Postpartum depression affects many women in the U.S., where there is a lack of paid family leave. Here's how better leave can help mothers.

By Lisa Heffernan
December 19, 2019
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It's no secret paid leave is hard to come by in the United States. In fact, only 16 percent of workers have access to it, according to the Bureau of Labor and Statistics. But Congress just passed a bill that would guarantee federal employees 12 weeks of paid leave to care for a newborn or adopted child. As the U.S. government is the nation's largest employer, this sets a standard for what all workers should get.

Aside from parents getting to spend more time bonding with Baby, could this also help in the battle against postpartum depression (PPD)? Unlike the "baby blues," which are feelings of worry, sadness, and fatigue that affect up to 80 percent of new mothers, PPD is more extreme and lasts longer, often interfering with a woman's ability to care for herself or her child.

Between 10 to 20 percent of women in the U.S. experience PPD and symptoms can appear up to one year after giving birth. Risk factors include things like having a history of depression or bipolar disorder, sleep deprivation, breastfeeding difficulties, marital stress, and a lack of support. With the average cost of raising a child exceeding $233,000 (without college), financial anxiety is also understandable. Experts believe better paid leave could be part of the solution.

The Link Between Maternity Leave and Women's Health

While women still suffer from PPD in countries with stronger leave policies than the U.S., a randomized 2018 study from Norway found that maternal health outcomes greatly improved after the introduction of four months of paid family leave. Similarly, when the state of California introduced paid family leave in 2004, there were also improvements seen in maternal mental health.

Researchers at Stanford University recently studied a Swedish reform allowing fathers, or other caregivers, to take up to 30 days of flexible paid leave in the year after birth, when the mother is still on leave. Looking at the first six months postpartum, they found a 26 percent reduction in the mother's need for anti-anxiety medications, a 14 percent reduction in hospitalizations or visits to specialists, and an 11 percent decrease in antibiotic prescriptions.

"It appears that fathers use these flex days when mothers are not feeling well, or are seeking medical care," says study co-author Maya Rossin-Slater. "We find that the reduction in health care visits is entirely due to unplanned rather than scheduled appointments, suggesting that underlying maternal health becomes better as a result of the 'Double Days' reform."

Allowing the mother to get some sleep is one of the benefits of giving fathers flexible, paid family leave. Harvey Karp, M.D., a pediatrician and children's environmental health advocate, agrees, emphasizing the importance of postpartum support for mothers. He believes exhaustion is the main trigger for PPD, and recommends breastfeeding more often during the day, and reducing it to every four hours at night.

"Knowing the baby is safe reduces anxiety," says Dr. Karp, who created the SNOO Smart Sleeper Bassinet, which can add a couple of hours to a baby's night sleep by combining "gentle rocking with soothing white noise and snug, safe swaddling," imitating the womb's environment. "By giving a mom help to calm and put her baby to sleep, she'll feel like it's not all on her shoulders, reducing the tendency of depression."

What Else Do Moms Struggling with PPD Need?

In the meantime, as Neel Shah, M.D., an OB-GYN at Beth Israel Deaconess Medical Center in Boston, points out, postpartum women need access to health care in order to get screened for PPD. "One of the cruelest features of the American healthcare system is that we guarantee insurance coverage for mothers who are pregnant, and they often lose it during the postpartum period when they need it the most," says Dr. Shah, an assistant professor of obstetrics at Harvard Medical School. "We cannot address PPD without ensuring that pregnant women have access to health care."

But not even the most financially secure and supported women are immune to PPD. Public figures like Chrissy Teigen and Gwyneth Paltrow have been vocal about their experiences. Both women chose to get therapy, with Teigen taking an anti-depressant, and Paltrow incorporating exercise and a stable sleep schedule to help her through it.

If high-tech baby sleep products are out of your budget, try a white noise machine and don't be afraid to ask others for help. "Do not suffer in silence. Women weren't meant to raise babies by themselves," says Dr. Karp. "Speak to friends, doctors, clergy, and never hesitate to call a hotline. Even though you may feel like it will never get better, hundreds of thousands of women struggle with PPD and get to the other side feeling great again."

The Bottom Line

Paid leave for both parents would allow mothers to better care for themselves and their babies, and studies show it could improve maternal mental health. Importantly, it could help prevent moms from feeling exhausted, a big cause of PPD.

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