Evaluating the Effect of San Francisco’s Paid Parental Leave Ordinance on Birth Outcomes

Deborah Karasek (), Sarah Raifman, William Dow, Rita Hamad and Julia M. Goodman
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Deborah Karasek: Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, CA 94143, USA
Sarah Raifman: Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94158, USA
Rita Hamad: Department of Family and Community Medicine, University of California, San Francisco, CA 94143, USA
Julia M. Goodman: Oregon Health & Science University—Portland State University School of Public Health, Portland, OR 97201, USA

IJERPH, 2022, vol. 19, issue 19, 1-12

Abstract: Since 2017, San Francisco’s Paid Parental Leave Ordinance (PPLO) has allowed parents who work for private-sector employers to take 6 weeks of fully paid postnatal parental leave. Previous studies have linked paid parental leave with health improvements for birthing people and babies, although evidence for birth outcomes is limited. We hypothesized that the PPLO may have improved birth outcomes via reduced stress during pregnancy due to anticipation of increased financial security and postnatal leave. We used linked California birth certificate and hospital discharge records from January 2013 to December 2018 ( n = 1,420,781). We used quasi-experimental difference-in-difference (DD) models to compare outcomes among SF births before and after PPLO to outcomes among births in control counties. Births from January 2017 through December 2018 among working San Francisco (SF) people were considered “exposed” to PPLO; births during this time among working people outside of SF, as well as all births before 2017, served as controls. We conducted subgroup analyses by race/ethnicity, education and Medicaid coverage at delivery. Overall analyses adjusting for covariates and indicators for time and seasonality indicated no association between PPLO and birth outcomes. Our results indicate that PPLO may not have affected the birth outcomes we examined among marginalized groups who, due to structural racism, are at heightened risk of poor outcomes. We speculate that this result is due to the PPLO’s design and focus on postnatal leave. Future work should examine the policy’s effects on other outcomes.

Keywords: paid parental leave; policy evaluation; preterm birth; low birth weight; California (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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