Postpartum-specific anxiety among working mothers in relation to maternity leave perceptions: a cross-sectional study...

Postpartum anxiety is common among working mothers, and statutory maternity-leave provisions may not align with maternal recovery needs. This study examined whether working mothers' subjective perceptions of maternity-leave adequacy were associated with their postpartum-specific anxiety levels, beyond what would be expected from objective leave duration and demographic factors alone. A descriptive, cross-sectional study was conducted with 287 employed mothers in the postpartum period (defined as up to 12 months after delivery) in Turkey between March and July 2024. Data were collected through an online questionnaire that included sociodemographic and obstetric characteristics, maternity-leave perceptions, and the 47-item Turkish version of the Postpartum-Specific Anxiety Scale (PSAS), which is treated as a unidimensional measure with scores ranging from 47 to 188. Statistical analyses included chi-square tests, the Mann-Whitney U test, the Kruskal-Wallis H test, and Spearman's rank-order correlation, with categorical anxiety classified as low (≤ 73), moderate (74-100), and high (≥ 101). The mean PSAS score was 92.10 (SD = 23.86), and 81.2% of respondents fell into the moderate or high anxiety category. Three-quarters of participants (75.3%) rated the 16-week maternity leave as insufficient, and 69.7% indicated that it was inadequate for postpartum recovery. Perceiving maternity leave as insufficient was significantly associated with higher anxiety category, χ²(4) = 10.92, p = .028, and the clearest categorical association emerged between the intention to extend leave and anxiety, χ²(4) = 21.37, p < .001. On the continuous PSAS score, sociodemographic and obstetric characteristics were largely non-significant, with the exception of gestational health problems, Mann-Whitney U = 3819.5, p = .038. The distribution of anxiety categories differed according to maternity-leave perceptions; however, the pattern was not strictly monotonic, and effect sizes (Cramer's V) for the leave-perception items ranged from trivial to small. The clearest categorical association was observed for the intention to extend maternity leave, and findings should therefore be interpreted as suggestive of a meaningful, but bivariate and modest, link between subjective leave appraisal and postpartum anxiety. The gap between statutory provisions and lived maternal experience supports further investigation of policy and workplace measures that may extend beyond minimum leave durations, including phased return-to-work models, paid lactation breaks, and routine screening for postpartum anxiety in occupational and primary care settings.