Parental leave and work adaptation at the transition to parenthood: Individual, marital, and social correlates

Association between maternity leave policies and postpartum depression: a systematic review

PURPOSE

Working mothers are at greater risk for postpartum depression. Maternity leave characteristics, including length, wage replacement and employment protection, could have relevant implications for mothers' mental health. We propose to explore whether there is an association between maternity leave characteristics and postpartum depression.

METHODS

We conducted a systematic review searching for randomized controlled trials, quasi-experimental, cohort or cross-sectional studies on five databases using search terms including maternity and parental leave and depression, as well as references in relevant articles. We identified 500 articles and included 23 of those. We used the EPHPP Quality Assessment Tool for Quantitative Studies to assess the quality of the studies.

RESULTS

Paid and longer maternity leaves tend to be associated with a reduction of postpartum depression symptoms in high-income countries. No studies explored the association between employment protection and postpartum depression. The quality of studies ranged from strong to weak, mostly influenced by study design.

CONCLUSION

More restrictive maternity leave policies tend to be associated with higher rates of postpartum depression, although more research needs to be conducted in the Global South.

The neonatal perspective of paid family medical leave (PFML)

Paid family medical leave (PFML) offers infants, parents, and society at large numerous health and economic benefits. It has been shown to improve neonatal and maternal outcomes, breastfeeding rates, familial relationships, and decrease gender inequalities in the workplace. Though the economic feasibility of PFML has been well established in many countries, the USA lacks a cohesive and comprehensive federal PFML policy. Neonatal healthcare providers play a critical role in impacting neonatal health and should actively advocate for the development and promotion of a federal PFML policy, particularly one that is inclusive of both mothers and fathers and is at least 12 weeks in duration.

Dyadic Association Between New Parents' Mindfulness and Relationship Satisfaction: Mediating Role of Perceived Stress

The transition to parenthood is marked by increased potential stressors and relationship satisfaction declines among new parents. Recently, it has been suggested that people with greater mindfulness perceived their environment as less stressful during difficult times in life, which in turn, is associated with greater relationship satisfaction. Accordingly, this dyadic diary study evaluated if perceived stress explains the link between new parents' mindfulness and relationship satisfaction. A total of 78 new parent couples (N = 156 participants; M = 6 months postpartum) provided ecologically valid perceived stress and relationship satisfaction data by responding to a questionnaire on their smartphones, between 7 p.m. and midnight, for 14 consecutive days. Data were analyzed using Actor-Partner Interdependence Mediation Model (APIMeM). Results revealed that parents with higher mindfulness reported lower perceived stress, which in turn was associated with them reporting higher relationship satisfaction. In addition, one's mindfulness was directly positively associated with their partner's relationship satisfaction. Lastly, when all partner effects between mindfulness, perceived stress and relationship satisfaction were tested together without defining specific partner paths, one's mindfulness was positively associated with their partners' relationship satisfaction. Our findings extend current knowledge on the dyadic association between mindfulness and relationship satisfaction during the transition to parenthood by highlighting perceived stress as a key variable underlying this relationship.

Paternal Leave Entitlement and Workplace Culture: A Key Challenge to Paternal Mental Health

Paternal mental health continues to be a health concern in the UK. Paternal leave entitlement and workplace cultures have failed to support fathers in navigating the complexity of fatherhood, which has an impact on fathers' wellbeing. Interviewing twenty fathers in the York area, this study seeks to explore the impact of parental leave entitlements and workplace cultures on fathers' mental health. The findings demonstrate that the influence of gendered norms and hegemonic masculinity perceptions are ingrained in the current leave entitlement and workplace cultures. While fathers are entitled to take leave, the leave is significantly insufficient to allow them to forge a meaningful bond with a newborn or adapt to the change in routine brought about by the birth of a baby. Furthermore, workplace cultures fail to recognise the responsibilities that come with fatherhood and provide insufficient support for fathers. The COVID-19 lockdown presented fathers with a unique opportunity to be available and take on more family responsibilities. Fathers felt they did not have to navigate gendered and hegemonic perceptions to spend more time with the family. This paper challenges structural and cultural barriers that prevent fathers from taking leave and impacting negatively on fathers' mental health. The paper suggests a review of the current paternal leave entitlement and cultural change in the workplace.

Paternal and maternal rejection and Chinese children's internalizing and externalizing problems across the transition to siblinghood: A developmental cascade model of family influence

This longitudinal study examined the reciprocal associations between paternal and maternal rejection and firstborn children's (M_age  = 49.9 months; 55% boys) behavior problems across the transition to siblinghood in a sample of 120 families recruited from 2016 to 2018 from Shanghai, China. Parental rejection and behavior problems were assessed before (prenatal) and 1, 6, and 12 months after the birth of a baby sibling. Random intercept cross-lagged panel models revealed positive relations between internalizing problems and both maternal and paternal rejection, and between externalizing problems and paternal rejection at the between-person level (rs = .32-.37), but only cross-lagged effects from children's internalizing and externalizing problems to maternal rejection at the within-person level (βs = .30-.54).

The effect of parental leave on parents' mental health: a systematic review

Mental health disorders during the post-partum period are a common morbidity, but parental leave might help alleviate symptoms by preventing or reducing stress. We aim to summarise available evidence on the effect of different types of parental leave on mental health outcomes among parents. For this systematic review, we searched Ovid MEDLINE, Web of Science, PsycINFO, CINAHL, and Scopus from database inception to Aug 29, 2022, for peer-reviewed, quantitative studies written in English. We included studies if the exposure was postnatal parental leave; a relevant comparison group was present (eg, paid vs unpaid leave); and if indicators related to general mental health, including depression, anxiety, stress, and suicide, for either parent were evaluated or recorded at any time after childbirth. The Review is registered with PROSPERO (registration number CRD42021227499). Of the 3441 records screened, 45 studies were narratively synthesised. Studies were done in high-income countries, and they examined generosity by any parental leave (n=5), benefit amount (n=13), and leave duration (n=31). 38 studies were of medium or high quality. Improved mental health was generally observed among women (referred to as mothers in this Review) with more generous parental leave policies (ie, leave duration and paid vs unpaid leave). For example, increased duration of leave was generally associated with reduced risk of poor maternal mental health, including depressive symptoms, psychological distress and burnout, and lower mental health-care uptake. However, the association between fathers' leave and paternal mental health outcomes was less conclusive as was the indirect effect of parental leave use on partners' mental health.

Examining the Relationship Between Return to Work After Giving Birth and Maternal Mental Health: A Systematic Review

INTRODUCTION

The negative impacts of mental health disorders on the well-being of women and their infants are clear. However, less is known about the relationship between returning to work after giving birth and mental health. Previous reviews examined the relationship between maternity leave and mental health, but we defined return to work as the process of returning to part-time or full-time work after giving birth and caring for infant. This systematic review aims to: (1) describe operational definitions for return to work and (2) describe the evidence on the relationship between return to work and maternal mental health.

METHODS

We searched PubMed, PsycINFO, CINAHL, and Web of Science for peer-reviewed studies. Articles were selected if they were published within the past 20 years, examined at least one mental health condition (e.g., depression, anxiety), and included a study sample of U.S. working mothers.

RESULTS

We identified 20 articles published between 2001 and 2020. We found conflicting evidence from longitudinal and cross-sectional data demonstrating that return to work was associated with improvements and negative consequences to mental health. Work-related predictors of mental health included: access to paid maternity leave, work-family conflict, total workload, job flexibility, and coworker support.

DISCUSSION

This review provides evidence that return to work and mental health are related, though the study samples have limited generalizability to all U.S. working mothers. More research is needed to understand the direction of this relationship throughout the perinatal period and how return to work affects other mental health conditions (e.g., anxiety, stress).

Paid maternal leave is associated with infant brain function at 3 months of age

The first months of life are critical for establishing neural connections relevant for social and cognitive development. Yet, the United States lacks a national policy of paid family leave during this important period of brain development. This study examined associations between paid leave and infant electroencephalography (EEG) at 3 months in a sociodemographically diverse sample of families from New York City (N = 80; 53 males; 48% Latine; data collection occurred 05/2018-12/2019). Variable-centered regression results indicate that paid leave status was related to differences in EEG power (ps < .02, R² s > .12). Convergent results from person-centered latent profile analyses demonstrate that mothers with paid leave were 7.39 times as likely to have infants with EEG profiles characterized by increased higher-Hz power (95% CI, 1.9-36.9), potentially reflecting more mature patterns of brain activity.

The Impact of Paid Maternity Leave on the Mental and Physical Health of Mothers and Children: A Review of the Literature and Policy Implications

For decades, national paid maternity leave policies of 12 weeks or more have been established in every industrialized country except the United States. Despite women representing 47% of the current U.S. labor force, only 16% of all employed American workers have access to paid parental leave through their workplace. As many as 23% of employed mothers return to work within ten days of giving birth, because of their inability to pay living expenses without income. We reviewed recent studies on the possible effects of paid maternity leave on the mental and physical health of mothers and children. We found that paid maternity leave is associated with beneficial effects on (1) the mental health of mothers and children, including a decrease in postpartum maternal depression and intimate partner violence, and improved infant attachment and child development, (2) the physical health of mothers and children, including a decrease in infant mortality and in mother and infant rehospitalizations, and an increase in pediatric visit attendance and timely administration of infant immunizations, and (3) breastfeeding, with an increase in its initiation and duration. Given the substantial mental and physical health benefits associated with paid leave, as well as favorable results from studies on its economic impact, the United States is facing a clear, evidence-based mandate to create a national paid maternity leave policy. We recommend a national paid maternity leave policy of at least 12 weeks.

Conditional regard, stress, and dyadic adjustment in primiparous couples: A dyadic analysis perspective

Many couples transitioning into parenthood are at risk for dyadic adjustment declines. It is therefore important to explore key, theory-driven deterrents of enduring relationships during this period, as well as potential underlying mechanisms. This study examined the relationship between perceived conditional negative regard (i.e. a behavior that thwarts basic psychological needs; T1), stress (T1), and dyadic adjustment (T2) during the transition to parenthood. Primiparous couples (N = 144) were recruited to fill out an online questionnaire when their babies were 6-months (T1) and 12-months (T2). Path analysis with an Actor-Partner Interdependence Mediation Model was conducted. Results show that for each partner (actor effects), stress (T1) mediated the link between perceived conditional negative regard (T1), and later dyadic adjustment (T2). For the partner effects, while stress (T1) did not play a mediating role between these variables, other partner effects were found. Each primiparous parent's perceived conditional negative regard (T1) was associated with the other parent's later dyadic adjustment (T2). However, when examining longitudinal changes in stress and dyadic adjustment over time (T2, controlling for respective T1), no significant associations were found. Overall, the findings shed light on the dyadic associations of conditional negative regard, and the mechanisms through which it is negatively tied with dyadic adjustment during the transition to parenthood.

Overlapping Stigmas of Pregnancy, Motherhood, and Weight: Policy Implications for Employment and Higher Education

Pregnant women and new mothers experience numerous biases: they are inappropriately touched, less likely to be hired or promoted, paid less, and subjected to a host of stereotypes. Pregnant women and mothers are perceived as warm and maternal, but also incompetent and uncommitted. If they return to work, they are perceived as cold, but still incompetent, and uncommitted. These stigmas worsen when pregnant women are heavier, as weight-based stigmas add additional biases. This article explores the overlapping stigmas of pregnancy, motherhood, and weight in the workplace and higher education. Each has implications for policies. Addressing the stigmas for pregnant women and mothers will increase diversity in the workforce and higher education. The COVID-19 pandemic brings additional pressures on pregnant women and mothers.

Longitudinal associations between prenatal testosterone and postpartum outcomes in a sample of first-time expectant lesbian couples

Although increasing numbers of gay and lesbian individuals ultimately become parents, the vast majority of research on the transition to parenthood focuses exclusively on heterosexual samples. Even less is known about the physiological implications of this major life transition among those who identify as sexual minorities. The present study begins to redress these gaps in the literature by assessing prospective links between prenatal testosterone, a steroid hormone that is negatively associated with nurturance and caregiving, and postpartum outcomes in a sample of 25 first-time expectant lesbian couples (N = 50 individuals). Consistent with prior work in heterosexual samples, which suggests that lower testosterone promotes both partnering and parenting, we found that, in both partners, lower testosterone during the prenatal period predicted better romantic relationship and parenting outcomes at three-months postpartum (e.g., higher relationship quality, more time spent doing baby care). There was also evidence for dyadic associations; for instance, birth mothers reported more overprotective behavior, and non-birth mothers reported greater commitment, when their female partners had lower testosterone. Together, our findings contribute important new knowledge about the functionality of testosterone in close relationships contexts, including some of the first evidence among sexual minorities.

Mom-and-Pop Narcissism: The Impact of Attention Seeking and Grandiosity on Couples' Experience of the Transition to Parenthood

Various studies have demonstrated associations between personality disorders and relationship satisfaction. The authors examine the associations between attention seeking and grandiosity, both features of narcissistic personality disorder, and relationship satisfaction before and after the transition to parenthood. The authors then expand their analysis to parental satisfaction and postpartum depression (PPD). Nonclinical couples (N = 103 couples) expecting their first child completed measures of grandiosity, attention seeking, and relationship satisfaction before birth, and of relationship satisfaction, parental satisfaction, and PPD symptoms 3 months afterward. Attention seeking was associated with less parental satisfaction and more PPD symptoms, and with less prepartum relationship satisfaction for participants' partners. For men, attention seeking was also associated with prepartum relationship satisfaction. Grandiosity was associated with a decrease in relationship satisfaction after birth, although, surprisingly with fewer PPD symptoms for participants' partners. The authors discuss how these findings might be related to changes in social support and work-life balance during the transition to parenthood.

Early education and care quality: Does it matter for maternal working hours?

This study investigates whether mothers whose children enter early childhood education and care (ECEC) centers of higher quality are more likely to work longer hours. The empirical analysis links the Socio-Economic Panel (SOEP) Study with the K²iD-SOEP extension study, which collected ECEC quality information from childcare centers across Germany. Based on a sample of 556 mothers of 628 children with a mean age of 2.6 years at center entry, the authors applied change score models with entropy balancing to account for differences in a rich set of observable characteristics. The findings show that higher levels of quality with respect to child-teacher-ratio and partly also activities promoting child learning and offered services for parents are associated with greater increases in working hours for mothers since the year before using the ECEC center. No significant relationships emerged for group size and equipment.

Mental health and wellbeing during the transition to fatherhood: a systematic review of first time fathers' experiences

OBJECTIVE

The aim of this systematic review was to identify and synthesize the best available evidence on first time fathers' experiences and needs in relation to their mental health and wellbeing during their transition to fatherhood.

INTRODUCTION

Men's mental health and wellbeing during their transition to fatherhood is an important public health issue that is currently under-researched from a qualitative perspective and poorly understood.

INCLUSION CRITERIA

Resident first time fathers (biological and non-biological) of healthy babies born with no identified terminal or long-term conditions were included. The phenomena of interest were their experiences and needs in relation to mental health and wellbeing during their transition to fatherhood, from commencement of pregnancy until one year after birth. Studies based on qualitative data, including, but not limited to, designs within phenomenology, grounded theory, ethnography and action research were included.

METHODS

A three-step search strategy was used. The search strategy explored published and unpublished qualitative studies from 1960 to September 2017. All included studies were assessed by two independent reviewers and any disagreements were resolved by consensus or with a third reviewer. The recommended Joanna Briggs Institute (JBI) approach to critical appraisal, study selection, data extraction and data synthesis was used.

RESULTS

Twenty-two studies met the eligibility criteria and were included in the review, which were then assessed to be of moderate to high quality (scores 5-10) based on the JBI Critical Appraisal Checklist for Qualitative Research. The studies were published between 1990 and 2017, and all used qualitative methodologies to accomplish the overall aim of investigating the experiences of expectant or new fathers. Nine studies were from the UK, three from Sweden, three from Australia, two from Canada, two from the USA, one from Japan, one from Taiwan and one from Singapore. The total number of first time fathers included in the studies was 351. One hundred and forty-four findings were extracted from the included studies. Of these, 142 supported findings were aggregated into 23 categories and seven synthesized findings: 1) New fatherhood identity, 2) Competing challenges of new fatherhood, 3) Negative feelings and fears, 4) Stress and coping, 5) Lack of support, 6) What new fathers want, and 7) Positive aspects of fatherhood.

CONCLUSIONS

Based on the synthesized findings, three main factors that affect first time fathers' mental health and wellbeing during their transition to fatherhood were identified: the formation of the fatherhood identity, competing challenges of the new fatherhood role and negative feelings and fears relating to it. The role restrictions and changes in lifestyle often resulted in feelings of stress, for which fathers used denial or escape activities, such as smoking, working longer hours or listening to music, as coping techniques. Fathers wanted more guidance and support around the preparation for fatherhood, and partner relationship changes. Barriers to accessing support included lack of tailored information resources and acknowledgment from health professionals. Better preparation for fatherhood, and support for couple relationships during the transition to parenthood could facilitate better experiences for new fathers, and contribute to better adjustments and mental wellbeing in new fathers.

Quality of life in Japanese couples during the transition to parenthood

OBJECTIVE

This study aimed to examine the quality of life (QOL) in Japanese couples during the transition to parenthood with their first child.

BACKGROUND

Relevant literature suggests that the health status of women drop during pregnancy and the postpartum period. However, less is known about their partner's well-being during the transition to parenthood and little research has addressed the relationship between couples' QOL across multiple domains.

METHOD

Participants included 9216 married Japanese men and women, including 3729 couples, who were expecting or raising their first child under the age of three. They independently completed questionnaires on baseline demographics and on WHOQOL-BREF.

RESULTS

Men showed higher scores for psychological QOL, while women had higher scores for social and environment QOL. A significant interaction between gender and stage of transition to parenthood was found. The moderating effect of age between the stage and QOL was found for men on the physical and psychological domains. Couples' QOL scores were weakly to moderately correlated.

CONCLUSION

Findings suggest that both men and women had lower QOL, with the exception of women's physical QOL, after childbirth, but they showed different trends during the transition to parenthood across different domains of QOL.

Maternity Leave Access and Health: A Systematic Narrative Review and Conceptual Framework Development

Background Maternity leave is integral to postpartum maternal and child health, providing necessary time to heal and bond following birth. However, the relationship between maternity leave and health outcomes has not been formally and comprehensively assessed to guide public health research and policy in this area. This review aims to address this gap by investigating both the correlates of maternity leave utilization in the US and the related health benefits for mother and child. Methods We searched the peer-reviewed scholarly literature using six databases for the years 1990 to early 2015 and identified 37 studies to be included in the review. We extracted key data for each of the included studies and assessed study quality using the "Weight of the Evidence" approach. Results The literature generally confirms a positive, though limited correlation between maternity leave coverage and utilization. Likewise, longer maternity leaves are associated with improved breastfeeding intentions and rates of initiation, duration and predominance as well as improved maternal mental health and early childhood outcomes. However, the literature points to important disparities in access to maternity leave that carry over into health outcomes, such as breastfeeding. Synthesis We present a conceptual framework synthesizing what is known to date related to maternity leave access and health outcomes.

Prospective and dyadic associations between expectant parents' prenatal hormone changes and postpartum parenting outcomes

During the transition to parenthood, both men and women experience hormone changes that are thought to promote parental care. Yet very few studies have explicitly tested the hypothesis that prenatal hormone changes are associated with postpartum parenting behavior. In a longitudinal study of 27 first-time expectant couples, we assessed whether prenatal hormone changes were moderated by self- and partner-reported parenting outcomes at 3 months postpartum. Expectant fathers showed prenatal declines in testosterone and estradiol, and larger declines in these hormones were associated with greater contributions to household and infant care tasks postpartum. Women whose partners showed larger testosterone declines also reported receiving more support and more help with household tasks. Expectant mothers showed prenatal increases in testosterone and estradiol, and larger increases in these hormones were associated with lower partner-rated support. Together, our findings provide some of the first evidence that prenatal hormone changes may indeed be functional and that the implications of these changes may be detectable by co-parents.

Population Health and Paid Parental Leave: What the United States Can Learn from Two Decades of Research

Over the last two decades, numerous studies have suggested that dedicated time for parents to be with their children in the earliest months of life offers significant benefits to child health. The United States (US) is the only wealthy nation without a formalized policy guaranteeing workers paid time off when they become new parents. As individual US states consider enacting parental leave policies, there is a significant opportunity to decrease health inequities and build a healthier American population. This document is intended as a critical review of the present evidence for the association between paid parental leave and population health.

Interventions for Women With Postpartum Depression Symptoms

Using the stress-buffering hypothesis as a guide, this integrative review aims to identify how human resource development (HRD) professionals can address the issues faced by working women who are experiencing postpartum depression symptoms, in addition to identifying gaps in HRD research on this emerging topic. Most of the studies reviewed came from the nursing and psychology literature; none were found in the HRD literature. This review was undergirded by the stress-buffering hypothesis, which posits that social support can moderate the effect of a stressful event. Studies pointed to social support, especially from coworkers and supervisors, as having a positive effect on postpartum depression symptom scores. Overall, the findings of this study are entry points into HRD research and practice about how employers can support working women who are experiencing postpartum depression symptoms. Further research should examine the type of social support that is effective in helping working mothers.

Psychological Aspects of Contraception, Unintended Pregnancy, and Abortion

The knowledge of important biopsychosocial factors linking women's reproductive health and mental health is increasing. This review focuses on psychological aspects of contraception, unintended pregnancy, and abortion because these are common reproductive health experiences in U.S. women's lives. This review addresses the mental-health antecedents and consequences of these experiences, mostly focusing on depression and depressive symptoms before and after unintended pregnancy and contraception. As mental-health antecedents, depressive symptoms predict contraceptive behaviors that lead to unintended pregnancy, and mental-health disorders have been associated with having subsequent abortions. In examining the mental-health consequences, most sound research does not find abortion or contraceptive use to cause mental-health problems. Consequently, evidence does not support policies based on the notion that abortion harms women's mental health. Nevertheless, the abortion-care setting may be a place to integrate mental-health services. In contrast, women who have births resulting from unintended pregnancies may be at higher risk of postpartum depression. Social policies (e.g., paid maternity leave, subsidized child care) may protect women from mental-health problems and stress of unplanned children interrupting employment, education, and pre-existing family care responsibilities.

PROGRESS ON THE PATERNAL BRAIN: THEORY, ANIMAL MODELS, HUMAN BRAIN RESEARCH, AND MENTAL HEALTH IMPLICATIONS

With a secure foundation in basic research across mammalian species in which fathers participate in the raising of young, novel brain-imaging approaches are outlining a set of consistent brain circuits that regulate paternal thoughts and behaviors in humans. The newest experimental paradigms include increasingly realistic baby-stimuli to provoke paternal cognitions and behaviors with coordinated hormone measures to outline brain networks that regulate motivation, reflexive caring, emotion regulation, and social brain networks with differences and similarities to those found in mothers. In this article, on the father brain, we review all brain-imaging studies on PubMed to date on the human father brain and introduce the topic with a selection of theoretical models and foundational neurohormonal research on animal models in support of the human work. We discuss potentially translatable models for the identification and treatment of paternal mood and father-child relational problems, which could improve infant mental health and developmental trajectories with potentially broad public health importance.

The role of satisfaction with social support in perceived burden and stress of parents of six-month-old infants with a congenital anomaly: Actor and partner effects

This exploratory study examined the role of satisfaction with support from family and friends on the burden and stress of parents of infants with a congenital anomaly (CA). The effects of social support were examined within the couple (actor and partner effects). A total of 36 couples whose six-month-old infant has a CA participated in this study. The parents completed questionnaires regarding satisfaction with support, burden (Impact on Family Scale - Revised), and parenting stress (Parenting Stress Index). The results showed that fathers directly benefited from the support they received from friends in reducing their burden, while mothers only indirectly benefited from it through the father's adjustment. The pattern was different for stress: mothers directly benefited from the support they received from their family in reducing their stress levels, while fathers benefited both directly from the support they received from friends and indirectly from the support that their partners received from family. These results highlight that (1) the different support needs of mothers and fathers (due to their different roles during transition to parenthood) and (2) the diffusion of benefits of social support within the couple should be taken into account when developing strategies to promote support to families of six-month-old infants with a CA.

Employment, family leave, and parents of newborns or seriously ill children

OBJECTIVES

Parents of newborns and children with special health care needs (CSHCN) often experience conflict between employment and family responsibilities. Family leave benefits such as the federal Family and Medical Leave Act and California's Paid Family Leave Insurance program help employed parents miss work to bond with a newborn or care for an ill child. The use of these benefits, however, is rare among mothers of CSHCN and fathers in general and limited even among mothers of newborns. We explored barriers to and experiences with leave-taking among parents of newborns and CSHCN.

METHODS

We conducted semistructured qualitative interviews in 2008 with 10 mothers and 10 fathers of newborns and 10 mothers and 10 fathers of CSHCN in Los Angeles to explore their need for and experiences with family leave. Qualitative analytical techniques were used to identify themes in the transcripts.

RESULTS

All parents reported difficulties in accessing and using benefits, including lack of knowledge by employers, complexity of rules and processes, and inadequacy of the benefits themselves. Parents of CSHCN also described being too overwhelmed to rapidly seek and process information in the setting of urgent and often unexpected health crises. Most parents expressed a clear desire for expert guidance and saw hospitals and clinics as potentially important providers.

CONCLUSIONS

Even when parents are aware of family leave options, substantial barriers prevent many, especially parents of CSHCN, from learning about or applying for benefits. Clinics and hospitals might be opportune settings to reach vulnerable parents at times of need.

Couple psychoeducation for new parents: observed and potential effects on parenting

The transition to parenthood is a substantial challenge for many couples, and the extent to which the partners can support each other and their relationship is strongly related to the sensitivity and responsiveness of their parenting of their infant. This paper critically analyses the links between the couple relationship and parenting of infants and reviews the research evaluating couple psychoeducation (CP) to assist couples' parenting of their infant. It is concluded that CP has considerable potential to enhance couples' adaptation to parenthood and enhance the sensitivity and responsiveness of parenting of new infants.

Paid health and family leave: the Canadian experience in the global context

OBJECTIVES

Two thirds of Canadian adults participate in the workforce. Their health and that of their families can be markedly affected by the availability of paid sick leave, paid leave to care for family members' health and paid parental leave.

METHODS

We gathered data from all Canadian provinces and territories on these essential leave policies and compared Canadian policies with data collected on 186 United Nations (UN) countries.

RESULTS

While Canada pays sickness benefits for 15 weeks for serious illnesses, globally at least 90 countries provide benefits for at least 26 weeks or until recovery. Moreover, within Canada only Saskatchewan and Quebec guarantee job protection if sick leave lasts over 12 days. The federal government guarantees Canadian workers six weeks of paid leave to provide care or support to gravely ill family members. Only 39 countries guarantee such leave with pay. Most, but not all, provinces guarantee workers' job protection during compassionate care leave. Eligibility for job protection during parental leave varies across the country from having no restrictions to requiring at least one year of service.

CONCLUSION

Compared with Canada, many countries offer a longer duration of paid sick leave for employees and replace a higher percentage of wages lost. Internationally, Canada performs well in having policies that guarantee paid leave to care for dependants with serious illnesses, but it lags behind in the provision of paid leave to address the health needs of children or family members' with non-life-threatening conditions. Finally, while paid parental leave is of adequate duration, the wage replacement rate lowers its accessibility to families with limited means.

Traditional and Nontraditional Gender Roles and Work—Family Interface for Men and Women

In this article, we examine traditional and nontraditional gender roles and work—family interface for men and women. Recent empirical literature is reviewed and implications for career counselors are discussed. We discuss changing gender roles in career, marriage, and parenting and provide strategies for helping clients to cope with work—family role strain and to find a satisfying balance between life roles. Directions for future research are also discussed.

Maternal versus child risk and the development of parent-child and family relationships in five high-risk populations

Individual, dyadic, and triadic influences on the development of the family system were examined in the context of developmental risk. Participants were 145 couples and their 4-month-old first-born child in six groups: controls, three mother-risk groups (depressed, anxious, comorbid), and two infant-risk groups (preterm, intrauterine growth retardation). Dyadic and triadic interactions were observed. Differences in parent-infant reciprocity and intrusiveness were found, with mother-risk groups scoring less optimally than controls and infant-risk groups scoring the poorest. Similar results emerged for family-level cohesion and rigidity. Structural modeling indicated that father involvement had an influence on the individual level, by reducing maternal distress, as well as on the triadic level, by increasing family cohesion. Maternal emotional distress affected the reciprocity component of early dyadic and triadic relationships, whereas infant negative emotionality impacted on the intrusive element of parenting and family-level relationships. Discussion considered the multiple and pattern-specific influences on the family system as it is shaped by maternal and child risk conditions.

The role of culture in moderating the links between early ecological risk and young children's adaptation

To examine the effects of risk on infant development within cultural contexts, 141 dual-earner Israeli and Palestinian couples and their first-born child were observed at 5 months and again at 34 months. Eight ecological determinants were examined as potential risk factors, including the infant's observed and parent-reported difficult temperament; the mother's depressive symptoms, work-family interference, and experience of childbirth; the parents' marital satisfaction and social support; and observed maternal and paternal sensitivity. Symbolic play and behavior problems were assessed at 34 months. Culture-specific effects of risk and protective factors were found. Parent sensitivity facilitated symbolic competence to a greater extent in the Israeli group. Culture moderated the effects of maternal depression and family social support on toddlers' behavior problems. Maternal depressive symptoms had a negative impact on the behavior adaptation of Israeli children and social support buffered against behavior problems in the Arab group. Implications for research on risk and resilience and the role of culture in moderating the effects of ecological risk are discussed.

Mothers' time with infant and time in employment as predictors of mother-child relationships and children's early development

This study tested predictions from economic and developmental theories that maternal time with an infant is important for mother-child relationships and children's development, using time-use diaries for mothers of 7- to 8-month-old infants from the National Institute of Child Health and Human Development Study of Early Child Care (N = 1,053). Employment reduced time with infants, but mothers compensated for some work time by decreasing time in other activities. With family and maternal characteristics controlled, time with infants predicted high Home Observation for Measurement of the Environment (HOME) scores and maternal sensitivity, but bore little relation to children's engagement with mothers, secure attachment, social behavior, or cognitive performance from 15 to 36 months. Mothers who spent more time at work had higher HOME scores. Maternal time with infants may reflect maternal characteristics that affect both time allocation and maternal behavior.