How Paid Leave Can Address Maternal Mental Health, Save Lives

By Isha Weerasinghe and Emily Andrews  

May is Maternal Mental Health Month, offering an opportunity to raise awareness around the challenges new mothers face and the policy solutions that can support maternal mental health.   

This country is facing a maternal health crisis. According to the Centers for Disease Control and Prevention (CDC), U.S. maternal mortality rates jumped 38 percent in the last year to 32 deaths per 100,000 live births in 2021, up from 21 deaths per 100,000 in 2020. This jump follows a steady rise in maternal mortality rates over the past several years. The impact of this devastating statistic is not borne equally. Reflecting historic and current systemic racism in our health care system, the maternal mortality rate for Black women was 2.6 times that of white women.  

A CDC review of data from 36 states found that 53 percent of pregnancy-related maternal deaths occur between 7 days and 1 year after pregnancy, and the leading underlying cause of pregnancy-related deaths was mental health conditions. Indeed, one in eight U.S. women suffer from mental health concerns following the birth of a child, a risk that is 1.6 times higher for Black women. 

The United States stands out among other wealthy nations for our high maternal mortality rate and our related lack of paid family leave. We have the highest maternal mortality rate of any OECD country, averaging over three times the rate of most other high-income countries. Our nation is the only OECD country that doesn’t offer paid family and medical leave. In fact, we are one of only seven countries in the world that doesn’t offer paid maternal leave to new mothers.  

Without a federal guarantee to paid family and medical leave, the vast majority of birthing persons lack the ability to take time off to heal after giving birth and care for themselves and their young infant. The time after birth presents many emotional, physical, and social changes, and facing these changes plus caring for a newborn can feel overwhelming. Many consider this time of life to be the “fourth trimester,” a critical time of discovery and bonding for parents and infants. 

Paid family and medical leave is critical to address maternal mental health concerns. A review of 45 studies on paid leave found that parental leave—especially paid leave of at least 2-3 months—can protect mothers against mental health concerns in the postpartum period.  Specifically, researchers found that significant parental leave decreased the risk of stress, reduced the number of depressive symptoms, and lowered rates of hospital admissions for mental health conditions. In 2021, only 1 in 4 employees in the private sector had access to paid family leave.  For those individuals earning the least—the lowest 10 percent of earners—only about 1 in 20 had access to paid family leave.  

Thankfully, there is a growing movement to demand paid family and medical leave policies. Currently, 11 states and the District of Columbia have passed policies that provide or will soon provide paid family leave, and additional states like Minnesota are currently considering legislation. Unfortunately, a state-level approach leaves many women, especially Black women, behind. The majority of Black Americans live in Southern states, which—due to universal Republican control of state legislatures—will likely never pass a statewide paid family and medical leave program. Federal action to ensure all workers have access to paid family leave is critical to address the alarming rates of maternal mental health concerns, the related maternal mortality rates, and the disproportionate harm borne by Black women and families.  

This month Congress reintroduced the Family and Medical Insurance Leave Act, or FAMILY Act, which would provide workers with 12 weeks of paid family and medical leave to welcome a new child, care for a seriously ill loved one, or address an individual’s own serious health condition. As mothers who both experienced health complications after childbirth, we feel deeply that no woman or birthing person should have to make the impossible choice between healing from childbirth and earning a paycheck. And as researchers and advocates who study paid family leave and mental health concerns, we know conclusively that a federal paid family and medical leave program would save lives. 

Isha and her daughter
Emily and her daughter