Increase in sick leave rates caused by back pain among pregnant Swedish women after amelioration of social benefits. A paradox.

Abstract

A retrospective population study. To explore whether the increase in social benefits for pregnant women introduced in Sweden between 1978 and in 1986 was associated with a decrease in the use of sick leave caused by back pain during the same period. Back pain is a common condition among Swedish pregnant women. It may be regarded as a normal discomfort of pregnancy, because at least 50% of pregnant women experience back pain to some extent during pregnancy. Participants were women consecutively delivered in 1978 (n = 1524) and in 1986 (n = 1688). Between these two time points, the number of offered days of parental benefit increased and a new benefit, the pregnancy benefit, was introduced. Data were collected from the antenatal care and delivery records and from pregnant women's social insurance files. From 1978 to 1986 the use of sick leave because of back pain during pregnancy increased. The number of pregnant women granted sick leave employed pregnant women because of back pain increased from 11% in 1978 to 29% in 1986 (P < 0.001). The sick leave rate increased in most occupations and especially among young women. The Swedish society has provided ample social benefits to allow the pregnant woman to take leave from work, without having to be labeled as "ill," because of normal conditions such as back pain during pregnancy. Instead of an expected decrease in sick leave because of back pain during pregnancy, an increase was observed.