• Maternity leave;
  • low birthweight;
  • out-of-pocket expenses;
  • employment

Objective: To determine how employment, income and out-of-pocket expenses changed in 224 families of low birthweight infants during the first 6 months after the infant was discharged home.

Design: Prospective, descriptive.

Population, Sample, Setting, Years: Families of preterm, low birthweight infants. A convenience sample of families of 224 preterm (<37 weeks gestation) low birthweight (<2500 grams) infants was obtained from one hospital in the Northeastern U.S.A. Mothers were interviewed over the telephone at each of the data points. Years of data collections were 1990–1994.

Methods: Mothers kept logs of expenses and were interviewed about changes in employment and income at infant discharge from the hospital and 1, 3, and 6 months later.

Findings: All but two of the employed mothers had to leave employment early because of pregnancy complications. After delivery, fewer mothers returned to work or returned later and worked less than mothers in national studies. Families spent 2% to 4% of their income in non-reimbursed out-of-pocket expenses; transportation was a major expense.

Conclusions: Having a low birthweight infant results in unexpected changes in employment and in increased and unexpected out-of-pocket expenses.

Clinical Implications: Study findings support the need for longer leave for mothers who have small infants.