsel GJ. Inequalities in perinatal and maternal health. Curr Opin Obst. 2013;25:98–108.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

TIA was responsible for the design, drafting, and review of the manuscript, and approved the final version. CELD was responsible for the conception and review of the manuscript, and approved the final version.

Corresponding author

Correspondence to Tamara I. Arnautovic.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arnautovic, T.I., Dammann, C.E.L. The neonatal perspective of paid family medical leave (PFML). J Perinatol 43, 1055–1058 (2023). https://doi.org/10.1038/s41372-021-01300-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-021-01300-6

This article is cited by

Search

Quick links