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Ten days after giving birth to my son, Mateo, I was able to walk, but not much more than a few careful steps from couch to bathroom.
I was still bleeding. I was fighting mastitis, a breast infection that delivered a high fever and the worst chills I have ever experienced. Did I mention I was breastfeeding nearly every 45 minutes around the clock? I was totally in love, and completely exhausted.
Luckily for me, I didn’t have to go back to work right after Mateo’s birth. But the same is not true for far too many American women. In fact, about one quarter of mothers in the United States have no choice but to return to work within 10 days of having a baby -- many of them still bleeding, still trying to establish breastfeeding, completely exhausted, and often traumatized by leaving their newborns at a time when they need their mothers most.
"At times I feel deeply disappointed that I couldn’t manage to fight harder for what every mother, including me, deserves: time and space to heal and to bond with her new baby."Katey Zeh
In an effort to learn more about the issue, I put together an informal survey that I shared on Facebook and Twitter. One respondent, Katey Zeh, a maternal health advocate with the United Methodist Church, shared her story of lacking access to family leave: In 2014, she gave birth on a Monday, returned to work emails on a Friday, and fully returned to work the following Monday.
Paid parental leave is "partially about economic justice, but it's also about my parenting — and my family — being affirmed by our society,” Zeh said. In a blog post, she describes in a bit more detail what the lack of leave meant to her:
Now that my daughter is six months old I look back on that time with a lot of regret. If I couldn’t advocate for myself, what kind of advocate was I anyway? If I couldn’t advocate for my kid, what kind of mother did that make me? At times I feel deeply disappointed that I couldn’t manage to fight harder for what every mother, including me, deserves: time and space to heal and to bond with her new baby.
Another respondent, a Catholic school teacher from Ohio who asked that her name not be published, said she loved her work but knew she would not be ready to return to its long hours only four weeks after giving birth — the amount of partial pay leave her employer offered. She also knew that her husband’s work would not allow him to share the home responsibilities, as his job required even longer hours and offered no paternity leave benefits. She left the job she loved.
Others shared their anxiety about depleting savings in order to stay with the baby just a few extra weeks; still others discussed shame and guilt for not sorting out a way to be with the baby longer.
As I read the survey responses, I realized that I was collecting stories of human dignity violated.
The evidence for the benefits of paid leave — for health, equity, economics and more — is strong and clear. Paid leave improves maternal and newborn health, contributes to more women in the workforce, and reduces worker turnover. These are the fundamentals — health, equity and economics — that fuel most arguments for paid leave policies.
Are these arguments working? We’ve seen some momentum: Just last month, the city of San Francisco and the state of New York passed paid leave legislation guaranteeing six weeks and 12 weeks, respectively. But at a federal level, the United States remains the only industrialized country lacking paid leave for new mothers.
As a public health scientist, I’m frustrated by few things more than a disregard for established evidence. But when it comes to the lack of paid leave in the U.S., I find myself even more troubled by the disregard for human dignity.
Several months ago, I read a New York Times blog post by Amber Scorah about her son, Karl: A baby dies at daycare, and a mother asks why she had to leave him so soon. I put myself in the mother’s shoes, I put Mateo in her baby’s shoes, and I realized that I couldn’t watch this issue play out from the sidelines.
Last month, I paid a visit to the Massachusetts State House to explore what my elected representatives were doing about the problem. I learned that Rep. Kenneth Gordon, a Democrat, has introduced a bill to guarantee 12 weeks of paid leave to care for a new child or a severely ill child, parent or grandparent.
I asked Representative Gordon what compelled him to action on this issue. He shared stories of people forced to choose work instead of remaining at the bedside of a sick child. He also talked of his years as an attorney representing victims of gender-based discrimination in the workplace.
The responses to my survey, the piece in the New York Times and my conversation with Gordon made me wonder: Would we begin to see more traction if policymakers began to frame paid family leave as an issue of human dignity?
I think so, but the data matter too. We need it to know how big the problem is, who is most affected, and how best to craft the details of the solution.
On that last point of crafting the details of the solution, Gordon had a question for me: “Could you share the public health data supporting 12 weeks of paid leave as a good minimum to shoot for?”
The data actually show that 12 weeks might not be enough to support improvements in maternal health.
Here’s the problem: The data actually show that 12 weeks might not be enough to support improvements in maternal health, particularly a reduction in depressive symptoms. The evidence suggests that shooting for six months of paid leave is a good place to start to support postpartum mental and physical health. It’s also worth noting that the World Health Organization recommends six months of exclusive breastfeeding, something that becomes increasingly complicated as women return to work.
When I asked Representative Gordon what he thought about shooting for six months, he said the Legislature would never go for it — the focus needs to be on incremental change.
Why is it that the rest of the world seems to understand that, at some point in life, we will all need to care for someone dear to us and that we should be able to do so with dignity?
Some version of Gordon’s bill is expected to emerge from committee this week. When it comes to a vote at the end of June, I hope that legislators will help us catch up with the rest of the world.
I believe that the data -- and basic human dignity -- argue for at least 24 weeks of paid leave. I realize that our best hope, politically, may be 12 weeks. That would be a start, but not enough of one to make a difference to Amber Scorah. When her son died on his first day of daycare, he was 15 weeks old.
Kate Mitchell, MPH, is a DrPH candidate at Boston University School of Public Health specializing in maternal and newborn health.
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