Predictors and Outcomes of U.S. Quality Maternity Leave: A Review and Conceptual Framework

Neoliberalism

Neoliberalism is an economic policy model that shifts economic control from the public sector to the private sector. This trend in the United States has resulted in policies focusing on privatization, deregulation of corporations, increased labor market participation, decreased spending on social welfare, decreased taxation, and increased tax benefits for organizations and the wealthy (Shuffelton, 2013; Smith, 2008). U.S. neoliberal policies are highly individualistic and rely upon the idea of a patriarchal household as the norm, backdropped against a societal goal of increasing corporations’ ability to make profits (Shuffelton, 2013; Smith, 2008). As such, neoliberal policies have shifted the responsibility of unpaid caregiving to the domestic sector, in which women are often expected to fulfill unpaid caregiving roles while simultaneously being pressured to participate in paid market work (Shuffelton, 2013; Smith, 2008). This shift has resulted in a lack of social safety nets for mothers, especially for mothers with marginalized identities (e.g., low-income mothers, mothers of color; Calder, 2003; Shuffelton, 2013; Smith, 2008). Additionally, the neoliberal, capitalistic society in the U.S. informs privilege and access to resources as well as how employers and employees view maternity leave. Dominant narratives in the United States position paid labor as more valuable and important than other kinds of labor, especially those that involve unpaid caregiving work. The United States and many organizations do not provide opportunities for paid caregiving work, including maternity leave, which provides the metacommunication that caregiving work is incompatible with corporate employment and undervalued in the United States (Buzzanell et al., 2017; Shuffelton, 2013).

Cultural values surrounding caregiving

Shifting U.S. cultural values and norms surrounding caregiving, pregnancy, mothering, gender, and work affect maternity leave policies; decisions of how, when, and to what extent to utilize maternity leave and other family friendly policies; and employers’ and employees’ perceptions and treatment of mothers in the workplace (Budig et al., 2012). U.S. cultural values and expectations also affect the division of labor in the household and mothers’ participation and earnings in the workforce (Budig et al., 2012). Embedded within these cultural values lies sexism toward women that predicts discriminatory behaviors, such as not hiring women for fear that they may become pregnant and need to take maternity leave, which leads to increased gender inequity (Aisenbrey et al., 2009; Budig & England, 2001). Therefore, it is vital to examine cultural values that influence maternity leave and various outcomes, including societal gender role attitudes and gender-related stigma (Budig & England, 2001). Few scholars have examined U.S. cultural caregiving values and how they interact with mothers’ maternity leave experiences. However, societies hold beliefs about what constitutes a good mother, which then affects perceived accessibility of leave and leave policies (e.g., when cultures are supportive of employed women, childcare is more available; Budig et al., 2012).

Federal and state maternity leave policies

Despite global trends toward longer paid maternity leave and higher rates of wage replacement, the United States has lagged behind other countries (Gault et al., 2014). In 1993, congress passed the gender-neutral FMLA, which provides 12 weeks of unpaid, job-protected leave for employees’ caregiving needs, including for newborn and newly adopted children (Klerman et al., 2012). However, the FMLA has limitations, which include that employees must have worked at least 12 months and 1,250 hr in 12 months, and the leave does not cover the employees of companies with fewer than 50 workers (Guendelman et al., 2014; Klerman et al., 2012). Additionally, few U.S. states or employers have instituted additional paid parental leave provisions to fill the gaps of the FMLA, leaving nearly half of the employees in the United States without access to family and medical leave while almost half of the eligible employees are financially unable to take it (Guendelman et al., 2014; Klerman et al., 2012). Thus, current U.S. maternity leave provisions are significantly inadequate for many workers.

To remedy this, some states have enacted paid maternity leave policies (Guendelman et al., 2014). California is among several U.S. states that have provided paid maternity leave through temporary disability insurance, termed State Disability Insurance, wherein employees pay the state who disburses the proposed allotments for leave (Gault et al., 2014). Scholars have examined the utilization of maternity leave in these states, specifically California, after they adopted maternity leave provisions and discovered that leave utilization more than doubled, especially among mothers of color and mothers who have less education (Rossin-Slater et al., 2013). Additionally, this extension of leave empowers mothers to take antenatal maternity leave (Goodman, 2018). However, even this state-provided leave may not be adequate at 6 weeks of leave with 55% wage replacement in addition to FMLA as compared to the suggested 14–18 weeks of leave with 75% wage replacement set forth by the International Labour Organization (Gault et al., 2014). Many mothers still experience symptoms of childbirth at 5 weeks postpartum, especially those who undergo a Caesarean section, so 6 weeks of leave may remain inadequate (McGovern et al., 2006).

Organizational policies

Organizational policies, often referred to as family-friendly policies, include the supplemental leave that organizations offer to their employees and may include flextime, on-site childcare, and the use of paid time off to supplement leave income (Brown et al., 2002; Budd & Mumford, 2006). While many countries have these kinds of federal policies, the lack of such policies like in the United States and UK places the responsibility of determining maternity leave policies on employers (Budd & Mumford, 2006). Notably, when mothers are more satisfied with organizational leave policies, they are more likely to be satisfied with their jobs (Brown et al., 2002).

Workplace culture and support

Workplace or organizational culture is defined as shared values, beliefs, and assumptions in a workplace, and an aspect of workplace culture, work–family culture, refers to employers valuing and supporting employees integrating their family and work lives (Lyness et al., 1999). Workplace culture affects support to take leave and caregive, general workplace flexibility, and discriminatory workplace experiences. Workplaces that have family-friendly cultures may be more likely to provide support to mothers in taking the leave that is right for them, retain mothers postleave, and foster higher organizational commitment (Houston & Marks, 2003; Lyness et al., 1999; Millward, 2006). Thus, workplace culture and support and its impact on parenthood and maternity leave may be critical contributing factors to mothers’ QML. For example, a generally supportive workplace culture may include supervisors informing mothers of organizational policies regarding leave, benefits, and breastfeeding; offering flexible work schedules or location (e.g., telecommuting); and providing support to employees in utilizing these policies (Atkinson, 2016; Boushey, 2008; Cabrera, 2009; Goodman, 2018). In contrast, some workplace cultures may be unsupportive of caregiving roles, unwilling to provide flexibility, and unhelpful in providing adequate information regarding benefits available to employees. Unsupportive workplace cultures appear to contribute to employers’ negative perceptions of mothers taking maternity leave or not returning from leave quickly postnatally, which may lead mothers to not take the leave they need or return to the organization (Buzzanell & Liu, 2005; Houston & Marks, 2003). Similarly, workplace cultures that perpetuate gender and racial discrimination likely impact mothers’ access to QML.

Discriminatory workplace experiences may include gender and racial segregation of employees (e.g., assigning Black women to service positions), harassment from colleagues, unequitable hiring practices, and wage inequality (Ortiz & Roscigno, 2009). As a result of discriminatory workplace experiences, mothers may feel less supported, perform extra work, not ask for accommodations, or not disclose their pregnancies (Major, 2004). However, when mothers perceive a more supportive work–family culture, they are more committed to the organization, more likely to return to work sooner postnatally, less likely to experience pregnancy-related stigma, and less likely to leave the organization (Fox & Quinn, 2015; Lyness et al., 1999; Millward, 2006).

Work characteristics

Work characteristics encompass the type and nature of mothers’ employment. For example, mothers involved in low-wage employment, labor unions, and precarious work have differential access to and utilization of maternity leave.

Low-wage employment. Low-wage employment, or employment at the minimum wage or below the poverty line, leads to a host of inequities regarding mothers’ access to and utilization of maternity leave, especially QML. Despite low-wage workers often having higher caregiving responsibilities than more affluent workers, only half of low-wage workers are covered by the FMLA and over three quarters of lower wage workers lack access to adequate paid time off (Bornstein, 2011; Donovan, 2019). Low-wage workers often work in jobs that are less flexible and have fewer family-supportive policies or benefits such as vacation and sick days (Bornstein, 2011). Additionally, lower wage mothers may face more instances of workplace discrimination and harassment, especially if they are mothers of color, such as being fired after announcing a pregnancy, refused reasonable accommodations, prohibited from certain tasks despite their ability to perform the required duties, asked about their birth control usage, or encouraged to get an abortion (Bornstein, 2011).

Privilege and access to resources and power

Privilege and access to resources and power refers to the identities and resources that mothers hold and have access to that affect their access to QML. Although mothers’ identities intersect to form more complex experiences of privilege and power, or lack thereof, we will primarily discuss them individually as is done in the literature (Andres et al., 2016). Mothers’ identities as women in patriarchal societies are inherently devalued and stigmatized, which then intersect with various social status and power identity factors discussed here (Fox & Quinn, 2015). These identities are bound in inherently discriminatory and prejudiced systems which affect mothers’ attainment of maternity leave and QML. For instance, women of color and women who have lower incomes are more likely to need paid maternity leave provisions but are the least likely to have access to these provisions (Calder, 2003). Additionally, although not adequately addressed in the literature, gender identity and sexual orientation likely also affect QML attainment, especially regarding workplace discrimination in who has access and support to take maternity leave. Further, marital status, education, and family income appear to be some of the strongest predictors of access to maternity leave (Andres et al., 2016). Factors regarding privilege and access to resources and power include race/ethnicity, level and education and skills, ability status and health, income, marital status, and social support.

Race/ethnicity. Although positioning race and ethnicity as a predictor of QML is inaccurate due to there being no agreed upon definition of race and ethnicity as a meaningful psychological construct, many scholars continue to use this variable in analyses instead of more meaningful constructs, such as ethnic identity, values, or experiences of discrimination (Helms et al., 2005). Despite this lack of clarity, we included this variable as a predictor due to the importance of examining the effects of structural racism, discriminatory experiences, and lack of racial/ethnic privilege in regard to maternity leave and QML.

Mothers of color are significantly less likely to have access to and take maternity leave. Black and Hispanic mothers, in comparison to White mothers, are significantly less likely to take leave despite indicating need for leave, although there are conflicting findings that have found that Black women receive more paid time off and higher rates of wage replacement, which may reflect self-selection into employment with better benefits or working conditions (Gault et al., 2014; Shepherd-Banigan & Bell, 2014). In contrast, when paid leave is provided (e.g., in California), Black and Hispanic mothers are most likely to benefit from these policies as evidenced by their increased leave-taking (Rossin-Slater et al., 2013). Most scholars who have examined race/ethnicity as a variable pertaining to maternity leave have not expanded upon the cause of these differences or what they may mean for mothers of color. Thus, race and ethnicity as a predictor of QML may be better explored with variables related to experiences of discrimination or other variables scholars may find relevant to mother of colors’ racialized experiences of QML.

Level of education and skills. There is a complex relation between mothers’ attainment of maternity leave and their privilege with respect to level of education or skills. Research has found that women who have a postbachelor education are more than two times as likely than women with a high school education or less to receive paid maternity leave, and mothers with less education are more likely to turnover (Boushey, 2008; Shepherd-Banigan, & Bell, 2014). Additionally, mothers with more education or skills tend to have greater access to paid and unpaid maternity leaves as well as adequate benefits packages, and they may be more likely to take advantage of this access (Boushey, 2008; Evans, 2007). Relatedly, women with higher levels of education are more likely to return to work after maternity leave, work later into their pregnancies, and return to work earlier than women with less education; however, there are mixed findings regarding these results, so further research would be useful in determining the relation among level of education and QML and what underlies this relation (Cabeza et al., 2011; Lyness et al., 1999).

Attitudes toward and perceptions of maternity leave

Mothers make decisions regarding utilization of maternity leave based in part on their perceptions of and attitudes toward maternity leave. Attitudes toward and perceptions of maternity leave refer to beliefs held about motherhood, maternity leave, and maternity leave accessibility. For example, some groups or cultures may view taking leave from work as mandatory for a new mother, while other groups (e.g., professionals) may view maternity leave as optional or undesirable (Fox & Quinn, 2015; Lyness et al., 1999). Additionally, mothers may perceive leave as detrimental to their professional skills or career advancement and they may fear job loss upon taking leave (Bencsik & Juhasz, 2010). These concerns are likely valid because many scholars have found that when women become pregnant or utilize family-friendly policies, including maternity leave, they are viewed as less work-oriented or competent (Cuddy et al., 2004). Mothers may feel pressured to continue working later into their pregnancy or to do the same job duties to maintain perceptions of competency, which may result in them not experiencing QML (Buzzanell et al., 2017). For example, scholars have found that women who had fewer traditional attitudes toward parenting and gender roles (e.g., believing that women should stay at home) planned to work later into their pregnancies and return to work sooner postnatally (Fox & Quinn, 2015; Lyness et al., 1999).

Perceptions toward maternity leave also include perceived access to maternity leave which is defined as employees’ knowledge of family-friendly policies and their perception that they can utilize these policies (Budd & Mumford, 2006; Diamond et al., 2007). Although the United States offers FMLA to some workers, this may be inadequate for those who cannot access FMLA, which may result in mothers perceiving FMLA as an inaccessible way to take leave. Additionally, because paid maternity leave is not mandated in the United States, mothers may struggle to (a) understand the ways in which they can receive wage replacement or organizationally provided leave, (b) have confidence in their negotiation skills, or (c) locate appropriate parties to get more information (Diamond et al., 2007). Therefore, the availability of maternity leave is inadequate if mothers do not perceive leave as accessible, which may affect their experience of QML, and this perception is related to work-level predictors including workplace culture and support (Budd & Mumford, 2006).

General physical health and well-being

After childbirth, mothers need time for their bodies to heal which is estimated to take approximately 6 weeks (McGovern et al., 2006). However, healing rates vary among mothers, especially those who have given birth via Caesarean section or had an episiotomy, which may include time to heal from infections postnatally (McGovern et al., 2006). Scholars have found that longer leave, especially when paid, is negatively related to health symptoms and positively related to stress management and exercise (Jou et al., 2018). Additionally, longer paid maternity leave results in mothers experiencing less overall stress upon their return to work (Albagli & Rau, 2019). Mothers’ stress levels may also be related to their ability to access QML, including obtaining the accommodations they need to perform their vocational duties during their pregnancies and having to silently negotiate between their roles as employees and mothers (Buzzanell & Liu, 2007). Moreover, mothers who take longer leaves, whether paid or unpaid, and return to work 6 months postnatally report better self-rated overall health and fewer outpatient health visits in comparison with mothers who returned to work sooner (Chatterji & Markowitz, 2012; Chatterji et al., 2013). Thus, QML appears to contribute to several beneficial health outcomes.

Mental health

Mothers may face a host of mental health concerns both pre- and postnatally, and some mothers may find their leave to be inadequate to cope with the stress and integration of roles as mothers and employees (Chatterji & Markowitz, 2012; Dagher et al., 2014; Hyde et al., 1995). Mothers who are single, low income, and have more than one child are at a particularly high risk to experience depressive symptoms postnatally, potentially due to the added stress of raising an infant with limited resources (Dagher et al., 2014). In general, mothers have shown poorer mental health outcomes when having short maternity leaves, and having longer leaves is related to reduced depressive symptoms and general psychological distress (Feldman et al., 2004; Whitehouse et al., 2013). Along with depression, mothers may also experience anxiety and guilt regarding their decisions to return to work after maternity leave due to role conflict and, in some cases, the ideal of a good mother being one who stays at home to care for their children (Hyde et al., 1995; Millward, 2006

Moreover, mothers’ mental health and experience of QML may be influenced by stress they experience as a parent or romantic partner. Mothers who were not able to take the maternity leave that they wanted reported decreased time spent with their partners and increased marital incompatibility, likely finding it difficult to spend time with their partners due to new parenting responsibilities and a lack of time off (Hyde et al., 2001; Spiteri & Xuereb, 2012). Additionally, mothers who were unable to take the length of leave that they wanted reported more dissatisfaction with the division of household labor and childcare responsibilities, which may affect their ability to integrate their new role as a mother with their existing identities (Hyde et al., 2001). Clearly, maternity leave has an important role to play in mothers’ mental health outcomes, although there are no known studies examining the relation among mothers’ subjective maternity leave experiences and mental health outcomes.

Identity and role integration

Motherhood is likely to change a mother’s sense of identity as well as their decision making and values, which may shift over time and include decisions to return to work (Buzzanell et al., 2005; Hennekam et al., 2019; Millward, 2006). This identity shift is influenced by many factors, including social and cultural norms, family-friendly organizational policies, and workplace role models (Hennekam et al., 2019). Mothers are also likely to engage in sensemaking of their motherhood and leave experiences, including how people in the workplace react to their motherhood, and they integrate these experiences into their identity as a mother, employee, partner, and person (Buzzanell & Liu, 2005; Buzzanell et al., 2005; Millward, 2006). Motherhood identity centrality, or the personal importance of a woman’s identity as a mother, appears to protect mothers from stress in their mothering role (Martire et al., 2000). However, mothers who have not been able to take their desired length of maternity leave have reported experiencing a sense of role overload and difficulty in integrating these roles as well as a lower self-esteem (Feldman et al., 2004; Spiteri & Xuereb, 2012). With the help of QML, women are better able to integrate and validate their complex constellation of identities (Buzzanell & Liu, 2005; Millward, 2006).

Organizational commitment

Organizational commitment refers to the extent to which mothers identify as a member of an organization and the strength of their organizational involvement (Bae & Yang, 2017). Scholars in several cultural contexts have found that maternity leave provisions and other family-friendly policies (e.g., childcare leave and subsidy, telecommuting) are positively related to mothers’ organizational commitment via social exchange in which employees feel motivated to reciprocate to their organization due to the benefits that they receive (Bae & Yang, 2017). Although there is little research regarding mothers’ organizational commitment following maternity leave, scholars have found that increased workplace support is positively related to women’s organizational commitment, which may in turn be related to their intentions to return to work postnatally (Lyness et al., 1999).

Turnover intentions and return to work

Turnover intentions indicate whether employees plan to stay employed at a given organization, can be costly for both employees and employers, and are significantly correlated with actual turnover (Vandenberg & Nelson, 1999). Replacing employees is costly, so it is likely beneficial for employers to retain mothers postleave (Fox & Quinn, 2015). In the United States, mothers return to work significantly more quickly than elsewhere, and this is especially true when they are able to utilize employer-provided leave (Berger & Waldfogel, 2004). Several scholars have noted that mothers who have access to both paid and unpaid maternity leaves demonstrate higher job continuity, and mothers who return to work later postnatally exhibit less return-to-work regrets, which were in turn predictive of withdrawal intentions (Baker & Milligan, 2008; Wiese & Ritter, 2012). Additionally, mothers who lived in states that extended maternity leave had less turnover postnatally (Clark & Gallagher, 2017). Thus, maternity leave, and likely QML, is critical to decrease turnover intentions and increase return to work.

Job satisfaction

Job satisfaction is the sense of enjoyment that people get from their jobs and is linked to important outcomes for mothers and organizations such as withdrawal cognitions, organizational commitment, and life satisfaction (Bae & Yang, 2017; Judge & Watanabe, 1993). Additionally, people are more likely to be satisfied with their job if they perceive their organization, work environment, and supervisors as family-supportive (Allen, 2001; Bae & Yang, 2017; Brown et al., 2002). Interestingly, scholars have discovered that mothers indicated their job satisfaction was significantly higher before their pregnancies than during or after their pregnancies and found that women’s satisfaction with maternity leave policies after taking leave was significantly related to their satisfaction with their job (Brown et al., 2002). Thus, mothers’ job satisfaction postnatally may partially depend on their attainment of QML.

Career advancement outcomes

Labor market participation, wage penalties, and lack of opportunities for advancement are several outcomes affecting mothers’ career advancement that are linked to maternity leave and motherhood. When offered maternity leave, mothers are more likely to return to work postnatally, in part due to having the time they need to heal from childbirth and integrate their new role as a mother into their identity (Ulker & Guven, 2011; Ybarra, 2013). Women who may not otherwise return to work postnatally may be able to do so if offered adequate maternity leave (Goodman, 2018). Additionally, by taking maternity leave, mothers face a lack of wage increases postnatally that adds to the growing U.S. gender wage gap. While the wage gap between childless women and men has been decreasing, mothers continue to be at a wage disadvantage that may be influenced by reduced work experience (Budig & England, 2001; Budig et al., 2012). One contributor to the motherhood penalty may be the negative biases people hold about mothers (e.g., mothers being less competent, committed, or interested in advancement than nonmothers; Buzzanell & Liu, 2007). These biases may decrease interest in hiring, promoting, and training mothers who have taken leave, contributing to a dearth of opportunities for advancement (Cuddy et al., 2004). Other gender stereotypes may accompany this dearth of promotional opportunity offerings to mothers including perceptions that women, especially pregnant women and mothers, are too emotional and cannot be relied upon for leadership roles (Buzzanell & Liu, 2007).