Does Hong Kong’s extended statutory maternity leave improve maternal mental health outcomes?

Abstract

<p>BACKGROUND</p><p>Maternity leave is an essential employee protection that has been shown to provide critical health benefits. Hong Kong recently extended its paid statutory maternity leave duration from 10 to 14 weeks. We take advantage of the natural experiment created by the policy implementation to assess the mental health implications of the leave extension.</p><p><br></p><p>METHODS</p><p>This natural experiment study uses a prospective pre/post-policy design to evaluate the effects of Hong Kong’s statutory maternity leave policy extension on maternal mental health outcomes (Edinburgh Postnatal Depression Scale scores ≥ 10). Respondents for the two policy groups were recruited to complete the survey between October 2021 and November 2022. Our primary outcomes were: 1) postpartum depression (EPDS scores ≥10), and 2) emotional well-being interference with baby care in the first two months postpartum. Multivariate logistic regression was applied to estimate odds ratios.</p><p>RESULTS</p><p>A total of 1414 respondents (254 pre- and 1160 post-policy) were included in the analysis. One-third of all respondents (33.0%) were at risk for postpartum depression (EPDS scores ≥10). Post-policy respondents had significantly lower odds of EPDS scores ≥10 (OR: 0.62, CI: 0.45-0.86) and emotional well-being interfering with baby care (OR: .48, CI: .35-.65). Higher occupational skill level was a significant protective factor for maternal mental health.</p><p>CONCLUSION</p><p>The 4-week statutory maternity leave policy extension was associated with significantly improved postpartum mental health outcomes. Nevertheless, despite the beneficial effects of the policy, maternal mental health concerns in Hong Kong remain pervasive requiring further intervention.</p>