Injuries/Violence
Paid Family and Medical Leave and Physical Abuse During Pregnancy: Evidence from a Multi-State Quasi-Experimental Analysis Krista Neumann* Krista Neumann Neumann Neumann Neumann Neumann University of Washington
Abuse during pregnancy is associated with serious maternal and infant health consequences. Structural economic policies may influence risk of abuse by reducing financial stress and relationship conflict. Paid family leave (PFL), although typically used postpartum, may affect prenatal experiences by shaping economic security and household dynamics around childbirth. Evidence, though, on whether state PFL adoption is associated with abuse during pregnancy is limited. We used data from the Pregnancy Risk Assessment Monitoring System (PRAMS), a population-based survey of postpartum individuals, from 2000–2022 and restricted to respondents with valid information on physical abuse during pregnancy. The outcome was a binary indicator of self-reported physical abuse by a husband or partner during pregnancy. The exposure was state adoption of a PFL policy, defined as the first year benefits became available. We estimated the association between PFL adoption and abuse during pregnancy using a staggered difference-in-differences design that compared states with PFL policies to those that had not yet adopted PFL. Event-study estimates were used to assess pre-policy trends and post-adoption dynamics. Standard errors were clustered at the state level. Between 2009 and 2021, six states participating in PRAMS adopted PFL. Overall, 2.3% of respondents reported physical abuse during pregnancy. Event-study estimates showed no evidence of differential pre-policy trends. In the 1–3 years following adoption, PFL was associated with a 0.15 percentage-point decrease in abuse during pregnancy (95% CI: −1.14, 0.83). Larger reductions were observed in years 4–7 post-adoption (0.41 percentage-point decrease; 95% CI: −0.94, 0.12). These findings contribute to limited empirical evidence on structural policy interventions for reducing abuse during pregnancy and suggest PFL policies may have benefits for abuse prevention during pregnancy, especially as programs become more established.
