Mother's health prior to pregnancy and eligibility for earnings-related parental leave benefits

BACKGROUND: Parental leave generosity is protective for mothers’ mental health in the postpartum period and beyond. Strong work requirements exist for parents to receive more generous benefits which might penalise individuals who, due to poor health, have a weak labour market attachment. The aim of the study was to examine whether mothers with poor health prior to pregnancy are less likely to be eligible for more generous benefits in Sweden. METHODS: We used total population registers to study first-time mothers aged 25-45 years who were resident in Sweden and gave birth between 1 January 2009 and 30 September 2013 (n = 151,452). We performed logistic regressions to assess the association between health one and two consecutive years prior to pregnancy (to evaluate chronicity) and eligibility for earnings-related parental leave benefits. RESULTS: Mothers who were admitted to hospital or received specialist outpatient care for any health condition in the year prior to pregnancy were less likely to be eligible for earnings-related benefits (OR 0·79, 95%CI 0·76-0·83) compared to healthy mothers, with the likelihood reduced further among those with chronic health issues (OR 0·64, 95%CI 0·62-0·68). Findings were driven by mothers with mental health conditions (OR 0·22, 95%CI 0·20-0·23 for the year prior to pregnancy and OR 0·16, 95%CI 0.15-0·18 for chronic conditions). CONCLUSIONS: Mothers with prior health conditions, and in particular mental disorders, are less likely to benefit from the protective health effect of parental leave as they may not meet the eligibility requirements for more generous remunerations. KEY MESSAGES: • Mothers with prior health conditions are less likely to benefit from the protective health effect of parental leave as they may not meet the eligibility requirements for more generous entitlements. • The work requirement for parental leave benefits may invertedly increase health inequalities in society.