The importance of parental leave for fathers and non-birthing parents

Being a new parent is an exciting yet stressful period. This major transition calls for parents to be home caring for their newborn while the need for support is also there for the parent who has just given birth. While many developed countries have paid parental leave, the United States lacks a protected maternity/paternity leave for new parents. A Baylor College of Medicine reproductive psychiatrist emphasizes the importance of parental leave for not only new mothers, but for fathers and non-birthing parents.

“The U.S. is one of the few countries without a national mandate for protected, paid paternity leave. We are behind in recognizing that the postpartum period is a very fragile time for women, particularly after they go home,” said Dr. Nicole Cirino, professor of obstetrics and gynecology and psychiatry and behavioral sciences at Baylor. “Most maternal complications occur after hospital discharge.”

Having a partner at home during this period increases the likelihood that warning signs, such as headaches, bleeding, shortness of breath or mood changes, can be detected early for proper treatment. It is crucial for the non-birthing partner to have protected and paid leave to provide the support the mother needs immediately postpartum during the most vulnerable period.

Perinatal challenges

According to Cirino, the postpartum period is medically high risk but socially under supported. Some issues that can occur after hospital discharge include risks of infection, elevated blood pressure or preeclampsia, and the onset of perinatal anxiety disorders. Some populations show an increase of substance use in the postpartum period.

“The highest rate of maternal mortality is after the woman comes home. When trying to address mortality rates, the most common cause of maternal mortality is behavioral health conditions, including mood and anxiety disorders and substance abuse. If those can be caught early, they’re treatable, but if they are missed or not addressed, they can worsen or lead to adverse consequences for the mother,” she said.

Newborn bonding

The mother who carries the pregnancy often has more opportunities to develop that bond than the father or non-birthing parent. The non-birthing parent taking part in caring for the baby improves bonding, which is important during the first few weeks and months. It is the foundation for long-term relationships between the infant and parent, and having caretakers that are engaged and invested in the health of a child helps with their overall physical and mental health.

Support

Scientific data supports that having the father or non-birthing parent home can be preventative for mood and anxiety disorders in the postpartum period. This can decrease isolation, support sleep preservation and support the mother’s recovery from delivery.

“Without that, there are several risk factors that can increase the rate of postpartum depression and anxiety. We know that isolation is one of the major risk factors, as well as sleep deprivation for postpartum depression and anxiety,” Cirino said.

The father or non-birthing parent helping in the postpartum period is essential to help with recovery challenges. If the mother is recovering from a c-section, they can access meals and medication and lift the baby as she will have limited capacity and will need significant postpartum care. They also can assist with diapering the baby, transporting the baby from the crib to mother, bottle feeding, taking the child to pediatrician appointments and being involved in the child’s medical needs.

Physiological benefits

Sleep deprivation increases a stress response, which can increase infection, mood and anxiety disorders, postpartum preeclampsia and other medical issues. When the burden of sleep deprivation is shared between two partners, it can allow more sleep. Cirino recommends taking shifts at night where one partner is on for a 4-to-6-hour period, then they switch. This can allow each partner to go through an entire sleep cycle, which is about 4 to 4.5 hours, and alleviates healing from delivery and mental health issues.

“Both parents’ sleep will be disrupted, so it’s stressful to have to get up and go to work, because many partners are already helping the birthing mom, but it is dangerous to be sleep deprived and drive to work and concentrate on work,” she said. “It’s a time to focus on the mother healing and the child for several weeks postpartum.”

Postpartum mental health of fathers/non-birthing parents

The transition requires particular focus on medical and mental healthcare. Fathers and non-birthing parents have a 1 in 10 risk of developing postpartum depression or postpartum mood disorders.

“This is a stressful time for fathers and non-birthing parents as well, so they should have the space to be able to stay home, care for their child and have paid leave so they’re also not worried about finances and the stress of financial concern,” Cirino said. “Paternity leave is preventative medicine for mothers.”

Cirino is a reproductive psychiatrist at The Women’s Place – Center for Reproductive Psychiatry at Texas Children’s Pavilion for Women – one of the only clinics in the U.S. that addresses reproductive mental health. The team consists of physicians with expertise in both women’s health and psychiatry, licensed psychologists and social workers. They work closely with obstetric providers, lactation consultants and other team members for prevention and treatment of maternal mental health disorders.

By Homa Warren