The effect of New York State's Paid Family and Medical Leave Program on birth outcomes.

Paid Family and Medical Leave (PFML) programs provide material resources and time away from the labor force around the time of a child's birth. Past research indicates that the programs improve maternal and child health and may increase fertility. To date, 13 states and the District of Columbia have passed PFML laws, with varying lengths of leave, eligibility, job protections, and benefit levels. Programs in states other than California remain understudied. We examined the effects of New York State's (NYS) PFML program on birth outcomes using difference-in-differences (DiD) models with data from the Centers for Disease and Prevention National Vital Statistics System (NVSS) on the universe of U.S. births from 2013 to 2019. We compared trends in multiple measures of birthweight and gestational age at birth between NYS and states lacking PFML benefits during this time period, exploring mechanisms and how markers of disadvantage moderate effects. Results indicate that NYS's PFML program led to small decreases in gestational age and birthweight. We also find evidence that the program increased fertility, partially via reductions in fetal deaths. Findings suggest that PFML may increase live births, with these additional infants driving the observed declines in birth outcomes.