Parental leave benefits and fathers’ postpartum mental health in Sweden

Background

Mental health conditions in the postpartum period are common among parents. Generous parental leave has been shown to protect against poorer postpartum mental health among mothers; however, evidence for fathers remains limited. This study examined the association between levels of paid parental leave benefits and fathers’ mental health in the first year after childbirth in Sweden.

Methods

Using national population registers, we conducted a cohort study of 210,285 first-time fathers whose child was born between 2007 and 2011, with 12 months of postpartum follow-up. Associations were estimated using logistic regression, with results presented as odds ratios (OR) and 95% confidence intervals (95%CI), both unadjusted and adjusted for child’s birth year, father’s age, mental health history, income and employment.

Results

Fathers receiving basic benefits had higher odds of receiving any mental healthcare (OR 2·06, 95%CI 1·84-2·31), being prescribed antidepressants or anxiolytics (OR 1·82, 95%CI 1·60-2·07), using specialist outpatient care (OR 3·36, 95%CI 2·83-3·99) and being hospitalised (OR 2·64, 95%CI 1·60-4·36) compared with those receiving higher-level benefits. Despite history of mental health having a strong association with all mental health outcomes, its inclusion in the models only partially attenuated the associations. After further adjusting for income and employment status, the odds attenuated across all outcomes. However, fathers receiving basic benefits still had higher odds of receiving any mental healthcare (OR 1·17, 95%CI 1·01-1·36), being prescribed antidepressants or anxiolytics (OR 1·23, 95%CI 1·05-1·45) and receiving outpatient care (OR 1·36, 95%CI 1·11-1·65) but not hospitalisation (OR 0·87, 95%CI 0·52-1·46).

Conclusions

Overall, fathers with access to more generous paid parental leave benefits experienced better postpartum mental health than those with basic benefits independent of employment, income, and mental health history.

Key messages

• Well-compensated parental leave may benefit fathers’ postpartum mental health while also promoting gender equality in caregiving.

• Generous parental leave provision can also be regarded as a public health intervention aimed at protecting fathers’ mental health.