Poor Health Before Pregnancy Limits Access to Generous Parental Leave Benefits
Mothers with pre-pregnancy health issues – especially mental health conditions – are less likely to qualify for Sweden’s more generous parental leave benefits. This is according to a new study conducted by researchers at Stockholm. University and Karolinska Institutet, Stockholm
In the study Health before pregnancy and eligibility for parental leave benefits: a Swedish total population cohort study, the researchers investigated whether existing work and income eligibility rules for parental leave benefits unintentionally disadvantage women with poorer health. Using national register data, they examined 151,452 first-time mothers aged 25–45. Women who gave birth in Sweden between 2009 and 2013 and had lived in the country for at least three years prior to pregnancy.
The study shows that mothers who had received hospital or outpatient care for any health condition before pregnancy were less likely to meet eligibility criteria for more generous parental leave. The disparity was especially marked among women treated for mental health conditions. This was particularly the case if the care spanned two consecutive years before pregnancy.
The benefit system excludes certain women
“While generous parental leave benefits support maternal wellbeing, our findings show that current eligibility rules may exclude the very women who need that it supports the most,” says the study’s first author Amy Heshmati, PhD student at Karolinska Institutet, seated at the Centre for Health Equity Studies, Stockholm University/Karolinska Institutet.
These findings carry important implications for policymakers. The researchers caution that strict employment and income requirements – intended to ensure fairness and sustainability – may inadvertently reinforce existing health and socioeconomic inequalities. As the study highlights, women with poor health are more likely to have interrupted work histories. That is something that makes them less likely to qualify for full parental leave benefits.
Norway´s model is more inclusive
The research team points to Norway’s parental leave model as a more inclusive example. By assessing employment history over a longer period before childbirth, Norway’s system may better accommodate individuals with non-linear work trajectories due to health or caregiving responsibilities.
Policies that tighten residency or work requirements risk widening health disparities.
The findings in this study are especially timely in light of the Swedish government’s recent proposal – announced on April 28, 2025 – to revise eligibility for social benefits, including parental leave. The proposed reform would require individuals to have lived in Sweden for five consecutive years within a fifteen-year period, with the possibility of shortening this through employment. However, the exact employment thresholds remain unclear.
Risk of widened health disparities
“Policies that tighten residency or work requirements risk widening health disparities,” says Sol Juárez, Senior Lecturer and Associate Professor at the Department of Public Health Sciences. “We urge decision-makers to seriously consider our findings and the need to more flexible and equitable eligibility frameworks.”
The study adds to growing evidence that public benefit systems must be designed with inclusivity in mind, especially when targeting maternal and child health.
Håkan Soold
Facts
The study Health before pregnancy and eligibility for parental leave benefits: a Swedish total population cohort study was published recently in the scientific journal BMC Public Health. It is part of the research project The unintended consequences of Swedish parental leave policy: A health equity perspective that ran 2019–2022.
In addition to Amy Heshmati, the following researchers participated in the study: Andrea Dunlavy, researcher, and Sol Juárez, associate professor, both at the Department of Public Health Sciences at Stockholm University, and Eleonora Mussino, researcher at the Stockholm University Demography Unit (SUDA) and Sara Fritzell, researcher at the Department of Global Public Health at Karolinska Institutet, Stockholm.
Last updated: May 15, 2025
Source: Department of Public Health Sciences