Oregon Health & Science University - Portland State University School of Public Health, Portland, Oregon.
School of Public Health, University of California, Berkeley, Berkeley, California.
Womens Health Issues. 2024 Jul-Aug;34(4):331-339. doi: 10.1016/j.whi.2024.02.002. Epub 2024 Apr 3.
Even in the small number of U.S. states with paid parental leave (PPL) programs, studies have found awareness of PPL remains low and unevenly distributed among parents. Moreover, little is known about whether parents with perinatal health complications have unmet needs in obtaining information about and support for accessing parental leave during that time. This study aims to address this research gap. Given the strong evidence linking paid leave with improvements in maternal and infant health, it is critical to evaluate access among vulnerable populations.
We used a multiple methods approach, including a subset of the 2016-2017 Bay Area Parental Leave Survey of Mothers (analytic sample = 1,007) and interview data from mothers who stayed at a neonatal intensive care unit in 2019 (n = 7). All participants resided at that time in California, a state that offers PPL. The independent variable for the survey analysis was a composite measure of perinatal complications, quantified as binary with a value of 1 if respondents reported experiencing any of the four complications: poor maternal mental health during or after pregnancy, premature birth, or poor infant health. Dependent variables for the survey analysis measured lack of support or information for accessing PPL. We used linear probability models to assess the relationship between perinatal complications and PPL support. Thematic analysis was conducted with the interview data to understand how perinatal complications shape the process of accessing PPL.
Survey results revealed that parents with perinatal complications had a lower understanding of PPL benefits and low overall support for accessing leave, including from employers, compared with parents without perinatal complications. From interviews, we learned that perinatal complications present unique challenges to parents navigating PPL. There were multiple entities involved in managing leave and providing information, such as the benefits coordinator and employers. Supervisors were reported as providers of critical emotional and financial support.
Taken together, the findings from surveys and interviews suggest that health care and human resources personnel should be better equipped to provide information and support, particularly to those who experience perinatal complications and might struggle to complete paperwork while facing health challenges.
即使在美国少数几个有带薪育儿假 (PPL) 计划的州，研究发现，人们对 PPL 的认识仍然很低，而且在父母中分布不均。此外，人们对围产期有健康并发症的父母在这段时间获得有关育儿假的信息和支持方面是否有未满足的需求知之甚少。本研究旨在解决这一研究空白。鉴于带薪休假与改善母婴健康之间有着强有力的联系，评估弱势人群的获得途径至关重要。
我们采用了多种方法，包括 2016-2017 年湾区母亲带薪育儿假调查的一个子集（分析样本=1007）和 2019 年在新生儿重症监护病房停留的母亲的访谈数据（n=7）。所有参与者当时都居住在提供 PPL 的加利福尼亚州。调查分析的自变量是围产期并发症的综合衡量标准，用一个值表示，如果受访者报告在怀孕期间或之后经历了以下四种并发症中的任何一种，则量化为二元：产妇心理健康状况不佳、早产或婴儿健康状况不佳。调查分析的因变量衡量获得 PPL 的支持或信息的缺乏。我们使用线性概率模型来评估围产期并发症与 PPL 支持之间的关系。对访谈数据进行了主题分析，以了解围产期并发症如何影响获得 PPL 的过程。
调查结果显示，与没有围产期并发症的父母相比，有围产期并发症的父母对 PPL 福利的了解较少，对获得休假的总体支持也较低，包括来自雇主的支持。从访谈中，我们了解到围产期并发症给父母在管理 PPL 方面带来了独特的挑战。有多个实体参与管理休假并提供信息，例如福利协调员和雇主。主管被报告为提供关键的情感和财务支持的人。
总的来说，调查和访谈的结果表明，医疗保健和人力资源人员应该更好地配备提供信息和支持的能力，特别是对那些经历围产期并发症并且可能在面临健康挑战的同时难以完成文书工作的人。
