Background: Childbirth has been suggested to increase sickness absence (SA) and disability pension (DP). This may vary by occupation; however, knowledge in this field remains limited. We explored SA and DP in the years before and after childbirth among women in four occupational groups and those without occupation.

Methods: We studied nulliparous women aged 18–39 years, living in Sweden on December 31, 2004 (n = 492,504). Women were categorized into five skill-level based occupational groups and three childbirth groups; no childbirths within 3 years (B0), first childbirth in 2005 with no childbirth within 3 years (B1), and first childbirth in 2005 with at least one more birth within 3 years (B1+). We compared crude and standardized annual mean SA (in spells> 14 days) and DP net days in the 3 years before and 3 years after first childbirth date.

Results: Women in the highest skill level occupations and managers, had less mean SA/DP days during most study years than women in the lowest skill level occupations group. In B1 and B1+, absolute differences in mean SA/DP, particularly in SA, among occupational groups were highest during the year before childbirth. DP was most common in B0, regardless of group and year.

Conclusions: We found that women’s mean SA/DP days before and after first childbirth was higher with decreasing skill-level of the occupational group and these differences were most pronounced in the year before childbirth. DP was most common among women not giving birth, regardless of occupational group.