Materinity Leave and Post Partum Depression

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Women who go back to work within six months of giving birth are at an increased risk for postpartum depression (PPD), according to a study recently published in the Journal of Health Politics, Policy, and Law. For women in the United States, this finding is especially disconcerting because the majority of women return to work within three months postpartum.

Dr. Rada K. Dagher, of the University of Maryland School of Public Health, discovered that by 6 months, nearly 87% of women are back to work (with 7% at 6 weeks and 48% at 12). This is concerning, according to Dagher, because the data indicates that the less time women spend at home postpartum, the more likely they are to develop PPD. Furthermore, of the 800 women in the study, those who continued with maternity leave had significantly lower scores on the Edinburgh Postnatal Depression Scale than mothers who went back to work. Additional investigation also shows that women with unplanned pregnancies return to work sooner than women whose pregnancies were planned.

PPD affects women almost immediately and can last for many months, even up to a year after the birth of a new child. Sudden changes in hormones, roles at home and work, as well as the constant demands of a newborn can be overwhelming. Caring for a new family member can be financially stressful, as well, which may drive women back to work sooner than anticipated. With the prospects of unpaid leave, or no leave at all, women in the U.S. have little choice than to return to employment.

How does policy affect women’s choices?

The U.S. lags far behind the majority of industrialized nations in terms of paid/unpaid leave and time allotted for leave. Of 181 countries, the U.S., Papua New Guinea, and Swaziland are the only three that fail to provide paid maternity leave. Not only does the U.S. not offer paid leave, but it guarantees the fewest amount of time than any other country, at 12 weeks (through the Family and Medical Leave Act). Even then, not all women are eligible for leave under U.S. law, and many cannot afford to lose pay throughout that time. Therefore, most women go back to work shortly after giving birth.

This year, the FMLA celebrates its 22nd birthday. And while this accomplishment highlights the importance of family and infant care, its effectiveness as a policy to protect mothers is nothing to celebrate. The FMLA is a federal law that mandates qualified employers to provide its employees unpaid leave, for up to 12 weeks, for a number of reasons. One of the most popular uses of the FMLA is maternity leave; however, not all employees are eligible and not all places of employment are covered by the FMLA. Specifically, only half of American employees work in a job that is protected by the FMLA.

Consequences of Post Partum Depression

At a time when women are being called upon to “Lean In” at work, many are desperately trying to hold on at home. Nearly 13% of all mothers will develop PPD, and its prevalence worsens with each subsequent pregnancies. While not all women will receive PPD diagnoses, results from the Listening to Mothers II questionnaire revealed that nearly 62% of all U.S. mothers have experienced some depressive symptoms after birth. Women are most vulnerable in the first year of experiencing symptoms akin to clinical depression. A loss of interest in daily routines, increased anxiety and hopelessness, and a desire to hurt herself or her newborn are all signs of depression.  

The burden of PPD can be debilitating and prevents women from providing adequate care for their new children. These circumstances are especially concerning as development—social, emotional, physical, and cognitive—within the first year lays the foundation for future growth. Children with depressed mothers may develop insecure attachments and become withdrawn. These factors can lead to future behavioral and interpersonal issues. Additionally, babies of mothers with PPD are at an increased risk of developing anxiety or depressive disorders as children and teenagers, which puts them at risk for many other problems, such as heart disease, obesity, and substance abuse.

Why support more comprehensive maternity leave?

Other studies conclude that paid and extended maternity leave is beneficial in more ways than preventing PPD and its effects on children. Data in other countries indicate that paid leave increases the likelihood of breatfeeding, decreases the infant mortality rate, and improves overall infant health and immunization rates.  Women have very little choice regarding maternity leave, but they can and should maintain their mental and physical health postpartum. In the meantime, Dagher recommends that U.S. policy makers create legislation that protects families further and focuses on maternal health. Additionally, she encourages employers to consider paid leave or leave that offers women more time at home than the current 12 weeks mandated through the FMLA. 

- Melissa Laverly, M.S.

References

Family and Medical Leave Act of 1993. (2014, December 17). Retrieved February 5, 2015, from http://en.wikipedia.org/wiki/Family_and_Medical_Leave_Act_of_1993

Hall, K. (2013, February 21). Paid Parental Leave: U.S. vs. The World (INFOGRAPHIC). Retrieved February 5, 2015, from http://www.huffingtonpost.com/2013/02/04/maternity-leave-paid-parental-leave-_n_2617284.html

Northwestern University. (2013, March 14). Postpartum depression: Surprising rate of women depressed after baby. ScienceDaily. Retrieved February 5, 2015 from www.sciencedaily.com/releases/2013/03/130314124618.htm

Postpartum Depression Fact Sheet. (n.d.). Retrieved February 5, 2015, from http://www.apa.org/pi/women/programs/depression/postpartum.aspx

Suddath, C. (2015, January 15). Maternity Leave: U.S. Policies Still Fail Workers. Retrieved February 5, 2015, from http://www.bloomberg.com/bw/articles/2015-01-15/maternity-leave-u-dot-s-dot-policies-still-fail-workers

University of Maryland. (2014, May 5). Women with unintended pregnancies take the shortest maternity leaves. ScienceDaily. Retrieved February 5, 2015 from www.sciencedaily.com/releases/2014/05/140505211422.htm

University of Maryland. (2013, December 12). Longer maternity leaves lower women's risk of postpartum depression. ScienceDaily. Retrieved February 5, 2015 from www.sciencedaily.com/releases/2013/12/131212100140.htm

US: Lack of Paid Leave Harms Workers, Children. (2011, February 23). Retrieved February 5, 2015, from http://www.hrw.org/news/2011/02/23/us-lack-paid-leave-harms-workers-children