The Real War on Families: Why the U.S. Needs Paid Leave Now

Investigation reveals the devastating effects of the lack of paid family leave: Our data show nearly 1 in 4 employed mothers return to work within two weeks of childbirth.

Sharon Lerner

Each one of these women went back to work less than two months after giving birth due to the financial toll of unpaid maternity leave. (Kate Milford)

Leigh Ben­ra­hou began lay­ing plans to have a sec­ond child almost as soon as she had her first, a daugh­ter named Johara, in 2011. Ben­ra­hou, 32, want­ed to time the next birth so that when she returned to work, her moth­er, who works at an ele­men­tary school and has sum­mers off, could babysit. Most impor­tant­ly, Ben­ra­hou want­ed to spend as much time as she could with her new baby while also keep­ing her rel­a­tive­ly new job as the reg­is­trar at a small college.

Benrahou had to attend to another crisis: she was the mother of a very sick baby, and her carefully constructed paid maternity leave had disintegrated.

While her hus­band, Rachid, 38, earns enough at a car­pet clean­ing com­pa­ny to cov­er their mort­gage and food, with­out her pay­check they’d be forced to live close to the bone. And if she quit her job, Ben­ra­hou, who has a mas­ters in non­prof­it man­age­ment, would take a big step back­ward in what she hoped would be a long career in high­er education.

So Ben­ra­hou, who has wavy dark blond hair, blue eyes and a ten­den­cy to smile even through dif­fi­cult moments, set about what may be the least roman­tic aspect of fam­i­ly plan­ning in the Unit­ed States: fig­ur­ing out how to max­i­mize time with a new­born while stay­ing sol­vent, employed and, ide­al­ly, sane.

Only in America

Most peo­ple are aware that Amer­i­cans have a raw deal when it comes to mater­ni­ty leave. Per­haps they’ve heard about Swe­den, with its drool-induc­ing 16 months of paid parental leave, or Fin­land, where, after about 9 months of paid leave, the moth­er or father can take — or split — addi­tion­al paid child care leave” until the child’s third birthday.

But most Amer­i­cans don’t real­ize quite how out of step we are. It’s not just wealthy, social demo­c­ra­t­ic Nordic coun­tries that make us look bad. With the excep­tion of a few small coun­tries like Papua New Guinea and Suri­name, every oth­er nation in the world — rich or poor — now requires paid mater­ni­ty leave.

Paid parental leave frees moth­ers and fathers from choos­ing between their careers and time with their infants. For women, still most often the pri­ma­ry care­givers of young chil­dren, this results in high­er employ­ment rates, which in turn trans­lates to low­er pover­ty rates among moth­ers and their children.

Research shows that paid leave can also be a mat­ter of life and death for chil­dren. By chart­ing the cor­re­la­tion between death rates and paid leave in 16 Euro­pean coun­tries, Christo­pher Ruhm, a pro­fes­sor of pub­lic pol­i­cy and eco­nom­ics at the Uni­ver­si­ty of Vir­ginia, found that a 50-week exten­sion in paid leave was asso­ci­at­ed with a 20 per­cent dip in infant deaths. (The biggest drop was in deaths of babies between 1 month and 1 year old, though mor­tal­i­ty of chil­dren between 1 and 5 years also decreased as paid leave went up.)

Accord­ing to the Bureau of Labor Sta­tis­tics, only about 13 per­cent of U.S. work­ers have access to any form of paid fam­i­ly leave, which includes parental leave and oth­er time off to care for a fam­i­ly mem­ber. The high­est-paid work­ers are most like­ly to have it, accord­ing to BLS num­bers, with more than 1 in 5 of the top 10 per­cent of earn­ers get­ting paid fam­i­ly leave, com­pared to 1 in 20 in the bot­tom quar­tile. Union­ized work­ers are more like­ly to get ben­e­fits than nonunion­ized workers.

What do the rest of Amer­i­can women do with­out a law that guar­an­tees this basic sup­port? Some new moth­ers who don’t get paid leave quit their jobs, which can leave them des­per­ate for income and have seri­ous con­se­quences in terms of work oppor­tu­ni­ties and life­time earn­ings. Oth­ers may choose not to have chil­dren (though it’s impos­si­ble to defin­i­tive­ly quan­ti­fy how the dif­fi­cul­ty of inte­grat­ing work and child­birth fac­tors into those deci­sions). And some try to stitch togeth­er their own paid leaves through accu­mu­lat­ed vaca­tion time and per­son­al days, or through inde­pen­dent­ly pur­chased insur­ance policies.

The best-laid plans

Though her employ­er doesn’t offer paid leave, Ben­ra­hou fig­ured she’d cre­ate her own, tak­ing time away from work through the Fam­i­ly and Med­ical Leave Act, which enti­tles new par­ents to up to 12 weeks off, unpaid. She knew all about the law’s loop­holes — that, for instance, it only applies to work­places that have at least 50 employ­ees. Hers did; she wouldn’t have tak­en the job if it hadn’t. She knew, too, that she had to have worked for her employ­er for at least 12 months to qual­i­fy. That part was trickier.

She had start­ed her job in Feb­ru­ary 2014, which meant that she wouldn’t qual­i­fy until the fol­low­ing Feb­ru­ary. She count­ed back nine months from then and got to May, but then, to be safe, tacked on anoth­er two months in case the baby came ear­ly, so: July. That’s when she and Rachid would start try­ing for a second.

Then there was mon­ey. Reluc­tant to lose 12 weeks of income, Ben­ra­hou decid­ed to opt into her employer’s dis­abil­i­ty insur­ance pol­i­cy, pay­ing rough­ly $40 a month into the plan so she could receive 60 per­cent of her salary for up to six weeks of her mater­ni­ty leave, plus an addi­tion­al $1,000 toward the cost of her hos­pi­tal stay. She would also save up her two weeks of annu­al paid vaca­tion time.

Num­bers crunched and pol­i­cy pur­chased, Ben­ra­hou went off birth con­trol on sched­ule in July and became preg­nant with­in a month. But her care­ful­ly laid plans start­ed to go awry in her 20th week, when she was diag­nosed with pla­cen­ta pre­via, which can result in ear­ly deliv­ery. Despite some bleed­ing and cramp­ing, and sev­er­al brief hos­pi­tal stays that used up her sick days, Ben­ra­hou stuck to her plan, work­ing as much as pos­si­ble after her diag­no­sis in order to save her pre­cious vaca­tion time. But, in late Decem­ber, her water broke. Though her due date was April 1, Leigh Ben­ra­hou gave birth by C‑section on Christ­mas Eve — too soon to qual­i­fy for FMLA leave or any pay­off from her dis­abil­i­ty insurance.

Ramzi Ben­ra­hou was born at 26 weeks and just over 2 pounds. Know­ing that 20 per­cent of babies born at his ges­ta­tion­al age don’t sur­vive, Leigh spent the first hours after the deliv­ery sin­gu­lar­ly focused on her tiny son’s sur­vival. He need­ed oxy­gen, since his lungs weren’t ful­ly devel­oped. And, when he was whisked away for med­ical atten­tion, Ben­ra­hou had to attend to anoth­er cri­sis: She was the moth­er of a very sick baby, and her care­ful­ly con­struct­ed paid mater­ni­ty leave had dis­in­te­grat­ed. So, fresh­ly stitched up and still grog­gy from anes­the­sia, she spread out her med­ical fact sheets, insur­ance pol­i­cy papers and lists of phone num­bers on her hos­pi­tal bed and began to grap­ple with her new real­i­ty. Though her col­lege was on win­ter break, which put off her return by about a week, Ben­ra­hou real­ized she’d have to go back to work when class­es resumed on Jan­u­ary 6, less than two weeks after giv­ing birth.

Less than a month

Like Ben­ra­hou, most U.S. women end up return­ing to work soon­er than they’d like — some­times just weeks or days after hav­ing a baby. Just how soon they’re going back is dif­fi­cult to deter­mine. We know that most employ­ers don’t offer paid leave, but no fed­er­al agency col­lects reg­u­lar sta­tis­tics on how much post-child­birth time off, paid or unpaid, women are actu­al­ly taking.

Cen­sus data on employ­ment pat­terns among first-time moth­ers show that between 2005 and 2007, more than half who worked dur­ing their preg­nan­cy were back on the job with­in three months of giv­ing birth. A 2008 study by the Depart­ment of Health and Human Ser­vices’ Mater­nal and Child Health Bureau, mean­while, found that the aver­age length of mater­ni­ty leave, when tak­en, was 10 weeks. But more recent data is scarce, even though the reces­sion left many women liv­ing on razor­thin mar­gins, ratch­et­ing up the pres­sure to rush back to work after giv­ing birth.

How are new moth­ers far­ing in today’s age of aus­ter­i­ty? Data ana­lyzed for In These Times by Abt Asso­ciates, a research and eval­u­a­tion com­pa­ny, pro­vides a win­dow into these expe­ri­ences. Abt went back to a 2012 sur­vey it con­duct­ed for the Depart­ment of Labor of 2,852 employ­ees who had tak­en fam­i­ly or med­ical leave in the last year, look­ing specif­i­cal­ly at the 93 women who took time off work to care for a new baby.

Near­ly 12 per­cent of those women took off only a week or less. Anoth­er 11 per­cent took between one and two weeks off. That means that about 23 per­cent — near­ly 1 in 4 — of the women inter­viewed were back at work with­in two weeks of hav­ing a child.

The edu­ca­tion­al divide between those who took short­er and rel­a­tive­ly longer leaves is strik­ing: 80 per­cent of col­lege grad­u­ates took at least six weeks off to care for a new baby, but only 54 per­cent of women with­out col­lege degrees did so.

Pump­ing in the park­ing lot

What’s it like to be back on the job in the first weeks after hav­ing a baby?

For Natasha Long, who was back three weeks after her third child, Jay­den, was born in 2012, the worst part was miss­ing out on bond­ing time with her son.

Long, who was 29 at the time, was deter­mined to make sure Jay­den got breast milk. But the fac­to­ry where she worked, ACCO Office Sup­plies in Booneville, Mis­sis­sip­pi, didn’t have a lac­ta­tion room. So when she was on breaks, she had to run out to her truck. She sat in the cab, wor­ried that some­one might see her, and pumped, while tears rolled down her face and over the plas­tic suc­tion cups attached to her breasts.

Long cried because she want­ed to be hold­ing her baby rather than sit­ting in the park­ing lot of a fac­to­ry in her old Yukon Denali. But exhaus­tion clear­ly also played a role in her emo­tion­al state. Her job was sim­ple — to place stick­ers with the com­pa­ny logo on the bot­tom right-hand cor­ner of plas­tic binders and then box up the binders. But the shifts were long — from 6 a.m. to 6 p.m. — and she put in four or five a week. Because the fac­to­ry was an hour’s dri­ve from her home in Okalona, Mis­sis­sip­pi, Long had only 10 hours left in the day to do every­thing else, includ­ing tend to her three chil­dren, spend time with Jayden’s father, and sleep. By the time she got back in the evening, her chil­dren, who were being looked after by her father dur­ing the day, were on their way to bed. To pump breast milk before leav­ing for work, she had to get up at 4 a.m.

After just a few days of this crazed sched­ule, Long began to devel­op strange symp­toms, includ­ing a headache that nev­er seemed to go away and a chok­ing sen­sa­tion that left her feel­ing breath­less. She start­ed bit­ing her fin­ger­nails to the quick — some­thing she’d nev­er done before — and cry­ing a lot. I felt like I was alone,” says Long. I want­ed to fall off the face of the earth.” Long had nev­er been depressed. But when she went to the doc­tor, he sur­mised that her phys­i­cal symp­toms were root­ed in her men­tal state, which was itself root­ed in her sched­ule. When her doc­tor said he thought she was depressed, Long wor­ried that if child wel­fare author­i­ties found out, they might take her chil­dren away. She had seen oth­er people’s chil­dren put in fos­ter care. But when her doc­tor pre­scribed her anti­de­pres­sants, she took them. 

Long is not the only one to suf­fer emo­tion­al­ly from a quick return to work. Research has shown that longer mater­ni­ty leaves, whether paid or unpaid, are asso­ci­at­ed with a decline in depres­sive symp­toms, a reduc­tion in the like­li­hood of severe depres­sion, and an improve­ment in over­all mater­nal health, accord­ing to a work­ing paper issued by the Nation­al Bureau of Eco­nom­ic Research. One nation­al study of 1,762 moth­ers found that a one-week increase in mater­ni­ty leave was asso­ci­at­ed with a 5 to 6 per­cent reduc­tion in depres­sive symp­toms from six to 24 months after birth. Anoth­er found that women who took less than eight weeks of paid leave expe­ri­enced more depres­sion than those who had longer leaves and were in worse health over­all. Moth­ers who work more than 40 hours a week, as Long was, were more like­ly to be depressed than those who worked 40 hours or less, accord­ing to a study by Child Trends, a research center.

Women who go back soon­er also tend to breast­feed less, which cuts into the ben­e­fits breast milk con­fers, includ­ing bet­ter immu­ni­ty and low­er rates of child­hood obe­si­ty, aller­gies and sud­den infant death syn­drome. It was only through hero­ic efforts that Long was able to breast­feed Jay­den until he was 1.

Short­er mater­ni­ty leaves may also have a neg­a­tive effect on the devel­op­ment of ear­ly motor and social skills and even, lat­er, on vocab­u­lary, accord­ing to sev­er­al stud­ies. So far, Jay­den, 3, hasn’t shown signs of miss­ing any devel­op­men­tal mile­stones. What nags at Long is the thought that her absence in those first few months might have affect­ed their rela­tion­ship. He refus­es to call her mama,” and although there’s no research to indi­cate this would be a result of failed ear­ly bond­ing, she still fears that’s the reason.

Too busy to fight

For low-income women, the lack of paid mater­ni­ty leave is just one of many miss­ing sup­ports to help them stay afloat while bring­ing new life into the world. By the time Jay­den was born, preg­nan­cy had already put Long in a per­ilous finan­cial sit­u­a­tion. She was on bed rest for the last four and a half months of her preg­nan­cy. Big Dol­lar, where she worked at the time, didn’t fire her for not com­ing in — but it didn’t pay her, either. So Long filed for pub­lic assis­tance, which required her to attend class­es. Though Mis­sis­sip­pi is sup­posed to exempt peo­ple who are phys­i­cal­ly unable to take such class­es, and Long’s doc­tor had warned her to stay off her feet, she says she was denied ben­e­fits when she didn’t attend.

Fam­i­ly mem­bers pitched in to pay for her gro­ceries and rent while she was unable to work, but by the time Jay­den was born (healthy, at 37 weeks), Long knew she had reached the lim­it of their gen­eros­i­ty. When she went back to work at the dol­lar store, they offered her only reduced hours. It wasn’t enough to repay her debts, so she went to an employ­ment agency, made no men­tion of her days-old baby, and got her job at ACCO.

Oth­er social sup­ports are glar­ing­ly absent for U.S. moth­ers, espe­cial­ly poor ones, who fill wait­ing lists for scarce sub­si­dized child­care spots and under­fund­ed ear­ly edu­ca­tion class­es. In com­par­i­son, Swe­den and Den­mark spend rough­ly 10 times what we do on child­care per person.

With­out ade­quate options or sup­port, low-income work­ers, who are more like­ly to live pay­check to pay­check and less like­ly to have access to any type of leave, often have lit­tle choice but to pow­er through. As our data con­firm — and as finances dic­tate — less edu­cat­ed women, who tend to have low­er-pay­ing jobs, are like­ly to take less time off after hav­ing chil­dren. Often, that means not just going back to work ear­ly, but going back to very long work hours, very early.

Raven Osborne, for instance, a 22-year-old sin­gle moth­er in Tupe­lo, Mis­sis­sip­pi, went back to work just one week after her first child, Kylan, now 2, was born in August 2013. In addi­tion to being a full-time col­lege stu­dent, Osborne was wait­ress­ing full-time at IHOP, but her earn­ings — tips plus a base salary of $2.13 an hour — weren’t enough to cov­er her rent, car pay­ments and day­care costs. Per­haps iron­i­cal­ly, her tips were much high­er — some­times more than $100 a shift — when she was vis­i­bly preg­nant. But once she had the child, they went down again, so Osborne added a few overnight shifts at Tex­a­co when Kylan was four weeks old, leav­ing the baby with his grand­moth­er. Work­ing upwards of 60 hours each week, the new moth­er bare­ly saw her son, except when she got home from work, when she often fell asleep hold­ing him. She could have tak­en unpaid leave from IHOP but chose not to because she need­ed the pay.

This win­ter, Osborne returned to work four weeks after her sec­ond child, Antho­ny, was born. Now she’s work­ing full-time at a debt col­lec­tion agency on top of sev­er­al shifts at the near­by Coles supermarket.

I don’t like ask­ing for help” is how Osborne explains the fran­tic pace she’s kept up dur­ing her first year-and-a-half of moth­er­hood. Her moth­er pitch­es in by watch­ing the kids when she can, though she, too, has two full-time jobs — one at Wal­mart and anoth­er as an aide at a retire­ment community.

Clear­ly, women with low earn­ings are the least like­ly to have a finan­cial cush­ion that allows them to for­go a pay­check. But it’s not only those on the bot­tom of the pay scale who can’t afford to take unpaid leave. More than 2.5 mil­lion employ­ees need time off from work to care for them­selves or anoth­er but can’t afford to take it, accord­ing to a 2012 study from the Cen­ter for Eco­nom­ic and Pol­i­cy Research.

Tra­cy Mal­loy-Cur­tis, a fundrais­er at a non­prof­it in New York City, could have tak­en more time off, unpaid but with job secu­ri­ty, after she had a baby a few years back. (“It’s a civ­il rights orga­ni­za­tion,” she explains, though she doesn’t want to name it because she still works in the field.) Instead, Mal­loy-Cur­tis, who is 43, mar­ried, and the pri­ma­ry bread­win­ner in her fam­i­ly, went back five and a half weeks after hav­ing a son — and a com­pli­cat­ed C‑section — for fear she oth­er­wise could not afford to pay her mort­gage and cov­er the oth­er basic costs of her life.

Phys­i­cal­ly, I was a wreck,” she says. An infec­tion around her C‑section wound hadn’t yet healed when she went back to work. I was still bleed­ing, my inci­sion wasn’t closed.” Pus dripped down her leg under her work clothes.

Those who do take leave may find them­selves penal­ized after­ward. Jack­ie Wheel­er took six weeks of paid mater­ni­ty leave after her son, Enzo, was born in 2011. Wheel­er, who lives in West­min­ster, Colo., was work­ing at the front desk of a local branch of Chase Bank. Though her son had severe med­ical prob­lems as a result of being born ear­ly, Wheel­er had intend­ed to go back to her job. Before giv­ing birth, she says, she had even been talk­ing with her boss about inter­view­ing for an assis­tant man­ag­er posi­tion. I saw myself as mov­ing along in the com­pa­ny,” she says.

But after she returned to work and Enzo was released from the hos­pi­tal, she took anoth­er six weeks of leave. At that point, her boss told her he thought it was best that she resign — if he didn’t fill her posi­tion right away, he said, cor­po­rate head­quar­ters would elim­i­nate it. And Wheel­er was too over­whelmed at the time to chal­lenge him.

The birth of hope

While, in the Unit­ed States, the lack of time off can too often turn new moth­er­hood into a dis­tress­ing ordeal, most oth­er cul­tures treat this imme­di­ate post-natal peri­od as a sacred time, when both the new moth­er and baby receive help and spe­cial atten­tion. Through­out his­to­ry and all over the world, peo­ple have tend­ed to carve out a min­i­mum of at least six weeks in which women are exempt from respon­si­bil­i­ties oth­er than child care, accord­ing to Malin Eber­hard-Gran, a Nor­we­gian pub­lic health schol­ar who has com­piled a cross-cul­tur­al com­par­i­son of post-natal practices.

In some Mus­lim tra­di­tions, new moth­ers spend the first 40 days after birth in their moth­ers’ homes, for instance. Many Latin Amer­i­can cul­tures also brack­et dur­ing the same peri­od, known as la cuar­an­te­na (from the Span­ish word for forty”), and exempt women from work respon­si­bil­i­ties. In some oth­er coun­tries, women are grant­ed spe­cial treat­ment for even longer. Tra­di­tion­al­ly, women in Japan and India go to their moth­ers’ homes for sev­er­al months after giv­ing birth. And today, by law, the 30 coun­tries in the Orga­ni­za­tion for Eco­nom­ic Co-oper­a­tion and Devel­op­ment (OECD) — democ­ra­cies with mar­ket economies — pro­vide an aver­age of more than a year of paid leave.

Here in the Unit­ed States, advo­cates have been fight­ing for a cen­tu­ry to get new par­ents just a few weeks off with pay. But the tide may be turn­ing. In 2002, Cal­i­for­nia became the first state to pass a paid fam­i­ly leave law, which pro­vides work­ers who need to care for a new baby with 55 per­cent of their usu­al week­ly pay, to a lim­it of $1,104 for up to six weeks. New Jer­sey passed a sim­i­lar law in 2008. And in 2013, Rhode Island grant­ed work­ers up to four weeks off with pay for fam­i­ly care,” includ­ing care of a new baby. Despite dire warn­ings from busi­ness inter­ests, most employ­ers in New Jer­sey and Cal­i­for­nia (where pro­grams have been in effect long enough to be stud­ied) haven’t found that paid leave has hurt pro­duc­tiv­i­ty, prof­itabil­i­ty or turnover. (Full dis­clo­sure: I was a co-author of the New Jer­sey study).

The Oba­ma admin­is­tra­tion is attempt­ing to build momen­tum for paid sick leave, one of the main ways women piece togeth­er paid mater­ni­ty leave. In the 2015 State of the Union address, Pres­i­dent Oba­ma called on Con­gress to send him a bill guar­an­tee­ing U.S. work­ers sev­en days of paid sick leave — but in ear­ly August, Sen­ate Repub­li­cans blocked a Demo­c­rat-spon­sored bill to do so. In the mean­time, Oba­ma has an exec­u­tive order in the works that will extend a week of paid sick leave to all fed­er­al con­trac­tors, and his admin­stra­tion has issued $1.25 mil­lion in grants to study how paid leave pro­grams can be devel­oped in states. Labor Sec­re­tary Tom Perez, who has been out­spo­ken on the issue, has spear­head­ed a #lead­on­leave cam­paign, in which he and White House aide Valerie Jar­rett trav­el the coun­try to boost local paid leave policies.

But, so far, even a Demo­c­ra­t­ic admin­is­tra­tion com­mit­ted to the issue hasn’t been enough to over­come resis­tance to it. When bills have been debat­ed in states, Repub­li­cans have been so vehe­ment that paid leave is bad for busi­ness and a job killer” that leg­is­la­tion at a fed­er­al lev­el has been assumed to be a no-go. And, at least until very recent­ly, con­gres­sion­al Repub­li­cans have most­ly scoffed at Demo­c­ra­t­ic efforts. But for the first time, a bill pro­posed by Sens. Kirsten Gilli­brand (D‑N.Y.) and Rosa DeLau­ro (D‑Conn.) this spring that would pro­vide ben­e­fits for work­ers who take time off to care for a new baby or sick fam­i­ly mem­ber was met with a coun­ter­pro­pos­al from Repub­li­cans, which would allow hourly work­ers to put over­time toward paid leave.

The issue is also clear­ly gain­ing ground in cer­tain states, where at least ten fam­i­ly leave pro­pos­als have been intro­duced since March. Though Repub­li­can pres­i­den­tial can­di­dates have had lit­tle to say about the issue, Demo­c­ra­t­ic con­tenders Hillary Clin­ton and Bernie Sanders have both come out as strong pro­po­nents of paid leave. While Sanders has been more spe­cif­ic about his plan, call­ing for 12 weeks off, with pay, both are mak­ing a moral case to which there is no polit­i­cal­ly sound retort: Fam­i­lies need paid time off to take care of their new babies. Men, women and chil­dren will gain from this basic human dignity.

Bar­rel­ing ahead

After three months, Leigh Ben­ra­hou only has a blur­ry rec­ol­lec­tion of her first weeks back at work just days after her pre­ma­ture son was born. I remem­ber walk­ing real­ly slow and wear­ing stretch pants and just mak­ing it hap­pen,” she says hazi­ly. She spent those ear­ly days cut­ting a path between the col­lege; the hospital’s neona­tal inten­sive care unit (NICU), where Ramzi spent four months and under­went two stom­ach surg­eries; her 3‑year-old daughter’s day­care cen­ter; and her home, where, despite her exhaus­tion, she found it dif­fi­cult to sleep.

At work, Ben­ra­hou tend­ed to the needs of her stu­dents, whose ques­tions about enroll­ment require­ments and course changes occa­sion­al­ly pro­vid­ed dis­trac­tion from her own, far graver prob­lems. But most­ly it was sur­re­al — and painful — to be there. Climb­ing stairs was dif­fi­cult because of her recent surgery. And pret­ty much every time she closed the door to pump breast milk, she wound up cry­ing. Hard­er still was being away from her tiny baby, whose health was still so uncer­tain. Every time she got a call from the hos­pi­tal when she was at work — and there were many — her stom­ach clutched.

They say it’s like being on a roller coast­er, [hav­ing a child] in the NICU,” says Ben­ra­hou. But a roller coast­er is fun. I want­ed to throw up all the time.”

Ben­ra­hou didn’t throw up, though. Instead, like so many oth­er Amer­i­can women, she bar­reled ahead, doing her best to both take care of her new­born and remain employed. Though she nev­er got to take leave when and how she had planned, she was recent­ly able to take 12 weeks off through the FMLA under the cat­e­go­ry of car­ing for a sick rel­a­tive — in this case, her infant son. And now the woman who so painstak­ing­ly planned her family’s future doesn’t know what’s ahead. Ramzi’s long-term prog­no­sis is unclear; he’s still on oxy­gen and has a feed­ing tube. About a quar­ter of babies born at 26 weeks go on to have last­ing disabilities.

Benrahou’s hope is to keep work­ing. And most­ly she remains upbeat. But some­times she can’t help but won­der whether Ramzi’s ear­ly birth was pre­ventable; and whether con­tin­u­ing to work after her diag­no­sis so she could make the best of her minis­cule amount of time off brought about Ramzi’s ear­ly deliv­ery. It cer­tain­ly wasn’t the way she planned it.

This arti­cle was sup­port­ed by the Leonard C. Good­man Insti­tute for Inves­tiga­tive Report­ing.

Sharon Lern­er is an award-win­ning inves­tiga­tive jour­nal­ist liv­ing in Brook­lyn. She is the author of The War on Moms: On Life in a Fam­i­ly-Unfriend­ly Nation” and cov­ers health, the envi­ron­ment and oth­er issues affect­ing chil­dren and families.
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