International agreements and guidelines

The international context of agreements among countries is an important source of influence on national policies regarding leave associated with childrearing. Regarding the interests of the mother and baby, but also those of other parties at an indirect level, the World Health Organisation (WHO) currently recommends that infants should be breast fed for at least two years, with weaning foods added from six months onwards - implying that exclusive breastfeeding for at least six months will provide the most desirable start in life for the young child. Six to eight feeds in every 24 hours are needed, pus enough rest and nutrition for the mother to maintain the supply of milk (Galtry, 2000). In line with the WHO recommendations, the American Academy of Pediatrics recommends breastfeeding for at least 12 months and as long thereafter as mutually desired. Their advice notes that paediatricians and parents should be aware that exclusively breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life and provides continuing protection against diarrhoea and respiratory tract infection. There seems little doubt that the optimal length of leave should be at least six months, and preferably more than a year from a health and well-being perspective.

As well as the WHO recommendations regarding the importance of establishing breastfeeding and safeguarding maternal and child health, the International Labour Organisation (ILO) has also emphasised since its establishment in the importance of ensuring the health and well-being of employees around the time of childbirth. The Maternity Protection Convention 1919 (No 3) was among the first instruments to be adopted, and has been revised several times since, most recently as ILO Convention 183, issued in 2000 (ILO 2000). Article 4 recommends that women be entitled via national laws or regulations to a period of maternity leave of at least 12 weeks, including a period of compulsory leave after the confinement of no less than six weeks, with the remaining six weeks being available before or after the birth, or divided between the two. Article 6 then states that women on maternity leave shall be entitled to receive cash and medical benefits (from social insurance or public funds) at a rate that ensures the "full and healthy maintenance" of woman and child at a "suitable standard of living". To date, 12 countries have ratified Convention 183 - of the 23 countries considered in this report, only Austria, Hungary and Italy have completed ratification, although the earlier version of it (Convention 103) was ratified by 40 countries, including these three plus Greece, Netherlands, Portugal, Slovenia and Spain. New Zealand has not ratified either convention.

Further to ILO Convention 156 Workers with Family Responsibilities, Recommendation No. 165 (ILO 1999) provides men and women workers with the right to parental leave in order to take care of their children, with the duration and conditions of such leave to be determined in each country. In this recommendation parental leave is regarded as part of an integrated approach rather than in isolation from other initiatives intended to contribute to the reconciliation of family and work responsibilities. At the time of the originating conference in 1999, it was noted that 36 countries had enacted provisions governing parental leave, although major differences could be found among these countries regarding conditions, payments and flexibility. The ILO report notes that while parental leave schemes are effective in some countries, in others the enactment of legislation has not necessarily met the needs of working parents. Notably, the period of prior employment required (usually six- 12 months with the same employer) is increasingly difficult for precarious and casual workers to meet. Many of these workers are women, who (then, in 1999) tended to have less job tenure, more short-term turnover and higher rates of temporary employment than men did.

The ILO report also points out the importance of ensuring an adequate rate of payment is associated with leave - otherwise it is impossible for lower-paid workers to take it. However some countries such as the United Kingdom had tried to compensate for the absence of paid parental leave by providing other family benefits aimed at improving the material conditions of children, and also maintaining to some extent the living standards of women. New Zealand's Domestic Purposes Benefit could also be seen as a further example. The OECD (1995) compared take-up rates in countries with a policy of high earnings-related benefits with those where no benefits were attached to parental leave. It found that a strong link existed between earnings replacement rates and take-up rates - in countries such as Denmark, Norway and Sweden which provided an allowance which compensates to some extent for the loss of wages, parental leave was used by nearly all eligible families.

Ring-fencing paid leave for fathers is also acknowledged by the ILO report as a strategy likely to induce fathers to take leave, although at that time it was too early to judge the effectiveness of the EU Parental Leave directive. Evidence at the time, however suggested that fathers take parental leave only when a relatively high level of compensation for loss of earnings exists. Otherwise taking leave is unaffordable for many families, in spite of the beneficial effects it would have on family well-being.

The OECD published in 2003 a paper that voiced caution about potential negative effects of providing too much leave - effects such as declining labour market attachment for women (Jaumotte 2003). This paper was followed up by the Babies and Bosses series of reviews of work and family arrangements within selected OECD countries and a summary of conclusions (OECD 2004). In this summary, the multi-faceted context of women's labour market participation is set out in a way that demonstrates the inter-linkages between tax/benefit policies, public child care policies, family leave rights and benefits, firms' policies and family-friendly work practices, and working-time regulations and anti-discrimination measures targeted on parents and prospective parents. Each county's unique mix of these factors will determine the dynamics of the labour force participation of its parents - not just the length of its paid leave.

In her 2003 paper, Jaumotte cited evidence that " very long parental leaves" make it difficult for women to return to the labour market, a problem more acute when parental leave is not job-protected, and when mothers are low-skilled. Further evidence was cited that extended parental leaves had a negative impact on the salary of returning mothers, although a Danish study at the same time reported a catch-up of mothers' salaries to those of childless women. But how much leave is too much? This point is not clarified in the paper. With the benefit of hindsight, it is at least possible to speculate that some of the evidence informing this view could have been associated with a particular period of natalist policy plus unemployment in France, and also with other specific country circumstances elsewhere.

For example, Moss and O'Brien's (2006) publication identifies that in France, a 1994 change to the then childrearing benefit payment regime APE (Allocation Parentale d'Education) extended eligibility for payments to parents with two children and introduced the option of part-time work from the beginning of the payment period. These changes contributed to a dramatic increase in the number of recipients - numbers almost doubled from 275,000 in 1995 to 563,000 in 2003. The economic activity rate of mothers with two children, the youngest aged less than three years, decreased from 69 percent in 1994 to 53 percent in 2998. It has been estimated that between 1994 and 1997 about 110,000 working mothers with two children left the labour market to take advantage of APE. The incentive for low paid mothers to stop working was strong because of savings on childcare costs and other expenses. Research also showed that mothers living in rural areas and small towns where public childcare provision is scarce, claimed APE more frequently.

The country notes for France in Moss and O'Brien (2006) suggest that mothers who were in employment just before maternity leave, were more likely to claim APE if they are entitled to parental leave because they had a job guarantee. In times of high unemployment, most working mothers who are not entitled to parental leave cannot take the risk of losing their job unless their partner has secure employment. Further, it has been hypothesised that deteriorating working conditions at the time was also one of the factors leading to the high take-up of APE. From this perspective, taking parental leave with a payment like APE was one way to escape a job with difficult working conditions that created problems for workers trying to balance work and family responsibilities, and helps to help explain French women's response at the time (98-99 percent of parents taking leave at the time were women). The APE system has been replaced for children born after January 2004 with a new system (CLCA) that pays less, but includes families with one child as well as the larger families that were the focus of the previous natalist policies.

In the Central and Eastern European countries such as Hungary that are now characterised by lengthy periods of childcare leave, a care-at-home trend was identified in the late 1990s by the ILO (1999), in which families responded to the major labour market changes that took place following the collapse of the Soviet Union and its political and economic influence. From having sustained very high levels of parental employment alongside widespread provision of poor quality childcare, a return to traditional values in many of these countries has encouraged women to take up the option of caring for their children at home - a luxury previously thought to be the preserve of wealthier Western women. Previously extensive childcare systems are being circumscribed through the closure of centres and the imposition of very high fees. The ILO points out that not surprisingly, a care-at-home childcare policy has emerged, which is less costly for the state and assures children better care than in poor quality childcare centres.

More recent research in the United Kingdom on informal care and employment found evidence of a causal link between caring responsibilities and lower employment participation. The study suggests that carers give up work in order to fulfil caring responsibilities rather than taking up care responsibilities in the absence of employment opportunities (Aequus 2006). These arguments focus not only on the existence of paid leave and return-to-work statistics, but place them in the context of other relevant country conditions such as the cost of childcare, the availability of employment for both women and men, and the strength or otherwise of moves to achieve greater gender equality.

Maternal and child health

Given the long-standing association between maternity leave and maternal and child health outcomes, the countries that appear to place a highest priority on maternal and child health outcomes can be expected to be those with the longest and/or most generously paid maternity leave: the United Kingdom and Ireland. However, the overlapping meanings attached to particular leave policies by different countries means that countries like Sweden should be included in this list as well, even though no statutory maternity leave is provided. Once the United Kingdom has extended its paid maternity leave to 12 months, it will operate very much like the period of paid parental leave provided in Sweden.

In accordance with the policy responses in the countries reviewed, the element most associated with prioritising maternal and child health over other outcomes associated with parental leave policies are providing maternity leave that is compulsory, for either all or some of it. A number of countries also make a spell of leave before the birth compulsory as well as afterwards. However, to avoid financial hardship for parents on very low incomes, it is reasonable to assume some provision of payment would be needed to maintain their income at a life-cycle stage of increasing financial demand. In addition, multiple births are the focus of policies in many countries that double the leave entitlements (i.e. the paid duration) for twins and triple it for triplets, in recognition of the far higher level of pressure on parents associated with a multiple birth.

Well-being of pre-school children

The policy context of the well-being of pre-school children is a more complex issue, involving health and pre-school care and education policies, but also economic policies that mediate parents' access to income through paid work or income support. Finland is an example of a country where the provision of a publicly-funded childcare place for each child is provided from birth, as well as a three-year leave entitlement (paid plus unpaid) - so the option is always there for parents to increase labour market participation as and when they wish to. Denmark and Sweden also provide a universal entitlement to an early childhood place for each child that coincides with the expiry of the paid leave period. No gap opens between the entitlements, that parents have to fill with simultaneous responsibility for earning income and providing care. The relationship between parental leave policies and early childhood policies is consecutive, not overlapping. France supports a similar arrangement, but without a guaranteed entitlement to an early childhood place. In France, Hungary, Germany, and Spain, long spells of usually unpaid leave following the paid entitlement are available, and early childhood places are widely available for children aged over three, with near universal coverage.

The policy instruments associated with prioritising the well-being of children are therefore those associated with maternal and child health, plus provision of publicly-funded childcare places for all children, from as early in their lives as their mothers might need or wish to return to their jobs. Alternatively, income support for parents wanting to avoid the publicly-funded childcare provision is also provided in some countries.

Income security in families with children

The maintenance of socially acceptable levels of income within families with young children is an important part of the provision of paid leave rather than unpaid, for the duration of the time when at least one parent is required to provide the 24-hour care a young child needs. Most countries now provide some level of payment during leave, and many are considering increasing it in the near future. Countries which offer paid paternity leave for fathers appear to place additional emphasis on the maintenance of family income, by making it affordable for fathers to take leave. The longest ring-fenced paid paternity leave is found in Iceland and in Norway, although many other countries now have a family entitlement to paid parental leave that can be taken up by fathers or by mothers. Family entitlement systems provide the leave for the parents to distribute between themselves, rather than it being an individual entitlement for one parent (usually the mother) to give to the father. This enables the parents to maximise their income from the labour market as well as providing parental care for their child.

A number of countries also provide leave (or extended leave) or payments (or extended payments) to support the care at home of children with serious illnesses and/or disabilities. Many such arrangements for payment are means-tested, and some countries also include care for the elderly within such policy instruments, but the arrangement is still described as leave. What level of job-protection available is not made clear in the information surveyed, however.

Thus the policy instruments associated with prioritising income security for families are the provision either of paid, job-protected leave with eligibility as inclusive as possible, or payments to all parents regardless of their employment circumstances, or both, plus income support for parents with a particularly high caring responsibilities associated with having a child or a close family member with a serious illness or disability.

Labour market attachment for parents, particularly mothers

Economic prosperity for the country as well as the family is an important outcome of the maintenance of mothers' attachment to the labour market. Job-protected leave for childbirth and rearing, but also provision of affordable childcare once children are past the first year of life are the main instruments used by countries to ensure the link between mothers and employment is not broken during the child-rearing phase of the life-cycle. Sweden and Finland are notable examples of countries that have implemented this approach, but job protection is the cornerstone of parental leaves in many countries, whether the leave is short or longer.

The countries with the highest employment rates of mothers with children aged under 12 years include the five Nordic countries, but also three of the Central and Eastern European countries - Czech Republic, Estonia and Slovenia. Yet Canada and the United States also have high employment rates for women, as do France and the Netherlands. Clearly these high female employment rates cannot be considered as a result of the leave provisions in those countries: it is more likely that the leave provisions have developed over time to support the overall mix of social and economic conditions in each country. The diversity among the labour markets in these countries yet again demonstrates how a focus on any one aspect of a country's conditions or leave provisions may be misleading.

Despite this diversity it can be seen from the analysis of the 23 countries that the policies associated with maintaining women's labour market attachment are those that focus on maximising the level of job-protection for those on leave, no matter which parent takes it, or in what circumstances, or for how long. Furthermore, increasing the degree of flexibility available in leave arrangements will also assist women in particular to maintain the perception of themselves as employees on leave, rather than mothers outside the labour market. Modes of flexibility practised among the 23 countries include taking leave in blocks of time over a longer period, say until the child is three (so that the actual duration of leave is still around nine months to a year); returning to work part-time while receiving the leave payments part-time; having the option to take a shorter leave at a higher rate, or a longer leave at a lower rate; permitting both parents to take their parental leave at the same time, whether paid or not; and having the right to request part-time work arrangements when they return to work, either permanently or for a set period. A further aspect of leave policies to assist parents to care for their children after they reach school age are annual childcare leaves (usually unpaid) of anything from a few days a year up to 13 weeks per family (as in Iceland), during which parents can attend important events involving their child, or care for them during school holidays.

Gender equity within families, and in the labour market

Women's right to access the jobs they aspire to in a labour market context where their ambitions and effort are rewarded equally to those of men is an important motivator of gender equity policies that now shape women's experience within the labour market and elsewhere. Women's experience at home, most often characterised by an unequal division of labour, has not until recent times been thought an appropriate area for policy-led influence beyond health and welfare matters. Women's exclusive role in childbirth and breastfeeding have in the past generated policies that did not challenge the ongoing consequences for mothers or for fathers, as children grow older. The contemporary approach is more likely to recognise and protect women's labour market position around the time of birth and breastfeeding, but also the importance of gender equity issues to women's re-entry to the labour market, as well as the parenting young children need at home.

The Nordic countries have been the most prominent in strengthening the gender equity impacts of leave policies - for example, in Iceland the same length of paid leave (three months) is now available to mothers and fathers as separate, individual entitlements, with a further three months as a family entitlement then provided for the couple to distribute. This policy package was introduced after persistent action from men via the court system to challenge women's apparently favoured access to family leave. Thus the child can experience nine full months of parental care that is accompanied by parental income compensation, and an additional 13 weeks per year of unpaid leave for each parent is provided until the child is eight. It is still likely that the mother will provide more of this care than the father, but the parents make the choice on an equal footing. In another context, the FMLA leave entitlements to eligible employees in the United States are completely gender neutral, being just as available to men as they are to women.

Policy related research

Kamerman (in Moss and O'Brien 2006) points out that all the EU countries and most of the OECD countries have now enacted parental leave policies, and the Central and Eastern European countries are leading the way in providing extended 'child-rearing' or child care or home care leaves. Generous leave policies are associated with the potential to improve child health (Rhum 1998 and 2000, Galtry 2000; Tanaka 2005, Berger, Hill and Waldfogel 2005, and Gregg and Waldfogel 2005).

To widen the perspective, Kamerman emphasises the view that leave policies can lead to improved child health, but they also play an important part in attracting women to the labour force and maintaining their attachment (Kamerman, 2000). But the quality of the leave matters: research evidence highlights the importance of leave being job-protected and paid, since unpaid and non job-protected leaves have no significant effect. Kamerman cites Tanaka's (2005) findings from a study of 18 OECD countries over 30 years to investigate the effects of job-protected leaves and other leaves. The research found a significant association between the extension of weeks of job-protected paid leave and decreasing infant mortality rates: a 10-week extension in paid leave predicted a decrease in infant mortality rates by four percent. In a similar study, Rhum (1998 and 2000) concluded that parental leave policies may be a cost-effective method of improving child health, a finding supported by Galtry (2000) who found that parental leaves lead to longer period of breastfeeding and less maternal stress. Kamerman concludes that:

• Longer paid maternity leave reduces infant mortality and neo-natal mortality but unpaid leave does not have the same protective effect;
• Longer leave improves other health outcomes, while children whose mothers return to work within the first three months after birth receive less health care.

Kamerman finds there is still plenty of scope for research on:

• The differential consequences of long leaves (two to three years) versus one year leaves;
• The outcomes for children of variations in parents' transitioning from home to work (returning to full-time or part-time work;
• The outcomes for children of leave policies used by parents who work irregular hours;
• the impact of fathers' take-up of parental leave and the impact of 'use it or lose it' policy on these take-up rates.

It should be pointed out that although the results of such research would undoubtedly be very helpful to policymakers, these research topics would be difficult to undertake. Meticulous observations of arrangements chosen by parents over time within a stable policy structure would be required, since it would not be ethical to risk child well-being by withdrawing aspects of care or parental attention in order to measure the outcome. These methodological and ethical issues perhaps explain the current lack of research evidence at this level.

A further aspect of leave policy is the extended leave available in some countries for parents to care for their disabled or seriously ill children. Such policies may also be considered to be potentially cost-effective, in the same way that the benefits of funding the health and development of well children via leave policy is now being recognised in a number of countries.