Public Health of Indonesia
E-ISSN: 2477-1570 | P-ISSN: 2528-1542
Review Article A Systematic Review of the Effects of Paternity Leave on the Health and Well-Being of Mothers and Children Fadiah Maharani*1.
Lindya Okti Herbawani1.
Qorinah Estiningtyas Sakilah Adnani2.
Hadi Susiarno3.
Victor Abiola Adepoju4 1Midwifery Post Graduate Program.
Faculty of Medicine.
Universitas Padjadjaran.
Bandung.
West Java.
Indonesia 2Departement of Public Health.
Faculty of Medicine.
Universitas Padjadjaran.
Bandung.
West Java.
Indonesia 3Departement of Obstetric and Gynecology.
Faculty of Medicine.
Universitas Padjadjaran.
Bandung.
West Java.
Indonesia 4 Department of HIV and Infectious Diseases.
Jhpiego .
n Affiliate of John Hopkins Universit.
Abuja.
Nigeria *Corresponding author Fadiah Maharani Midwifery Post Graduate Program.
Faculty of Medicine.
Universitas Padjadjaran.
Bandung.
West Java.
Indonesia Email: fadiah24001@mail.
DOI: https://doi.
org/10.
36685/phi.
Copyright: A 2025 the Author.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted noncommercial use, distribution, and reproduction in any medium provided the original work is properly cited.
Article History:
Received 19 October 2024 Revised 22 January 2025 Accepted 13 April 2025 Abstract Background: The role of fathers in childcare is increasingly recognized as essential to promoting family well-being, particularly through the provision of paternity leave policies that enable fathers to participate actively in caregiving during the early stages of a child's life.
Empirical evidence suggests that paternal involvement has significant positive impacts on maternal health and child development.
However, the implementation and effectiveness of paternity leave policies remain inconsistent across countries, with many failing to utilize them optimally to support familial health.
Objective: This systematic review aims to evaluate the impact of paternity leave on maternal and child health by synthesizing findings from recent quantitative studies on policy implementation.
Methods: Following PRISMA guidelines, a systematic search was conducted across PubMed.
ScienceDirect.
Scopus.
EBSCOhost, and SpringerLink, targeting articles published between 2019 and 2024.
Eligible studies included quantitative analyses assessing the effects of paternity leave on health outcomes among fathers, mothers, and Studies focusing solely on maternity leave or lacking relevant health outcomes were excluded.
Two independent reviewers assessed the quality and relevance of the selected studies.
Results: Of 712 articles identified, 15 met the inclusion criteria.
Findings consistently showed that paternity leave was associated with reduced postpartum depression, prolonged breastfeeding duration, and improved child health outcomes, although variations in policy structure and implementation were noted.
Conclusion: Paternity leave significantly contributes to maternal mental health, supports breastfeeding practices, and enhances child development.
These findings underscore the necessity for more equitable and standardized paternity leave policies to support family health.
Keywords: paternity leave.
maternal health.
child well-being.
health outcomes.
Volume 11.
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July Ae September 2025 Background The significance of paternal engagement in childcare is progressively acknowledged worldwide, particularly concerning the advancement of familial health and welfare, alongside initiatives for gender equality (Yogman & Eppel, 2.
A fundamental idea of effective parenting is bonding, defined as the emotional connection between parents and children (Kinsey & Hupcey, 2.
This tie, first examined primarily within the mother-child context, is now acknowledged as significant in the father-child relationship as well (World Health Organization, 2024.
Diniz.
Brandao, & Verissimo, 2023.
Garcia et al.
Additional research indicates that paternal involvement in parenting during childhood not only enhances children's health and physiological stress regulation in adulthood but also diminishes the likelihood of drug and tobacco use and improves children's emotional and social regulatory skills (Choi et , 2021.
Maselko et al.
, 2019.
Rossin-Slater & Stearns, 2.
Paternity leave is an essential support mechanism for parenting, significantly influencing both a parent's work-life balance and the distribution of caregiving responsibilities at home (Pilkauskas & Schneider, 2020.
Pizarro & Gartzia, 2.
In many parts of Eastern Europe and Asia, women spend, on average, three additional hours per day on unpaid care work, including childcare, with the prevailing belief being that childcare is predominantly the woman's responsibility (UNFPA, 2.
To address these gender imbalances, paternity leave policies in OECD countries aim to foster fathers' involvement in caregiving and promote gender equality (Fluchtmann, 2023.
Bipartisan Policy Center, 2.
According to (United Nations, 2.
AuThis policy aligns with the pursuit of sustainable development goals, particularly SDG 3 .
xcellent health and well-bein.
and SDG 5 .
ender equalit.
Ay Despite these legislative advancements, paternity leave has not always been effective in encouraging fathers to take on primary caregiving roles (Duvander & Johansson, 2019.
Gartzia, 2.
Therefore, understanding the key factors that influence the success of paternity leave policies remains a challenge in both organizational research and gender equality initiatives (Jurado-Guerrero & Muyoz-Comet, 2.
The paternity leave policy not only benefits children but also positively influences the health and welfare of mothers.
Research indicates that partner support after childbirth is essential for preventing issues such as baby blues syndrome and postpartum depression, enhancing the success of exclusive breastfeeding, and promoting other maternal health behaviors (Panahi et al.
, 2022.
Rahadian et al.
, 2020.
Sangsawang et al.
, 2022.
White et al.
, 2.
Although extensive evidence suggests a positive impact of paternity leave on both maternal and child health, the outcomes vary across different contexts, with some studies yielding contradictory findings.
This variability is partly due to the differing durations of paternity leave, ranging from a few days to several months, which can influence the observed outcomes.
Such inconsistencies underscore the need for a thorough investigation to clarify the true effects of paternity leave on the health and well-being of mothers and children.
Methods Study design The literature search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist procedure (Page et al.
, 2.
Ethical approval was not required for this review as it does not involve clinical studies or patient data.
However, ethical considerations were maintained by adhering to established guidelines for systematic reviews, including ensuring transparency and objectivity in study selection and data analysis.
Search methods We utilize the Population.
Intervention.
Comparison.
Outcome, and Study Design (PICOS) framework (Amir-Behghadami & Janati, 2.
Articles are incorporated into a systematic review if they satisfy the subsequent criteria: .
published within the last five years .
conducted either nationally and internationally .
including a research sample that consists of fathers, mothers, and children to assess how paternity leave influences the health and overall well-being of both mothers and .
and serving as the main analysis of quantitative research, such as cross-sectional studies, casecontrol studies, cohort studies, and randomized controlled trials.
An article is excluded if: .
the full text is irretrievable.
it exclusively addresses maternity leave without considering paternity leave.
it constitutes an opinion piece, editorial, book chapter, or brief review article.
it involves animal subjects.
Volume 11.
Issue 3.
July Ae September 2025 .
it fails to evaluate maternal and child health outcomes .
, studies that solely investigate economic or corporate effect.
Search Outcomes We conducted literature searches across PubMed.
Science Direct.
SCOPUS.
EBSCOhost, and Springer Link for studies published between 2019 and 2024.
The selection of these databases was based on their relevance to the research topic, as they provide comprehensive access to peer-reviewed articles in health and social sciences.
Table 1 details the search terms and filters applied in each database.
All data were compiled and managed using Rayyan software, enabling duplicate removal and screening of unique study titles and abstracts according to eligibility criteria, carried out by two independent reviewers.
Quality Appraisal Two members of the research team independently evaluated the quality of the chosen studies utilizing the Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practices Project (Armijo-Olivo et al.
, 2.
Each article was evaluated as weak, moderate, or strong across six categories: selection bias, study design, confounder control, blinding, data collection methods, and withdrawal or dropout.
Evaluations were conducted based on predefined criteria for each category, minimizing bias through the use of objective measures.
In cases of discrepancy, a third independent reviewer was involved to resolve differences.
Articles were ranked overall based on the evaluations across all six categories.
Table 1.
Search terms and filters for each database search Database Search terms and filters PubMed 1 (("Parental Leave" OR "Paternity Leave" OR "Family Leave") AND ("Maternal Health" OR "Child Health" AND 2019:2024 .
)) Science Direct 1 (("Parental Leave" OR "Paternity Leave" OR "Family Leave") AND ("Maternal Health" OR "Child Health" AND 2019:2024 .
)) Scopus 1 (("Parental Leave" OR "Paternity Leave" OR "Family Leave") AND ("Maternal Health" OR "Child Health" AND 2019:2024 .
)) EBSCOhost 1 (("Parental Leave" OR "Paternity Leave" OR "Family Leave") AND ("Maternal Health" OR "Child Health" AND 2019:2024 .
)) SpringerLink 1 (("Parental Leave" OR "Paternity Leave" OR "Family Leave") AND ("Maternal Health" OR "Child Health" AND 2019:2024 .
)) .
means Publication date range Data Abstraction Following the independent screening of titles and abstracts, the research team reviewed the full texts of the eligible studies to ensure compliance with the inclusion criteria.
Disputes over study inclusion were resolved by discussion among reviewers, and where consensus could not be reached, a third reviewer We constructed two tables to encapsulate the attributes of the selected studies: primary author and year of publication.
data sources.
duration of data collection.
study design.
paternity leave policy.
comparison of paternity leave durations.
effects on maternal health and well-being.
and effects on children's health and well-being.
Data Synthesis and Analysis The data were synthesized descriptively due to significant differences in the definitions of "paternity leave" and its impact on maternal and child health and well-being.
We considered alternative methods, such as subgroup analyses or meta-regression, but found that these approaches were not feasible due to the variability in study designs and definitions.
Therefore, the study outlines its main findings, noting whether the reported associations reached statistical significance, indicated by a p-value of <0.
Results Study Selection We identified 712 papers through database searches (Figure .
After removing 123 duplicate articles, 589 papers remained for title and abstract evaluation.
Following the screening process, we excluded 529 articles, leaving 60 full-text reports for further evaluation.
Nine reports were not retrieved.
Volume 11.
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July Ae September 2025 and we evaluated the remaining fifty-one for eligibility.
We excluded 35 articles for the following reasons:
failure to address the research question .
, lack of measurement regarding the relationship between paternity leave and maternal child health and well-being .
, classification as a review article .
, requirement to send a letter to the editor .
, and designation as a study protocol rather than a completed study with results .
Consequently, our systematic review included 15 studies.
Study Characteristics Table 2 provides a summary of the characteristics of the selected studies, and Figure 2 illustrates the distribution of study designs used across the 15 publications.
The predominant type of studies identified were quasi-experimental, as evidenced by six articles (Bullinger, 2019.
Irish et al.
, 2021.
Kim.
Lebihan & Mao Takongmo, 2023.
Lee et al.
, 2020.
Roy Choudhury & Polachek, 2.
This approach frequently assesses policy impacts by contrasting the exposed group with the unexposed group regarding an intervention.
Identification Identification of studies via databases and registers Records identified throught database searching .
= .
A A A A A Records removed before PubMed .
= .
Science Direct .
= .
Scopus .
= .
EBSCOhost .
= .
SpringerLink .
= .
Duplicate records removed .
= .
Inappropriate title .
= .
Screening Records screened .
= .
Inappropriate abstract .
= .
Reports not retrieved .
= .
Reports sought for retrieval .
= A A A Reports assessed for eligibility .
= .
Reports excluded .
Included Study register .
= .
Irretrievable full-text .
= .
Conference abstract .
= .
A A A Studies included in review .
= .
Did not answer the research question .
= .
Did not measure relationship between paternity leave and maternal, child health and well-being.
= .
Review article .
= .
Letter to editor .
= .
a study protocol .
ot a completed study with result.
= .
Figure.
1 PRISMA flow diagram Cross-sectional studies constituted the second most prevalent design, with four articles employing this methodology (Eeles et al.
, 2022.
Grandahl et al.
, 2020.
Rosenberg et al.
, 2024.
Terada et al.
, 2.
The four investigations employed a cross-sectional design, albeit with varying analytical emphases.
Some Volume 11.
Issue 3.
July Ae September 2025 assessed the mental health consequences of parents (Eeles et al.
, 2022.
Terada et al.
, 2.
whereas others emphasize the length of breastfeeding (Grandahl et al.
, 2020.
Rosenberg et al.
, 2.
The cohort design is utilized in one paper (Barry et al.
, 2.
where research is performed by longitudinally observing a cohort of persons.
The next four research employed diverse methodological approaches to assess the effects of parental leave programs.
Khan .
utilized a two-way fixed effects model to examine paid leave policies in OECD countries, revealing that paid leave reduced newborn mortality rates and enhanced vaccine In a 2019 longitudinal study.
Huebener and colleagues applied a difference-in-differences approach to evaluate the impact of Germany's parental leave reform, finding that the program had no significant effect on child development.
Study Cardenas et al .
utilized a repeated-measures experimental design to assess the effects of paid paternity leave on parental mental health during the transition to parenting, demonstrating that paid leave enhances the mental well-being of both mothers and Canaan .
utilized a regression discontinuity design (RDD) to examine the extension of leave in France, revealing an escalation in gender inequality in labor force involvement and an adverse effect on children's verbal development.
The four research present diverse outcomes, although collectively underscore the significance of paid leave policies for family health and gender equality.
Figure 2.
General Characteristics for Study Selection .
These investigations were undertaken in several geographies, including one extensive study involving OECD countries (Khan, 2.
, and the other research primarily concentrates on high-income nations, such as the United States (Bullinger, 2019.
Cardenas et al.
, 2021.
Irish et al.
, 2021.
Kim, 2024.
Lee et al.
, 2020.
Rosenberg et al.
, 2024.
Roy Choudhury & Polachek, 2.
Japan (Terada et al.
, 2.
France (Barry et al.
, 2023.
Canaan, 2.
Canada (Lebihan & Mao Takongmo, 2.
Australia (Eeles et al.
, 2.
Sweden (Grandahl et al.
, 2.
, and German (Huebener et al.
, 2.
Synthesis of Results Maternal Psychological Well-being Paid family leave (PFL) programs generally enhance maternal mental health, significantly decreasing postpartum depressive symptoms.
PFL utilization correlated with a 4.
1% decrease in the incidence of postpartum depression (OR = 0.
CI: 0.
75Ae0.
and a 10% rise in the proportion of women indicating good mental health (Bullinger, 2019.
Lee et al.
, 2.
Mothers whose partners took paternity leave experienced a lesser reduction in postpartum depressive symptoms compared to those whose partners did not take leave, with an odds ratio of 1.
% CI: 1.
05Ae1.
(Barry et al.
, 2023.
Cardenas et , 2.
Paternity leave has been demonstrated to alleviate anxiety and stress, with 30% of mothers reporting a reduction in depressive symptoms when fathers utilize this time (Rosenberg et al.
, 2.
Volume 11.
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July Ae September 2025 Mothers who received enhanced support from their fathers during paternity leave showed notable increases in mental health (Huebener et al.
, 2019.
Khan, 2.
However, certain papers indicate that mothers have a heightened risk of depression when their partners take leave (Canaan, 2022.
Terada et al.
Maternal Physiological Well-being Compensated paternity leave positively influences the mother's physical well-being.
Studies indicate that mothers with access to Paid Family Leave (PFL) experience a 28% decrease in sick days (OR = 0.
CI: 0.
55Ae0.
and a 7% decline in adverse physical health conditions following the receipt of PFL (Bullinger, 2019.
Khan, 2.
Mothers who utilize paid paternity leave demonstrate a notable enhancement in physical health, evidenced by a 15% improvement compared to those who forgo such leave (Huebener et al.
, 2019.
Khan, 2.
The father's participation during paternity leave can alleviate the physical and psychological strain on mothers, consequently enhancing their overall physical health (Canaan, 2022.
Huebener et al.
, 2.
Furthermore, studies indicate that women who utilize paternity leave exhibit notable enhancements in physical health, with a 15% increase in their overall well-being (Khan, 2.
Child Physical Well-being The paid parental leave policy positively influences children's physical health.
Children of mothers utilizing Paid Family Leave (PFL) exhibit a 15% higher likelihood of timely immunization, with an odds ratio of 1.
15 (CI: 1.
05Ae1.
for complete vaccination (Bullinger, 2019.
Rosenberg et al.
, 2.
Fathers' participation in child care during paternity leave enhances children's physical health, evidenced by a 1015% reduction in hospitalization rates relative to children of parents who forgo leave (Khan, 2.
Children with engaged fathers exhibit fewer health issues, and evidence suggests that paternity leave used by fathers may mitigate delays in physical development (Eeles et al.
, 2022.
Roy Choudhury & Polachek.
Child Mental Health The active participation of fathers during paternity leave positively influences the child's mental health, resulting in a 20% decrease in the likelihood of developing behavioral issues (OR = 0.
CI: 0.
70Ae .
(Grandahl et al.
, 2020.
Rosenberg et al.
, 2.
Anxiety symptoms were reduced by 15% in children raised by parents who took extended leave (OR = 0.
CI: 0.
73Ae0.
, and there were fewer overall behavioral problems present (Lee et al.
, 2.
Increased paternal engagement during paid paternity leave helps alleviate maternal stress, therefore benefiting the child's mental health (Canaan, 2022.
Cardenas et , 2.
Research indicates that prolonged stressful events encountered by parents can lead to emotional development issues in their children later in life (Eeles et al.
, 2.
This underscores the need for parental support in fostering good emotional development in children.
Volume 11.
Issue 3.
July Ae September 2025 Author (Yea.
(Hueben er et al.
(Terada et al.
(Granda hl et al.
Location Data Source Germany (German SocioEconomic Pane.
Japan
Japan
COVID-19
Society Internet Survey Sweden Swedish Pregnancy Planning Study Data Perio Study Design Longitudi nal Study Table 2.
Characteristics of selected studies Parental leave Parental leave Sample Prior to the reform, eligibility was contingent upon a meanstested benefit, 28,987 Up to 14 months restricting access.
children with of compensated subsequent to the parental leave, reform, eligibility ve data on the with joint transitioned to an four domains eligibility for both earnings-related of child benefit, thereby participation in parental leave for both mothers and Crosectional 1,194 fathers Fathers are entitled to childcare leave until the child reaches one year of age.
Crosectional Study Eight Parental leave of up to 480 days, with 90 days allocated for each Volume 11.
Issue 3.
July Ae September 2025 Compare fathers who utilized paid leave with those who opted for unpaid leave or did not take leave at all.
Duration of exclusive and among parents who utilized Impact on Maternal Health & Well-being Impact on Child Health & Well-being Extended parental leave length correlates with enhanced mental health outcomes for mothers.
No substantial effect on children's verbal abilities, motor skills, socioemotional stability, and preparedness for school at the age of six.
Paternity leave correlates with elevated anger and rejection Extended parental leave may atmosphere for mothers, thereby Impaired bonding may hinder child growth and possibility of breastfeeding rates.
The extended duration of breastfeeding is associated with shared parental (Carden as et al.
California
(USA)
Unnamed al study Experime .
epeatedmeasures Seventy-two cohabiting in California who reported on paternity leave and prenatal and post-partum Volume 11.
Issue 3.
July Ae September 2025 California Paid Family Leave, initiated on July 1, 2004, permits employees to take up to 6 weeks of paid leave .
% of average salary, subject to a weekly maximu.
if they have been employed in the year preceding the child's birth and have earned at least US$300, to care for a newborn or adopted child, or for a seriously ill family member.
this program, in conjunction with the Family and Medical Leave Act, offers job protection to extended shared parental leave compared to those who utilized shorter leave Utilization of paid paternity leave:
unpaid leave, absence of leave, or selfemployment compared to any form of paid leave improving their mental health.
Mothers whose
spouses utilized paid leave escalation in stress and leave, enhancing health outcomes for Favorable correlation with familial cohesion and adaptation to enhances overall mental health
(Kim, (Barry et
California
(USA)
Survey of Income Program Participati on (SIPP) France Etude Longitudi Franyaise lAoEnfance (ELFE) Quasiexperimen .
ifferenc e-indifference Cohort Mothers aged 18 to 45 at the time of and all of age, who at any time during the nine months before birth and had nonzero average earnings, as paid family leave pertains solely to those in the 10,975 fathers and 13,075 Volume 11.
Issue 3.
July Ae September 2025 California Paid Family Leave (CAPFL) provides 6 weeks of leave with a 55% wage replacement Health results of California parents post-CA-PFL compared to parents in states lacking paid leave, both prior to and following CA-PFL Mothers indicated improved general health, fewer sick days, and less reliance on Enhanced maternal health indirectly promotes child health outcomes by enabling improved practices, including duration and superior newborn health results.
Two weeks of paternity leave at 80-100% of gross salary, subject to a daily limit.
Compared fathers who utilized paternity leave .
5% incidence of post-partum depressio.
with those who planned to take it .
and those who did not take it .
7%).
Elevated likelihood of depression in mothers whose spouses utilized paternity leave (OR 1.
08, 95% CI
02Ae1.
Paternity leave correlates with enhanced fatherchild interactions, improving child (Eeles et (Canaan.
Australia France National data from parents of French Nove Febr Retrospec Crosectional Regressio Discontin Design Two hundred thirty-one parents of infants born on or after January 1, 2013, were to a neonatal critical care unit or special care nursery in Australia.
150,000
Parents .
others and father.
aged 18 to 64 with a minimum of two children residing in the family Volume 11.
Issue 3.
July Ae September 2025 The Australian Government offers up to 18 weeks of paid parental leave at the national minimum wage and 2 weeks for secondary Up to three years of compensated parental leave, accompanied by financial rewards for parents.
Comparison of mental health financial stress, and caregiving between parents of preterm and ill infants with parents of healthy Analyzes parental leave outcomes in relation to labor force participation and work hours prior to and during the legislation that expanded benefits.
During their 83% of parents reported elevated levels of worry and sadness, while 76% of families faced financial stress, which adversely emotional wellbeing and parentinfant bonding.
The expansion of paid parental leave in France led to heightened with mothers being more inclined to leave the job market.
This transition frequently results in adverse consequences for professions, as they may forfeit
prospects for Prolonged emotional and financial strain that affects newborn
care and Prolonged parental leave correlates with negative verbal development in children, leading to heightened risks of subpar language evaluation scores, attributable to restricted social
progression, skill
enhancement, and (Khan, (Bulling (Lebihan & Mao
Takong
OECD
Countries OECD distinct OECD Paid parental leave regulations differ in duration and eligibility among OECD Duration of maternity versus paternal leave in various nations.
Extended parental leave correlates with improved health outcomes for mothers, including reduced incidence of Comparison of health outcomes for parents and children before PFL adoption against health subsequent to PFL Mothers indicated an 11% enhancement in self-assessed health and a 6point reduction in distress, hence augmenting total mental well-being.
The research analyzes parental leave results prior to and subsequent to the implementation of QPIP for parents Mothers exhibited minor health and extended following the Two-way 28,638 adults and 15,987 California's Paid Family Leave offers a maximum of 6 weeks of benefits at 60-70% of weekly wages, with a cap of $1,216 per week.
maternal and The Quebec
Parental Insurance Plan (QPIP), established in 2006, offers 50
weeks of California
and New
Jersey
(USA)
National Survey of ChildrenAos Health
(NSCH)
Quasiexperimen .
ifferenc e-indifference Quebec.
Canada se 3 data National Longitudi Post2006 .
fter Quasiexperimen .
ifferenc e-indifference Volume 11.
Issue 3.
July Ae September 2025 Paid paternity leave exhibited less pronounced effects on child health outcomes compared to maternity leave.
Paid maternity leave is correlated with reduced neonatal, baby, and under-five mortality rates.
Children exhibited a 25% decrease in reported asthma symptoms and engagement from parents, along with utilization of parental leave.
Notable extension of breastfeeding likelihood of beyond six months.
nal Survey
Children
and Youth
(NLSCY),
Survey of Young Canadians (SYC) and .
Canadian Communit Survey (CCHS).
QPIP
)2018
leave with income replacement and designated quotas for fathers.
(Roy Choudhu Polache k, 2.
California
(USA)
National Immuniza Survey Quasiexperimen .
ifferenc e-indifference (Irish et New Jersey and National Health Ae Quasiexperimen implementation of the Quebec Parental Insurance Plan (QPIP), although these effects lacked statistical Enhanced accessibility to time for parents to vaccinate their maternal health outcomes were not specified in this study.
Paid family leave correlated with 14,732 were born in California following the enactment of the Paid Family Leave The California Paid Family Leave Program offers up to six weeks of paid leave at a 55% salary replacement rate, effective since July Vaccination rates of newborns born in California prior to and during the implementation, in comparison to infants born in control states lacking such a 28,638 adults and 15,987 children, with .
New Jersey Paid Family Leave, initiated in July Eligibility for paid parental leave:
parents in Volume 11.
Issue 3.
July Ae September 2025 with children aged 0 to 1 year.
Following the policy late vaccinations decreased by up to 5 percentage points .
bout 10%) for children of parents in California, with a more pronounced effect on families living below the poverty line.
No notable effect on behavioral issues California
(USA)
Interview Survey .
ifferenc e-indifference the adults limited to and having under 2 years in the family.
Volume 11.
Issue 3.
July Ae September 2025 2009, offers up to 6 weeks of leave at two-thirds of weekly earnings.
California Paid Family Leave, commenced on July 1, 2004, employees to take up to 6 weeks of paid leave .
% of average salary, subject to a weekly ca.
if they have been employed in the year preceding the child's birth and earned a minimum of US$300 to care for a newborn, adopted child, or a seriously ill family California Paid Family Leave, in conjunction with the Family and Medical Leave Act, ensures job protection for eligible employees.
California before and subsequent to July 2004 and in New Jersey prior to and after July 2009 compared to parents in states lacking parental leave programs from 1997 to discomfort in enhancing their mental well-being.
(Lee et (Rosenb erg et al.
California
(USA)
Panel
Study of Income
Dynamics (PSID) USA
National Immuniza
SurveyChild
(NIS-C
Differ Perio Ae97.
QuasiExperime ntal Study 6,690 parents with a child under 2 years of age, whose child's state of birth is .
xcluding Rhode Island and New Jerse.
least one parent was working the preceding the Crosectional Analysis 35,995 .
ncluding 5,806 from offering paid family leav.
Volume 11.
Issue 3.
July Ae September 2025 California Paid Family Leave, initiated on July 1, 2004, permits employees to take up to 6 weeks of paid leave .
% of average salary, subject to a weekly ca.
if they have been employed in the year preceding the child's birth and earned a minimum of US$300, to care for a newborn or adopted child or a seriously ill family conjunction with the Family and Medical Leave Act, this program ensures job protection for eligible employees.
States with paid family leave legislation offer Eligibility for paid parental leave is determined by whether the parent's child was born in California after July 2004, as opposed to being born in a state that does not offer paid family leave, excluding New Jersey and Rhode Island.
Enhanced selfassessed health and less distress in mothers .
n increase of 11 percentage points and a reduction in discomfort of 0.
No notable effects on children's behavioral issues were found Breastfeeding outcomes vary according to parental leave revealing notable disparities in Increased rates correlate with mother support and mental health benefits derived A positive correlation exists duration and enhanced baby health outcomes, breastfeeding practices between families with paid leave and those from paid leave characterized by reduced infection Table 3.
Summary of global rating for quality assessment tool for quantitative studies (Barry et al.
(Eeles et al.
(Canaa (Khan, (Bulling (Lebiha n & Mao
Takong
Moder
Moder
Strong
Strong
Moder
Weak
Modera
Weak
Modera
Weak
Modera
Weak
Modera
Weak
(Roy Choudh
Polache Modera
Weak
Weak
Strong
Strong
Strong
Strong
Moder
Strong
Strong
Strong
Strong
Strong
Strong
Strong
Moder
Weak
Strong
Strong
Modera
Strong
N/A
N/A
N/A
Strong
N/A
N/A
N/A
WEAK
WEAK
STRO
STRO
WEAK
MODER
ATE
MODER
ATE
(Huebe ner et
(Tera da et
(Gran dahl et
(Carde nas et
Selectio
n Bias Study Design
Confoun
Blinding Moder
Moder
Strong
Weak
Weak
Weak
Weak
Weak
Weak
Strong
Strong
Strong
Strong
Data
Collectio
Methods Withdra
wals and Dropout
GLOBAL
RATING
Strong
Moder
Weak
Moder
Strong
N/A
N/A
STRON
WEAK
Compon (Kim.
Moder Strong Criteria for global rating.
Strong = no weak rating, 2.
Moderate = one weak rating, 3.
Weak = two or more weak ratings Volume 11.
Issue 3.
July Ae September 2025
(Irish et
(Lee et
(Rosen berg et
Modera
Weak
Modera
Weak
Modera
Weak
Strong
Strong
Strong
Strong
Modera
Strong
Modera
Strong
Modera
Strong
Modera
Strong
Modera
Strong
N/A
N/A
N/A
N/A
N/A
N/A
MODER
ATE
MODER
ATE
MODER
ATE
MODER
ATE
MODER
ATE
MODER
ATE
The evaluation of study quality with EPHPP revealed discrepancies across multiple components.
In Selection Bias, 9 of the 15 studies were assessed as having a moderate risk of bias, 5 were classified as weak, and 1 was deemed strong.
Regarding Study Design, 11 studies were assigned a weak rating, signifying methodological deficiencies, whilst four studies earned a moderate rating.
In the confounder control, 14 research were classified as strong, whereas just one study was deemed weak.
In Blinding, eight studies were classified as strong and seven as moderate.
Eleven out of fifteen research employed robust data-gathering procedures, while four studies were assessed as weak.
In the Withdrawals and Dropouts component, the majority of research was deemed irrelevant, except for one study that received a good rating.
In the Global Rating assessment, seven studies were classified as moderate, four as strong, and four as weak, indicating variability in the quality of the assessed studies.
Discussion This thorough review suggests that implementing paid paternity leave has diverse impacts on both maternal physical and emotional well-being, along with child health.
While most studies indicate favorable outcomes of PPL, specific contradictory findings have emerged, particularly in relation to mothers' mental health (Barry et al.
, 2023.
Cardenas et al.
A significant study indicates that paternal leave may alleviate symptoms of postpartum depression in mothers, yet, research also suggests that when spouses concurrently take leave, mothers may experience an elevated risk of sadness (Huebener et al.
, 2019.
Khan, 2.
This highlights the intricate dynamics of responsibility allocation within the household, emphasizing the emotional support that mothers require during this transitional phase.
Prior studies have demonstrated that spouse assistance helps alleviate the psychological strain on mothers (Canaan, 2022.
Kim, 2.
, but in certain instances, an over-reliance on paternal support during leave may induce supplementary stress if not adequately managed (Terada et al.
, 2.
Paternity leave also impacts maternal physical health.
PPL offers mothers a chance to rest and recover postchildbirth, enhancing their overall physical health (Lebihan & Mao Takongmo, 2023.
Lee et al.
, 2.
However, it is crucial to recognize that maternal physical health outcomes are not always directly linked to PPL, but rather to how effectively partner support aids mothers in managing their stress and health (Eeles et al.
, 2.
Furthermore, studies indicate paternal engagement during paternity leave positively influences a child's physical and mental well-being.
This participation enhances daily childcare and facilitates access to essential health services, such as immunizations (Bullinger, 2019.
Roy Choudhury & Polachek, 2.
Children exhibit improved health outcomes and reduced behavioral issues when both parents are actively engaged (Grandahl et al.
, 2020.
Rosenberg et al.
, 2.
The enhanced familial support fosters a more conducive atmosphere for childrenAos emotional and physical growth, further supporting the positive outcomes associated with PPL.
It is essential to acknowledge that various methods and timing of measurement can affect mental health findings (Irish et al.
, 2.
For example, some studies assess mental health at multiple intervals during the postpartum period, and these variations help elucidate temporal changes in mental health.
Moreover, external influences, including socioeconomic conditions, play a crucial role in shaping both maternal and child health outcomes.
Research by Irish et al.
emphasizes that children from low-income or specific racial groups may encounter poorer outcomes, including PPL initiatives.
This suggests that support for children's mental health should be more targeted and consider the socioeconomic background to yield improved outcomes.
Future research should explore changes in mental health during pregnancy and the postpartum phase, aiming to use these findings to shape more effective support systems for new As awareness of mental health among the elderly rises, the connection to workforce reintegration must be Employers and governmental policies should formulate and implement programs that facilitate reintegration into the workforce, offering sufficient time off and flexible work arrangements to meet the needs of parents, along with services to support mental health.
More inclusive policies can enhance the well-being of women and children while elevating the quality of life for families (Barry et al.
, 2023.
Kim, 2.
Consequently, paid paternity leave policies significantly enhance the health and well-being of women and children, yet certain challenges remain to be resolved to maximize these benefits fully.
Further research is essential to uncover the complex links between paternity leave, mental health, and physical health and to create effective family support Strength and Limitations This systematic review stands among the earliest studies to thoroughly explore the effects of paternity leave on mothers' and children's health and well-being, emphasizing outcomes related to maternal mental and physical health, as well as advantages for child development.
The collected data originated from various high-income nations, facilitating a comparison of distinct parental leave programs.
Using longitudinal and cross-sectional studies in the inclusion criteria Volume 11.
Issue 3.
July Ae September 2025 enhances the findings, as these methodologies offer insights into the impacts of both short-term and long-term paternity This review analyzes multiple facets of health, including postpartum depression, breastfeeding duration, and child development, so offering a comprehensive perspective on the impact of paternity leave on family health.
This review's emphasis on publications published within the last five years guarantees its relevance to contemporary parental leave However, certain limitations are present.
Most studies were carried out in high-income countries, restricting the applicability of these findings to low- and middle-income nations, where paternity leave policies may be insufficient or entirely absent.
Disparities in the methodologies of the included studies may result in outcome variations, complicating the ability to derive unified findings across various areas and strategies.
Certain studies have limited sample sizes, which may undermine conclusions regarding long-term child health outcomes.
This analysis primarily examines health however, it does not adequately explore other significant implications, such as the influence of paternity leave on familial connections or financial stability.
Future studies must broaden the review's reach by incorporating additional databases from diverse contexts and cultures, performing thorough evaluations of meta-analyses and reviews, and including publications published in languages other than English.
This type of expansion will uncover areas of interest that warrant further exploration.
Parental leave rules varied markedly among countries regarding duration, flexibility, and compensation, complicating the formulation of generally applicable conclusions across various enterprises and locales.
Moreover, additional studies must encompass a more comprehensive array of socioeconomic circumstances and investigate broader elements, including cultural determinants, to yield a more thorough knowledge of the advantages and obstacles associated with paternity Conclusion This review shows that paternity leave significantly improves both maternal mental and physical health, as well as child well-being.
Mixed results were observed about heightened stress in certain mothers when partners take leave, particularly in households with imbalanced role relations.
This underscores the necessity of evaluating the length of leave and more targeted socio-economic assistance in paternity leave programs, particularly in nations with considerable policy Declaration of conflicting interest The authors declare no potential conflict of interest.
Funding None Acknowledgment We express our gratitude to the authors featured in this systematic review.
Author contributions All authors are involved in the following activities: conducting systematic reviews, analyzing data, interpreting findings, composing manuscripts, and critically revising articles.
AuthorAos Biographies Bdn.
Fadiah Maharani.
Keb is a Magister Student in Midwifery at Faculty of Medicine.
Universitas Padjadjaran.
Bandung.
Indonesia.
Lindya Okti Herbawani.
Tr.
Keb.
Bdn is a Magister Student in Midwifery at Faculty of Medicine.
Universitas Padjadjaran.
Bandung.
Indonesia.
Qorinah Estininingtyas Sakilah Adnani.
SST.
Keb.
PhD is an Assistant Professor in Midwifery at Faculty of Medicine.
Universitas Padjadjaran.
Bandung.
Indonesia.
Dr.
Hadi Susiarno, dr.
Sp.
OG.
Sup.
Obgyn.
Sos (K).
Kes.
MH.
Kes is an Associate Professor of Obstetrics and Gynecology at the Faculty of Medicine.
Universitas Padjadjaran.
Bandung.
Indonesia.
Victor Abiola Adepoju.
PhD is a Project Manager at the Department of HIV and Infectious Diseases.
Jhpiego .
n Affiliate of John Hopkins Universit.
Abuja.
Nigeria
References