Increasing Maternity Leave and Decreasing Attrition Rates of U.S. Active Duty Women in the Prenatal and Immediate Postpartum Period

Abstract

Introduction: The USA currently does not have a national parental leave policy. In 2016, the Secretary of Defense increased the allotted maternity leave for active duty U.S. military members from 6 to 12 weeks. The purpose of this study was to understand the potential impact of this change on attrition rates of active duty women in the Army, Air Force, Navy, and Marines from their initial prenatal visit through the first year postpartum. Methods: All active duty women who had a confirmed pregnancy in the electronic health record from 2011 to 2019 were included for consideration in the study. A total of 67,281 women met the inclusion criteria. These women were followed from their initial documented prenatal visit for 21 months (9 months gestation and 12 months postpartum) for removal from the Defense Eligibility and Enrollment Reporting System signaling attrition from service presumably related to pregnancy or childbirth. Logistic regression models were used to assess the association between maternity leave policy and attrition adjusting for covariates. Results: Overall, women who were allotted 6 weeks of maternity leave were associated with higher attrition relative to women provided 12 weeks of maternity leave (odds ratio = 1.36; 95% CI, 1.31-1.42; P < .0001), representing a 22% decrease in attrition rates of women given 12 weeks vs. 6 weeks of leave. This impact of attrition rate was the greatest among members who were of lower rank (6 weeks vs. 12 weeks of leave: junior enlisted (E1-E3), 29.2% vs. 22.0%, P < .0001 and non-commissioned officer (E4-E6), 24.3% vs. 19.4%, P < .0001) and who served in the Army (28.0% vs. 21.2%, P < .0001) and Navy (20.0% and 14.9%, P < .0001). Conclusions: Family-friendly health policy appears to have the intended outcome of retaining talent in the military workforce. The impact of health policy on this population can provide a glimpse into the influence of similar policies should they be implemented nationwide.