Assessing the Optimal Length of Parental Leave for Child and Parental Well-Being

10.1177/0192513X04270344JOURNAL OF FAMILY ISSUES / March 2005Galtry, Callister / ASSESSING PARENTAL LEAVE

Assessing the Optimal Lengthof Parental Leave for Child

and Parental Well-BeingHow Can Research Inform Policy?

Judith GaltryPaul Callister

Victoria University

Parental leave is a complex area of public policy. Concerns include health protection forworking mothers, equal employment opportunities for women, access to adequate antenataland birthing care, maternal recovery, optimal nutrition for infants, and gender equality withinfamilies. Given this complexity, the design of parental leave schemes, including the optimallength of leave, should ideally be based on research from a wide range of disciplines. Yet re-search literature generally focuses on single issues. In this article, the focus is widened to en-compass mothers’ labor market outcomes, concerns surrounding childbirth and maternal re-covery, parent-infant bonding, children’s cognitive development, breastfeeding, andassociated with each of these, gender equity objectives. In light of information from a widerange of disciplines and based on two country models, Sweden and the United States, it isproposed that discussions about parental leave policy, including the appropriate length ofleave, should take a broad, interdisciplinary perspective.

Keywords: parental leave; health; labor markets; gender equality

Parental leave is a particularly complex and contentious area of publicpolicy (International Labour Organization, 1997; Kamerman, 2000; Moss& Deven, 1999; OECD, 1995). Concerns include health protection forworking mothers, equal opportunities for women workers, gender equityin the home, access to adequate antenatal and birthing care, and also the is-sue of payment, including who pays and how much (Heitlinger, 1993). Pa-rental leave policy is relevant not only to parents and children but also toemployers, co-workers, and the wider society. Given all these interestgroups, as well as the multiple and sometimes conflicting goals behind

219

JOURNAL OF FAMILY ISSUES, Vol. 26 No. 2, March 2005 219-246DOI: 10.1177/0192513X04270344© 2005 Sage Publications

Authors’ Note: This study was supported by a grant from the Alfred P. Sloan Foundationwhile the authors were working at the Cornell Employment and Family Careers Institute,Cornell University, N.Y. We would like to thank Professor Phyllis Moen for her support.

various parental/maternity leave policies, it is perhaps not surprising thatviews about parental leave are widely divergent.

Due to the complexity of parental leave discussions, research often fo-cuses on only one aspect of leave. For instance, in the labor market litera-ture, there is concern about how “time out” might affect earnings formothers, with the implications for parent-infant bonding and attachmentreceiving little attention. In the health arena, consideration is given to theoptimal length of leave necessary for both recovery from childbirth andbreastfeeding, but the potential effects of leave policies on gender equitygoals are not at the forefront of concerns. This article attempts to crosssome of these disciplinary boundaries so that individual parents, profes-sionals advising families, and those designing family policy might bettergauge the optimal period of parental leave. Although some of the issuescovered in this article are also relevant to adoption, the main focus is onleave associated with biological parenthood.

This review examines concerns associated with parental leave. Theseinclude labor market outcomes with particular relevance to women, child-birth and maternal recovery, parent-infant bonding, children’s cognitivedevelopment, and breastfeeding. With these issues in mind, two very dif-ferent models of leave—that of the United States and of Sweden—arethen explored. In the United States, at the federal level only 3 months ofunpaid leave are available under the 1993 Family and Medical Leave Act(FMLA), and eligibility criteria are restrictive, ruling out many contingentworkers. By contrast, Sweden provides 480 days of paid parental leavewith almost universal eligibility. However, it is also recognized that withinparticular countries, individual families will inevitably have their own setsof preferences and constraints, regardless of statutory provisions forleave. At this level also, then, decisions about the optimal length of leaveare likely to be multifaceted and complex.

In undertaking this review, there is awareness that factors other thanthose listed influence the optimal duration of leave. In particular, the na-ture, availability, and quality of early childhood education and care provi-sions that might be seen in many situations as an alternative to taking pa-rental leave are significant factors in determining the best possible lengthof leave. However, while important, the issue of the effects of child care isextremely complex and should be the subject of a separate discussion(Galtry, 2002; McGovern, Gjerdingen, & Froberg, 1992).

Finally, whereas researchers generally hope that policy will be basedon up-to-date, high-quality research, in reality, research often has little di-rect influence on policy making (e.g., Shulock, 1999). Policymaking is ahighly complex process, often involving a mix of personal views, popular

220 JOURNAL OF FAMILY ISSUES / March 2005

discourse, political bargaining, and the weighing of finite taxpayer re-sources against uncertain policy outcomes. As an example of this, theUnited States’ 1993 FMLA involved major trade-offs to secure the sup-port of both Democrats and moderate Republicans. However, even thoughsuch trade-offs are inevitable, researchers still have a responsibility to tryto identify “best practice” with the hope of better informing future debatesaround parental leave policy. This is ultimately the aim of this article.

PARENTAL LEAVE, LABOR MARKETOUTCOMES, AND HOUSEHOLD INCOME

If a mother leaves employment during pregnancy or after the birth of achild, she potentially faces some or all of the following costs:

• loss of earnings while not employed• loss of on-the-job training opportunities• depreciation of skills and experience and, at times, loss of confidence about

participating in paid work• costs associated with signaling a lack of commitment to employers• reinforcement of traditional roles and responsibilities if, in two-parent, het-

erosexual families, the mother leaves paid work and the father takes overthe role of sole “breadwinner”1

Parents potentially confront these costs whether or not they have theright to return to their job. However, some of the costs outlined above aremore applicable to individuals in career-type occupations rather than tothose in “dead-end” jobs. For example, some jobs have little or no on-the-job training, and employers may not necessarily expect contingent work-ers to have high levels of commitment. By contrast, for managers and pro-fessionals, signaling high commitment and loyalty to the company may bevery important.

If those parents taking “time out” do not have a guaranteed right to jobprotection, they potentially face further costs. These include the costs ofjob searches and possible unintended unemployment when wishing to re-enter the labor force and loss of work-related benefits, such as subsidizedhealth care, retirement income, and length of service-related benefits.

The costs of undertaking unpaid caring work are well-documented(e.g., Folbre, 1994, 2001; Institute for Women’s Policy Research, 2000;National Alliance for Caregiving and National Center on Women and Ag-ing, 1999; Wisensale, 2001). However, these costs tend to vary betweencountries. In those nations with well-developed and publicly funded

Galtry, Callister / ASSESSING PARENTAL LEAVE 221

health care systems, such as Sweden, a period of time out from employ-ment will not reduce access to health care in the same way that it oftendoes in the United States. Nor will loss of household income be as great inthose countries that have paid parental leave. Whereas it is difficult to de-termine any causal relationship between the generosity of parental leaveschemes and the length of leave taken, certainly in the United States thelack of taxpayer-funded payment is associated with the uptake of rela-tively short leaves. In Sweden in 1995, 98% of mothers and 18% of fatherstook 60 or more days of parental leave (Swedish National Social Insur-ance Board, 2001).2 In contrast, in the United States when asked aboutlength of longest leave by reason for leave, only 29% of respondents to theDepartment of Labor’s 2000 FMLA survey reported taking more than 60days for maternity or disability leave, whereas 10% reported taking a sim-ilar period of leave to care for a newborn, adopted, or foster child (U.S.Department of Labor, 2000). This research also suggests that manyAmerican parents would take more leave if they received financialsupport.

Even in countries where leave is paid, there is some concern that long-term earnings are potentially reduced if leave periods are extended. Thereis a wide range of international literature quantifying the long-term costsof time out of paid work, particularly for women. Much of this researchdraws either directly or indirectly on human capital theory. Central tothese understandings is the concept that tenure in paid work has a majorimpact on earnings. Examples of links between time spent in work andearnings have been found in a number of countries. For example, in theUnited States Shapiro and Mott (1994) found that wage premiums aresubstantially higher for women who are strongly attached to the laborforce than for those with relatively weak labor market links. Using Britishlongitudinal data, Waldfogel (1995) found a large wage premium associ-ated with the use of maternity leave and return to work relative to quittingwork. This finding is supported by subsequent research in both Britainand the United States (Joshi, Paci, & Waldfogel, 1999; Waldfogel, 1998).

Ruhm (1998a), analyzing the economic consequences of paid parentalleave in nine European countries between 1969 and 1993, notes that pa-rental leave is associated with increases in women’s employment but re-ductions in women’s relative wages in those contexts where long-termleaves are common. In Sweden, Stafford and Sundström (1994) also mea-sured the effects of time out of the labor force because of the birth of achild. They suggest that although there are significant costs associatedwith taking time out of paid work in Sweden, long-term earnings tend torecover. They also found that the costs were particularly high for men. Ac-


cording to Stafford and Sundström, some of the costs of time out of theworkforce for men are attributable to “signaling” effects, namely, the per-ception that such men are less committed to their careers. They also ob-serve that in the United States there is a particularly high career cost asso-ciated with time out to care for children. One explanation might be that incountries with a high level of income inequality, such as the United States,a period of time out of the workplace can be particularly expensive if,through signaling lowered commitment, it serves to slow promotion (Bell& Freeman, 2001). It is also likely that social norms play a role in deter-mining the cost of time out of paid work. But social norms do not neces-sarily operate independently of economic incentives. Sweden is an exam-ple of a country in which there is strong financial reinforcement forparents to take time out following childbirth.

Although research establishes that a long-term attachment to the laborforce offers significant advantages for many workers in terms of lifetimeearnings, this does not mean that taking a period of leave inevitably harmslabor market prospects. There is clearly much variation in the effects onvarious groups and individuals of taking time out of paid work. These ef-fects are dependent on factors such as levels of formal education, priorwork experience and employment patterns following the birth of a child,occupational status, length of leave, the number of leaves taken over a lifecycle, and employer attitudes. For parents with a pattern of intermittent at-tachment to the labor market, the costs of additional time out in terms ofincome growth are likely to be relatively low, even nil. The behavior of aparent following the period of leave can be just as important as the lengthof leave taken. For example, after a short period of leave, a full-timeworker may undertake reduced weekly hours of paid work. This couldhave a greater effect on his or her long-term earnings than taking a longerperiod of leave followed by a return to full-time employment. The benefitsof remaining “attached” to one employer also depend on the state of the la-bor market. In a period of full employment, re-entry into paid work maybe relatively easy for some groups of workers. In addition, the cost of timeout to mothers is not only dependent on their own behavior, but it is alsodetermined by the behavior of both women and men who take no leavearound childbirth and of individuals without children. Below-replacementfertility rates in most industrialized countries indicate that a significantproportion of women (and men) are no longer having children.

In Nordic countries, there has been much emphasis on encouraging fa-thers to increase their uptake of parental leave. These efforts recognize theadvantages to both children and fathers themselves of the latter’s involve-ment in child rearing, the potential costs to women associated with their


disproportionate uptake of leave, and the right, and indeed the responsibil-ity, of men to be fully involved fathers (Carlsen, 1998; European Commis-sion, 1994). In Sweden, encouraging men to take leave has been shown tohave direct positive effects for women. For instance, Haas and Hwang(1999) report that mothers experience less of a decline in income fromprechildbirth levels if their partners take a greater-than-average share offamily leave entitlement.

Finally, although not generally discussed in the parental leave litera-ture, the number of times an individual takes leave may be just as impor-tant as the length of each leave. For example, the effect on a parent’s careerof taking a 12-month leave period for one child may be far less than a par-ent of four children taking four periods of 6 months’ leave.

In a review of the labor market literature, Blau, Ferber, and Winkler(2001) conclude that if parents demonstrate a strong labor market attach-ment prior to having children, a relatively short leave with a return to thesame employer and to the same work pattern is likely to result in low ornegligible lifetime earning costs. Generally, a short leave is determined tobe around 3 months and a long leave 9 months or more (Ruhm, 1998a).Where individuals already exhibit a weak attachment to the labor force,additional time out is likely to have little impact on their income growth.By contrast, if there is no paid leave available, the actual loss of incomewhile out of the labor force is very important for this group (Callister,2002). Payment potentially allows a much larger group to take time out ofwork and to use longer periods of leave. It also signifies recognition by so-ciety that some parents might underinvest in leave if relying on their ownfinancial resources. Therefore, in those situations where parents are to-tally dependent on their own financial means, the optimal length of paren-tal leave may be quite different than what appears to be “best practice”based on medical and other research.

PREGNANCY, CHILDBIRTH,AND MATERNAL RECOVERY

A number of researchers have tried to estimate the optimal time out ofwork around pregnancy and childbirth from the perspective of maternalhealth. In terms of the prebirth period, if an employee’s occupational envi-ronment is potentially hazardous, she may need to be transferred to an-other job within the same firm or, if this is not possible, take a period ofleave for her entire pregnancy. There are also certain medical conditionsthat require that women rest during various stages of pregnancy. More-


over, there is a high prevalence of musculoskeletal complaints amongpregnant workers that are potentially exacerbated by heavy physicalworkloads (Treffers, 2000). Many workers, particularly those in non-manual occupations, are nevertheless able to continue working during thelater stages of pregnancy.

In some settings, leave taken prior to childbirth may reduce the amountof leave time available in the postnatal period. This potentially disadvan-tages those employees whose occupations and job conditions pose diffi-culties to working throughout most of the pregnancy, but who neverthe-less wish to take a period of postnatal leave to spend time with theirnewborn.

In the postbirth period, the length of time required for optimal recoveryfrom childbirth also depends on a range of factors. These include the birthexperience as well as a host of other emotional, physiological, andsociocultural factors. For instance, maternal recovery is usually longer forwomen who have given birth by cesarean section. The United States hashigh rates of cesarean section births relative to many other countries(Gerrard, 2001). In private hospitals in America, the cesarean section rateis about 40%, compared to 25% in the public sector. By contrast, nearly20% of births in the United Kingdom are by cesarean section.3

Research undertaken in the United States also shows that a period ofleave following childbirth substantially assists mothers’ physical andmental well-being (Gjerdingen, Froberg, & Kochevar, 1991; McGovern et al.,1997). The McGovern et al. (1997) study found that longer maternityleaves were associated with improved health after childbirth, although ef-fects were nonlinear. Women taking leaves of 12, 15, and 20 weeks ormore duration after childbirth reported greater vitality (>12 weeks), bettermental health (>15 weeks), and fewer limitations to their daily roles (>20weeks).

In a review of the effect of parental leave on maternal physical andmental heath, Lero (2003) discusses how a wide range of factors influencethe optimal length of leave. While Tulman and Fawcett (1991) have esti-mated that full recovery from childbirth can take up to 6 months or longer,other researchers note the effect of duration is also influenced by factorssuch as spousal and community support, marital concerns, the overallhealth of the mother, and infant temperament (Clark, Hyde, Essex &Klein, 1997; McKim, Cramer, Stuart, & O’Connor, 1999; Weinraub &Jaeger, 1991).

With regard to leave duration and maternal mental health, Lero (2003)observes that it may not be involvement in employment or staying at homethat is important but rather role quality, that is, the fit between a mother’s


actual and preferred role. Women who stay at home for extended periodsbut are concerned about role restrictions are at risk of depression.

Finally, the benefits of time out of work to undertake a period of breast-feeding have traditionally been viewed, at least in many industrializedcountries, as primarily accruing to the child (see next section). There is in-creasing evidence, however, of physiological and emotional benefits tomothers associated with breastfeeding. These include possible protectiveeffects against breast cancer in premenopausal women (Newcomb et al.,1994), ovarian cancer (Gwinn, Lee, Rhodes, Layde, & Rubin, 1990;Hartge et al., 1989), and osteoporosis (Blaauw et al., 1994). One studyalso suggests that women who have been breastfed as infants have lesschance of developing breast cancer in later life (Freudenheim et al., 1994).In relation to paid employment, both mothers and fathers or other partnersmay benefit from a breastfed child, as there is some indication that breast-fed babies are less likely to become ill and thus be excluded from childcare (Jones & Matheny, 1993). It is, however, difficult to determine fromthese studies the optimal duration of breastfeeding, including whether it isexclusive or partial, in terms of providing these benefits to mothers. Re-cent research on the association between breastfeeding and breast cancernevertheless concludes that longer breastfeeding duration is strongly as-sociated with reduced risk of breast cancer, having implications forwomen in developed countries, such as the United States (CollaborativeGroup on Hormonal Factors in Breast Cancer, 2002). Breastfeeding alsooffers mothers a range of other less easily quantifiable advantages in termsof their own well-being and self-esteem, as well as enhanced bondingwith their offspring (Labbok, 2001).

Overall, the literature on pregnancy, childbirth, and maternal recoverysuggests that optimal leave duration will vary according to a wide range offactors, including the relative ease or difficulty of the individual’s preg-nancy and childbirth. However, there is some indication that the optimallength of leave is likely to be in the order of months rather than weeks ordays, particularly postbirth.

PARENTAL LEAVE AND CHILD HEALTH

FETAL AND NEWBORN HEALTH

A period of time out of the workplace or a transfer to lighter work hasbeen shown in some studies to reduce the risk of having a preterm or lowbirthweight infant, particularly among employees with heavy workloads


(Treffers, 2000). In a review of maternity protection in both developed anddeveloping countries, Treffers (2000) notes that whereas it is difficult todraw any definitive conclusion about the relationship between workingconditions and preterm birth, the potential consequences of prematurity(especially before 33 weeks) poses “such a considerable risk to the infantthat any excess of pre-term birth caused by working conditions should beprevented, if possible, by adequate measures” (p. 2). Moreover, researchshows an association between an individual’s birthweight and his or hersubsequent risk of ischemic heart disease, hypertension, and diabetesmellitus (Barker, 1994). In the United States, low birthweight is also theprimary cause of neonatal morbidity and mortality (Stevens-Simon &Orleans, 1999).

One study that has examined parental leave entitlements specifically inrelation to child health is Ruhm’s (2000b) analysis of 16 European nationsin the period between 1969 and 1994. Focusing on the postbirth periodfrom the 28th day after birth through the 1st year, Ruhm found thatpostnatal parental leave entitlements have a substantial effect in reducinginfant mortality during early childhood. He attributed this, in large part, tothe additional time afforded by leave for parents to invest in their infants.Ruhm concluded that “parental leave may be a cost-effective method ofbettering child health” and that parental time is “an important input intothe well-being of children” (p. 933). However, it is difficult in such studiesto isolate a single factor such as parental leave entitlements from the widersocial context, including support for public health programs.

BREASTFEEDING

In recent years, research has increasingly focused on the relationshipbetween maternal employment and breastfeeding practice (e.g., Auer-bach & Guss, 1984; Gielen, Faden, O’Campo, Hendricks-Brown, &Paige, 1991; Kearney & Cronenwett, 1991; Lindberg, 1996; Roe, Whit-tington, Fein, & Teisl, 1999; Visness & Kennedy, 1997). This includes afocus on the gender equity implications for both child-rearing practicesand women’s labor market participation and economic outcomes (Galtry,1997, 2000). There are compelling biomedical and, more controversially,economic rationales for including breastfeeding as an essential part of anystudy on the development, design, and duration of parental leave policies(American Academy of Pediatrics, 1997; Weimer, 2001). These includethe association found between breastfeeding and enhanced cognitive de-velopment among infants (e.g., Angelsen, Vik, Jacobsen, & Bakketeig,2001; Horwood & Ferguson, 1998; Morley, Cole, Powell & Lucas, 1988).


International recommendations now advise 6 months of exclusivebreastfeeding (i.e., breastmilk without any additional fluid or food), withcontinued breastfeeding up to 2 years of age and beyond (World HealthOrganization, 2002). The American Academy of Pediatrics (1997) simi-larly recommends 6 months exclusive breastfeeding with continuedbreastfeeding for at least 1 year. Research also indicates that breastfeedingaffords protection against certain illnesses in a dose-responsive manner,even within developed countries (Scariati, Grummer-Strawn, & Fein,1997). Analyzing longitudinal data to determine if breastfeeding protectsU.S. infants from developing diarrhea and ear infections, Scariati et al.(1997) found that the more breastmilk an infant receives in the first 6months of life, the less likely he or she is to develop either of these condi-tions. Breastfeeding is nevertheless a time-intensive practice, particularlywhen it is exclusive (Auerbach, 1999; UNICEF, 1998).

A number of studies show an association between the duration of timeoff work and breastfeeding duration (Bick, MacArthur & Lancashire,1998; Lindberg, 1996; Roe et al., 1999; Visness & Kennedy, 1997). Therealso appears to be an association between the timing of return to work, thenumber of hours worked, and the effect on breastfeeding (Fein & Roe,1998). For instance, in a survey of women who planned to return to workwithin 12 months of giving birth, Roe et al. (1999) found that there wascompetition between breastfeeding and employment, with the greatestdecrease in breastfeeding duration occurring when employment was re-sumed in the first 12 weeks after birth. It was observed that each additionalweek of leave from work increased breastfeeding duration by almost halfa week. Moreover, women who worked full-time (more than 34 hours aweek) within 3 months of birth were most likely to stop breastfeeding.Roe et al. also observed an increase in breastfeeding frequency associatedwith time out of work, a finding that has implications for exclusivebreastfeeding practice.

In a nationally representative sample of new mothers, Ryan and Marti-nez (1989) compared the incidence and duration of breastfeeding amongAmerican mothers employed full-time outside the home with those not inpaid employment. They found that whereas the same proportion ofwomen in both groups (55%) initiated breastfeeding, those returning tofull-time paid work were less likely to be breastfeeding their babies at 6months. Only 10% of mothers in full-time paid employment breastfedtheir babies at 6 months of age compared with 24% of those not in paidemployment. Lindberg (1996) observed that conflicts between breast-feeding and employment vary according to the intensity of the work withsignificantly more mothers employed on a part-time basis likely to breast-


feed and for longer periods than those in full-time work. Lindberg alsofound that women are more likely to stop breastfeeding in the month theyenter employment, suggesting that these behaviors constrain each other.She concluded that for women to achieve the recommended 6 months ofbreastfeeding would require maternity leaves of at least 6 months.

In his 16-country study, Ruhm (2000b) observed that whereas there is arange of mechanisms by which parental leave may benefit child health,generous maternity/parental leave policies may mean that women breast-feed their offspring for longer periods. According to Ruhm, although it isdifficult to establish the exact effect of breastfeeding, based on previousstudies “a reasonable guess is that a substantial parental leave entitlementmight increase breastfeeding sufficiently to prevent 0.5 to 1.0postneonatal deaths per 1000 live births” (p. 952).

For mothers who wish to resume employment soon after childbirth orfor those in countries without generous and widely accessible periods ofleave, one alternative to taking a long period of leave to breastfeed is to ex-press breastmilk (either by hand or breastpump) in the workplace. Fre-quent feeding or expression is critical for ensuring milk production; if amother is unable to breastfeed or express/pump milk regularly, her supplywill gradually diminish, often resulting in early termination of breastfeed-ing (Auerbach, 1999). If she has access to lactation breaks and facilities inthe workplace, the mother may be able to resume employment and expressand/or pump milk with relative ease. This may also represent a gender eq-uity strategy for many families not only by enabling breastfeeding moth-ers to return to work earlier but also by introducing the possibility of fa-thers and other partners taking leave to bond with their infants. It isnoteworthy that there is no established body of research on the effective-ness of breastmilk expression as a long-term strategy, including forexclusive breastfeeding.

In general, the sooner a woman returns to work following childbirth,the more frequently she will need to express milk. This is because it takesseveral weeks for a good milk supply to become established. For instance,a study examining the experiences of American mothers found thatwomen who return to paid employment after 16 weeks “often may have awell-established milk supply, and may have successfully negotiated oneor more transient breastfeeding crises, thereby minimizing the potentiallynegative effects that employment can have on breastfeeding” (Auerbach& Guss, 1984, p. 960).4

From the perspective of breastfeeding then, it would appear that the op-timal length of postbirth maternity leave is at least 6 months. This, in com-bination with workplace nursing breaks and facilities for 12 months,


would greatly facilitate the time-intensive practice of exclusive breast-feeding, as well as providing minimum enabling conditions for employedmothers to continue breastfeeding according to best practice recommen-dations. A 1-year cap on breastfeeding breaks would also go some way toreassuring employers that the need for breastfeeding support in the work-place is not an open-ended measure. However, provided that good sup-ports are in place for breastfeeding/expressing milk in the workplace,postbirth maternity leave provisions of around 16 weeks, as identified byAuerbach & Guss’s (1984) study, may be sufficient to support optimalbreastfeeding practice. As yet, there is little evidence of workplace lacta-tion support being widely available in the United States. Thus, whereassome individuals, particularly those with strong negotiating power withtheir employers, may successfully integrate breastfeeding and paid workunder the current policy scenario, the design of optimal parental leavepolicy needs to take into account those workers with little negotiatingpower.

PARENTAL LEAVE AND PARENT-CHILD BONDING

For both mothers and fathers, one of the benefits of having a period oftime off work after the birth of a child is the increased potential for infant-parent bonding. Although the term “bonding” is often used interchange-ably with “attachment,” bonding generally refers to the newborn period,whereas attachment refers to a longer period of infancy. In an influentialbut subsequently much contested study, Bowlby (1952) studied childrenconfined to institutions. Bowlby found that in many cases, these infantsdisplayed inadequate emotional and personality development. He attrib-uted this, controversially, to “maternal deprivation.” Similarly, Ainsworth(1967) claimed an association between the security of infant attachmentand aspects of maternal care giving. Based on research in Uganda andlater in Baltimore, Maryland, Ainsworth observed that distinct patterns ofattachment evolve between infants and their mothers in the early years oflife. She suggested that the nature of the maternal-infant relationship re-lated to the level of responsiveness demonstrated by the mother to hernewborn. According to Ainsworth, those mothers who responded morequickly to their infants’ cries at 3 months were more likely to havedeveloped secure maternal-child attachments by 1 year.

In the 1970s, Klaus and Kennell suggested that a “sensitive period” ex-isted during the first few hours of life. The baby’s emotional developmentwas seen as heavily reliant on close emotional contact with the mother,


and the bonding process was often related to the mother’s hormonal pro-cesses (Klaus & Kennell, 1976). However, studies that linked child devel-opment and well-being primarily to the immediate postbirth period and/orto the mother’s presence came to be seen as increasingly controversial bychild development researchers. Among this group were those who wishedto assert the importance of both biological parents to the child’s develop-ment, as well as those who felt that previous research had often been moti-vated by, and had resulted in, a form of mother blame. Other researcherspointed out that whereas the prevailing perception of “good development”predicated on mother-child inseparability had come to be regarded as auniversal, ahistorical truth, it failed to take into account the specificities ofdiverse family types and employment arrangements. For instance, Lamb(1976) argued that fathers had been neglected, historically, in child devel-opment and attachment studies. In addition, many feminist writers criti-cized earlier accounts for the way in which they made many mothers feelguilty, in particular those who had not had the opportunity to bond or hadnot bonded with their offspring in the manner prescribed by the “experts”(see Hrdy, 1999).

Later research generally emphasized the importance of viewing bond-ing more as a complex and enduring process “influenced by the parents’perceptions of their infant, the reward value of the interactions, and evensocial and economic situations that may or may not complicate the par-ents’ lives” (Harris, 1993, p. 294). This was accompanied by the growingrealization that parent-child attachments do not always occur immediatelyat birth but are more likely to be part of a gradually evolving and enduringprocess that is mutually influenced through “a process of familiarizationand reciprocal interactions” (Harris, 1993, p. 293).

Despite a greater focus on bonding than on issues of child health moregenerally in the parental leave research literature (McGovern et al., 1992),research on child development offers little guidance regarding the exacttime required to make such a bond. However, in contrast to many otherfields, such as those concerning health and labor markets, where delibera-tions about the effects on women and children of different policies andpractices are more confined within specific disciplinary boundaries, dis-cussions about bonding have become part of popular discourse in recentyears. Concerns surrounding appropriate bonding times are thus the sub-ject of much public and often highly charged debate. Moreover, bondingis a far more difficult phenomenon to test empirically than, for instance,the effects of lost wages related to time out of work or infant mortalityrates.


PARENTAL LEAVE AND CHILDREN’SCOGNITIVE DEVELOPMENT

It is more difficult to assess the psychological benefits than the poten-tial physiological benefits to children of parents taking leave. There is alarge amount of controversial and generally inconclusive historical litera-ture on the effects of mothers’employment on child development, includ-ing on cognitive development (see Hoffman, Youngblade, Coley, Fuligni,& Kovacs, 1999). Not surprisingly, debate continues about family-workfactors that potentially influence the cognitive development of young chil-dren (e.g., Ruhm, 2000a; Han, Waldfogel, & Brooks-Gunn, 2001). Thisincludes discussion of the effects of the mother’s and, to a lesser extent,the father’s employment in the early years of a child’s life. Ruhm (2000a),as well as Han et al. (2001), found that maternal employment early in thechild’s life adversely affects his or her cognitive development. Using U.S.National Longitudinal Survey of Youth data, Ruhm (2000a) noted thatmaternal labor market involvement during the first 3 years of the child’slife “is predicted to have a small negative effect on the verbal ability of 3and 4 year olds and a substantial detrimental impact on the reading andmath achievement of 5 and 6 year olds” (p. 1). The mother’s employmentduring the 2nd and 3rd years of the child’s life also appears to “have lessfavorable or more deleterious consequences when the mother is also em-ployed in the first year.” Ruhm further observed that “paternal and mater-nal employment have qualitatively similar effects, hinting at the impor-tance of time investments by fathers” (Ibid). Han et al. suggest, however,that the father’s full-time presence in the home, if due to unemployment,negatively affects the infant’s cognitive development. Note that unem-ployment, an often involuntary situation, needs to be distinguished from aperiod of job-protected leave, where the father is generally making anactive decision to be at home with the child.

PARENTAL LEAVE, GENDEREQUITY, AND CHILD WELL-BEING:

THE UNITED STATES AND NORDIC MODELS

As shown, taking a long period of maternity/parental leave is poten-tially detrimental to new parents in terms of their employment and eco-nomic outcomes. This is especially relevant to women, given that in allcountries, they take the majority of leave following childbirth (Interna-tional Labour Organization, 1997). The labor market literature suggests


that a relatively short period of paid leave with a guarantee of job reinstate-ment is preferable in terms of women’s economic and employment inter-ests. Aside from lack of payment, the United States model of a short leaveperiod appears to fit this model.

Whereas leave policies vary among different states, at the federal levelonly 3 months of unpaid leave is available under the 1993 FMLA. More-over, due to strict eligibility criteria, many parents are not covered by theFMLA (Callister, 2002). As of the end of 2002, the United States was,along with Australia, one of only two industrialized countries withoutpaid leave.

Despite its apparent fit with research supporting a short period of leavefor women’s economic well-being, 12 weeks does not appear to be suffi-cient either to protect children’s health or, in many cases, to promote opti-mal maternal well-being following childbirth. Although welfare provi-sion is not the specific subject of this article, sociocultural ideologiesabout appropriate leave periods and parental time input for newborns andinfants are also likely to have implications for welfare measures. For in-stance, in 1996, 3 years after the FMLA’s enactment, the United StatesCongress enacted the Personal Responsibility and Work OpportunitiesReconciliation Act. This legislation requires that low-income mothersseek and accept employment from the time their babies are 3 months ofage, with only 12 states, as of 2000, exempting them from any work obli-gation until the infant’s first birthday (Kamerman, 2000). This periodmatches the 12-week leave period provided under the FMLA, although incontrast to these welfare provisions, family and medical leave under theact is unpaid.

Although the FMLA includes leave provision to care for dependentsother than children (such as the elderly)—which renders it unique and ar-guably progressive in international terms (Hattiangadi, 2000)—it is pre-mised on a narrow medical/disability model. This has important implica-tions for the way in which children’s well-being is addressed. The fact thatfamily leave is broader in its scope than most comparable countries’paren-tal leave schema, including an intergenerational component (Wisensale,2001)5, means that separating out specific provisions for re-assessmentand possible redesign becomes potentially more difficult. This includesdetermining the appropriate length of leave to cover the childbearing andearly child-rearing period. This broad-based and uniquely American ap-proach, although at face value more inclusive and potentially less discrim-inatory than some other countries’ leave schemes (particularly thosewhich provide only general-specific maternity leave), also reflects and re-inforces a lack of prioritization of children’s well-being in United States’


family-work policy development (e.g., Kamerman & Kahn, 1991; Skocpol,2000).

The differences, for example, between parental leave schema in theNordic countries and the United States are not only material (i.e., theFMLA’s provisions are brief, unpaid, and subject to restrictive eligibilitycriteria, whereas the former are universal, longer, and paid), they are alsogrounded in significant ideological differences. Most important, perhaps,the child is firmly at the center of the Scandinavian welfare state and itspolicy development (Esping-Andersen, 1996). Accordingly, children’swell-being is viewed as a public responsibility in which society is pre-pared to invest. Generous parental leave provisions in terms of accessibil-ity, length, and payment, such as those exhibited in Norway, Sweden, andto a lesser extent, Denmark, are seen as fundamental to this “social invest-ment” objective. For instance, in Sweden, whereas an extended period ofjob-protected paid parental leave was introduced in 1974, provision forjob-protected maternity leave was introduced as early as the 1930s, fol-lowed by paid maternity leave in the 1950s (Haas, 1992; Moen, 1989;OECD, 1995; Sundström, 1991).

Currently, under Sweden’s parental insurance scheme, which insuresfor income loss resulting from the care of infants, parents are entitled topaid parental leave for 480 days (as of January 2002).6 Three hundredninety days are paid at 80% of previous earnings, and the remainingmonths are paid at a standard, flat rate. Two months are reserved for eachparent—the “pappa” month and the “mamma” month—and cannot betransferred.

Sweden is an example of a country that has invested heavily in publicsupport of programs designed to improve children’s well-being, andclearly, parental leave policies are only one part of this investment strat-egy. Other features of the Swedish system include comprehensive healthprograms and high-quality, widely accessible early childhood educationand care provisions. Overall, this social investment approach appears tohave paid off. As evidence of this, Sweden has exemplary infant healthstatistics, including the lowest infant mortality rate among OECD coun-tries (OECD, 1999).7 While cautioning that no simple correlation can bemade between the two, Ruhm (1998b) noted that Sweden, which had themost generous parental leave policies of the nine Western European coun-tries studied in this analysis8—Denmark, Finland, France, Greece, Ire-land, Italy, Norway, the Federal Republic of Germany, and Sweden—hadthe fewest infant deaths—4.3 per 1,000 live births. Regarding the associa-tion observed by Ruhm between children’s well-being and parental time


available to invest in them, including through breastfeeding, it is also note-worthy that Sweden has high breastfeeding rates (including exclusivebreastfeeding rates at 6 months) relative to most other industrialized coun-tries (see Swedish National Board of Health and Welfare, 2000).9 In con-trast, the United States has a relatively low breastfeeding rate, with itsrates at 6 months identified as a particular cause for concern, especiallyamong African American women (U.S. Department of Health and HumanServices, 2000).10 Whereas breastfeeding practice is heavily influencedby wider sociocultural factors (Dettwyler, 1995; Greiner, 1990), it is nev-ertheless likely that these best practice recommendations for 6 months ofexclusive breastfeeding, as well as the desire in many cases to continuebreastfeeding, pose contradictory pressures for many new mothers in theUnited States (Galtry, 1997, 2001).

In contrast, then, to the United States model, Swedish parental leaveprovisions have been developed with both children’s welfare and genderequity goals in mind (Haas & Hwang, 1999). For instance, the 1995Swedish governmental report on equality, Shared Power and Responsibil-ity, notes that Sweden’s parental insurance scheme is predicated not onlyon the objective of gender equality in both the labor market and home butalso on the acceptance that both parents have rights and obligations in re-lation to their children (Swedish Ministry of Health and Social Affairs,1995).11 Sweden thus provides a substantial period of paid, gender-neutralparental leave through its social insurance scheme. This statutory entitle-ment offers mothers the opportunity to breastfeed their infants exclusivelyin the early months after birth, with nearly all mothers doing so, while stillretaining their attachment to the labor market (Galtry, 2001). However,Swedish leave policy has an inbuilt equity component that also offers theoption of other work-family integrating configurations. More specifically,in two-parent families both parents have the opportunity to spend time, al-though not concurrently, with their infants. Moreover, policies have alsobeen instituted to hasten gender equity by encouraging fathers to take aperiod of leave through the introduction and implementation in 1995 of anontransferable paid “pappa month” (Haas & Hwang, 1999; Sundström& Duvander, 1999), with an additional pappa month introduced in early2002.12

But how do the Nordic countries, Sweden in particular, fare in terms ofactual progress toward gender equity, particularly with regard to womenand men’s employment and respective use of parental leave? Signifi-cantly, even in these countries it is still primarily mothers who take the ma-jority of parental leave (Moen & Forest, 1999). Nearly all Swedish moth-


ers access paid parental leave, taking on average 11 months of parentalleave (Haas & Hwang, 1999).13 Rønsen and Sundström (1996) report thatat 6 months after the birth, about one tenth of Swedish mothers had re-sumed employment; at 1 year, approximately 50% were back at work, andat 18 months after the birth, about 60% were back on the job. By the timethe child was 3 years old, just over 80% of Swedish mothers had resumedactive employment.

Despite the fact that women take the majority of leave, Sweden has thehighest proportion of men taking parental leave among industrializedcountries. The nontransferable pappa month has affected the parental al-lowance days used by men. For instance, for those children born in 1993or 1994, prior to the pappa month’s introduction, half the fathers did notuse the allowance (Swedish National Social Insurance Board, 2001). Bycontrast, in 1995, only 23% of fathers took no parental leave up until thetime a child was 4 years of age. Of those who took leave, 35% took be-tween 1 and 29 days, 41% took between 30 and 59 days, and 19% took be-tween 60 and 179 days. Yet, despite recent progress, Haas and Hwang(1999) note that the pappa month has not had the anticipated effect on fa-thers’ uptake of leave, with Sweden still having a long way to go if it is toachieve equal parental leave uptake by men and women.

An optimal leave arrangement might, in fact, involve the mother ’s tak-ing the first 6 months of parental leave to recover from childbirth and tobreastfeed, with the father then taking a further 6 months of leave to maxi-mize shared time input into the child. This would also avoid the entrench-ment of traditional roles in employment and home life that often provesboth costly to women and difficult to change at a later date (Bergmann,1986).14 Whereas this suggested pattern can be observed in some Swedishfamilies, research continues in Nordic countries to try to identify ways ofsupporting equal use of parental leave by men and women across thewider society (Carlsen, 1998).

Although it is sometimes assumed that an emphasis on father care haslittle relevance to the United States policy scenario, a recent Americanstudy highlights the lack of fit between mothers’ preferred methods ofcare and the types and quality of care available. Based on a study of preg-nant women who returned to paid employment within the 1st yearpostpartum and used nonmaternal child care, Riley and Glass (2002)found that the majority of the mothers (53%) surveyed preferred fathercare. Whereas for a variety of reasons only 23% primarily used fathercare, this preferred arrangement would appear to fit the Swedish model,with an emphasis on longer periods of leave and paternal involvement.


CONCLUSION AND POLICY IMPLICATIONS

So what is the optimal length of parental leave? The research literaturefrom a range of disciplines and perspectives gives us different answers. Itseems that a relatively short period of leave following childbirth is lesscostly to most employees in terms of its long-term economic and employ-ment effects. Certainly, when leave is unpaid, a short leave period is not asdetrimental for parents. However, the adverse economic consequences oflonger leave appear to be less observable in countries such as Sweden,where such behavior is more predictable. Overall, in the context of theUnited States it seems that a short parental leave period, such as the 3months covered by the FMLA, is likely to have minimal impact onemployees’ long-term earnings.

With regard to fetal and maternal health, leave policies must includemeasures that offer pregnant workers the opportunity to take a period oftheir leave entitlement prior to childbirth. In the prenatal period, it is diffi-cult to establish a universally appropriate length of leave, as this is largelydetermined by both the nature of the pregnancy and the type of job andworking conditions. Following childbirth, women’s physical and mentalhealth is often enhanced by a period of leave. Some research supportspostnatal leave periods longer than 20 weeks to optimize women’s mentaland physical health. However, if they are able to access the full 12 weeksfollowing childbirth, the time period provided by the FMLA may be suffi-cient for many workers covered by this legislation. Yet, for those womenwho experience complications either during their pregnancy or followingchildbirth, 12 weeks will often be inadequate. The longer period of paidand universally available leave characterizing Swedish public policy al-lows women to determine better the most appropriate leave duration basedon their personal circumstances.

Although the issue of bonding is often a key component of discussionsabout the design of parental leave policy, the literature on this subject pro-vides little guidance as to the optimal length of time required. However, incontrast to the historical emphasis on maternal-infant bonding, there isnow increasing recognition of the benefits to both parents associated withthe opportunity to bond with their infants. With regard to heterosexualcouples, this means that parental leave schemes need to be designed, ashas increasingly occurred in recent years, to allow both mothers and fa-thers to spend time with their offspring. In their different ways, both theUnited States and Swedish parental leave schemes allow for this. But theSwedish model goes much farther by providing financial incentives to en-


courage fathers to take longer leaves. However, this goal appears to be ex-plicitly driven more by the wider societal ideal of gender equity than bytheories of bonding.

The literature on breastfeeding provides more direct guidance for thedesign of parental leave schemes. Current breastfeeding recommenda-tions and research appear to support the provision of 6 months paidpostnatal leave so that mothers can exclusively breastfeed their infantsduring this period. Longer duration of breastfeeding has also been shownto be protective against breast cancer in women. However, if an initial 6-month period of leave following childbirth is warranted primarily on ma-ternal and child health and, to a lesser extent, on cognitive developmentgrounds, leave then comes to be seen as unavoidably female specific, thatis, pertaining primarily to women. Herein lies the gender equity conun-drum. In heterosexual, two-parent families, if equality both in the homeand the workplace is to be achieved, parental leave needs to be sharedequally by both parents, thereby avoiding the entrenchment of traditionalroles and responsibilities. This then necessitates longer periods of leave sothat parents can take leave consecutively. Paid leave lasting longer than sixmonths would ensure that fathers have the opportunity to spend time withtheir child, as well as balancing the breastfeeding mother’s potential timeinput during the early months.

One way of achieving this scenario would be to emulate some aspectsof the Swedish public policy model. Although much progress is requiredif full gender equality is to be attained, Sweden has nevertheless managedto design and develop a parental leave policy package that recognizes andaddresses the dual and often conflicting objectives of child health andgender equity. Although the United States is characterized by a very dif-ferent institutional and public policy climate, measures that would enableboth health-promoting behavior and equitable leave-taking practices be-tween women and men need to be developed. The need to ensure equityand redistribution, as well as to enhance children’s life chances and oppor-tunities regardless of their family context, provides one of the strongest ar-guments for government intervention and redesign of appropriateparental leave policy, including in terms of its duration.

However, whereas research suggests that a period of leave supportsbreastfeeding duration, for a variety of reasons many new mothers eitherneed to or wish to return to work before 6 months. In the United States,where leave is unpaid, many individuals are not covered by the FMLA,and the cost of being out of employment is also seemingly higher than insome other countries, the pressure for an early return to work is likely to bemore intense. In countries such as the United States, workplace measures


are, therefore, required to enable employees returning to work immedi-ately following childbirth to integrate their work and family commitmentsbetter. These include measures for “phasing back” through part-timework, shorter working days and/or flextime, as well as provisions forbreastfeeding breaks and facilities. Such measures are also required to en-able employees returning to work after a period of leave to continuebreastfeeding.

Within two-parent, heterosexual households, the model whereby moth-ers return to work before 6 months while continuing to express breast milkand fathers take an equivalent, subsequent period of leave appears to offeran alternative model to the traditional gender division of leave uptake. Atface value, this scenario also seems ideal in terms of reconciling importanthealth and gender equity concerns. However, insufficient research isavailable to unconditionally recommend this model. As yet, there is littleevidence that provisions supportive of breastfeeding/breast milk expres-sion are widespread in the United States workplace. Moreover, further re-search is required on the effectiveness of breast milk expression, includ-ing through the use of a breast pump, as a strategy for maintainingexclusive breastfeeding, particularly in the United States where thismodel appears to be far more prevalent than in Europe.

In parental leave discussions, political and ideological considerationswill always be important, with political trade-offs playing a critical role inthe adoption of the FMLA. However, the design of parental leave schemesshould, ideally, be informed by research. If these schemes are to be guidedonly by research on labor markets and gender equity, then short leavesseem the best policy option. But once biomedical research is considered,the design of parental leave becomes far more complex. This body of re-search points to the need for much longer leaves than are currently avail-able in the United States. Ideally, postnatal leave should be for at least 6months. Given the need of many pregnant workers for a period of prenatalleave, the overriding leave period may need to be even longer than this.This 6-month period is a minimum that does not cover the goal of genderequity in labor markets and households. But such leave would also requirefar wider eligibility criteria than is currently the case, as well as incomesupport, especially for those who cannot afford to take time out of workwithout some form of income replacement. In addition, there needs to belegislation for breastfeeding breaks and facilities in the workplace, as stip-ulated in international law. Historically, American discussions of parentalleave have not foregrounded medical research. The research literaturesuggests that in the future they should.


NOTES

1. These traditional roles may also be difficult to change at a later time. Furthermore, ifparents separate, the primary caregiver will generally become the custodial parent.

2. In 1995, 84% of Swedish mothers took 300 or more days of leave (Swedish NationalSocial Insurance Board, 2001).

3. The World Health Organization notes that a country’s caesarean section rates shouldbe no higher than 10%-15% (Gerrard, 2001).

4. Forty percent of those women who returned to paid employment before 16 weeksnevertheless continued to breastfeed beyond the infant’s first birthday (Auerbach & Guss,1984).

5. Researchers and advocates for family and medical leave are divided on the value ofinitiatives proposing to limit paid leave to parental care alone. For instance, Wisensale (2001)argues that the FMLA was originally designed to provide intergenerational family care to en-able eligible individuals to take time off from work to care for a child or an elderly parent. Ac-cording to Wisensale, it is important to maintain this broad approach, given the impending re-ality of a large retirement population.

6. Separate provisions are also included for maternity leave (14 weeks) and paternityleave (10 days).

7. According to 1999 figures, after Poland, the United States had the highest infant mor-tality rates among OECD countries (OECD, 1999).

8. This analysis was later expanded to include 16 countries (Ruhm, 2000b).9. Sweden is one of the leading countries among the developed nations with respect to

breastfeeding practice. It not only has a high breastfeeding initiation rate—in 1997, at oneweek of age, 97% of infants were breastfed (93% exclusively, 4% partially)—but it is also no-table for its breastfeeding frequency rates, especially for infants at six months of age. In thisage group, fully 73% of all children born in 1998 were breastfed (41% exclusively breastfedand 32% partially breastfed) (Swedish National Board of Health and Welfare, 2000).

10. In 1998, 64% of American infants were breastfed (that is, received any amount ofbreast milk at all) in “the early postpartum period,” whereas at 6 months, only 29% of babieswere breastfed (U.S. Department of Health and Human Services, 2000).

11. Sweden has for a long time promoted the notion of children’s rights and was, alongwith the other Nordic countries, a major force behind the development of the United Nations’1989 Convention on the Rights of the Child and in 1990 was one of the earliest countries toratify it.

12. Another component of the Nordic family-work package, which is not directly thesubject of this article but is nevertheless critical in facilitating the labor market attachment ofleave-taking employees, is their extensive, high-quality, state-subsidized child care pro-grams. In Sweden, for instance, child care provisions conjoin with the parental leave entitle-ment through the provision of paid parental leave for 15 months, followed by high-quality,subsidized day care. This particular policy configuration serves through economic incentivesto shape and uphold the at-home ideal for the very young (followed by an out-of-home periodin day care), which, to varying degrees, is at the heart of Nordic family-work policy. This pol-icy package also has important fiscal implications—a factor that has sometimes been over-looked in international analyses supportive of the Swedish model (Galtry, 2001).

13. There are, however, variations in the timing of return to paid work among Swedishwomen. Stafford and Sundström (1994) suggest that there is a tendency for better paid and


more highly educated mothers to resume employment more rapidly after childbirth thanthose with lower education levels and lower rates of pay.

14. U.S. economist Barbara Bergmann argues that paid maternity leaves not only rein-force the notion that child rearing and other household chores are primarily the responsibilityof women but also are “really another version of pay for housewives” (1986, p. 213).

References

Ainsworth, M. (1967). Infancy in Uganda: Infant care and the growth of love. Baltimore:Johns Hopkins.

American Academy of Pediatrics. (1997). Breastfeeding and the use of human milk. Pediat-rics, 100, 1035-1039.

Angelsen, N. K., Vik, T., Jacobsen, G., & Bakketeig, L. S. (2001). Breast feeding and cogni-tive development at age 1 and 5 years. Archives of Diseases in Childhood, 85, 183-188.

Auerbach, K. G. (1999). Maternal employment and breastfeeding. In J. Riordan & K. G. Au-erbach (Eds.), Breastfeeding and human lactation (2nd ed., pp. 577-600). Sudbury, MA:Jones & Bartlett.

Auerbach, K. G., & Guss, E. (1984). Maternal employment and breastfeeding: A study of567 women’s experiences. American Journal of Diseases of Children, 138, 958-960.

Barker, D. J. P. (1994). Mothers, babies and disease in later life. London: BMJ.Bell, L., & Freeman, R. B. (2001). Working hard. In G. Wong & G. Picot (Eds.), Working time

in comparative perspective, Volume 1 (pp.71-105). Kalamazoo, MI.: W. E. Upjohn Insti-tute for Employment Research.

Bergmann, B. R. (1986). The economic emergence of women. New York: Basic Books.Bick, D. E., MacArthur, C., & Lancashire, R. J. (1998). What influences the uptake and early

cessation of breast feeding? Midwifery, 14, 242-247.Blaauw, R., Albertse, E. C., Beneke, T., Lombard, C. J., Laubsher, R., & Hough, F. S. (1994).

Risk factors for the development of osteoporosis in a South African population: A pro-spective analysis. South African Medical Journal, 84, 328-332.

Blau, F. D., Ferber, M. A., & Winkler, A. E. (2001). The economics of women, men, and work.Upper Saddle River, NJ: Prentice Hall.

Bowlby, J. (1952). Maternal care and mental health. Report prepared on behalf of the WorldHealth Organization as a contribution to the United Nations program for the welfare ofhomeless children. Geneva, Switzerland: World Health Organization.

Callister, P. (2002). Should job protection and income support for new parents be separated?Policy options in a U.S. and New Zealand context. Community, Work & Family, 5, 279-299.

Carlsen, S. (1998). Men on parental leave: How men use parental leave in the Nordic coun-tries. Report prepared for the Nordic Council of Ministers.

Clark, R., Hyde, J. S., Essex, M. J., & Klein, M. H. (1997). Length of maternity leave andquality of mother-infant interactions. Child Development, 68, 364-383.

Collaborative Group on Hormonal Factors in Breast Cancer. (2002). Breast cancer andbreastfeeding: Collaborative reanalysis of individual data from 47 epidemiological stud-ies in 30 countries. Lancet, 20, 360(9328), 203-10.

Dettwyler, K. (1995). Beauty and the breast: The cultural context of breastfeeding in theUnited States. In P. Stuart-Macadam & K. Dettwyler (Eds.), Breastfeeding: Bioculturalperspectives (pp. 167-216). New York: Aldine de Gruyter.


Esping-Andersen, G. (1996). After the golden age? Welfare state dilemmas in a global econ-omy. In G. Esping-Andersen (Ed.), Welfare states in transition: National adaptations inglobal economies (pp. 1-31). London: Sage.

European Commission. (1994). Leave arrangements for workers with children: A review ofleave arrangements in the member states of the European Union and Austria, Finland,Norway and Sweden (Document No. V/773/94-EN). Brussels: European Commission.

Fein, S. B., & Roe, B. (1998). The effect of work status on initiation and duration of breast-feeding. American Journal of Public Health, 88, 1042-1046.

Folbre, N. (1994). Who pays for the kids? Gender and the structures of constraint. London/New York: Routledge.

Folbre, N. (2001). The invisible heart: Economics and family values. New York: New Press.Freudenheim, J. L., Marshall, J. R., Graham, S., Laughlin, R., Vena, J. E., Bandera, E., et al.

(1994). Exposure to breastmilk in infancy and the risk of breast cancer. Epidemiology, 5,324-331.

Galtry, J. (1997). Suckling and silence in the USA: The costs and benefits of breastfeeding.Feminist Economics, 3, 1-23.

Galtry, J. (2000). Extending the “bright line”: Feminism, breastfeeding and the workplace inthe United States. Gender & Society, 14, 295-317.

Galtry, J. (2001). Maternal employment and breastfeeding: Policies and practices in theUnited States and Sweden (BLCC Working Paper #01-12). Ithaca, NY.: Cornell Univer-sity, Bronfenbrenner Life Course Center.

Galtry, J. (2002). Child health: An underplayed variable in parental leave policy debates.Community, Work & Family, 5, 257-278.

Gerrard, N. (2001, August 12). Delivery by caesarean section is now touted as the celebrities’choice. The Observer.

Gielen, A. C., Faden, R. R., O’Campo, P., Hendricks-Brown, C., & Paige, D. M. (1991). Ma-ternal employment during the early postpartum period: Effects on initiation and continu-ation of breast-feeding. Pediatrics, 87, 298-305.

Gjerdingen, D. K., Froberg, D. G., & Kochevar, L. (1991). Changes in women’s mental andphysical health from pregnancy through six months postpartum. Journal of Family Prac-tice, 32, 161-166.

Greiner, T. (1990, May 26-June 1). Breastfeeding and working women: Thinking strategi-cally. Revised background paper for the UNICEF Workshop on Work, Women, andBreastfeeding, Brasilia.

Gwinn, M. L., Lee, N. C., Rhodes, P. H., Layde, P. M., & Rubin, G. L. (1990). Pregnancy,breastfeeding, and oral contraceptives and the risk of epithelial ovarian cancer. Journal ofClinical Epidemiology, 43, 559-568.

Haas, L. (1992). Equal parenthood and social policy: A study of parental leave in Sweden.Albany: State University of New York Press.

Haas, L., & Hwang, P. (1999). Parental leave in Sweden. In P. Moss & F. Deven (Eds.), Paren-tal leave: Progress or pitfall? Research and policy issues in Europe (pp. 45-68). Brussels:Vlaamse Gemeenschap/CBGS.

Han, W-J., Waldfogel, J., & Brooks-Gunn, J. (2001). The effects of early maternal employ-ment on later cognitive and behavioral outcomes. Journal of Marriage and the Family,63, 336-354.

Harris, A. C. (1993). Child Development (2nd ed.). St. Paul, MN: West.Hartge, P., Schiffmon, M. H., Hoover, R., McGowan, L., Lesher, L., & Norris, H. J. (1989). A

case-control study of epithelial ovarian cancer. American Journal of Obstetrics and Gy-necology, 161, 10-16.


Hattiangadi, A. (2000, August 11). Bringing up baby: A comparison of U.S. and Europeanfamily leave policies. Contemporary Issues in Employment and Workplace Policy. Wash-ington, DC.: Employment Policy Foundation.

Heitlinger, A. (1993). Women’s equality, demography and public policies. Britain:MacMillan Press/New York: St. Martins.

Hoffman, L. W., Youngblade L. M., Coley, R. L., Fuligni, A. S., & Kovacs, D. D. (1999).Mothers at work: Effects on children’s well-being. New York: Cambridge University.

Horwood, L. J., & Ferguson, D. M. (1998). Breastfeeding and later cognitive developmentand academic outcomes. Pediatrics, 101, e9. [Pediatrics Online]. Available fromwww.pediatrics.org

Hrdy, S. B. (1999). Mother nature: A history of mothers, infants, and natural selection. NewYork: Pantheon Books.

Institute for Women’s Policy Research. (2000). Paid family and medical leave: Essentialsupport for working women and men, Fact sheet. Washington, DC.: Institute forWomen’s Policy Research.

International Labour Organization. (1997). Maternity protection at work: Revision of theMaternity Protection Convention (Rev. ed.), 1952 (No. 103), and Recommendation,1952 (No. 95), Report V (1). International Labour Conference, 87th Session. Geneva,Switzerland: International Labour Office.

Jones, E. G., & Matheny, R. J. (1993). Relationship between infant feeding and exclusion ratefrom child care because of illness. Journal of the American Dietetic Association, 93, 809-811.

Joshi, H., Paci, P., & Waldfogel, J. (1999). The wages of motherhood: Better or worse? Cam-bridge Journal of Economics, 23, 543-564.

Kamerman, S. B. (2000). Parental leave policies: An essential ingredient in early childhoodeducation and care policies. Social policy report, Volume XIV, 2. A Publication of the So-ciety for Research in Child Development. Michigan: University of Michigan.

Kamerman, S. B., & Kahn, A. J. (1991). A U.S. policy challenge. In S. B. Kamerman & A. J.Kahn (Eds.), Child care, parental leave, and the under 3’s—Policy innovation in Europe(pp. 1-22). Westport, CT: Auburn House.

Kearney, M. H., & Cronenwett, L. (1991). Breastfeeding and employment. Journal ofObstetric-Gynecologic and Neonatal Nursing, 20, 471-480.

Klaus, M. H., & Kennell, J. H. (1976). Maternal-infant bonding: The impact of early separa-tion or loss on family development. St. Louis, MO: Mosby.

Labbok, M. (2001). Effects of breastfeeding on the mother. Pediatric Clinics of North Amer-ica, 48, 143-158.

Lamb, M. E. (1976). The role of the father in child development. New York: John Wiley.Lero, D. S. (2003). Research on parental leave policies and children’s development:

Implications for policy makers and service providers. In R. E. Tremblay, R. G. Barr, & R.D. Peters (Eds.), Encyclopedia in early childhood development, 1-9. Montreal, Quebec:Centre of Excellence for Early Childhood Development retrieved from www.excellence-jeunesenfants.ca/documents/LeroANGxp.pdf

Lindberg, L. D. (1996). Women’s decisions about breastfeeding and maternal employment.Journal of Marriage and the Family, 58, 239-251.

McGovern, P., Dowd, B., Gjerdingen, D. K., Moscovice, I., Kochevar, L., & Lohman, W.(1997). Time off work and the postpartum health of employed women. Medical Care, 35,507-521.

McGovern, P., Gjerdingen, D. K., & Froberg, D. G. (1992). The parental leave debate: Impli-cations for policy relevant research. Women and Health, 18, 97-118.


McKim, M. K., Cramer, K. M., Stuart, B., & O’Connor, D. L. (1999). Infant care decisionsand attachment security: The Canadian transition to child care study. Canadian Journalof Behaviourial Science, 31, 92-106.

Moen, P. (1989). Working parents: Transformations in gender roles and public policies inSweden. Madison: University of Wisconsin Press.

Moen, P., & Forest, K. B. (1999). Strengthening families: Policy issues for the twenty-firstcentury. In M. B. Sussman, S. K. Steinmetz, & G. W. Peterson (Eds.), Handbook of mar-riage and the family (pp. 633-663). New York: Plenum.

Morley, R., Cole, T. J., Powell, R., & Lucas, A. (1988). Mother’s choice to provide breastmilk and developmental outcome. Archives of Diseases in Childhood, 63, 1382-1385.

Moss, P., & Deven, F. (1999). Parental leave in context. In P. Moss & F. Deven (Eds.), Paren-tal leave: Progress or pitfall? Research and policy issues in Europe (pp. 1-24). Brussels:Vlaamse Gemeenschap/CBGS.

National Alliance for Caregiving and National Center on Women and Aging. (1999). TheMetlife juggling act study: Balancing caregiving with work and the costs involved.Brandeis University, MA: National Alliance for Caregiving and National Center onWomen and Aging.

Newcomb, P. A., Storer, B. E., Longnecker, M. P., Mittendorf, R., Greenberg, E. R., Clapp,R. W., et al. (1994). Lactation and a reduced risk of premenopausal breast cancer. NewEngland Journal of Medicine, 330, 81-87.

OECD. (1995, July). Long-term leave for parents in OECD countries. Employment Outlook,171-202.

OECD. (1999). OECD health data 99: A comparative analysis of 29 countries. Paris: Author.Riley, L. A., & Glass, J. (2002). You can’t always get what you want: Infant care preferences

and use among employed mothers. Journal of Marriage and Family, 64, 2-15.Roe, B., Whittington, L. A., Fein, S. B., & Teisl, M. F. (1999). Is there competition between

breast-feeding and maternal employment? Demography, 36, 157-171.Rønsen, M., & Sundström, M. (1996). Maternal employment in Scandinavia: A comparison

of the after-birth employment activity of Norwegian and Swedish women. Journal ofPopulation Economics, 9, 67-285.

Ruhm, C. (1998a). The economic consequences of parental leave mandates: Lessons fromEurope. Quarterly Journal of Economics, 113, 285-317.

Ruhm, C. (1998b). Parental leave and child health (NBER Working Paper 6554). Cam-bridge, MA: National Bureau of Economic Research.

Ruhm, C. (2000a). Parental employment and child cognitive development (NBER WorkingPaper 7666). Cambridge, MA: National Bureau of Economic Research.

Ruhm, C. (2000b). Parental leave and child health. Journal of Health Economics, 19, 931-960.

Ryan, A. S., & Martinez, G. A. (1989). Breastfeeding and the working mother: A profile. Pe-diatrics, 83, 524-531.

Scariati, P. D., Grummer-Strawn, L. M., & Fein, S. B. (1997). A longitudinal analysis of in-fant morbidity and the extent of breastfeeding in the United States. Pediatrics, 99, e5 [Pe-diatrics Online]. Available from www.pediatrics.org

Shapiro, D., & Mott, F. L. (1994). Long-term employment and earnings of women in relationto employment behavior surrounding the first birth. Journal of Human Resources, 24,249-275.

Shulock, N. (1999). The paradox of policy analysis: If it is not used, why do we produce somuch of it? Journal of Policy Analysis and Management, 18, 226-244.


Skocpol, T. (2000). The missing middle: Working families and the future of American socialpolicy. New York: Norton.

Stafford, F. P., & Sundström, M. (1994, September 23-25). Time out for childcare and careerwages of men and women. Paper presented at the 6th annual conference of the EuropeanAssociation of Labour Economists, Warsaw.

Stevens-Simon, C., & Orleans, M. (1999). Low-birthweight prevention programs: Theenigma of failure. Birth, 26, 184-191.

Sundström, M. (1991). Sweden: Supporting work, family, and gender equality. In S. B.Kamerman & A. J. Kahn (Eds.), Child care, parental leave, and the under 3’s—Policy in-novation in Europe (pp. 171-199). New York: Auburn House.

Sundström, M., & Duvander, A. E. (1999). Family division of child care: Why do-or don’t-Swedish fathers take parental leave? (Stockholm research reports in demography).Stockholm: Stockholm University Demography Unit.

Swedish Ministry of Health and Social Affairs. (1995). Shared power and responsibility: Na-tional report by the government of Sweden for the fourth world conference on women inBeijing 1995. Stockholm: Author.

Swedish National Board of Health and Welfare. (2000). Statistics—Health and diseases.Breast-feeding, children born 1998 (Centre for Epidemiology. Official Statistics of Swe-den). Stockholm: Author.

Swedish National Social Insurance Board. (2001). Statistics on father’s use of parental leavein Sweden. Retrieved from www.rfv.se/english/stat/famba/pa.htm

Treffers, P. E. (2000, March 13-17). Health aspects of maternity protection. Background pa-per prepared for the World Health Organization/UNICEF Technical Consultation of In-fant and Young Child Feeding.

Tulman, L., & Fawcett, J. (1991). Factors influencing recovery from childbirth. In J. S. Hyde& M. J. Essex (Eds.), Parental leave and childcare: Setting a research and policy agenda(pp. 294-304). Philadelphia, PA: Temple University Press.

UNICEF. (1998). The state of the world’s children 1998. Oxford, UK: Oxford UniversityPress.

U.S. Department of Health and Human Services. (2000). Healthy people 2010. Office of Dis-ease Prevention and Health Promotion. (Objectives 16-19). Washington, DC: Depart-ment of Health and Human Services. Available from www.health.gov/healthypeople/

U.S. Department of Labor. (2000). FMLA Survey, 2000. Balancing the needs of familiesand employers: The family and medical leave surveys, 2000 update. Washington, DC:Author.

Visness, C. M., & Kennedy, K. I. (1997). Maternal employment and breast-feeding: Findingsfrom the 1988 National Maternal and Infant Health Study. American Journal of PublicHealth, 87, 945-950.

Waldfogel, J. (1995). The price of motherhood: Family status and women’s pay in a youngBritish cohort. Oxford Economic Papers, 47, 584-610.

Waldfogel, J. (1998). The family gap for young women in the United States and Britain: Canmaternity leave make a difference? Journal of Labor Economics, 16, 505-545.

Weimer, J. (2001). The economic benefits of breastfeeding: A review and analysis (Food As-sistance and Nutrition Research Report No. 13. Food and Rural Economics Division,Economic Research Service). U.S. Department of Agriculture.

Weinraub, M., & Jaeger, J. (1991). Time the return to the workplace: Effects on the develop-ing mother-infant relationship. In J. S. Hyde & M. J. Essex (Eds.), Parental leave andchildcare: Setting a research and policy agenda (pp. 307-322). Philadelphia: TempleUniversity Press.


Wisensale, S. K. (2001). Family leave policy: The political economy of work and family inAmerica. Armonk, NY: M. E. Sharpe.

World Health Organization. (2002). Infant and young child nutrition. Geneva, Switzerland:World Health Organization.


Assessing the Optimal Length of Parental Leave for Child and Parental Well-Being

Documents

Transcript of Assessing the Optimal Length of Parental Leave for Child and Parental Well-Being