Parental Leave Research Articles

Perspectives of US General Surgery Program Directors on Cultural and Fiscal Barriers to Maternity Leave and Postpartum Support During Surgical Training

Although pregnancy during surgical residency is increasingly common, studies of surgical residents have identified challenges associated with pregnancy and motherhood. These include perceptions of different maternity leave policies among institutions, lack of mentorship, stigma, and desire for greater lactation support. To describe the perspective and experience of US surgical program directors regarding maternity leave and postpartum support for surgical residents. This qualitative study included surgical program directors of US general surgery residency programs who were selected using purposive-stratified, criterion-based sampling. Transcripts were collected from semi-structured interviews, which were audio-recorded and transcribed verbatim, from October 21, 2018, to June 1, 2019. Maternity leave and postpartum support. Perspectives of program directors regarding maternity leave and postpartum support were categorized into common themes identified using content analysis. A total of 40 US general surgical programs directors (28 [70.0%] male; mean [SD] age, 49.7 [6.8] years) were interviewed, of whom 36 (90.0%) were from university-based programs. All reported having maternity leave policies allowing a duration of leave of 6 weeks or longer. Analysis of program director interviews identified 5 themes: (1) residents are reluctant to extend training despite being offered multiple leave options; (2) childbearing negatively impacts the quality of work of certain residents; (3) lack of formal lactation policies creates practical challenges in supporting residents who are nursing; (4) resentment from coresidents who are asked to provide maternity leave coverage varies based on the prepregnancy reputation of the resident on leave; and (5) lack of salary support limits the practicality of extended leave options. Complex interpersonal issues affected residents differently, including stigma, reluctance to change established surgical training patterns, and challenges with work-life balance. This qualitative study found that sociopolitical issues within surgical training culture and fiscal constraints created obstacles against program directors supporting pregnant residents. These findings suggest that a multidimensional approach to supporting residents through written maternity and lactation policies, structured mentorship and coaching programs, and efforts by leadership to enforce family priorities is needed to promote a surgical culture that normalizes pregnancy and motherhood during training.

The First Revision of the Hofmann Case Law on Maternity Leave and Discrimination Against Fathers: Care-Giving as the Pivot?

The First Revision of the <i>Hofmann</i> Case Law on Maternity Leave and Discrimination Against Fathers: Care-Giving as the Pivot?

Paid Parental Leave Policies Among U.S. News & World Report 2020-2021 Best Hospitals and Best Hospitals for Cancer

This cross-sectional study examines paid parental leave policies for faculty and staff physicians at leading US hospitals and cancer centers.

Gender equality and paid parental leave in Australia: A decade of giant leaps or baby steps?

The year 2020 marks the 10th anniversary of the Australian Paid Parental Leave Act 2010. Using Baird’s orientations typology and Brighouse and Wright’s equality framework, with evidence from the Workplace Agreements Database and the Workplace Gender Equality Agency, this article assesses changes in policy, bargaining and company provisions over the decade. We find that policy changes may enable more fathers and partners to take leave, although the period is short and barriers to uptake exist. In bargaining and company policy, we find modest growth in the proportion of agreements with paid primary and paid secondary carer leave provisions, but no movement in the duration of the leaves, with secondary carer leave much shorter. We conclude that although these changes suggest growing attention to improving women’s working conditions and fathers’ access to parental leave, short secondary carer leaves set normative standards of fathers as ‘supporters’ rather than recognising substantive involvement in care. Consequently, the changes do not promote gender-egalitarian sharing of parental leave. While the introduction of the government scheme was a ‘giant leap’, the 10 years since have seen modest ‘baby steps’ towards greater gender equality in the availability and potential use of paid parental leave.

Legal Regulations and Institutional Policies Underlying Parental Leave in Graduate Medical Education.

Legal Regulations and Institutional Policies Underlying Parental Leave in Graduate Medical Education.

Horizontal equity in the design of Australian family payments for newborns

AbstractEquity and efficiency are important evaluative criteria in tax and transfer policy. While matters of vertical equity receive more attention, horizontal equity is widely regarded as an important design principle. This is especially true in the design of family payments and has traditionally been interpreted as requiring universal – rather than targeted – payments to families on the basis the number, and ages, of dependent children. The focus of this paper is the horizontal equity of Australian family payments made specifically to the families of newborns. Under current policy, these families may receive maternity payments (the Newborn Supplement and Newborn Upfront Payment) or Parental Leave Pay (PLP), the former, a means‐tested birth grant; and the latter, a government‐funded paid maternity leave payment. Eligibility for PLP is largely contingent upon the birth mother providing a specific level of pre‐birth labour supply known as the “work test”. This paper uses microsimulation modelling to demonstrate the variation in the level of payment provided by the Australian Government under both programmes. It finds significant variation in the level of payment made both within and between families where the mother meets the PLP work test and finds higher levels of payment flowing to families where the mother is eligible for PLP. It concludes with a discussion of Australia's retreat from the provision of family payments on a universal basis with an emphasis on the equity–efficiency trade‐offs inherent to the PLP work test.

The impact of paid family leave on the timely vaccination of infants

Time constraints parents face can affect whether infant children are vaccinated on time. Using the National Immunization Survey, we employ a synthetic control difference-in-difference estimation technique to establish a causal relationship arising from California’s implementation of Paid Parental Leave Program as a natural experiment. We find California Paid Family Leave reduced late vaccinations by up to 5 percentage points or approximately 10% for children born to parents in California after the policy was implemented. Further, the policy had a stronger impact on families below the poverty line. Thus access to paid family leave can improve on-time immunization of infants.

A Study of the Teacher Development of child care teachers at Workplace Daycare Center reinstatement after Parental Leave

A Study of the Teacher Development of child care teachers at Workplace Daycare Center reinstatement after Parental Leave

The financing need of equitable provision of paid maternal leave in the informal sector in Indonesia: a comparison of estimation methods

BackgroundProviding an enabling environment for breastfeeding is hampered by the inequitable implementation of paid maternity leave, primarily due to perceived or actual financial costs. To estimate the real cost of paid maternity leave requires using reliable methods. We compared methods utilized in two recent studies in Indonesia. Study A estimated the financial need of providing paid maternity leave in the formal sector with a 10-year forecast at 21% coverage of eligible mothers, while study B estimated similar costs for the informal sector at 100% coverage annually. Results are critical for guiding future application of either method to inform paid maternity leave policies.MethodsWe compared number of covered mothers working informally, total annual cost, and cost per mother. We modified some parameters used in study A (method A) to be similar to study B (method B) for comparison, namely the period of estimate (annual), coverage (100%), estimate of women potentially breastfeeding, exchange rate, female labor force participation rate, the percentage of women working in the informal sector, and adding administration cost.ResultsThe methods differ in determining the number of mothers working in the informal sector who gave birth, the minimum wage as unit cost, and administrative cost. Both studies estimated the cost at various lengths of leave period. Method A requires more macro (e.g. national/regional) level data, while method B involves (e.g. individual) micro level data. We compared the results of method A with method B, respectively: 1) number of covered mothers working informally were 1,425,589 vs. 1,147,204; 2) total annual costs including administrative costs were US$650,230,167 vs. US$633,942,726, and; 3) cost/mother was US$456 vs US$553.ConclusionCertain flexibilities can be applied to both methods, namely using parameters specific to respective regions (e.g. provincial level parameters), flexible period of analysis, and the use of administrative cost. In a setting where micro data is scarce and not easily accessible, method A provides a feasible approach, while method B will be most appropriate if suitable micro data is available. Future comparison studies in other settings are needed to provide further evidence on the strengths and weaknesses of both methods.

Parental Leave Policies in Canadian Residency Education

In recent decades, the gender makeup of Canadian medical residents has approached parity. As residency training years coincide closely with childbearing years and paid parental leave is associated with numerous benefits for both parents and children, it is important for there to be clarity about parental leave benefits. We aimed to conduct a comprehensive review of maternity and parental leave policies in all residency education programs in Canada, to highlight gaps that might be improved or areas in which Canadian programs excel. We searched websites of the 8 provincial housestaff organizations (PHOs) for information regarding pregnancy workload accommodations, maternity leave, and parental leave policies in each province in effect as of January 2020. We summarized the policies and analyzed their readability using the Flesch Reading Ease. All Canadian PHOs provide specific accommodations around maternity and parental leave for medical residents. All organizations offer at least 35 weeks of total leave, while only 3 PHOs offer extended leave of about 63 weeks, in line with federal regulations. All but 2 PHOs offer supplemental income to their residents, although not for the full duration of offered leave. All PHOs offer workplace accommodations for pregnant residents in their second and/or third trimester. Although all provinces had some form of leave, significant variability was found in the accommodations, duration of leave, and financial benefits provided to medical residents on maternity and parental leave across Canada. There is a lack of clarity in policy documents, which may be a barrier to optimal uptake.

In Seas of Change, a Call to Action: 2021 American Board of Medical Specialties Policy on Parental, Caregiver, and Medical Leave During Training

Institutional graduate medical education (GME) programs are guided by architecture built by the Accreditation Council for Graduate Medical Education (ACGME), the American Board of Medical Specialties (ABMS) and, as radiology programs, the American Board of Radiology (ABR). At its core, GME is dynamic and progressive, committed to enhancing resident education and improving the patient care that residents deliver. In 2019 and 2020, new ACGME program requirements and the expanded second edition of ACGME Radiology Milestones added new guidelines affecting all accredited radiology residencies (1,2).

Lessons on Parental Leave: A Comparative Analysis of Parental Leave in South Africa and the United Kingdom

Recent amendments to the Basic Conditions of Employment Act 75 of 1997 have resulted in the introduction of parental leave. This provides employees with 10 consecutive days of time off from work to care for their newborn babies and may commence from the day of the birth. The right to parental leave has the additional benefit of impacting gendered social assumptions that place women in the primary role of caregiver and a secondary role as worker. With the rise in the labour participation of women, there has been an increase in the need for the involvement of men in the caregiving and upbringing of children in the home. Although parental leave applies to men and women, it has been enacted with the objective of encouraging working fathers to participate as caregivers and to share in the burden of care placed on new mothers to care for themselves and their newborn babies during maternity leave. This article considers the effects of parental leave as a recent addition to South African law by conducting a comparative analysis with the long-established parental leave models of the United Kingdom. These include the right to parental leave that is applicable to a parent who has parental responsibility for a child, and a right to shared parental leave, which allows the mother of the child to share her maternity leave with the other parent of the child. The parental leave rights of the United Kingdom have been developed to provide employees with choice and flexibility to accommodate their caregiving responsibilities, and may indicate a trajectory for the progression of the newly enacted right to parental leave in South Africa.

A Study on the Transition of the Parental Role of Fathers Who Experienced Parental Leave

A Study on the Transition of the Parental Role of Fathers Who Experienced Parental Leave

Scoping Out a Better Parental Leave Policy for Gastroenterology Fellows

Scoping Out a Better Parental Leave Policy for Gastroenterology Fellows

The yearly financing need of providing paid maternity leave in the informal sector in Indonesia

BackgroundThe economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15–49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) and assisted by unpaid/family worker(s). No specific maternity protection entitlements are currently available for WRA working informally in Indonesia. This study aims to estimate the financing need of providing maternity leave cash transfer (MCT) for WRA working in the informal sector in Indonesia.MethodThe costing methodology used is the adapted version of the World Bank methodology by Vilar-Compte et al, following pre-set steps to estimate costs using national secondary data. We used the 2018 Indonesian National Socio-Economic Survey to estimate the number of women working informally who gave birth within the last year. The population covered, potential cash transfer’s unitary cost, the incremental coverage of the policy in terms of time and coverage, and the administrative costs were used to estimate the cost of MCT for the informal sector.ResultAt 100% coverage for 13 weeks of leave, the yearly financing need of MCT ranged from US$175million (US$152/woman) to US$669million (US$583/woman). The share of the yearly financing need did not exceed 0.5% of Indonesian Gross Domestic Product (GDP).ConclusionsThe yearly financing need of providing MCT for eligible WRA working in the informal sector is economically attractive as it amounts to less than 0.5% of GDP nominal of Indonesia. While such a program would be perceived as a marked increase from current public health spending at the onset, such an investment could substantially contribute to the success of breastfeeding and substantial corresponding public health savings given that more than half of working Indonesian WRA are employed in the informal sector. Such policies should be further explored while taking into consideration realistic budget constraints and implementation capacity.

Widely Variable Parental Leave Practices for Urology Residency Programs in the United States

To query a cohort of program directors to better understand the contemporary landscape of parental leave for urology trainees. The American Board of Urology mandates that a resident must work 46 weeks annually in order to not extend residency. We hypothesize that formal parental leave policies may vary by institution and may not be easily accessible. A 22 question survey designed to assess parental leave policies was distributed to 144 American College of Graduate Medical Education accredited Urology residency program directors in the United States via e-mail. Results were collected anonymously. A total of 65 program directors completed the survey for a response rate of 43%. The median age of program directors was 49 and 78% were male. Only 12% reported no formal maternity leave policy, while 21% reported no formal paternity leave policy. Maternity leave duration varied greatly with 6 (49%) and 12 weeks (27%) as the most common duration, while paternity leave was most commonly reported as 2 (39%), 6 (18%) and 12 weeks (19%) in length. Most parental leave policies were available via an institutional website (81%), with only 39% available on a public website. While most leave policies covered compensation, few addressed call expectations or procedural safety precautions. Parental leave policies across Urology training programs in the United States are variable, and may not cover critical components of pregnancy or leave. An opportunity exists to create a comprehensive, standardized parental leave policy.

Does Employer-Paid, Job-Protected Maternity Leave Help or Hurt Female IT Workers? Evidence from Millions of Job Applications

Paid maternity leave is considered an important pathway to increasing women’s participation in IT because it helps address work and family balance concerns, which are pronounced in the field due to long hours, travel, and the need to keep up with technology. Many governments require that employers pay for maternity leave. Using micro-level data on millions of applications from an online job portal, our study examines whether a policy change in India that expanded employer-paid, job-protected maternity leave from short-term to medium-term (12 to 26 weeks) changes companies’ likelihood of considering female applicants to IT jobs and women’s likelihood of applying to such jobs. We find that post-legislation, there is a 4% decrease in the probability of women being invited for interviews and an 8% increase in the probability of a female applicant. Interestingly, in regions with low women’s labor force participation rates, we find a 31% decrease in the probability of women being invited for an interview, post legislation. In contrast, regions with high rates did not change their hiring practices, suggesting that the reform may increase regional inequality in women’s representation. Post legislation, women were significantly more likely to apply to jobs in regions with high women’s labor force participation rates relative to those with low rates. Our study identifies an important source of leakage in the pipeline for female IT workers and may inform policies aimed at reducing gender gaps in representation.

The Impact of Paid Maternity Leave on Maternal Health

We examine the impact of the introduction of paid maternity leave in Norway in 1977 on maternal health in the medium and long term. Using administrative data combined with survey data on the health of women around age 40, we find the reform improved a range of maternal health outcomes, including BMI, blood pressure, pain, and mental health. The reform also increased health-promoting behaviors, such as exercise and not smoking. The effects were larger for first-time and low-resource mothers and women who would have taken little unpaid leave in the absence of the reform. (JEL I12, J13, J16, J32)

A Study on the Problems and Improvement Measures of the Parental Leave System for Police Officials

A Study on the Problems and Improvement Measures of the Parental Leave System for Police Officials

Baby Steps in the Right Direction: Toward a Parental Leave Policy for Gastroenterology Fellows.

The American Board of Medical Specialties announced in July 2020 the adoption of a parental leave policy for residents and fellows allows for a minimum of 6 weeks of leave. This policy includes caveats: vacation and/or sick leave can be applied toward these 6 weeks, this leave can only be utilized once during training (whether for parental, caregiver, or medical leave), and this policy only applies to training programs of 2 or more years' duration. Although the new existence of a parental leave policy is a step in the right direction, trainees are in need of a more robust and evidence-based policy. There are particular challenges to be addressed in the male-dominated and procedural field of gastroenterology, in which women are underrepresented and female gastroenterology trainees are more likely to have career decisions limited around the availability of parental leave. This article reviews the evidence supporting the creation of a parental leave policy for gastroenterology fellows, with potential benefits to individual trainees as well as the field, in order to promote equity, recruitment, retention, and advancement of women in gastroenterology.