Parental Leave Research Articles

Maternity Leave for the Commissioning Mother

Maternity Leave for the Commissioning Mother

Income Loss and Leave Taking: Increased Financial Benefits and Fathers’ Parental Leave Use in Sweden

AbstractA major reason for the gendered division of parental leave use is the financial compensation during leave. Swedish national parental leave benefit provides 77.6 percent of earlier earnings up to an income ceiling, but collective agreements cover part of the income loss above the ceiling during leave. We focus on the importance of such collective agreements by examining fathers’ parental leave take-up across the 2000s, as agreements were expanded during this period in time. We combine register data for the period 2001 to 2011 with the Longitudinal Integrated Database for Health Insurance and Labour Market Studies (LISA) being the key data source. The main division of agreements is between the state, the municipality and county, and the private sector. Results indicate that fathers with income above the income ceiling increase their use over the time period. Especially in the private sector a polarisation can be seen, where high income fathers increase their leave use, while fathers with lower income fall behind. As we do not find stronger increase in fathers’ leave use in sectors where agreements expanded across time there is no evident support of a direct effect of the top-ups.

Gender-Specific Duration of Parental Leave and Current Earnings

Although male employees are increasingly making use of parental leave, gender differences in both usage and duration of parental leave are still prevalent. Based on signalling theory and the masculinities concept, the article explores the role of gender in the relationship between the incidence/duration of parental leave and wages/compensation after returning to a job. It is shown that pay gaps associated with parental leave are much more severe for male than they are for female middle managers in the German chemical industry.

Compensatory Work Devotion: How a Culture of Overwork Shapes Women’s Parental Leave in South Korea

Despite growing concerns that parental leave policies may reinforce the marginalization of mothers in the labor market and reproduce the gendered division of household labor, few studies examine how women themselves approach and use parental leave. Through 64 in-depth interviews with college-educated Korean mothers, we find that although women’s involvement in family responsibilities increases during leave, they do not reduce their work devotion but reinvent it throughout the leave-taking process. Embedded in the culture of overwork in Korean workplaces, women find it justifiable to use leave only when they are highly committed to work and adjust the length of leave to accommodate workplace demands. Upon returning to work, they try to compensate for their absence by working harder than before, thereby showing that they are more committed than their colleagues. Given this “compensatory” work devotion, women question their own entitlement in the workplace, and some quit when they cannot meet their goal of compensating by doing more than others. This study highlights how the workplace culture shapes women’s work devotion during and after leave.

The parent penalty: Parental leave and return to work in trainees and early-career faculty in oncology.

11005 Background: Prime childbearing years occur during medical training and early career, leaving physicians with tough choices between family planning and career growth. Restrictive parental leave (PL) policies can affect physician well-being and limit decisions about reproduction. We evaluated Medical and Radiation Oncology trainees and early career faculty to assess policies and practices regarding PL and return to work. Methods: An anonymous 48 question cross-sectional survey developed by researchers with expertise in gender equity was distributed via email and social media channels between May and June 2021 to oncology trainees and physicians within 5 years of terminal training. Descriptive statistics were used to compare study groups. Results: 255 physicians completed the survey- 54% female, 65% Medical Oncology and 35% Radiation Oncology, 71% trainees and 29% early career faculty. 46% (117) had no formal PL policy during training. PL impacted selection of first job for 37% (94) participants. Of all responders, 114 used PL, either in early career (18%), as a trainee (69%) or both (13%). Duration of PL during training was ≤4 weeks in 37%, 4-6 weeks in 19%, 6-8 weeks in 12% and ≥8 weeks in 24%. 27% of those who took PL as a trainee had to extend training to allow for this. Only 27%(31) of those who took PL had resources available at workplace to assist with transitioning back to work, primarily from informal mentoring by faculty/colleagues (65%, 20). Other important findings are summarized in the Table. Conclusions: In this study evaluating parental leave in oncology trainees and early faculty, almost half of the participants had no formal parental leave policy during training and majority of those who took parental leave during training had parental leave only for 6 weeks or less. Most participants experienced a parental leave penalty: guilt when seeking help and feeling overwhelmed at return to work. Policies and practices around parental leave need to be restructured to meet the needs of the evolving oncology workforce. [Table: see text]

Paid Maternity Leave in Vietnam: Awareness, Perceptions, Gaps, and Uptake Among Formally Employed Pregnant Women and Mothers of Infants

ObjectivesTo examine the uptake of Vietnam's paid maternity leave policy in terms of entitlements and awareness, perceptions, and gaps in implementation through the lens of formally employed female workers.MethodsIn this mixed methods study, we interviewed 494 formally employed female workers, among whom 107 were pregnant and 387 were mothers of infants and conducted in-depth interviews with a subset of these women (n = 39).ResultsOf the 494 women interviewed, 268 (54.3%) were working in blue-collar jobs and more than 90% were contributing to the public social insurance fund. Among the 387 mothers on paid maternity leave, 51 (13.2%) did not receive cash entitlements during their leave. Among the 182 mothers with infants aged 6–11 months, 30 (16.5%) returned to work before accruing 180 days of maternity leave. Of 121 women who had returned to work, 26 (21.5%) did not receive a one-hour paid break every day to express breastmilk, relax or breastfeed, and 46 (38.0%) worked the same or more hours per day than before maternity leave. Although most women perceived maternity leave as beneficial for the child's health (92.5%), mother's health (91.5%), family (86.2%), and society (90.7%), fewer women perceived it as beneficial for their income (59.5%), career (46.4%), and employers (30.4%). Not all formally employed women were aware of their maternity protection rights: women were more likely to mention the six-month paid maternity leave (78.7%) and one-hour nursing break (62.3%) than the other nine entitlements (2.0–35.0%). In-depth interviews with pregnant women and mothers of infants supported findings from the quantitative survey.ConclusionsAlthough Vietnam's maternity protection policy helps protect the rights of women and children, our study identified implementation gaps that limit its effectiveness. In order to ensure that all women and their families can fully benefit from maternity protection, there is a need to increase awareness of the full set of maternity entitlements, strengthen enforcement of existing policies, and expand entitlements to the informal sector.Funding SourcesBill & Melinda Gates Foundation (Grant Number OPP50838) and Irish Aid.

Breast Feeding Experiences of NHS Staff Returning to Work From Maternity Leave: A National Study

AimsAnecdotally, NHS staff feel unsupported in breastfeeding when returning to work from maternity leave. The NHS provides clear guidance to employers about provisions required for breastfeeding employees (clean lockable room, adequate time, clean fridge). We aimed to establish if these provisions were provided for NHS staff, and to further explore the difficulties reported.MethodsWe conducted a pilot study of NHS doctors, exploring their experiences of feeding on returning to work. The results highlighted difficulties for many of the 519 cases. We extended the study to encapsulate the experiences of all NHS professionals.The survey was distributed via various professional social media accounts.ResultsWe received 1201 responses. •79% of women were breastfeeding when they returned to work. 59% wished to continue on return.•78% of women were unaware of the local breastfeeding policy. Of those that were, only 7% were informed of the policy by their employer.•90% of women were unaware that they needed to inform their employer of their intention to breastfeed.•Only 6% of women had a breastfeeding risk assessment on their return to work.•Basic requirements were not consistently met (50% did not have access to a lockable room, 51% to a fridge, 69% to adequate time).•55% were interrupted whilst expressing.•23% of women expressed in changing rooms; 32% in toilets; 25% in their cars; 15% in cupboards.•88% of women did not have their duties adapted. 91% regularly held the bleep whilst expressing.•52% of women reported embarrassment and humiliation at work. 60% reported stress directly due to their difficulties expressing, with a further 15% experiencing mental health problems. 10% of women felt their experiences negatively affected their bond with their child.ConclusionOnly 1% of UK mothers continue to breastfeed at six months. There is a huge NHS drive to improve this statistic. 76.7% of NHS staff are women. These women are also NHS patients. NHS breastfeeding guidelines are not being consistently followed within the organisation. There is a direct impact on mother and child, and on patient care.We must support our NHS family, create a positive breastfeeding culture, and lead UK change.“I was ridiculed… it set me apart from my colleagues.”“Resigning was my only option.”“Subject to eye rolls and whispers… rude, unsupported and unkind.”“He unlocked the door and walked in while I shouted “stop”.”

Advocating for Physician Paid Parental Leave

Advocating for Physician Paid Parental Leave

Maternity Benefit Amendment Act (2017): A ‘Humble Gift’ Causing Motherhood Penalty in India

The twin goals of addressing gender inequality and improving child development has manifested itself in the proliferation of maternity leave policies across the world. While maternity leave has become a standard entitlement in several countries, variations exist in policy design and their gendered outcomes, suggesting that policies are influenced by factors such as cultural and social norms. In 2017, the Government of India enacted the Maternity Benefit Amendment Act to extend paid maternity leave from 12 to 26 weeks and to provide other non-monetary child benefits. The Government described it as a ‘humble gift’ to women, a day after the world celebrated International Women’s Day. While it has been recognised on some levels that certain policies entrench gender inequality, an area that remains unexplored is how enduring assumptions rooted in the traditional gendered division of domestic and non-domestic labour have underpinned maternity support, particularly in the context of the Global South. This piece intends to engage with this gap by exploring how maternity policy was created in India and how the Government has conceptualised gender. Challenges include the narrow construction of women and family, the limited coverage of the policy to biological mothers and formal workers, and the impact of employers’ economic decisions such as discriminatory recruiting practices against women in response to higher leave costs.

Association between Employer Provided and Planned Maternity Leave Duration and Breastfeeding Duration

Background: The American Academy of Pediatrics recommends breastfeeding for at least one year. However, studies have shown that the constraints of the Family and Medical Leave Act (FMLA), which provides 12 weeks of unpaid leave, may impede this recommendation. Our objective was to evaluate whether employer provided and planned maternity leave duration was associated with breastfeeding duration. Subjects and Method: This was a prospective cohort study wherein 480 postpartum women were recruited from Prentice Hospital between May and July of 2017. Participants completed a questionnaire immediately postpartum and at 12 to 14 weeks postpartum. Independent variables were employer provided and planed maternity duration and partner leave duration. Dependent variables were intention to breastfeed for one year and actual breastfeeding status at 12 to 14 weeks postpartum. Bivariable and multivariable analyses were performed. Results: Of the 480 women enrolled, 226 (47.28%) intended to breastfeed for at least one year. Women who planned a longer maternity leave were significantly more likely to intend to breastfeed for at least one year (37.41% vs 35.71%, p= 0.033). This persisted after controlling for possible confounders (aOR = 4.08, CI 95%= 1.10 to 15.13, p= 0.040) However, there was no difference in intention to breastfeed for at least one year by the duration of employer allocated maternity or partner leave. There were no differences in actual breastfeeding rates at 12 weeks postpartum across various durations of intended or taken maternity or partner leave. Conclusion: Increased planned maternity leave duration is associated with increased intention to breastfeed, however actual breastfeeding rates at 12 weeks postpartum were not associated with maternity leave duration.

Parental Leave as a Potential Demographic Policy Instrument in Russia: Mixed-Methods Research

In many countries, parental leave is an effective demographic policy measure. Its regulation is considered an important determinant of the birth rate. In Russia, the parental leave system is not flexible; however, the legislation provides for one of the longest parental leave in the world—36 months. According to a popular stereotype in Russia, as parental leave is longer than in other countries, there is no need to debate its effectiveness. This very reason may explain a lack of parental leave research in Russia.
 Our paper aims to demonstrate how mixed-methods research can be applied to study parental leave in Russia. In 2021, to analyse the problem in the Sverdlovsk Region (one of the largest), we did the following:
 1) surveyed 500 parents with both children under the age of 12 and currently living parents (i.e., grandparents);
 2) surveyed 500 grandparents with grandchildren under the age of 12.
 In both surveys, we used river sample. To increase the randomicity of the sample, we recruited respondents using multiple channels and sampled them with equal probability into the population analysed;
 3) conducted focus groups with parents having both children under the age of 12 and currently living parents and with grandparents having grandchildren under the age of 12.
 Our mixed-methods research yielded the following results.
 
 The parents surveyed view mothers as primary leave-takers. They also refer to grandmothers (most often, maternal ones) and fathers as potential leave-takers.
 Grandparents’ opinions on leave-takers are also diverse; their responses vary as much as parents’ ones. However, they are more restraint in terms of their own role as potential leave-takers.
 As focus groups revealed, “if a need arises”, parents are willing to delegate the right for parental leave to grandparents, who agree to take it.
 
 Our methodology is based on the mixed-methods research strategy. It allowed us to identify social attitudes towards the existing parental leave system in Russia and to draw attention to its transformation. The results may be of use when developing new mechanisms for the Russian state demographic policy.

Paternity Leave During Surgical Training: Perspectives of Male Residents

Recent literature on parental leave during residency has focused on the importance of supporting new mothers, but the needs and challenges faced by expectant nonchildbearing residents are less well described. Male residents are more likely than their female counterparts to have children during surgical training, and they experience similar stressors including childcare and conflicts between work and home priorities. As nonchildbearing parents of this generation become more involved in childrearing, the need to establish inclusive parental leave policies is essential. The aim of this study was to provide a deeper understanding of the perspectives of male residents about parental leave. A semi-structured interview guide was developed using a literature search and an expert panel. Interviews were audio-recorded and transcribed verbatim and emergent themes were identified using content analysis. Four academic institutions. Four focus groups were held with of a total of 15 male resident-parents. These were selected using convenience sampling. Multiple themes emerged: 1) male residents perceive greater stigma attached to taking leave compared to female colleagues; 2) paternity leave policies are vague and sometimes non-existent; 3) male residents experience a high burden of guilt related to burdening peers with clinical coverage while on leave; 4) male residents face internal conflict between surgical and parental responsibilities; 5) male residents have little mentorship on successful work-life integration and feel compelled to model the behavior of their attendings who often prioritize career before family; and 6) shifts in family values and priorities are common following childbirth and impact how male resident-parents view other new parents in training. Significant challenges exist for residents who become fathers during their surgical training. Key stressors include poorly defined leave policies, historic paradigms of prioritizing professional duties before personal duties, stigma against taking time off for parental bonding in the absence of medical need, and guilt related to extra work imposed on colleagues by time away. Establishment of formal parental leave policies for both genders, programmatic support to offset the increased workload on colleagues, and greater mentorship on balancing family and career are needed to foster a culture of work-life integration.

Differential attainment in higher surgical training: scoping pan-specialty spectra.

This study aimed to evaluate differential attainment during higher surgical training (HST; all specialties) related to three ethnic cohorts: White UK (WUKG), Black and Minority Ethnic UK Graduates (BMEUKG), and International Medical Graduates (IMG). Anonymised records of 266 HSTs (126 WUKG, 65 BMEUKG, 75 IMG; 7 years) in a single UK Statutory Education Body were examined. Primary effect measures were Annual Record of Competency Progression Outcome (ARCPO) and Fellowship of the Royal College of Surgeons (FRCS) pass. ARCPOs related to ethnicity and specialty were similar with the exception of general surgery (GS) trainees, four of whom received ARCPO 4 (GS 4.9% (75% BME; p=0.025) vs all other 0%). ARCPO 3 was commoner in women (22/76, (28.9%) than men 27/190 (14.2%), OR 2.46, p=0.006). FRCS pass rates (WUKG vs BMEUKG vs IMG) were 76.9%, 52.9% and 53.9% respectively (p=0.064) but unrelated to gender (M 70.4% vs F 64.3%). On multivariable analyses: ARCPO 3 was associated with Female gender and Maternity Leave (OR 8.05, p=0.001); FRCS pass with ethnicity (OR 0.21, p=0.028) and Hirsch Indices of ≥5 (OR 11.17, p=0.001). Differential attainment was plain with BMEUKG FRCS performance almost a third poorer than WUKG, and women twofold more likely to receive adverse ARCPOs, with return from statutory leave independently associated with training extension. Focused counter measures targeted at non-operative technical skills (including academic reach), Keeping in Touch, Return to Work, and re-induction programmed support are urgently needed for trainees at risk.

Length of Maternity Leave and Breastfeeding Outcomes Among Physicians [A284

INTRODUCTION: Physicians face unique challenges in the postpartum period, including limited maternity leave. We aim to determine the relationship between length of maternity leave and breastfeeding outcomes. METHODS: Physicians who had a singleton pregnancy during the most strenuous time of their career were included in the cross-sectional survey. Questions were adapted from the CDC's Infant Feeding Practices Study and Pregnancy Risk Assessment Monitoring System, along with investigator-developed questions. Surveys were distributed through social-media physician groups and email listservs. Descriptive and bivariate analyses were completed via STATA version 17. RESULTS: Of the 807 responses, 637 were eligible and complete. The most strenuous time identified was during residency (36%). Greater than 30 specialties and subspecialties were represented, and the most common were pediatrics (37%), obstetrics and gynecology (18%), and family medicine (16%). There were associations between medical specialty (P=.006) and birth year (P<.0001) and length of maternity leave. The average maternity leave duration was 10±0.4 weeks. Maternity leave >6 weeks was associated with meeting personal breastfeeding goals compared to ≤6 weeks (80% vs 71%, P=.02). The mean duration of breastfeeding for respondents with ≤6 weeks maternity leave was 15±1.7 months while the mean duration for those with >6 weeks was 17±1.4 months (P=.01). There was a positive correlation between breastfeeding duration and maternity leave (R 2=0.12, P=.01). CONCLUSION: There is a relationship between length of maternity leave and breastfeeding outcomes. Supporting adequate maternity leave for physicians, especially those in training, is important for breastfeeding outcomes.

A Nationwide Cross-Sectional Survey of Anesthesiology Fellowship Program Directors: Attitudes on Parental Leave in Residency and Fellowship Training.

Introduction:Little is known about the impact of parental leave on anesthesiology fellowship directors' perception of their fellows. In addition, use of parental leave during residency can result in “off-cycle” residents applying for a fellowship. This study sought to clarify fellowship directors' attitudes and beliefs on effects of parental leave on fellows and off-cycle fellowship applicants.Methods:An online survey was sent to anesthesiology fellowship program directors through e-mail addresses obtained from websites of the Accreditation Council for Graduate Medical Education and specialty societies. Descriptive statistical analysis was used.Results:In total, 101 fellowship directors (31% response rate) completed the survey. Forty-one (41%) directors had a fellow who took maternity leave in the past 3 years. Among the programs, 49 (49%) have a written policy about maternity leave and 36 (36%) have a written paternity or partner leave policy. Overall, most fellowship directors believed that becoming a parent had no impact on fellow performance and professionalism; more respondents perceived a greater negative impact on scholarly activities, standardized test scores, and procedural volume for female trainees than male trainees. Some fellowship directors (10/94; 11%) reported they do not allow off-cycle residents in their program. Among programs that allow off-cycle residents, more directors perceived it a disadvantage rather than an advantage.Conclusions:Fellowship directors perceive that anesthesiology residents who finish training outside the typical graduation cycle are at a disadvantage for fellowship training.

From Beaming Cancer to Beaming Parent: Paternity Leave Experiences in Radiation Oncology

Although supported by most men and women, paternity leave is heavily underused across industries owing in part to external pressures and inconsistent availability. The goal of this study was to assess the use of paternity leave in radiation oncology (RO) practices and identify any associated barriers. A 36-item survey was distributed via e-mail to 536 male domestic RO attending and resident physicians. Questions assessed paternity leave policies, use, and departmental support. Data were collected using Research Electronic Data Capture from January to February 2021. Descriptive statistics were obtained for analysis, and logistic regression was performed to analyze the association between practice type and presence of policy. The survey response rate was 20% (n = 108), with 98% of participants completing all applicable questions. Respondents included 63 attending physicians (58%) and 45 resident physicians (42%). The median age of all respondents was 35 years. Among all participants, 51 (47%) stated their practice had a formal paternity leave policy. The median time allowed for leave was 4 weeks (range, 0.5 weeks to unlimited), whereas the median time taken was 2 weeks (range, 0.5-12 weeks). Sixteen men felt pressure to take less leave than what was allowed by their policy, and 46% of men stated that in retrospect, they would have taken more time off for paternity leave. To the authors' knowledge, this is the first study to investigate the use of paternity leave in RO practices in the United States. Integrating expanded family leave policies, including specifically allowing for paternity leave and accompanying these policies with cultural changes acknowledging the importance of family leave, would be beneficial to improving quality of life and work-life balance for parents.

Paid Parental Leave and Reconciliation of Childcare and Work in Lithuania

Paid Parental Leave and Reconciliation of Childcare and Work in Lithuania

Development and Impact of a Progressive Parental Leave Policy in a Neurology Residency.

Appropriate parental leave policies remain an unmet need in graduate medical education. Although legal and institutional guidelines allow for policies that support parental leave, there are many challenges and perceived barriers to consider in developing and implementing a successful policy. In 2018, we revised the parental leave policy for our neurology residency. Here we describe the development of our policy, measure its effects, and offer guidelines for other programs to develop a similar approach. We propose solutions to commonly encountered problems, focusing on training and education, staffing of clinical services, evolving legal requirements, resident well-being and equity, and financial support.

Association of Paternity Leave with Impaired Father-Infant Bonding: Findings from a Nationwide Online Survey in Japan.

Although the number of fathers taking childcare leave is increasing, the impact of paternity leave on father–infant bonding remains to be fully investigated. This study aimed to assess the association between paternity leave and father–infant bonding among fathers with children under two years old. A cross-sectional study was performed using data from the Japan COVID-19 and Society Internet Survey study, a nationwide online survey conducted between July and August 2021 (N = 1194). Father–infant bonding was assessed by the Japanese version of the Mother–Infant Bonding Scale (MIBS-J), which comprised two subscales (lack of affection (LA), and anger and rejection (AR)), with a higher score denoting poor bonding. Four hundred (33.5%) fathers self-reported taking childcare leave. Paternity leave was associated with higher total MIBS-J score and AR score after adjusting for covariates (coefficient 0.51; 95% confidence interval (CI) 0.06–0.96, coefficient 0.26; 95% CI 0.03–0.49, respectively), but not with LA score (coefficient 0.10; 95% CI −0.13–0.34). There was no trend in the association between paternity leave and total MIBS-J score by children’s age group (p for trend = 0.98). Paternity leave was associated with impaired bonding, especially with increased anger and rejection, among fathers with children under two years of age.

Mothers in the Military: Effect of Maternity Leave Policy on Take-Up.

This study exploits changes in paid maternity leave offered by one of the United States' largest employers, the Department of Defense, to estimate the effect of such policies on mothers' leave-taking. Since 2015, the U.S. Marine Corps has shifted its maternity leave policy from 6 to 18 to 12 weeks. Leave expansions increased leave duration, whereas contractions decreased leave taken by active-duty service members. However, the policy changes crowded out other forms of leave: with an increase in maternity leave available, mothers increased use of maternity leave and stopped supplementing with additional annual leave. Although all mothers used the full 6 weeks of leave in the early period, it is the less advantaged mothers-those in the enlisted ranks, first-time mothers, and single mothers-who disproportionately used more of the additional leave than officers, experienced mothers, and married mothers. Pregnant officers, experienced mothers, and single women used less leave than nonpregnant women in the months leading up to birth, but expecting additional post-birth leave did not change average pre-birth leave-taking. Our results highlight the importance of optimally sizing family leave policies and provide evidence that the true cost of such programs may be lower than the raw count of weeks provided by additional maternity leave allowances.