Duke 2008 | ASHE | Equity and Efficiency in Health and Healthcare

The purpose of this paper is to examine the association between employment, maternity leave length, and health outcomes among infants and new mothers. We also examine the effects of part-time and alternative work arrangements (e.g. home-based work, flexible hours) on maternal and child health. First, we estimate the effect of returning to work during the first year after childbirth on health using a sample of mothers who worked in the year prior to childbirth. Subsequently, we focus on two samples of mothers who worked in the year prior to childbirth and who returned to work during the first year: (1) employed new mothers (full-time or part-time); and (2) full-time employed new mothers. Using the employed new mothers sample, we examine the effect of maternity leave length and work hours on health. Using the full-time employed new mothers sample, we consider the effects of maternity leave length, flexible work hours and home-based work on health. The maternal health outcomes studied include an indicator for depression, a measure of the number and frequency of depressive symptoms, and self-reported overall health. The child health outcomes studied include parent-reported measures of overall health, acute illnesses, and health services utilization for illnesses.

Data for the project come from the Early Childhood Longitudinal Study – Birth Cohort (ECLS-B), a nationally representative sample of 14,000 children born in 2001 and followed until kindergarten entry. We focus on outcomes measured at an interview conducted about 9 months after childbirth. We use a standard OLS as well as an instrumental variables approach with county-level employment conditions and state-level maternity leave policies as identifying instruments. The IV approach accounts for the possibility of reverse causality (e.g., post-partum health affecting employment decisions) and also for the possibility that employment decisions after childbirth are correlated with unobserved factors that influence health outcomes.

Our preliminary findings on maternal health outcomes indicate that for mothers who worked in the year prior to childbirth, returning to employment (either full-time or part-time) in the first year is associated with fewer depressive symptoms. Among mothers who worked prior to childbirth and who return to work in the first year, longer maternity leave is associated with reductions in depressive symptoms and depression, but the magnitudes of these effects are small. We find, however, that flexible work hours may have important health benefits for new mothers. For mothers who are employed full-time during the first year after childbirth, flexible work hours are associated with a large reduction in the likelihood of depression. Results for child health outcomes are in progress.