The effect on women's health of extending parental leave: a quasi-experimental registry-based cohort study

Emilie Courtin*, Andreas Rieckmann, Jessica Bengtsson, Vahe Nafilyan, Maria Melchior, Lisa Berkman, Naja Hulvej Rod

*Corresponding author for this work

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3 Citations (Scopus)
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Abstract

Background Parental leave policies have been hypothesized to benefit mothers' mental health. We assessed the impact of a 6-week extension of parental leave in Denmark on maternal mental health. Methods We linked individual-level data from Danish national registries on maternal sociodemographic characteristics and psychiatric diagnoses. A regression discontinuity design was applied to study the increase in parental leave duration after 26 March 1984. We included women who had given birth between 1 January 1981 and 31 December 1987. Our outcome was a first psychiatric diagnosis following the child's birth, ascertained as the first day of inpatient hospital admission for any psychiatric disorder. We presented cumulative incidences for the 30-year follow-up period and reported absolute risk differences between women eligible for the reform vs not, in 5-year intervals. Results In all, 291 152 women were followed up until 2017, death, emigration or date of first psychiatric diagnosis. The median follow-up time was 29.99 years, corresponding to 10 277 547 person-years at risk. The cumulative incidence of psychiatric diagnoses at 30 years of follow-up was 59.5 (95% CI: 57.4 to 61.6) per 1000 women in the ineligible group and 57.5 (95% CI: 55.6 to 59.4) in the eligible group. Eligible women took on average 32.85 additional days of parental leave (95% CI: 29.20 to 36.49) and had a lower probability of having a psychiatric diagnosis within 5 years [risk difference (RD): 2.4 fewer diagnoses per 1000 women, 95% CI: 1.5 to 3.2] and up to 20 years after the birth (RD: 2.3, 95% CI: 0.4 to 4.2). In subgroup analyses, the risk reduction was concentrated among low-educated, low-income and single women. Conclusions Longer parental leave may confer mental health benefits to women, in particular to those from disadvantaged backgrounds.

Original languageEnglish
JournalInternational Journal of Epidemiology
Volume52
Issue number4
Pages (from-to) 993–1002
Number of pages10
ISSN0300-5771
DOIs
Publication statusPublished - 2023

Keywords

  • Parental leave
  • mental disorders
  • quasi-experiment
  • social determinants of health
  • women's health
  • PAID MATERNITY LEAVE
  • REGRESSION DISCONTINUITY DESIGNS
  • MENTAL-HEALTH
  • FAMILY LEAVE
  • DEPRESSION
  • EPIDEMIOLOGY
  • PREVALENCE
  • DISORDERS
  • POLICIES
  • OUTCOMES

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