Variations in sickness absence and use of social benefits among pregnant women in a Swedish community 1978‐1997

SUBJECT Pregnancy is a well defined condition. Any possible need for sickness absence should remain unchanged over time. STUDY OBJECTIVE To investigate the relationship between rates of sickness absence during pregnancy in a long term perspective. SUBJECTS STUDIED: Two thousand nine hundred and thirty-five women consecutively delivered at the University Hospital in Linköping in 1978, 1986, 1992 and 1997. RESULTS In 1986, after a period of expansion of social benefits, the proportion of sick-listed pregnant women was observed to be significantly higher (78 per cent) than in 1978 (51 per cent). Parallel to cuts in compensation, sickness absence 1997 was observed to decrease (53 per cent). The mean number of days of sickness absence per pregnant woman increased from 18.9 in 1978 to 36.5 in 1986. In 1997 the mean number of days was 18.8. The Parental benefit, available to all pregnant women, was significantly ameliorated during the period of the study. In spite of this, the mean number of sickness absence days used before delivery decreased from 11.7 days in 1978 to 6.6 days in 1997. CONCLUSIONS Sickness absence among pregnant women is to a high degree sensitive to the levels of compensation in the available social benefits. A high level of reimbursement and expanded social benefits seem paradoxically to increase the sickness absence among pregnant women, but cuts in benefits lower the absence, suggesting an adaptation and a coping strategy to what seems most economically favorable for the pregnant woman and her family.