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For Postpartum Mental Health, Parental Leave Might Lessen Depressive Symptoms
Common postpartum mental health issues, including depressive symptoms, might be guarded against with parental leave policies in place, according to the findings of a systematic review and meta-analysis published in The Lancet Public Health.
“Mental health disorders during the postpartum period are a common morbidity, but parental leave might help alleviate symptoms by preventing or reducing stress,” said Amy Heshmati, MSc, doctoral candidate, Department of Global Public Health, Karolinska Institutet, and co-authors.
“[T]he aim of this systematic review was to examine international evidence on the association between parental leave and mental health among parents. Specifically, the objectives were to assess whether access to parental leave and parental leave generosity by payment and duration are associated with parents’ mental health outcomes.”
The authors searched 5 databases (Ovid MEDLINE, Web of Science, PsycINFO, CINAHL, and Scopus) for eligible peer-reviewed studies. Included studies had the following criteria: an exposure of postnatal parental leave (paid or unpaid, maternal or paternal); contained a relevant comparison group; and/or contained indicators to general mental health (including depression, anxiety, stress, substance use, disordered eating, self-injury, and suicide) for either parent were reported. Ultimately, 45 articles were included in the review.
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The authors then evaluated the studies with particular attention to the effect that “different aspects of generosity” (ie, benefits and duration of parental leave) had on parents’ postpartum mental health. They also examine the indirect effect of one parent’s use of leave on the other’s mental health.
The meta-analysis showed that parental leave had a protective effect against worsening mental health for mothers, especially if it was a paid leave lasting at least 2-3 months. “This finding was observed despite large study heterogeneity by country context, outcome, and methodological design, including both observational and quasi-experimental evidence,” said Hashmati et al.
Regarding fathers’ mental health, the authors reported “inconclusive findings,” but found that the evidence “suggested that fathers exhibit mental health improvements with policies that provide either adequate wage replacement or incentives through other means, such as uptake quotas.”
The study also found that parental leave for time beyond the postpartum period may protect mothers’ mental health, but the same was not true for fathers.
Finally, the indirect effect of parental leave of one partner on the other “showed conflicting results.” Extended leave for mothers was associated with a smaller risk for paternal anxiety, but not depression. The association between fathers’ leave effect on maternal mental health was “inconclusive.”
“To our knowledge, this systematic review is the first to present a complete summary of the effect of different dimensions of parental leave, including amounts of benefits and leave duration, on both mothers’ and fathers’ mental health…. Taken together, the findings of this Review have implications for the well-being of the entire family in the long term,” the authors concluded.
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