The single policy intervention that can improve health for moms and babies | Expert Opinion
It’s time to put families first by passing the Family Care Act.
As mothers and pregnant women, we know that the birth of a child is one of life’s most meaningful experiences. Yet in Pennsylvania, where there is no state-supported paid family leave program, most parents face an impossible choice: take leave without pay and stay home to care for a new baby, or return to work to earn the resources needed to survive, risking the health and welfare of a new infant. As physicians who care for women and children, we know that not having paid family leave has profoundly negative effects on the health and well-being of Philadelphia’s mothers and infants. A lack of paid family leave is associated with increased risks of postpartum depression and suicide, maternal and infant hospitalization, and infant death.
We think a lot about our patient, who we’ll call Danielle. Danielle brought her baby in for a newborn visit at our pediatric office. When asked about her plans for feeding her baby, Danielle replied that she had to go back to work in two weeks, so although she knew the health benefits of breastfeeding her baby, she would be switching to formula. Danielle also had a C-section, but without paid family leave, she had no choice but to return to a physically demanding job long before her body could heal and recover.
The Pennsylvania legislature should act now to improve the health and well-being of Danielle, her baby, and thousands like them by enacting the Family Care Act. The Family Care Act would create a paid Family and Medical Leave Insurance Program that allows Pennsylvania workers to take paid leave to care for a new child, care for themselves in the event of a serious health condition, and/or take paid time to care for a close family member with a health condition.
The health benefits of creating such a program are tremendous. Mothers who take paid leave are less likely to need rehospitalization, more likely to report better mental and physical health, and more likely to be successful with breastfeeding. Fathers who take paid leave experience stronger bonding and relationships with children. And a 10-week extension of paid parental leave was found to reduce infant mortality rates by 2.5% and child mortality rates up to age 5 by 3%.
Access to paid family leave is also a matter of health and racial equity. Families of color have less access to paid leave, with about 25% of Hispanic and Black adults in the United States reporting needing family or medical leave but being unable to take it. In Philadelphia, a survey of postpartum mothers found 16% of non-Hispanic Black women reported returning to work at less than 8 weeks postpartum compared to 9.5% of non-Hispanic white women.
This matters because families of color also suffer from worse maternal and infant health outcomes. In Philadelphia, Black women are two times more likely than white women to suffer severe complications and four more times more likely to die following delivery. Black infants in Philadelphia are almost three times more likely than white infants to die before their first birthday. A state supported, paid family leave program, would expand benefits to nearly all workers in Pennsylvania, with the potential to dramatically reduce racial disparities in maternal and infant health.
In our fields of pediatrics and OB/GYN, it is rare to find a single policy intervention that could so positively impact both maternal and infant health. With more time to recover and care for her child, Danielle, and others like her, can better learn their babies’ cues for feeding, attend necessary medical appointments for themselves and their babies, and focus on their own mental and physical health while adjusting to parenthood before returning to work—all without the financial stress of going without pay or losing their jobs. That is why our prescription for the health of Philadelphia’s women and babies is a simple one: enact the Family Care Act.
Stacey Kallem is a pediatrician and the Director of the Division of Maternal, Child, and Family Health at the Philadelphia Department of Public Health. Aasta D. Mehta is an Obstetrician/Gynecologist and the Medical Officer of Women’s Health in the Division of Maternal, Child, and Family Health at the Philadelphia Department of Public Health. Yuan He is a general pediatrician and a postdoctoral research fellow in the National Clinician Scholars Program at the University of Pennsylvania.