The United States is the only developed nation without a mandated paid parental leave. As of 2022, the Accreditation Council for General Medical Education has mandated a minimum 6-week parental leave during medical training in US training programs. Our objective was to evaluate current parental leave policies and attitudes toward leave across OBGYN subspecialties, identify barriers to fellows taking leave, and evaluate the level of support for lactation. We distributed an anonymous electronic questionnaire to fellows and program directors (PDs) across OBGYN fellowships in five subspecialties (complex family planning, female pelvic medicine and reconstructive surgery, gynecologic oncology, maternal-fetal medicine, and reproductive endocrinology and infertility) in the United States at the end of the 2023-2024 academic year. A total of 148 fellows and 76 PDs participated in the survey. Typical program parental leave reported by all participants was 6 weeks. Most (69.9%) fellows felt this typical leave to be too short, compared to half (45.7%) of PDs (p = 0.001). Only 4 (3.0%) fellows believed there are no barriers to trainees taking leave in fellowship, compared to 14 (20.0%) PDs (p < 0.001). Most commonly cited barriers to taking leave were culture in medicine, limited number of co-fellows, and need to extend training. Across the entire cohort, 74.3% fellows reported that being in training influenced their decision of when to have children, compared to 42.5% PDs (p < 0.0001). Fewer fellows compared to PDs were satisfied with their program's parental leave policy (46.6% vs. 68.5%, p = 0.03), and 51.2% fellows were neutral toward or dissatisfied with institutional support for lactation. OBGYN fellows face barriers to being able to take leave in fellowship, are dissatisfied with parental leave length, and do not have enough lactation support.

The nursing profession faces critical workforce shortages, intensified by high attrition linked to burnout and inadequate family supports. In the United States, maternity leave remains short and often unpaid, forcing premature returns to work that undermine health, family bonding, and career longevity. Although previous studies have quantified these outcomes, few have captured the moral distress and role strain experienced by nurse-mothers. To explore the lived experiences of nurse-mothers navigating maternity leave transitions within critical care settings. This study was guided by interpretive phenomenology. Purposive sampling was used to enroll 54 US critical care nurses in the study. Semistructured audiovisual interviews conducted between April and August 2024 were transcribed and analyzed using the hermeneutic circle. The analysis yielded 4 themes: (1) paid time off supplementation for maternity leave; (2) national responsibility in addressing unpaid, underpaid, and brief leave; (3) critical care nurses' need for more time; and (4) the need for additional support and adaptive policies. For critical care nurses, maternity leave often becomes a moral and existential dilemma shaped by time scarcity and financial strain, contributing to burnout and attrition. Evidence-based strategies to address the problem include front-loading paid leave, phased return-to-work options, and guaranteed lactation coverage. Aligning US policy with international standards regarding extended paid leave could promote retention, enhance staffing flexibility, and protect the quality of patient care.

Disclosing a Parental Leave to Patients Via Telehealth.

Despite the well-documented benefits of paid parental leave, many employees hesitate to take it. This study employs a two-player stochastic game (SG) model to analyze how various factors affect parental leave decisions. The proposed SG model incorporates (1) an employee’s perceived utility from taking leave, (2) the effect of colleague’s parental leave, (3) career penalties after taking leave, and (4) a paid parental policy. To accurately obtain equilibrium strategies, we extend Nash-Q learning by incorporating backward iteration and optimistic initialization. These two methods exploit the structural properties of the model to accelerate convergence and improve solution quality. Numerical experiments reveal that a stronger willingness to take parental leave and lower career penalties increase parental leave uptake. Furthermore, the competitive career penalty, which captures interpersonal factors, is particularly influential when a colleague is less likely to take parental leave. Our results suggest that reducing career penalties can substantially increase leave uptake in typical parameter ranges, highlighting the importance of workplace policies that mitigate career penalties associated with parental leave.

This study investigates social disparities in the uptake of paid parental leave (PPL) and engagement in childcare by Bulgarian fathers within the context of shifting gender norms and recent policy reforms. Based on survey data from 503 fathers of young children, it examines attitudes toward involved fatherhood, motivations and obstacles to PPL use, and the interaction between gender stereotypes and socioeconomic conditions. Despite EU‐aligned measures such as a two‐month non‐transferable paternal leave, uptake remains limited due to enduring male breadwinner expectations, income‐related disincentives, and traditional caregiving models centered on mothers. Findings indicate a hybrid model of fatherhood: While maternal dominance in caregiving persists, a growing number of fathers, particularly those with higher education or remote work opportunities, are adopting more egalitarian roles. Logistic regression results highlight key predictors of PPL uptake, including the number of children, household income, and workplace flexibility. Moreover, PPL use of fathers correlates positively with egalitarian gender attitudes, implying that paternal leave functions as both a reflection and a catalyst of cultural transformation. Nonetheless, ambivalence endures among lower‐income and less educated fathers, for whom caregiving often conflicts with masculine identity. Overall, the analysis underscores that although normative shifts are emerging, sustained progress requires comprehensive support through policy, workplace culture, and broader societal change to promote equitable parenting and normalize active fatherhood. The findings enrich ongoing discussions on gender equality, social inclusion, and evolving masculinities in post‐socialist societies.

Introduction: Parental leave (PL) and maternity policies are important considerations that can influence prospective residents' selection of emergency medicine (EM) residency programs, yet little research has explored their transparency on program websites, often the first contact point for applicants. Accessibility is vital as policies vary widely, and related inquiries have been traditionally stigmatized. This study aimed to evaluate the availability of PL and pregnancy accommodation information provided on the websites of EM residency programs and affiliated graduate medical education (GME) sites.Methods: Descriptive statistics were collected from 285 EM program websites and their affiliated GME websites in July 2024. Chi-square tests assessed whether PL information availability was associated with program director sex, program size, or program age.Results: Twenty-nine program websites (10.2%) contained PL information: 16 (5.6%) detailed specific policies, and 13 (4.6%) mentioned leave. Two (0.7%) detailed specific accommodations for pregnant residents. Sixty-two program websites (21.8%) linked to a GME website containing leave information. On GME websites, 149 programs (52.3%) had PL information; 94 provided details about compensation and leave length. About 130 programs (37.5%) had no relevant information available on either site. Larger (>11 annual positions) and older (est. 2010 or earlier) programs were more likely to provide PL information (χ² (1, N = 285) = 5.91, p = 0.015; χ² (1, N = 285) = 5.95, p = 0.015)). We found no significant association between program director sex, program length, or program region and the presence of PL information on EM program or GME websites.Conclusion: Our findings reveal significant gaps in the availability of PL and pregnancy accommodation information across EM and GME program websites, underscoring the necessity for all medical specialties to improve transparency and accessibility. Providing clear and reliable information is crucial to support prospective residents who may be hesitant to inquire about these policies during interviews. Enhancing these resources will contribute to a more inclusive and supportive training environment, ultimately benefiting both residents and program leadership.

Prior work conducted within U.S. civilian graduate medical education (GME) programs has uncovered negative perceptions of parenthood related to trainee wellness and performance. However, this subject remains understudied within U.S. military GME which affords trainees 12-18 weeks of paid parental leave. We disseminated a web-based survey to trainees, faculty physicians and program directors (PDs) at U.S. military GME programs querying participants on the impact of parenthood and parental leave on trainee wellness and performance. Applicable statistical analyses were utilized to assess differences between groups. Content analysis was used to identify themes within participant open-ended responses. The survey was completed by 211 respondents from 24 different medical or surgical specialties across the Military Health System. A majority of participants reported that their program's parental leave policy either somewhat or significantly decreased the stress of trainee parents (trainee 50.5% vs. faculty 60.6% vs. PDs 61.9%). Participants reported no impact of parental leave on trainee dedication to patient care, clinical performance, scholarly activities or standardized test scores. Participants reported a somewhat negative impact of training interruptions on the training experience of peers, with no significant difference in how they rated birth and non-birth parents (birth parent 2.44 vs. non-birth parent 2.48, P = .10, d = -0.11). Technical skills and procedural volume were both rated lower for birth parents versus non-birth parents (technical skills: birth parent 2.50 vs. non-birth parent 2.60, P ≤ .001; d = -0.25, procedural volume: birth parent 2.32 vs. non-birth parent 2.41, P <. 001; d = -0.23). Content analysis uncovered themes consistent with the survey data but also revealed persistent stigma surrounding use of full parental leave benefits within certain GME programs. The current parental leave policy within U.S. military GME is perceived to decrease parental stress and can have a positive impact on trainee wellness. While this policy has been effectively implemented with limited perceived impact on trainee performance, work remains to be done to promote full acceptance of parental leave within military GME.

In 2022, the United States Supreme Court’s Dobbs decision overturned Roe v. Wade and returned the question of abortion legality back to the states. Since then, 23 states have enacted full or partial bans on abortions. This necessitates a revisitation of the pros and cons of paid maternity leave. If women are going to be forced to carry pregnancies to term and delivery, they will require maternity leave from work. According to the numbers of abortions reported to the CDC each year, the 23 states with full or partial abortion bans averaged 250,000 abortions per year in the four years prior to the Dobbs decision for working-aged women. With abortion access no longer guaranteed, paid maternity leave will become even more important.

To examine the impact of China’s 2016 maternity leave extension on mothers’ health, this study uses difference‐in‐differences models and five waves of the China Family Panel Studies (2012–2020). We find that extended maternity leave significantly improves mothers’ physical health and reduces depression. An extension of 10 days is associated with a 0.013‐unit decrease in self‐rated health and a 0.098‐point decrease in depression scores. Notably, the beneficial effects are more pronounced for those residing in rural areas and with a spouse; moreover, early childbearing benefits in physical health, and late childbearing benefits in mental health. Mechanistic analyses further reveal that extended maternity leave improves mothers’ health outcomes through improving life satisfaction. These findings provide new evidence from China on the health benefits of maternity leave and underscore the need for multidimensional postnatal health support and stronger family support policies as integral components of maternity leave reforms.

We study whether policy can shift gendered beliefs, norms, and labor market outcomes by exploiting a major expansion of earmarked paternity leave in Denmark. The reform generated large first-stage effects, substantially reallocating leave from mothers to fathers. Using a regression discontinuity design combined with new survey data linked to administrative records, we show that the reform makes parents more supportive of paternity leave, shifts gender-role beliefs in a progressive direction, and reduces perceived differences in childcare ability. The reform also narrows gender gaps in earnings and hours worked. The earnings gap falls by 33pp in the first year following childbirth (during leave) and by 2.8pp in the second year (after leave). These results demonstrate that policy can meaningfully influence beliefs, norms, and gender inequality. On the other hand, earmarking restricts families’ ability to allocate leave freely and lowers leave satisfaction, highlighting a central trade-off inherent in paternalistic policies.&lt;br&gt;&lt;br&gt;Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at &lt;a href="http://www.nber.org/papers/&amp;#119;34862" TARGET="_blank"&gt;www.nber.org&lt;/a&gt;.&lt;br&gt;

Point-counterpoint: Compensation for Parental Leave Coverage.

Point-counterpoint: Compensation for Parental Leave Coverage.

Time plays a crucial role in how trainees experience pregnancy and parental leave within graduate medical education (GME). Prior research mainly highlights the negative impact of time-related factors on trainee experience. However, a recent qualitative analysis within military GME challenged this antagonistic view of time, rather highlighting how it can be optimized to facilitate trainee personal and professional success. To date, there has been no formal quantitative analysis of how trainees manage time related to parental leave within military GME. As such, we investigated the impact of 12 to 18 weeks of parental leave on trainee parents' experiences within military GME programs. We utilized a voluntary, anonymous web-based survey to query trainee parents, non-parent peers, faculty physicians, program directors, and associate program directors within U.S. military GME programs. The survey covered personal decision-making regarding parenthood within medical training as well as perceptions of parental leave policy and impact on training experience and career outcomes. Appropriate statistical analyses were utilized to summarize participant demographics and assess for differences between groups. Content analysis was utilized to assess open-ended responses. The survey was fully or partially completed by 211 respondents from 24 different medical or surgical training programs across the Military Health System. There were similar numbers of male and female respondents who became parents during medical training, (35.3% vs. 32.3%, P = .77). Fifty-three percent of birth parents took 10 weeks or longer of parental leave while 50% of non-birth parents took 1 to 3 weeks of leave. Only 10% of birth parent trainees and about one-third of non-birth parent trainees would prefer a 6-week leave duration, the current minimum mandated within civilian programs. Birth parents were more likely to utilize an extension in training (45.2% vs. 8.3%, P = .00). Approximately one-third of all parents planned to, or did, utilize fewer weeks of parental leave than their program's allotment, most commonly (81.8%) because of a desire to graduate from training on time. Both birth and non-birth parents most commonly reported "no impact" of parental leave on the quality of their medical education. However, trainee parents did report more negative impact of an extension in training on career advancement when compared to non-parent peers, faculty, or program leadership. This study demonstrates that parental leave durations of 10 weeks or greater have been successfully incorporated into military GME programs. Trainees commonly prefer durations of parental leave in-line with current Department of Defense policy, with minimal perceived effect on quality of medical education. However, challenges persist regarding training interruptions, extensions in training and military-specific impact of training graduation delays.

Abstract: In Germany, gender equality is an important topic both in terms of a strong legal framework and ongoing public debate. Article 3 of the Constitution of the country states that women and men have equal rights. Despite the progress made in recent years, significant disparities still remain, especially in the labor market gender wage gap and representation in leadership positions. The government is implementing various policies to address these inequalities. The issue of women's representation in leadership positions also remains a serious problem. To address this problem, Germany introduced a 30% quota for women on the Supervisory Boards of large companies in 2015. Although this move has led to some progress, the number of women in executive leadership positions is still very low. It defines the obligation of the state to promote this equality and to eliminate existing disadvantages. At the federal level, there is still no statutory quota for women's representation in the Bundestag (German Parliament). However, in response to this problem, in party quotas, many major political parties have their own internal quota systems that ensure that a certain percentage of candidates are women. In 2015, a mandatory quota for women was introduced in the supervisory boards of large companies. In Germany, the main support for parents to reconcile work and family life is the Elterngeld (Parental Allowance) and Elternzeit (Parental Leave) programs. The benefit is paid for up to 14 months in total, but the full amount is received if both parents are involved (each taking at least two months of leave). The main purpose of this &amp;quot;partner months&amp;quot; policy is to encourage fathers to take a more active role in childcare. In this model, the father traditionally works and the mother takes care of the house and children. This model causes women to work part-time or take a career break, which directly increases the gender wage gap.

Background Early pregnancy loss is a very common experience resulting in adverse mental health outcomes, such as depression and PTSD. There is currently little research on the impact of parental leave on improving these mental health outcomes. As more employment policies are beginning to provide parental leave for early pregnancy loss, the efficacy of this treatment must be explored. Objective This study aimed to investigate the impact of parental leave after early pregnancy loss on mental health and access to professional mental health support. Study Design A 2023 retrospective cohort online survey was created after screening and recruiting participants via electronic medical records. To be eligible, participants had to be 18 years of age and above diagnosed with first trimester pregnancy loss in 2022, English speaking, and in Cincinnati, OH. Results Of the eligible 297 patients, 65 (21.9%) usable responses were collected. The rate of leave among respondents was 15.4% (n=10) which is similar to a national rate of 21.9% of companies offering leave (p=0.366). Those that took leave had significantly lower modified PHQ scores out of 9 (3.5 +/- 2.12) than those that didn’t (5.35 +/- 2.55) (p=0.035). The relative risk of patients believing their mental health was better due to leave was 33.45 (CI: 4.72-236.89, p&lt;0.001). Patients that took leave also believed that they were better able to access professional mental health support (p&lt;0.001), although only 50% of those actually did proceed with therapy. Conclusion Taking leave after early pregnancy loss results in less depressive symptoms and a more positive view of mental health and support access. Future studies should continue to explore the impact of leave after loss and advocate for parental rights.

Despite China’s continuous relaxation of fertility policies, accompanied by fertility subsidies and extended maternity leave for women, the birth rate in 2024 remained at a globally low level of 6.77%, with a risk of further decline. The conflict between childbirth and employment for women is particularly prominent in the workplace. By reviewing domestic and international literature and practices, this study focuses on the implementation status of China’s paternity leave and male parental leave, analyzes their impact on married women’s labor market participation, and explores policy optimization directions based on international experiences. The results show that China’s paternity leave and male parental leave policies face issues such as fragmented legislation, low male participation in childcare for children aged 0–3, and insufficient policy implementation. However, the effective implementation of these two types of leave can increase women’s labor force participation rate and salary levels. International models from Nordic countries and East Asia provide important references for China. The study concludes that it is necessary to improve the design of paternity leave and male parental leave policies from three dimensions—legal, economic, and cultural—and promote the implementation of fertility support policies to alleviate women’s workplace dilemmas, advance gender equality, and achieve sustainable development of the labor market.

The protection of maternity leave rights for female workers represents an embodiment of the principles of social justice and humanity as mandated in Article 27(2) of the 1945 Constitution. However, in practice, violations of these rights continue to occur across various employment sectors. This study aims to analyze the legal provisions governing maternity leave rights under Law No. 13 of 2003 on Manpower and to evaluate the extent to which their implementation reflects the principles of justice, legal certainty, and humanity. Employing a normative juridical approach through the analysis of primary and secondary legal materials as well as industrial relations court cases, the study finds that although the normative framework provides clear legal protection, its implementation remains weak due to inadequate supervision, low legal awareness, and persistent gender bias in the workplace. In conclusion, the Indonesian labor law system formally upholds legal certainty but has yet to fully achieve substantive justice and humanitarian protection for pregnant female workers.

Researchers and policy makers who focus on paid family leave have devoted little attention to American Indian and Alaska Native (AIAN) people. To address this gap, the authors investigate earnings stability, parental leave access, and associated outcomes among AIAN mothers in Washington state. Using mixed methods and grounded in an Indigenous theoretical framework, we explore factors that alternately facilitate and impede these mothers’ leave access and related outcomes. Quantitative findings reveal significant perinatal income disruptions, disparities in both earned income and projected paid leave eligibility, and intersectional inequities in projected paid leave eligibility. Qualitative results underscore the serious adverse impacts of insufficient paid leave access for working AIAN mothers, as well as both the inequities and the individual and community strengths they experience after welcoming a new child. This study highlights the need for comprehensive, culturally aligned policies and support structures to address AIAN perinatal well-being.

Studies focusing on how the migrant population understands and utilises family policies are scarce in Southern European countries. We focus on the use of paternity leave by American and European migrant fathers in Spain. This work is based on an online survey of parents (QUIDAN, 2021), which is nationally representative with a sample of 3100 respondents. We have conducted descriptive statistics and explanatory multivariate models. The main result shows that American-born (but not European) fathers take paid paternity leave less often than Spanish fathers. This outcome raises new questions about migrant parental roles and the shortcomings of public policies.

Reply to Editorial Comment on "Variability in Accessibility of Residency Parental Leave Policies Across Surgical Specialties".