Ruth Rodriguez has two jobs, one full time on weekdays and one part time on weekends. The difference in how the two employers treat nursing mothers like her is striking.
Monday through Friday, Rodriguez, 43, can access a private room with a locked door twice a day to express milk for 10-month-old Mateo. On weekends, she spends her 15-minute break pumping milk while standing over a sink in the company bathroom.
"I'm sure it's not sanitary," said Rodriguez, of North Philadelphia, who asked that her employers not be identified. "I had a conversation with a manager who doesn't have kids who was, like, 'Why should we accommodate you?' I said, 'Do you get your food served in a bathroom? I don't think you'd like your food served in a bathroom.' "
Under the guidelines of 2010's Affordable Care Act, employers must provide employees who need to express breast milk a "reasonable" amount of time and a private space that is not a bathroom. As Rodriguez's case shows, the mere existence of a law doesn't mean conditions change immediately, but it does give workers the option to contact the Department of Labor for help.
The ACA guidelines, however, largely exclude salaried employees and management. So Philadelphia lawmakers in 2014 passed similar guidelines to cover all people working in the city.
To spread the net even wider, State Rep. Mary Jo Daley (D., Montgomery) has been fighting for state legislation since 2014. Her most recent effort, House Bill 1100, introduced in May 2015, has remained in the Labor and Industry Committee since a hearing in the spring.
"I'm going to be hopeful that we can get a vote in committee and move to the House floor, but I recognize that time is moving quickly" until the legislative session ends Nov. 15 and pending bills become moot, she said.
One holdup, she believes, is that the bill doesn't have the backing of the Pennsylvania Chamber of Business and Industry, which represents about half of the private businesses in the state. Alex Halper, the Chamber's director of government affairs, notes that House Bill 1100, if passed, would cover all state employees, including those already covered by the ACA. Having two laws - one at the state level and one national - governing the same behaviors could confuse some employers, he said.
The state bill also lays out different employee grievance procedures from those established under the ACA, he said, making it easier for a complainant to go directly to the courts if there is a problem.
"We fully support the intent behind the legislation and certainly understand why this overall issue is important, but we do have some concerns," Halper said.
Pamela Gwaltney, deputy director of compliance for the Philadelphia Commission on Human Rights, said her office has received only a handful of complaints from employees whose employers are not following the city law. All of the cases were quickly resolved without litigation, she said.
"Once the employer knows the law, they're willing to come into compliance to help meet the employee's needs," she said. "They just don't know about the law."
The American Academy of Pediatrics recommends that babies be breast fed exclusively for the first six months. Formula and solid foods can then be used to supplement breast milk until the child's first birthday. Babies who receive breast milk have a lower risk of having asthma or allergies, have fewer ear infections and bouts of diarrhea, and require fewer hospital trips or doctor visits, the academy says.
Rosemarie Halt, director of health policy and practice for the nonprofit Maternity Care Coalition, formed in 1980, pointed to the long-term societal and financial benefits of breast feeding, and the near-term payoff for employers who can promote their family-friendly atmosphere.
"The real issue is misunderstanding what the accommodations would be," she said. "It's maybe an additional 20-minute break in an eight-hour workday. . . . For a small business, it doesn't have to be a special room with fancy accommodation, a pampering room. It can be an office with a tag on the door that says, 'Mom at work. Please knock.' Sometimes, that's all it takes. It's a clean space that's private and has access to electricity."
This is not a gender issue, Halt notes, but, instead, a temporary accommodation for a worker. It's similar to what an employer would do for a data-entry worker who breaks an arm, or a driver who breaks a leg. An employee with an overactive bladder might spend the same amount of time visiting a restroom.
"This is not just a nice thing for a mother to be able to do for her child," Halt said. "This is a basic human right."
When Casey Ann Beck was pregnant with her older son, Joey, now 25 months, her workplace was experiencing a mini-baby boom, with four other employees expecting at the same time. Still, she said, her bosses figured out a way to set aside a room.
"Space is tight at work so they made accommodations, a cover for the window, and a lock on the door," she said.
Beck, 33, said she suspects some coworkers resented what may have seemed like special treatment - not so much the room, but the time not working.
"It looks like a break because I'm away from my desk, but for me personally, becoming a mom has made me more efficient and resourceful. I usually bring my laptop with me [while pumping] and get emails and things like that out of the way at the same time. It doesn't hurt my productivity," she said.
Now nursing her second son, 6-week-old Bobby, Beck said breast feeding is hard work, and it saddens her to think that the effort mothers put in at home can be wasted if they go back to work and can't express milk. In addition to not being able to set aside milk that can be given to their babies, mothers who can't pump regularly also can suffer painfully clogged ducts or mastitis, an infection that may require antibiotics and causes some women to give up breast feeding entirely.
"It's funny to me that we even need a law. This is common sense to me," she said.
When Rodriguez works weekends, she makes time to pump - by skipping meals.
"I know I'm not feeding myself like I should be," she said. "I'd rather not eat so I'll be able to pump so he can have six ounces of breast milk and not formula."
Although Rodriguez now weighs less than she did before her pregnancy, her son is flourishing and weighs in at a healthy 20-plus pounds.