The next morning, Karen, 34, sat at the bedside of her recovering 5-day-old, tapping away on her smartphone—not to announce that the operation had been a success (though it had), but to reply to work messages. Two days later—a mere week after giving birth—she was back at her full-time job.
Her employer had offered Karen 12 weeks off, unpaid, under the federal Family and Medical Leave Act (FMLA). But with her salary making up nearly half of the family's income, "we couldn't afford it," says the Nevada-based mom. So, like millions of women, she sucked it up and soldiered on. The carpal tunnel she had developed during pregnancy intensified, making typing excruciating. Sleepless nights piled up. Her ability to focus plummeted.
How ironic that Karen worked for an organization that advocates for global maternal health, while her own country—our country—treats working mothers like second-class citizens.
In a 2013 survey of 38 countries, America ranked dead last both in paid leave and protected leave—behind smaller (and poorer) nations such as Latvia, South Korea, and Mexico. Many of those regions give new moms a full salary, some for up to a year.
It gets worse: Wider research shows that out of 183 countries, the U.S. is one of only three that promises no paid leave whatsoever (even third-world Sudan and the Congo offer something). In fact, the U.S. doesn't even provide unpaid leave to every taxpayer: 40 percent of workers aren't even covered by FMLA.
People!! Two decades after FMLA was passed, in 20-mother-effin'-15, the way America approaches working mothers isn't acceptable—it's completely ridiculous. The outrage is rising: President Obama called for paid leave in his 2015 State of the Union address; John Oliver's Mother's Day segment—"We have just one thing to say to all the mothers out there: Get the fuck back to work"—was viewed more than 4 million times on YouTube. And the subject has taken over social media: One lifestyle blog quickly racked up more than 1.2 million Facebook likes after posting an "FMLA is bullshit" rant.
In a 2013 survey of 38 countries, America ranked dead last both in paid leave and protected leave.
But all the talk is nowhere near enough. Not for Karen, or moms like her. "I developed anxiety," she says. Eight months after delivering her baby girl, exhausted and overwhelmed, Karen gave notice.
"The first three months are critical for the baby and the mother," says T. Berry Brazelton, M.D., emeritus professor of pediatrics at Harvard Medical School. "Going back to work before then is asking for trouble." Yet, forced to choose between finances and family, many women do just that.
M.D.s recommend at least six to eight weeks off of work to recover from, ya know, expelling a human being from your body. It takes about four weeks for the uterus to shrink from the size of a watermelon to the size of an apple, and six for vaginal tears or C-section incisions to heal. Hormones can take months to stabilize, and "it can take up to six weeks for breast-feeding mothers' milk supply to become fully established," says Jeanne Conry, M.D., past president of the American Congress of Obstetricians and Gynecologists.
One study found that infants whose mothers went back to work before 12 weeks were less likely to receive all of their immunizations within the first 18 months, leaving them vulnerable to serious diseases. Another showed that women who return to the job before those 12 weeks are less likely to breastfeed—a shame for those who would like or are able to nurse, since research suggests breast milk can lower a baby's chances of getting asthma, diarrhea, type 2 diabetes, and respiratory and acute ear infections. Breastfeeding may also help protect Mom against diabetes, heart attack, and breast cancer.
A hasty return to work also makes it more likely that your baby blues will turn black. While up to 19 percent of all new mothers will suffer from postpartum depression (PPD), one study revealed that those who clock 40 or more hours when their infants are 12 weeks old are 22 percent more likely to be depressed than moms who work less.
One study found that infants whose mothers went back to work before 12 weeks were less likely to receive all of their immunizations within the first 18 months.
Predelivery complications can add to the mental stress: Without a financial safety net, women face gut-wrenching decisions. Prescribed bed rest during your pregnancy? You could use up all of your leave before you even give birth. Child born prematurely? You may have to choose whether to spend that time with her while she's in the NICU or when she comes home.
Even if you do get paid maternity leave, you're not in the clear. Another side of your health might suffer: that of your career. Three-quarters of women entering the workforce today will become pregnant, often just as they hit their professional stride. Talk to any of them who have spent years clawing up the corporate ladder and you'll hear "ambition," but also "career insecurity" and "guilt." The work-life-balance conundrum screeches into overdrive.
Mara* knows that seesaw intimately. She was a rising star on Wall Street when she got pregnant. Her company's policy included three months of fully paid leave—but after two weeks, her colleagues were e-mailing, expecting instant replies. "My coworkers acted like I was on vacation. I ended up going back after a month, afraid I'd be cut out of new business," she says.
Experts like Vicki Shabo, vice president of the National Partnership for Women & Families, say universal paid leave could help change this culture. A culture in which, studies show, employers consider mothers to be less competent and less committed to their jobs, and moms receive fewer raises and promotions than childless coworkers.
"Yes, women need time to heal from childbirth, but they are 'disabled' only for a short time," says Ellen Bravo, executive director of Family Values @ Work. "Yet when they return to work, they're often treated as if they're impaired by motherhood." The burn can even happen pre-baby: After Janelle Green, a 29-year-old researcher at a health-care company in Portland, Oregon, announced her pregnancy, she overheard an older female coworker tut, "Companies really need to think about this when they're interviewing and hiring young women."
Three-quarters of women entering the workforce today will become pregnant.
This archaic mindset can also keep women in dead-end positions and erode their self-confidence. Janelle turned down a new job when she was pregnant because, without accrued vacation days, she wouldn't have had any income during her three-month leave. Back at work, she often feels like a liability. "I can never come in early or stay late, or work on the weekends like my coworkers."
So what's stifling our government's ability to make a universal progressive leave policy? Conservative trade groups and lawmakers claim it's just too expensive, says Bravo. (A handful of GOP leaders support some form of paid family leave, but the party has historically opposed government-funded time off; Republican senators recently voted against a similar bill to provide paid sick days.)
Yet evidence from three states that have instituted their own paid leave—Rhode Island, California, and New Jersey—proves that it actually benefits employers.
In California, which gives six weeks off at around 55 percent pay, 91 percent of companies report the law has boosted or had no impact on profits. Indeed, 9 percent say it saved them money, since they didn't have to shell out to replace workers. Plus, moms who took the allotted leave were more likely to return to work and go on to earn more.
Some private companies are getting hip to this: After Google started offering moms 18 weeks' leave at full pay in 2007, new mothers quit at half the previous rate. Just before we went to press, Microsoft and Netflix both announced extended policies, with the latter giving a year at full pay.
The federal solution, says Bravo, is "a social insurance fund." Enter the Family and Medical Insurance Leave Act (FAMILY). First introduced by Senator Kirsten Gillibrand in 2013, it would grant every worker—low-wage, self-employed, part-time included—66 percent of their pay for 12 weeks by collecting a tiny portion of payroll contributions. The average person would chip in about $1.40 per week (about 0.2 percent of their wages). "It would be a dramatic improvement from where we are now," says Christopher Ruhm, Ph.D., a professor of public policy and economics at the University of Virginia.
That big business has stalled the bill is infuriating. After all, the vast majority of Democratic and Republican voters support paid leave. So what will it take for the U.S. to take action?
After Google started offering moms 18 weeks' leave at full pay in 2007, new mothers quit at half the previous rate.
That's what Janelle wants to know as she and her spouse desperately tag-team care of their newborn and 2-year-old. He works nights, she works days. She recently wrote her daughters a letter detailing the stress she feels at work, her guilt over missing bedtimes, the fights with her husband. She hopes her girls will get longer, paid maternity leave—that they'll avoid the pain and exhaustion that she continues to endure.
To help us advocate for paid leave:
Read: Why Every Woman Who Gives Birth Deserves Paid Leave by Senator Gillibrand.
Tweet: "#PaidLeavePays because..." saying why you want change. Or make a sign and post a photo like WH's editor-in-chief Amy Keller Laird did.
Sign: Our Change.org petition, which calls on 2016 presidential candidates to disclose their positions on paid leave, and asks debate moderators to include the topic in upcoming debates.
For more information about FMLA and why paid leave is so crucial, pick up the October 2015 issue of Women's Health, on newsstands now.