The Impact of Child and Maternal Health Indicators on Female Labor Force Participation after Childbirth: Evidence for Germany

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INTRODUCTION

In the last few decades, the labor force participation of mothers has increased dramatically in Germany. While this trend has been seen outside Germany as well, the situation here is unique in two respects. First, labor force participation among German mothers with very young children is relatively low in comparison to other Western European countries (see, e.g., OECD 2006). Second, in West Germany it has remained virtually unchanged over the last 20 years: From 1985 to 2003, the percentage of mothers active on the labor market with children under the age of three remained below 30% (Bundesministerium fur Familie, Senioren, Frauen und Jugend, 2005). (1) Today more than ever, it is crucial to identify the obstacles that hinder these women from working. Policy studies have sought the roots of the problem in Germany's welfare state: in the strict maternity leave regulations, lack of childcare options, and inflexible working hours (for an overview, see Gornick and Meyers, 2003). Nevertheless, individual factors such as poor maternal and child health can present obstacles as well (Wolfe and Hill, 1995). Poor maternal health, on the one hand, can lead to higher physical and mental health risks at childbirth and increased stress in everyday life, especially with the added burden of childcare. Poor child health, on the other, can create the need for more intensive childcare. Children with health problems pose a higher average caregiving burden, and their mothers can thus be expected to show a higher preference for staying home. Apart from this direct effect, we might also expect to find indirect effects due to the lower availability and higher costs of daycare for unhealthy children (Brandon, 2000), which in turn create increased time demands (Leonard, Brust, and Sapienza, 1992). The sum of these effects may produce a negative impact on maternal labor force participation.

Apart from this, the subject of child health and its influence on female labor force participation after childbirth has gained attention due to the significant increase in child health problems in Germany--as in other countries--over recent decades (Kuhltau and Perrin, 2001). One reason for this is, paradoxically, that progress in medical and pharmaceutical research has increased the survival rates of premature babies and children born with chronic diseases and congenital disabilities (Brandon and Hogan, 2001). Between 1960 and 2000, the mortality rate of infants in West Germany decreased from 3.38 percent to 0.44 percent (Federal Statistical Office, 2001). Furthermore, asthma--the most common chronic disease in children--has more than doubled since 1990 in West Germany (Hermann-Kunz, 2000).

A further crucial issue is that reduced maternal labor force participation due to health problems can reinforce a low socio-economic status. Brandon and Hogan (2001) found that child health problems prevent women from leaving welfare. Furthermore, Hogan, Rogers, and Msall (2000) showed that in the US, children with health problems more often come from poor or welfare-dependent families. Although Hogan et al. do not claim a causal relationship between health and poverty, their findings allow for the reverse explanation: that growing up in a poor family can result in poor health.

Moreover, decreased maternal labor market participation may decrease investments in the health of all family members and thus exacerbate a negative effect of labor force participation on health, leading in turn to even poorer health outcomes. However, this effect is most likely to be found in countries such as the US that lack universal health care coverage. The only empirical study done on this topic in Germany was unable to establish a connection between poverty and child health outcomes, except in the case of preterm births (Tamm, 2005). The insignificant effects found in this study suggest that the German health care system can be expected to produce weaker effects on children's health, or none at all. …