The Effects of California's Paid Family Leave Law on Maternal Psychological Distress

Background: The US is the only developed country that does not guarantee a period of paid and job-protected leave for new parents. In 2004, California became the first state to enact a paid family leave (PFL) program, providing up to six weeks of paid leave to new parents. While the labor effects of the program have been extensively researched, its impacts on health have been less studied. Previous literature indicates positive associations between length of leave and postpartum maternal psychological health; California’s PFL may contribute to improvements in maternal postpartum psychological distress by decreasing the stress associated with simultaneously navigating the birth of a child and responsibilities in the workplace.

Methods: We use restricted data from the 2000 to 2012 National Health Interview Survey to conduct new analyses of the effects of the California law on an important health outcome: maternal psychological distress.

Our basic identification strategy leverages a natural experiment to estimate differences-in-differences models, where changes in the outcomes in California, before and after enactment of the PFL program are compared to corresponding changes over time in control states. Analysis of pre-treatment trends indicates potentially different trends pre-law between California and the rest the U.S., which may compromise our identification strategy. We therefore use synthetic control models to construct a “synthetic California,” which is a weighted average of characteristics in other states such that the pre-treatment period is similar to that of California. This synthetic California provides a comparison group that is not compromised by differing pre-treatment trends. We study both average effects of the law, and the impacts in mitigating (or aggravating) disparities by maternal education, marital status, age at birth, and race/ethnicity.

Results: Our difference-in-difference estimates indicate that mothers in California experienced at least a 29 percent reduction in mean psychological distress symptoms after the enactment of paid leave, and they were 7.5 percentage points less likely to experience mild forms of psychological distress as measured by a cut-off. These results are robust to a variety of specifications. The estimated effects are most pronounced for black, single, and low-income mothers, populations who traditionally have had less access to paid family leave. Our synthetic control models have not yet completed the disclosure process required to release restricted data, but they will be available for presentation and discussion at the conference.

Conclusions: These findings provide new information on whether publicly mandated work-family policies, such as PFL, promote maternal health and address maternal health disparities, and contribute to enhancing our understanding of the extent to which work-family policies improve population health and health equity.