The evidence for the impact of paid family leave in the United States reveals that the policy improves a variety of child and family outcomes, but the research only represents a few states. Only California, New Jersey, and Rhode Island had family leave laws that were in effect before 2018. The oldest family leave laws have been in effect in California and New Jersey since 2004 and 2009, respectively, and these laws have expanded and evolved since their initial implementation. Therefore, many states have not had family leave laws for enough time to study the impacts in a rigorous way. Although most countries outside of the United States have implemented paid family leave and many international studies have found positive impacts, the effects of those laws must be considered within the broader context of universal child care, universal health care, and child allowances in some countries.43 Due to these systemic policy differences, examining laws within the US is the best basis for building evidence on the policy’s effectiveness for families in this country.
The research discussed here meets our standards of evidence for being methodologically strong and allowing for causal inference, unless otherwise noted. Each strong causal study reviewed has been assigned a letter, and a complete list of causal studies can be found at the end of this review, along with more details about our standards of evidence and review method. The findings from each strong causal study reviewed align with one of our eight policy goals from Table 1. The Evidence of Effectiveness table below displays the findings associated with paid family leave (beneficial, null,iii or detrimental) for each of the strong studies (A through R) in the causal studies reference list, as well as our conclusions about the overall impact on each studied policy goal. The assessment of the overall impact for each studied policy goal weighs the timing of publication and relative strength of each study, as well as the size and direction of all measured indicators.
Table 2: Evidence of Effectiveness for Paid Family Leave by Policy Goal
|Policy Goal||Indicator||Beneficial Impacts||Null Impacts||Detrimental Impacts||Overall Impact on Goal|
|Access to Needed Services||Leave-Taking||B, N, R||Positive|
|Parents’ Ability to Work||Labor Force Participation||D, F, Q||Mostly Positive|
|Average Weekly Work Hours||B, N|
|Employment||B, D||N, O||A*, F|
|Attachment to Pre-Birth Employer||B, O||A|
|Sufficient Household Resources||Household Income||M||N||Mixed|
|Risk of Poverty||M|
|Annual Wage Earnings||A**|
|Parental Health and Emotional Wellbeing||Self-Rated Health||P||Positive|
|Maternal Mental Health||C|
|Paternal Mental Health||C|
|Coping With Demands of Parenting||C|
|Nurturing and Responsive Child-Parent Relationships||Mothers’ Time Spent With Children on Reading, Outings, Meals||A, C⁺||Positive|
|Optimal Child Health and Development||Breastfeeding||G, H, K||Positive|
|Timely Infant Vaccinations||E|
|Child Health||C, J|
|Allergies (Food and Respiratory)||C|
|Abusive Head Trauma||I|
*Effects of paid family leave on long-run employment were statistically significant in the negative direction for first-time mothers, but were null for all mothers considered.
**Effects of paid family leave on earnings were negative for first-time mothers, but null for all mothers considered.
⁺This study examined reading, but not outings and meals.
Access to Needed Services (Leave-Taking)
Research from California found that the implementation of paid family leave was associated with mothers and fathers taking longer leave and both parents taking leave simultaneously.B,N,R A 2013 study found that the policy doubled maternal leave-taking (paid or unpaid) from an average of 3 to 6 weeks,N and a 2016 study found that leave-taking increased by 5 weeks for mothers and 2 or 3 days for fathers.B A 2018 study found that the policy increased the probability of fathers taking leave by 46 percent, but fathers were still taking only an average of 1.5 weeks out of the 6 weeks that were available at that time in California.R The study noted that mothers took an average of 9 weeks out of the 12 paid weeks available through both Temporary Disability Insurance and paid family leave at that time.R
Research suggests that the effect on leave-taking may be greater for unmarried women and Black women than other groups; the 2013 study mentioned above found that Black mothers’ probability of taking any leave increased by 10.6 percentage points from a rate of 2 percent prior to California’s paid leave policy.N White mothers, meanwhile, saw a 4 percentage point increase from a rate of 7 percent prior to the policy. However, more research on leave-taking effects by subgroup would be valuable to corroborate these findings, which had fairly large standard errors.
Although the policy has increased the uptake of maternity leave, one study found that only approximately 40 percent of eligible mothers in California took advantage of paid leave benefits 10 years after implementation.31 The study also found that “median earnings of leave takers are an estimated $10,000 higher than the median income for all working women in California” (p. 1).31 Although some of this difference may be attributed to differential likelihood of eligibility, research also suggests that awareness of eligibility is low: a 2011 study found that only half of eligible adults reported they knew about California paid family leave, with lower-wage earners least likely to know about it.7 Increasing awareness of the program could boost participation and allow more families, especially lower earners, to reap the child and parental benefits supported by the evidence, discussed below.
Parents’ Ability to Work
Overall, research on the impact of paid family leave on mothers’ employment and labor force participation finds mostly positive results. A 2016 study of California’s policy found that paid family leave increased the probability of mothers working 1 year after a birth by 12.9 to 18.3 percentage points, depending on how much work experience the mother had before the birth.B The policy increased weeks worked and average weekly work hours during the child’s second year by 7.1 and 2.8, respectively, for those who worked at least 20 weeks during their pregnancy.B Additional research has shown that paid family leave is associated with higher labor force participation among young women.D,F,Q For example, one study of California and New Jersey’s policies found a 5 to 8 percentage point increase in the labor force participation rate of mothers in the months surrounding birth, as well as a significant increase in weeks spent with a job, compared to weeks spent looking for work.D A second study that examined both states similarly found a positive impact on labor force attachment – in California, the authors found that paid leave reduced labor market exit by 20 percent through 5 years after a birth, and in New Jersey, the effects averaged 46 percent through 5 years.Q The authors found that the effects were concentrated among women with higher educational attainment.
A 2013 study found that among mothers who worked following a birth, those who had accessiv to paid leave saw a 6 to 10 percent increase in weekly work hours, with an increase of 10 to 17 percent in work hours among those who reported having worked in the prior calendar year.N The study found no significant effect on the likelihood of employment overall.
Another study found that labor force participation increased by 1.4 percentage points in California following the implementation of paid family leave.F The study, however, also reported unanticipated effects of paid family leave: a significantly higher unemployment rate (an additional 1.5 percentage points) and a longer duration of unemployment, at 1.6 weeks longer.F The author speculated that paid family leave may result in higher labor costs, and employers may be less inclined to hire younger women, causing higher unemployment rates in this group. However, this theory was not tested in the study, and other research suggests no such effect on employers.7
A 2019 study of California’s paid leave policy, one of the largest studies on paid leave to date, found negative impacts on employment and wages in the long run among first-time mothers who took leave immediately after the policy was implemented in 2004.A The authors found a reduction of 7 percent in maternal employment and an 8 percent drop in wages 6 to 10 years after giving birth among women whose first birth was timed such that they were eligible for paid leave (compared to those who gave birth a few months before implementation). However, the authors found that self-employment income offset some of the decrease in wages. The rationale for focusing on first-time mothers was that “the availability of paid leave may…have a greater impact on new mothers than on women who have already established their child care and work routines [because] women learn how to manage motherhood when they have their first child”(p. 16).A The long-run employment findings for all mothers eligible for paid leave were not statistically significant, but employment was 0.2 percentage points lower than expected in the long-run (5 to 11 years after the birth) among this group.
Findings for job continuity, or attachment to the pre-birth employer, are mixed but lean positive. A 2018 study examined the impact of benefit levels using a sample of mothers just above and just below the maximum weekly benefit in California (high-earning women), and the authors found that a 10 percent increase in the weekly benefit amount increased the likelihood that a mother would return to her pre-birth employer by up to 5 percent.O A 2016 study with a broader sample found a positive and statistically significant 13 percent increase in the likelihood of working at the pre-birth job 1 year after the birth with a paid family leave policy.B Very small and insignificant effects on job continuity were found in a large 2019 study, however.A
Sufficient Household Resources
A study from California with a large sample found that paid family leave was associated with better economic security for families.M The study found that household income was approximately $3,400 higher (4.1 percent) among families with access to paid family leave relative to those who did not have access, and the effects were greater among married mothers, likely because they tend to take longer leaves than single mothers. The study also showed that families with access to paid leave were 10.2 percent less likely to be in poverty, resulting in a 2 percentage point reduction in the poverty rate, with the greatest effects for less-educated, low-income, single mothers.M
A 2013 study found that an increase in weekly work hours for mothers who took paid leave led to very small, and statistically insignificant increases in wage income.N A 2016 study found an insignificant effect of paid leave on hourly wages 1 year after the birth, with impacts ranging from a 3.6 percent increase to a 5 percent increase depending on how many weeks the mother worked during pregnancy.B Finally, a 2019 study found that paid family leave had a detrimental effect on the long-run annual wages of first-time mothers, with a net 10-year loss of $24,000.A However, the authors noted that because they found increases in first-time mothers’ time spent with children, their results could also be interpreted as “an increase in investment of $24,000 worth of mothers’ time in children” (p. 26).A,36
Parental Health and Emotional Wellbeing
Two studies of California’s policy found that parents’ physical and mental health benefited when parents had access to paid family leave. A 2019 study found that mothers with access to paid family leave were more likely to report having very good or excellent mental health (a 7 to 17 percentage point increase, depending on the control group examinedv) and coping well with the day-to-day demands of parenting (a 3 to 5 percentage point increase).C Effects on paternal mental health were not significant in this study and trended in both positive and negative directions, depending on the age of the child at data collection and the control group examined. A 2020 study found multiple positive impacts on parent health (including mothers and fathers): a significant, 11 percentage point increase in the likelihood of reporting very good or excellent health, a 0.79 point reduction on a 24 point scale of psychological distress, an 8.2 percentage point decline in the risk of being overweight, and a 12 percentage point decline in any alcohol consumption.P Mothers reported greater impacts on distress and overall health, whereas fathers saw greater declines in alcohol consumption.
Nurturing and Responsive Child-Parent Relationships
Two studies offer evidence that paid family leave increases the quality of parent-child relationships.A,C A 2019 study, using data from the Survey of Income and Program Participation, found that California’s paid family leave policy led to mothers spending more time with their children up to 4 years after the birth; in particular, mothers who took paid leave reported reading to their children 11.4 more times per week, going on outings with children 9.8 more times per month, and having breakfast with their children 3.6 more times per week than those who did not take paid leave.A The effects for all who had access to paid leave, rather than the smaller sample of those who took it, were smaller but still positive. A second study also examined reading, and found that parents were 10 to 20 percent more likely to read to their infants 4 or more days per week when they had access to paid leave in California, depending on the control group.C
Optimal Child Health and Development
Evidence shows that parents with access to paid family leave in California saw improvements in a variety of measures of their infants’ health and later child health in elementary school. In particular, increases in breastfeeding have been cited in multiple studies.G,H,K
Three studies present evidence that access to paid family leave increases breastfeeding,G,H,K which has been linked in some research to a number of beneficial impacts for infants, including stronger immunity, reduced infections, and reduced infant mortality.32 A study with a very large sample from California and New Jersey showed that paid family leave policies increased the percentage of exclusively breastfed infants at age 6 months by 1.3 percentage points.G The study also found statistically insignificant but positive effects on any breastfeeding at 6 and 12 months. The authors noted that the relatively small overall effects found may underestimate the true effects among working women, who are more likely to be affected by paid family leave, because the sample included both working and non-working women.
A second study found that in California, paid family leave led to a significant 5 percentage point increase in the likelihood of breastfeeding at 6 months, and a marginally significantvi increase in breastfeeding duration of 18 days, from a base of 221 days on average.K There was no significant overall effect found for breastfeeding initiation, however; the authors suggested that because many women had access to 6 weeks of paid leave through Temporary Disability Insurance, they were already quite likely to initiate breastfeeding prior to the new paid leave policy (85 percent of mothers breastfed). However, the policy had significant effects on breastfeeding initiation among some subgroups. For example, the study found the greatest effects for Black mothers (a 7.5 percentage point increase in the likelihood of breastfeeding at all) and for mothers with incomes below 50 percent of the federal poverty level, with a 5 percentage point increase in likelihood of breastfeeding.K Overall, the study found greater effects on breastfeeding for less-advantaged groups, including those with lower education levels.
An additional study from California with a higher-income and less generalizable sample showed that paid family leave led to an increase of 3 to 5 percentage points in exclusive breastfeeding at 6 months, and an increase in breastfeeding at all for at least 3, 6, and 9 months that ranged from 10 to 20 percentage points.H
Other outcomes may benefit from paid family leave policies as well. A study of California found that after the paid leave policy went into effect, hospitals saw 3 to 6 percent fewer infant admissions, particularly for avoidable conditions—hospital admissions decreased 25 to 33 percent for upper respiratory infections and 9 to 15 percent for gastrointestinal diseases.L The authors suggested that increased breastfeeding, and parents having more time to seek preventive care for their infant, may have driven these results. However, the study did not examine breastfeeding and preventive care as outcomes. Another California study found that infants in families with access to paid family leave were 1.4 to 5 percentage points less likely to receive late vaccinations (measured for vaccines typically given before 6 months old), depending on the specific vaccination, and the effect was even stronger for families with low income, with a 5 to 7 percentage point reduction in the likelihood of receiving a late vaccination relative to similar families in states without paid leave.E
A third study revealed that California’s policy boosted the likelihood that a child had very good or excellent health, as reported by their parents, by between 4.8 and 8.6 percentage points, depending on the control group examined.C The study also found a significant reduction in the likelihood of asthma (2.7 percentage points) for infants under age 1 year, and a reduction of 5 percentage points for all children ages 0 to 17. Results for food and respiratory allergies were mixed, with mostly null impacts except for a significant decline of 2.5 percentage points in respiratory allergies for infants under age 1.
Paid family leave also appears to be linked to better child health in elementary school, suggesting that the policy can have long-lasting beneficial impacts beyond the infant years. A 2017 study showed that children whose families had access to paid family leave were less likely to be overweight (4.1 percentage points), have ADHD (0.7 percentage points), have hearing problems (2.4 percentage points), and have communication problems (1.1 percentage points), with greater effects seen among boys and among children with lower socioeconomic status for the likelihood of being overweight and having ADHD.J
Finally, a 2016 study showed that paid family leave was linked to a significant reduction in the rate of pediatric abusive head trauma in children below age 2.I For children below age 2, paid family leave led to a rate reduction of 2.8 cases per 100,000 children; for children under age 1, the policy led to 5.1 fewer cases per 100,000 children.I The authors suggested that this may be driven by reduced maternal stress and better mental health after the introduction of paid leave, a mechanism supported by other studies reviewed.C,P
- An impact is considered statistically significant if p<0.05.
- For the purpose of their analyses, most studies included in this review defined “access” as “living in a state with a paid family leave policy” and examined outcomes relative to timeframes prior to implementation of the policy, relative to families in states without a paid leave policy, or relative to families without infants or young children. “Having access” does not mean that every family in the treatment sample was eligible for paid leave or received benefits.
- The authors analyzed and reported differences for infants and children in neighboring states, in other large states, and in all states except California.
- An impact is considered marginally significant when p<0.10.