Women’s health is a salient public health and medical concern in our nation. We live in a country that takes enormous pride in being different, but I find it hard to believe that such a prideful country is lettings its mothers fall by the wayside, when it comes to maternity leave. This is especially surprising because it has been shown that paid maternity leave, especially one that extends to at least one month prenatally and lasts a full year, has shown to be beneficial in Britain[1]. Maternity leave in the US is simply too short to prove effective. Furthermore, our policy in all states, even those with some paid leave, is unhelpful, is limited to large companies, poorly protects women’s jobs, places undue stress on women to return to work early, and grossly ignores many of the documented benefits of paid maternity leave. Enforcing paid maternity leave would stop women from returning to work prematurely. Most importantly, it would reduce the number of cesarean sections, improve early infant health, and reduce the postpartum maternal mental health problems.
Currently, the U.S. policy for maternity leave as set by The Family and Medical Leave Act guarantees 12 weeks of unpaid leave after giving birth and protects mothers’ jobs [2]. The policy does not include any antenatal care, thus keeping women working until their due date. I believe it is likely that this prolonged work schedule is likely correlated to the high rate of cesarean sections and its associated health risks. Women working until their due date often deal with occupational stress which is associated with increased risk of preeclampsia[3] and increased rates of cesareans. Additionally, both occupational stress and poor sleep are associated with an increased rate of cesarean sections[4]. The rate of cesareans are currently two times recommended by the World Health Organization [5] and four times more likely among women not receiving antenatal care [6].
The current policy ignores the rise in cesareans and its serious implications associated with the high number cesarean sections performed in the U.S. Women who deliver by cesarean are likely to undergo surgical complications, are twice as likely to be re-hospitalized during the first thirty days after birth [7], and are associated with longer stays in hospitals, thereby placing the mother at a high risk of contracting a hospital-born infection that further separates the mother and infant. Furthermore, extended paid maternity leave is shown to bolster infant health by decreasing the number of low birth weight babies. Additionally, chronic work stressors during the antenatal period have been associated with a moderate relationship between stress hormone concentration and preterm deliveries [8]. Infants whose mothers return to work prematurely are less like to receive regular medical checkups, immunizations, and breastfeed [9].
Lastly, an extended aid maternity leave will help alleviate the incidence of maternal mental health problems. About 8-15% of women have postpartum depression and 50-80% have the postpartum blues [10]. Postpartum depression is serious and often makes women hate themselves, feel they lack maternal skills10, and decreases verbal and play time with infants, thereby weakening the crucial mother infant bonding in the early years of life[11].
Clearly, we should question our health policy agenda. Legislators and public health officials cannot ignore the red flags described above. Collaboration is necessary because our currently policy is undermining the health of our women and children.
Sources:
The two news articles are below with the hyperlinks, then all of the sources including the news articles are listed again below in APA format.
http://www.forbes.com/2009/05/04/maternity-leave-laws-forbes-woman-wellbeing-pregnancy.html
http://www.huffingtonpost.com/2011/02/23/paid-parental-leave_n_826996.html
[1] Ray, R, J Gornick, and J Schmitt. Parental Leave Policies in 21 Countries Assessing Generosity and Gender Equality Washington, D.C: Center for Economic and Policy Research, 2009. http://www.cepr.net/documents/publications/parental_2008_09.pdf.
[2] Baum II, C L. “The Effect of Government-Mandated Family Leave on Employer Family Leave Policies.” Contemporary Economic Policy 24, no. 3 (2006): 432-445. doi:10.1093/cep/byj025.
[3] Robles De Medina, P J., A C. Huizink, B R. Van den Bergh, J K. Buitelaar, and G H. Visser, and . “Prenatal Maternal Stress: Effects of Pregnancy and the (unborn) Child.” In Early Human Development, 3-14. 2002.
[4] Lee, L, and C Gay. “Sleep in late pregnancy predicts length of labor and type of delivery.” Journal of Obstetrics and Gynecology 191, no. 6 (2004): 2041-2046. doi:10.1016/j.ajog.2004.05.086.
[5] Weitz, R. “The Social Meanings of Illness.” In In Sociology of Health, Illness, and Health Care, 5th ed., 107-129. Boston, MA, USA: Wadsworth CENGAGE Learning, 2010.
[6] Guendelman, S, M Pearl, S Graham, A Hubbard, N Hosang, and M Kharrazi. “Maternity leave in the ninth month of pregnancy and birth outcomes among working women.” Womens Health Issues 19, no. 1 (2009)
[7] Declercq, E, M Berger, H J. Cabral, S R. Evans, M Kotelchuck, C Simon, J Weiss, and L J. Heffner. “Maternal Outcomes Associated With Planned Primary Cesarean Births Compared With Planned Vaginal Births.” In Obstetrics & Gynecology, 669-677. 2007.
[8] Guendelmen, S, J L. Kosa, M Pearl, S Graham, and M Kharrazi. “Exploring the relationship of second-trimester corticotropin releasing hormone, chronic stress and preterm delivery.” Journal of Maternal-Fetal and Neonatal Medecine 21, no. 11 (2008): 788-795. doi:10.1080/14767050802379031.
[9] Berger, L M., J Hill, and J Waldfogel. “Maternity leave, early maternal employment and child health and development in the US.” In The Economic Journal, F29–F47. 2005.
[10] Perfetti, J, R Clark, and C M. Fillmore. “Postpartum Depression: Identification,Screening,and Treatment.” Wisconsin Medical Journal 103, no. 6 (2004): 56-63.
[11] Righetti-Veltema, M, A Bosquet, and J Manzano. “Impact of postpartum depressive symptoms on mother and her 18-month-old infant.” European Child and Adolescent Psychiatry 12, no. 2 (2003): 75-83. doi:10.1007/s00787-003-0311-9.
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