Maternity leave policies in U.S. states: Associations with maternal and child health status, healthcare utilization, role function, and health-related behaviors

 产假与儿童的积极健康和认知结果有关，特别是在带薪和超过六周的情况下，也可能有助于产妇的身心健康。目前，美国妇女只能通过《家庭和医疗休假法》（FMLA）获得产假保障，该法要求雇主为符合条件的员工提供长达12周的无薪工作保护假期，以照顾家庭成员，包括新生儿。然而，多达40%的妇女没有资格或负担不起长期无薪休假。此外，关于产假与女性身心健康之间关系的研究结果喜忧参半，大多数现有研究使用的是国际或小规模的区域样本，这些样本很难推广到美国人口。美国上一次关于产假的全面研究是在二十多年前进行的。这项研究将使用两个新的、具有全国代表性的数据集来确定美国派产假和无薪产假的可用性、使用和持续时间的趋势，并探讨休假与健康之间的关系。倾听母亲III是在2011-12年在美国医院分娩的18-45岁育龄妇女的全国样本中进行的调查（N= 2，400）。它包括对妇女怀孕和产后就业经历的独特衡量;产假的提供、使用和持续时间;以及妇女和婴儿的健康状况、保健利用和产后与健康有关的行为。2006-2010年全国家庭增长调查由疾病控制和预防中心通过家庭访谈进行;其怀孕补充资料包括过去5年内生育的4 579名妇女的答复。这是唯一一个包含就业和产假详细信息的数据集，样本量足够大，可以按受访者出生时的居住国对产假的可用性、使用情况和持续时间进行比较分析。这项研究的预期成果包括以下方面的新信息：（1）产假与美国妇女和婴儿健康之间的联系，区分带薪和无薪假期;（2）居住在实施了扩大FMLA最低规定的政策的州的妇女是否在可用性，使用和持续时间方面有更多的机会获得产假;以及3）这些政策是否通过对休假机会的影响，与各州之间孕产妇和儿童健康的显著差异有关。该项目处理与AHRQ优先人口妇女和儿童、低收入人口和少数民族健康高度相关的问题。这项研究的结果将对妇女、儿童和家庭感兴趣;对寻求平衡向雇员提供产假福利的成本和收益的雇主感兴趣;对寻求在决策过程中使用研究证据的政策制定者感兴趣，特别是在带薪家庭假进入国家政策议程的情况下。

 DESCRIPTION (provided by applicant): Maternity leave is associated with positive health and cognitive outcomes for children, especially when paid and longer than six weeks, and may also contribute to maternal physical and mental health. Currently, U.S. women are guaranteed access to maternity leave only through the Family and Medical Leave Act (FMLA), which requires employers to offer eligible employees up to 12 weeks of unpaid job-protected leave to care for family members, including newborn children. However, as many as 40% of women are either ineligible or cannot afford to take extended leaves of absence from work without pay. In addition, findings on the association between maternity leave and women's physical and mental health are mixed, with most existing research using either international or small, regional samples that are difficult to generalize to the U.S. population. The last comprehensive study on maternity leave in the U.S. was conducted over two decades ago. This study will use two new, nationally-representative datasets to identify trends in the availability, use, and duration of pai and unpaid maternity leave in the U.S. and to explore the association between leave and health. Listening to Mothers III is a survey conducted among a national sample of childbearing women ages 18-45 who gave birth in a U.S. hospital in 2011-12 (N=2,400). It includes unique measures for women's employment experiences during pregnancy and postpartum; maternity leave availability, use, and duration; and women's and infants' health status, healthcare utilization, and health-related behaviors postpartum. The National Survey of Family Growth 2006-2010 was conducted by the Centers for Disease Control and Prevention (CDC) via household interviews; its Pregnancy Supplement includes responses from 4,579 women who gave birth within the last 5 years. It is one of the only datasets containing detailed information on employment and maternity leave with a large enough sample size to conduct comparative analyses of maternity leave availability, use, and duration by respondents' state of residence at the time of birth. The expected outcomes of this research include new information on: 1) associations between maternity leave and health for U.S. women and infants, differentiating between paid and unpaid leave; 2) whether women residing in states that have implemented policies expanding on the minimum provisions of the FMLA have significantly more access to maternity leave in terms of availability, use and duration; and 3) whether these policies are associated with significant differences in maternal and child health across states, via their impact on access to leave. This project addresses issues highly pertinent to the AHRQ priority populations of Women and Children, Low-Income Populations, and Minority Health. The results of this research will be of interest to women, children, and families; to employers seeking to balance the costs and benefits of offering maternity leave benefits to employees; and to policymakers seeking to use research evidence in their decision- making processes, especially as paid family leave enters the national policy agenda.