Paid family leave is an investment in public health, not a handout

Most Americans – on both sides of the political aislesay they support paid parental leave. However, we haven’t yet found the political will to make it happen. In part, that’s because the discussion always seems to start with the question, “How do we pay for it?”

That question goes only halfway, though. As a researcher who focuses on stress and health within families, I believe there’s a more important question to ask: “How do we pay for the lack of parental leave?” In other words, how does the stress of a rapid return to work affect parents, and in turn, cost society as a whole? Recently, I sought to answer this question by delving into research on the many changes that new parents experience in the first weeks, months, and years after the birth of a new child – and the possibility that all these changes might not just compromise children’s well-being, but also put parents’ long-term health at risk.

A global outlier

How fast should women “bounce back” after giving birth? Instantly, at least according to celebrity magazines. And many workplaces in the United States deliver the same message. The typical American maternity leave lasts only 10 weeks, and a quarter of new mothers return to work within two weeks of delivering a child.

The U.S. is one of the only countries in the world that does not guarantee paid leave to new parents. The 1993 Family Medical and Leave Act provides for unpaid leave – but almost half of U.S. workers are not eligible, and many cannot afford time off without pay. Compare this to the rest of the globe, where paid maternity leave is standard, averaging 18 weeks internationally and extending beyond six months in many developed countries.

New parent stress, long-term effects?

Economists have examined paid family leave policies and measured their impact on worker retention and productivity, as well as health outcomes. But their studies typically focus on population-level trends. As a psychologist whose work takes a more intimate look at family processes, I wondered: How does the stress of work-family conflict affect the well-being of new parents?

I reached out to Stanford economist and family leave policy expert Maya Rossin-Slater to help digest the body of research on health and family leave. Together with developmental neuroscientist Diane Goldenberg, we reviewed existing studies and proposed future directions for research and policy in a recent paper published in American Psychologist.

Psychologists already know that the transition to parenthood is a high-risk time for mental health problems like anxiety and depression. New parents are about twice as likely to report clinically significant depression as are adults at other life stages.

Physical health risks may worsen during this time as well. For example, obesity: many mothers gain in excess of physician-recommended weight guidelines during pregnancy, and may struggle to lose this weight after birth. New fathers also gain weight: “Dad bod” is real.

Dads have big adjustments during this transition, too. Zach Vessels/Unsplash, CC BY
Stress influences both mental health and weight gain, and may also affect immune and inflammatory processes that can contribute to long-term health risks. Costly chronic diseases like heart disease and cancer drain the economy, and yet few researchers have zeroed in on the transition to parenthood as a potential inflection point in risk for these diseases. Are these risks magnified when parents lack protected time to recover from birth and adjust to parenthood? If so, the U.S. may be setting up new parents – and especially low income parents – to fail.

In making sense of the research that speaks to health in parents, we started by first identifying what changes over the transition to parenthood in order to spotlight potential areas of vulnerability.

Neurobiological changes

At the neurobiological level, researchers are finding that new parents’ hormones and brains may be particularly changeable – what scientists call plastic.

Research on rodents has found that pregnancy hormones remodel the maternal rat brain, helping prep the mother-to-be for infant care. Human mothers also show dramatic changes in hormones across pregnancy and the postpartum period. One neuroimaging study scanned women pre-pregnancy and then tracked them over several years, scanning them again after childbirth. Surprisingly, women’s brains actually shrunk over the transition to motherhood, showing reductions in volume particularly in areas linked with social cognition. Pruning may have helped these areas work more efficiently to support caregiving, since women who lost more brain volume also reported stronger attachment to their infants.

Fathers may also undergo neurobiological transformation across the transition to parenthood. Studies have found decreased testosterone in new dads and changes in men’s brain volume in early parenthood, for example.