Maternity Leave In The Ninth Month of Pregnancy and Birth Outcomes Among Working Women
Received 15 January 2008; received in revised form 23 July 2008; accepted 23 July 2008.
Purpose
The health effects of antenatal maternity leave have been scarcely evaluated. In California, women are eligible for paid benefits up to 4 weeks before delivery. We explored whether leave at ≥36 weeks gestation increases gestation and birthweight, and reduces primary cesarean deliveries among full-time working women.
Methods
Drawing from a 2002–2003 nested case-control study of preterm birth and low birthweight among working women in Southern California, we compared a cohort of women who took leave (n = 62) or worked until delivery (n = 385). Models weighted for probability of sampling were used to calculate hazards ratios for gestational age, odds ratios (OR) for primary cesarean delivery, and multilinear regression coefficients for birthweight.
Main Findings
Leave-takers were similar to non–leave-takers on demographic and health characteristics, except that more clerical workers took leave (p = .02). Compared with non–leave-takers, leave-takers had almost 4 times lower odds of cesarean delivery after adjusting for covariates (OR, 0.27; 95% confidence interval [CI], 0.08–0.94). Overall, there were no marked differences in length of gestation or mean birthweight. However, in a subgroup of women whose efforts outstripped their occupational rewards, gestation was prolonged (hazard ratio for delivery each day between 36 and 41 weeks, 0.56; 95% CI, 0.34–0.93).
Conclusion
Maternity leave in late pregnancy shows promise for reducing cesarean deliveries and prolonging gestation in occupationally strained women.
aSchool of Public Health, University of California, Berkeley
cProgram Research and Demonstration Section, Genetic Disease Screening Program, Richmond, California
Correspondence to: Sylvia Guendelman, PhD, LCSW, School of Public Health, University of California, Berkeley, 207J University Hall, Berkeley, CA 94720-7360; Phone: 510-642-2848, Fax: 510-643-6426.
Funding for this study was obtained from the Maternal and Child Health Bureau (Award #R40-MC00305-01) and from the Center for Health Research at UC Berkeley.
ABSTRACT