Association for Public Policy Analysis & Management

I study the causal effect of longer maternity leave on postpartum depression and other measures of mental health. I take advantage of exogenous variation in paid maternity leave introduced by a 2011 policy change in Chile, which increased the paid postnatal leave period from 12 to 24 weeks. Using a difference-in-difference instrumental variable approach, I find that one extra week of paid maternity leave increases the probability of being diagnosed with postpartum depression by 0.3 percentage points. However, I find no evidence of an increase in self-reported maternal stress level during the first 18 months after delivery using the Parental Stress Index (PSI) or an increase in longer term depressive symptoms measured by the CES-D scale. A likely mechanism driving the increased diagnosis is that longer paid maternity leave increases the likelihood of diagnosis given a fixed level of depressive symptoms. I show that longer leave increases labor market attachment of mothers and thereby affects insurance coverage and doctor visits. By remaining employed, women are not only less likely to be uninsured (1.2 percentage points), but also they get access to better health insurance (7 percentage points). The availability of better health insurance combined with more time to go to the doctor, increase doctor visits during the first year after delivery, especially mental health visits (1.2 percentage points). Taken together, the evidence suggests that longer maternity leave increases postpartum depression diagnosis mainly by increasing diagnosis as opposed to worsening mental health. This is important because diagnosis is an important prerequisite to get treatment.