As of April 2021, nine states and the District of Columbia had enacted state-specific paid family leave (PFL) programs, offering partial wage replacement to parents after the birth of a child. The Biden Administration also proposed the development of a national solution through the American Families Plan. Despite these advances, concerns with workforce disruptions and economic costs have hindered wider adoption of PFL. While studies have documented the potential health benefits of PFL for women and babies, less is known about the mechanisms that lead to PFL potentially impacting women’s mental health. This mixed-methods study is based on focus groups with over 100 women in four states with operating programs and a secondary analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) data. It presents evidence of how PFL may facilitate longer leave that possibly leads to improved mental health outcomes by providing more time at home.