Better Life Lab

How Much Paid Leave Is Enough?

Photo illustration by Lisa Larson-Walker. Photos by Thinkstock.

Ask American mothers and fathers how much time they can take off work to care for and bond with a new infant, and the answers are all over the map

Lauren, who works for a big financial services firm, is on the 19th week of what will be six months of leave paid by her employer at 100 percent. When she returns to work, her husband will take three months off at 100 percent pay. Their baby will be eight months old by the time he starts child care. “We are fortunate,” she says.

Most other Americans aren’t. Chris, who works as a restaurant server, took eight weeks of unpaid leave, which—even with her husband working 70 hours a week—threw the family into financial chaos and her into postpartum depression. She would have loved more time to heal and for she and her husband to adapt to their new family life, but the financial stress was too much. “It takes the joy away a bit. Not that we don’t love our son, but we worry all the time for money,” she said. “Honestly? I feel robbed.”

And then there are the low-income women that Laura Brown, of First Shift Justice, tries to help—women who get fired just before they’d qualify for leave, or for whom any kind of leave of any length is a luxury. “They’re all in really bad situations,” she said. “But people just endure them.”

Just 14 percent of American workers are eligible for paid leaves, and high-wage workers like Lauren are three-and-a-half times more likely than lower-wage workers like Chris to get it. A recent Pew Research Center survey found that the median length of paid or unpaid time new mothers take leave to heal and care for infants is 11 weeks—the time when infants are about to being to recognize a caregiver’s voice, smell, and face, and five weeks before an infant can hold its head steady. For fathers, it’s one week.

But how much time is enough? The Family Medical Leave Act offers eligible employees—about 60 percent of the workforce—12 weeks of unpaid leave. The 35 countries that make up the Organization for Economic Cooperation and Development average 52 weeks of paid parental leave, ranging from zero in the United States to 166 weeks in Estonia. And amid growing public pressure, the Trump administration is proposing six weeks of paid parental leave.

To better understand how much time families need for caregiving in order to achieve the best outcomes, we scanned more than 100 studies, representing some of the best U.S. and international research, for a new Better Life Lab report examining how the length of paid family leave impacts four areas: infant and child health and wellbeing, maternal health and well-being, gender equality, and businesses and the economy. There is compelling scientific evidence that the optimal length of time to ensure the best infant and child health and well-being is one year of paid leave at adequate wage replacement, split between parents.

Studies have found paid family leave can contribute to fewer low-birth-weight and early-term babies (particularly for children of single and African American mothers), fewer infant deaths, fewer cases of child maltreatment, higher rates of breastfeeding, well-baby care, and immunizations, longer parental lifespan, improved mental health, and increased long-term achievement for children. Forty weeks is the optimal length of leave for reducing infant mortality. The U.S. has among the highest rates of infant death, maternal death and Sudden Infant Death Syndrome of any developed country.

The research shows that a minimum of six months of paid leave is ensures the best physical and mental health outcomes for mothers. Even at six months, many new mothers are experiencing at least one symptom of physical illness such as fatigue, pain, dizziness, or incontinence. Studies find that paid leaves of at least six months have significant, positive effects on maternal physical and mental health (even into old age), reductions in postpartum depression, an increase in breastfeeding, which has significant health benefits for mother and child, and a reduction in maternal stress and intimate partner violence. Leaves of fewer than 12 weeks have been associated with higher maternal depression and anxiety, reduced sensitivity to the infant and knowledge of infant development, negative impact on self-esteem, work stress, and overload, and marital dissatisfaction.

To best promote gender equality, the studies don’t point to any particular length of leave, but indicate that equal-bonding leave policies, which give men extra encouragement to actually use leave, lead to more equality for men and women at work and home. Giving men time to care is associated with reduced family stress, improved gender equality, and more involved parenting, which can lead to better social, emotional, cognitive and health outcomes for children, as well as healthier, more stable relationships with partners. One survey in Sweden found that men who were on parental leave for 30 to 60 days had a 25 percent reduced mortality risk compared to men who did not take leave.

And while some studies show paid family leaves have found neutral or positive impacts on business productivity, morale and employee retention, paid leaves that are either too short or too long tend to discourage women from returning to work. The research shows that leaves between nine months to one year are optimal for ensuring women’s return to productive work. Paid family leave has been found to help close the gender pay gap, reduce family reliance on public assistance, and boost women’s return to work. One study found that mothers who take paid leave are 93 percent more likely to be in the workforce 9 to 12 months after a child’s birth than women who take no leave.

Research has found that simply becoming a mother changes assumptions others have regarding her commitment and even competence. That could change, argues Taryn Morrissey, a public policy professor at American University and author of Cradle to Kindergarten: A New Plan to Combat Inequality, “if both mothers and fathers took paid leave and were viewed as being equally committed to family, and work.”

Morrissey takes this question of the adequate length of paid family leave personally. As a university professor, Morrisey and her husband were able to arrange shared paid leaves of five months for their daughter and seven months for their son. But Morrissey’s sister, Krystie Morrisey Niver, a dentist in Virginia Beach, had eight weeks of unpaid leave. When Niver was hospitalized with life-threatening preeclampsia and her daughter was born 15 weeks early by emergency C-section, she was faced with choosing to take leave either while her daughter was in the neo-natal intensive care unit or waiting until she came home months later.

Niver opted to save her leave for her daughter’s homecoming. So, one and a half weeks after her liver nearly ruptured and her kidneys nearly failed, she returned to work, still bleeding, sore from her incision and stitches, and on medication to control her dangerously high blood pressure. Niver’s employer counted the time she had been in the hospital against her eight-week leave. Niver visited the hospital every morning, pumped breast milk in the car as she drove to visit her baby on her lunch break, and spent evenings with her husband and fragile baby in the NICU. She didn’t have any other choice. “I just sucked it up and went to work,” she said. Niver has since changed jobs.

Jody Heymann, dean of the UCLA Fielding School of Public Health, is leading a study analyzing paid family leave systems around the world. “The good news is, countries have demonstrated you can be economically competitive and provide paid family leave,” she said. “It’s crucial that we do, too. We need to unite for the future of our children. It’s fundamental for the future of our country.”