Evaluating COVID-Era Paid Parental Leave Policies: Maternal Health Outcomes Among Low-Income Populations in Two States

• In Event: Support or Strain? The Real-World Impact of Family Policy on Health, Care, and Work

Abstract

This study uses Pregnancy Risk Assessment and Monitoring System (PRAMS) data (2012–2021) and state-level paid family leave (PFL) enactment data to estimate the effects of paid parental leave (PPL) on maternal health outcomes among low-income individuals during the COVID-19 pandemic. Recent state PPL programs offer high wage replacement rates, potentially increasing participation and improving health among lower-income mothers.

We employ a quasi-experimental design to evaluate policy enactments in New Jersey and Washington, which in 2020 provided 12 weeks of leave at up to 85–90% wage replacement. Data from 17 states without PPL policies form a synthetic comparison group. The final analytic sample includes 19 jurisdictions across 10 years (2012–2021), yielding 190 location-year observations. Using trajectory balancing as the primary estimator, we construct synthetic counterfactuals based on pre-treatment trajectories, accounting for time-varying confounding and nonlinear trends. Results are compared to augmented synthetic control and two-way fixed effects (TWFE) models.

Across methods, we find no statistically significant effects of PPL enactment on breastfeeding duration, postpartum depression, or postpartum checkup attendance. Point estimates are directionally consistent with expected benefits: small positive effects on breastfeeding (ATT = 0.0067–0.0183) and postpartum visits (ATT = 0.0214–0.043), and small negative effects on postpartum depression (ATT = −0.0136 to −0.0153). Only the TWFE estimate for postpartum visit attendance is statistically significant.

Overall, results provide weak evidence that PPL expansions during the early COVID-19 years may improve maternal health among low-income mothers. Future research should examine longer post-policy periods and effects among those living below the federal poverty level.

Authors

• Amelia Reese Masterson, University of California - Los Angeles
  Presenting Author

• Keri Lintz, University of California - Los Angeles
  Non-Presenting Co-Author

• Dana Beck, University of California - Los Angeles
  Non-Presenting Co-Author