A Northeastern University study of working parents of newborns in rural and metropolitan areas of Maine found that people in rural areas were less likely to have paid parental leave than their urban counterparts and were more likely to experience financial distress.
The study showed that 64% of respondents in metro areas had some paid parental leave after childbirth, compared to 43% of those in small rural areas, according to Louisa H. Smith, a Northeastern epidemiologist and co-author of the survey.
The differences may translate into increased stress for rural families, Smith says.
“We asked if you were ever worried about running out of food in the first 12 weeks postpartum,” says Brianna Keefe-Oates, who co-authored the survey report as a postdoctoral fellow at Northeastern.
For those in small rural areas, the answer was yes for 33%, compared to 7% for survey respondents in metropolitan areas and 26% for those in large rural areas.
The finding indicates that having paid leave could help decrease financial stress during the 12-week postpartum period, Keefe-Oates says.
Maine passed a Paid Family and Medical Leave law two years ago that will provide parents with 12 weeks of paid leave after childbirth, fostering or adoption, but it won’t go into effect until mid 2026.
In the meantime, parents with unpaid leave struggle with the same sleep deprivation, doctor appointments and pressure from employers to return to work as those with paid leave benefits, Smith and Keefe-Oates say.
They just do it with less of a financial cushion.
“Interestingly, we didn’t see differences in the median amount of leave that people took,” Smith says. “People, even if they didn’t have paid leave, were still taking leave for the most part because they needed that time to recover from childbirth. They needed that time to be with their infants.”
The median amount of paid leave came to about 12 weeks.
“It’s not just about recovering but also about having to go to the doctor for ongoing care as their babies are rapidly developing,” Keefe-Oates says. About 44% of new parents brought their newborns to the doctor for visits outside well-child checks.
Their report analyzed data from two sources, their own survey of new parents, called the Maine Assessment of Parental Leave Experiences (MAPLE), as well as state and federal data from the Maine Pregnancy Risk Assessment and Monitoring System (PRAMS).
The Northeastern survey included 151 new mothers from around the state of Maine, while the PRAMS survey included over 400 participants.
Smith and Keefe-Oates say understanding rural-urban differences is key to making sure Maine’s new paid leave law, with its salary replacement component, addresses health disparities rather than aggravates them.
“Rural residents already face greater challenges accessing maternal health care, with higher rates of maternal medical conditions and fewer health care resources, especially in light of closures of obstetrics units at hospitals throughout the state,” they wrote.
With or without these challenges, the benefits of paid leave and increased leave duration are many and include increased breastfeeding, timely immunizations, reduced risk of hospitalization from infections and improved maternal mental health, Smith and Keefe-Oates report.