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Pregnancy leave used for medical problems, not R&R
Availability of benefit found less central to women's decision to take leave than health issues, discomfort

| 13 April 2006

Only one in three working women who qualify for pregnancy leave in California take advantage of the employee benefit, according to a new study by Berkeley researchers. Their findings suggest that pregnancy-leave benefits in California are not contributing to excessive leave-taking; rather, those who take leave cite medical necessity, physical discomfort, and stress or fatigue as the reason.

"What struck us most is that so few women do think about taking leave," says the study's lead author, Sylvia Guendelman, a professor of maternal and child health in the School of Public Health. "And when they do, it's because they have to, not because they want to."

The study, published online on March 31 by Maternal and Child Health Journal, will appear in print later this month.

California is one of five states that offer paid pregnancy leave, with payments to women averaging $293 per week in 2003. To find out who is using these leave benefits, how they are being used, and what drives women's decisions about whether to use them, Guendelman and her team interviewed 1,214 participants in a study of birth outcomes in Southern California. All the women had recently given birth, and all had either worked at least 20 hours per week during the first six months of their pregnancy or through the date of prenatal screening, which usually occurs about 15 to 20 weeks into pregnancy.

The researchers found that 52 percent of the women worked up to the time of delivery, while only 32 percent took pregnancy leave. Another 9 percent quit their jobs before giving birth, 5 percent cut back on their hours, and 2 percent were fired during pregnancy. Of the women who took leave, about 75 percent received cash benefits.

Half of the women who took leave (as well as half of the women who quit their jobs) attributed their decisions to medical problems, including stress and fatigue. Another 10 percent in both groups said they had left work due to physical discomfort. Interestingly, only one in four of the women who did take leave said she based her decision on the availability of the leave benefit.

Job fulfillment kept women working

Comparing these statistics with other information obtained in the interviews, Guendelman and her co-authors then looked for patterns that might predict whether a woman would take leave or stay on the job. They found that predictors for taking leave were having young children at home, working night shifts, and having work flexibility. Women who quit their jobs were about two times more likely to work for employers who did not offer pregnancy- or maternity-leave benefits or health insurance than were women whose employers offered these benefits. On the other hand, women who stayed at work were more likely to have postgraduate education and to feel fulfilled in their jobs.

The findings suggest that rather than being used predominantly as health-promoting behavior, pregnancy leave constitutes a coping response to stress and tiredness and the need to mother young children already in the house, Guendelman says.

"Women who take leave are not doing it out of a culture that tells them to slow down, relax, and take care of their bodies so that they can perform better and have easier deliveries or healthier babies, or be in a better position to nurse their child. They are taking it because they are feeling fatigued or stressed or are having complications," she says.

There are a number of other take-home lessons from the study, Guendelman says. One is that women who have a strong attachment to their work or who are afraid of sacrificing career-advancement opportunities seem to be more likely to work through their pregnancies. And employers should note, she added, that if they want to boost worker retention, offering benefits like pregnancy leave or health insurance would be a good place to start.