PARENTAL LEAVE AFTER CHILDBIRTH IN MAINE:
FINDINGS FROM TWO SURVEYS
Research Brief
Brianna Keefe-Oates
Louisa H. Smith
May 2025
I NTRODUCTION
Paid parental leave increases the amount of time parents take off work after the arrival of a new child.1 Paid leave and increased leave duration are associated with decreased rates of postpartum hospitalizations, improved maternal mental health, and increased breastfeeding initiation and duration.2–7 Similarly, paid parental leave has been found to be associated with timely immunizations and reduced risk of hospitalization from infections.8,9 In Maine, a Paid Family and Medical Leave law was passed in 2023, which will provide working parents with 12 weeks of paid leave following childbirth or adoption beginning in mid-2026.10 Yet little is known about current patterns of work and leave during the postpartum period in the state.
Despite the well-documented health benefits of paid leave at the population level, significant knowledge gaps exist regarding how such policies affect rural communities such as those in Maine. Rural residents already face greater challenges accessing maternal healthcare, with higher rates of maternal medical conditions and fewer healthcare resources, especially in light of closures of obstetrics units at hospitals throughout the state.11–15 These geographic disparities are compounded by socioeconomic factors, as rural workers typically have lower median incomes and less access to workplace benefits compared to their urban counterparts.16–19 Understanding these rural-urban differences is critical to ensuring Maine's new paid leave law effectively addresses health disparities rather than exacerbates them, particularly given the policy's intentional design focusing on equity through longer leave duration and higher salary replacement than many other state programs
The objective of this research brief is to share data regarding birthing people’s experiences in Maine with work, parental leave, and the postpartum period in the first 12 weeks after giving birth. Through analyses of two datasets, we find that people in rural areas have less access to paid leave, while also reporting greater financial stress. We also describe the demands that people experience in the first 12 weeks after giving birth on their sleep, mental health, and healthcare needs.
METHODS
This research brief reports on analyses of two complementary data sources: the Maine Assessment of Parental Leave Experiences (MAPLE) survey and the Maine Pregnancy Risk Assessment and Monitoring System (PRAMS). Our research team conducted the MAPLE survey as a pilot study to understand people’s experiences in Maine with work, leave, and postpartum health. Study participants, recruited through social media and community outreach, responded to the survey if they had given birth 3-24 months prior, were 18 years or older, and worked during pregnancy. Participants were asked about their experiences during their pregnancy and in the first 12 weeks after giving birth. The PRAMS survey is a study jointly conducted by the Maine Centers for Disease Control and Prevention (CDC) and the US CDC. PRAMS data from people who had a live birth in 2023, were 18 years or older, and answered the survey 2 months postpartum. While these two some content, PRAMS provides a more representative sample of people statewide who gave birth the MAPLE survey offers a more detailed examination of experiences with work, leave, and postpartum and infant health.
Figure 1. Rurality in Maine as classified by 2010 Rural-Urban Commuting Area codes mapped to zip codes.
We analyzed questions about work, leave, and healthcare access from the two surveys. We calculated means and frequencies in the samples overall, as well as stratified by geographic residence using Rural-Urban Commuting Area codes and categorized geographic areas as metro, large rural, or small rural (see Figure 1).21 In this brief, statewide results refer to those from the PRAMS survey, which was designed to provide statewide estimates, and which included 563 responses representing approximately 11,000 births statewide. We also share more detailed results from the MAPLE survey, which included 151 respondents from around the state who responded to our survey in 2024-2025 Several illustrative responses from open-ended questions from the MAPLE survey are also presented with the findings For more details on our methods as well as tables accompanying the figures, please see the Appendix.
KEY FINDINGS
1. Most pregnant people in Maine work during pregnancy and return to work after pregnancy. While the median length of leave is 12 weeks, the median amount of paid leave is much lower. People in rural areas are less likely to have access to paid leave.
• Statewide, approximately three-quarters of people work during pregnancy. Of those who work, approximately 83% return to work after their pregnancy.
• The median length of leave after birth statewide was 12 weeks; however, much of this is unpaid leave. Substantial differences by geography in access to paid leave exist. Statewide, over half of people in small rural areas did not receive any paid leave, compared to approximately one-third of people in large rural and metro areas.
• In the MAPLE study, people in large and small rural areas had a median of 0 weeks paid leave, while people in metro areas had a median of 6 weeks paid leave.
Figure 2. Distribution of leave type available after childbirth statewide (PRAMS 2023). Paid leave refers to any paid leave, including disability leave.
“I have two children under two years old. There are no day care options in my small town and I wouldn't trust someone random to watch my children. I left a full-time position after my firstborn child, then worked [part-time] then chose to stay home with both my children.”
“At 12 weeks postpartum I was still barely sleeping and didn't feel remotely close to being ready to leave my baby or be in the right mindset to work. Having to put my young baby in daycare during the winter was also very stressful as she became ill frequently causing stress for the family as well as missed days of work, which I didn't have any PTO left so it was very stressful.”
2. Finances substantially influence people’s choices to take leave, and most people wish they could take more leave. People in rural areas expressed more financial concerns in the first 12 weeks after giving birth.
• In the MAPLE study, 79% of people said the amount of leave they took wasn’t enough, regardless of how much they took.
• When asked what influenced people’s choices about how much leave to take, the most common response was: “Could not afford more leave” (70% overall).
• Other common responses about what influenced choices around leave included: “Felt employer pressure to return” (32%), and “Worried about losing health insurance” (23%).
• People in small rural areas expressed more financial need and worry than those in metro and large rural areas, with 33% in small rural areas and 26% in large rural areas saying in the first 12 weeks after their baby was born they were concerned about running out of food.
“I cried for most of my first day back at work. It felt way too soon. It felt like I was being forced to go back before I was ready. I could not afford to take more leave. Now, working, I am so tired. When my baby has bad nights because he is teething or sick, I am up a lot with him in the night. Then, I have to go to work all day….It makes me feel like I am not doing a good job at work or a good job parenting where I feel like my number one job right now should be parenting. I wish I had more time off to take care of myself and my baby.”
3. In the first twelve weeks after giving birth, mothers face extreme demands on their attention, sleep, time, and health while caring for themselves and their infants.
• 50% of MAPLE respondents said they “frequently” or “occasionally” had trouble staying awake during daily activities
• 22% of respondents wanted mental health services postpartum but couldn’t get them.
• 44% said they had to take their child to a non-routine medical visit (e.g., a pediatrician, specialist, urgent care, or ER visit) in the first 12 weeks after they were born.
• 58% said they themselves had to go to a medical visit that was not their standard postpartum checkup in the first 12 weeks after their child was born.
• These visits were in addition to the routine visits that almost all respondents attended for themselves and their babies. It is recommended that people have at least one, but generally two, postpartum follow-up visits in the first 12 weeks after giving birth. Babies usually attend 2-3 routine doctor’s appointments in the first 12 weeks after birth.
“I had health complications besides a cesarian related to my birth … but because my birth was considered normal I was not given more short-term disability. By the time my labs indicated that something actually needed to be addressed, I was expected to return to work. Had I had a choice…I would have returned at 15 or 16 weeks. However, I have a role higher up in my organization and I was expected to return and manage my team as my employer did not hire per diem/ temp oversight.”
“I ended up quitting my job because I needed more time with my baby after realizing how little support I had. I was struggling with postpartum PTSD and felt very overwhelmed and scared being away from my daughter. At more than a year in this is still a major concern for me ”
Figure 3. Health and well-being concerns in the first 12 weeks after childbirth, MAPLE study (no significant differences by geography).
IMPLICATIONS
The findings here illustrate the challenges people in Maine confront when navigating work, personal health, and their child’s health in the first twelve weeks after giving birth. We find that people in rural areas have less access to paid leave, while also reporting greater financial stress. Paid leave during the postpartum period can ensure financial stability and increase the amount of time people can take to establish breastfeeding, take care of their baby, and help themselves recover physically. Maine’s new Paid Family and Medical Leave law may provide added benefit for people in rural areas, allowing them to take more time off after birth to care for themselves and their children and helping ensure financial stability.