Generous parental leave has been shown to protect mothers from poor mental health during the postpartum period. However, little is known about how strict work requirements to access these benefits may disadvantage those with weaker ties to the labour market, including individuals whose employment is disrupted by ill health.
To address this knowledge gap, researchers from Stockholm University and Karolinska Institutet used total population data to identify mothers who had their first child between 2009 and 2013 with the aim of examining whether those mothers with poorer physical and mental health before pregnancy were less likely to qualify for generous, earnings-related parental leave benefits. In Sweden, parents who meeting the eligibility criteria for earnings-related parental leave benefits received around 80% of their salary, while those who do not qualify received a basic flat-rate benefit.
The findings show that mothers who were hospitalised or received specialised outpatient care for any health condition (especially among those with severe mental health disorders) in the year before pregnancy were less likely to be eligible for more generous parental leave benefits. Importantly, the study shows that these associations were even stronger among mothers with chronic health conditions.
The results of this study reveal the interplay between health and social inequalities showing how health before pregnancy may play a key role in determining access to generous parental leave, thus excluding mothers who are most in need of support after childbirth.
These insights carry important implications for policymakers. Strict work requirements for generous parental leave may unintentionally reinforce existing health inequalities in society. The rising prevalence of mental health issues among young adults and the increasing precarisation of the global labour market, where temporary contracts continue to grow, suggest that inequalities in access to generous parental leave benefits may increase if strict eligibility conditions remain in place or become stricter. Policies that promote stable employment and relax stringent eligibility rules could help improve maternal mental outcomes in the postpartum period.
The findings are particularly timely given the Swedish government’s recent proposal, announced in April 2025, to revise the eligible rules for social benefits, including parental leave. Under the proposal, individuals would need to reside in Sweden for five consecutive years within a fifteen-year period to qualify, although this period could be shortened through employment. Details on the employment threshold has yet to be specified. Such reforms that introduce stricter residence or work requirements risk deepening health inequalities.
Overall, this research contributes to growing evidence that social benefit systems should be designed with inclusivity at their core, especially when aiming to promote maternal health.