SUBSCRIBE TO OUR FREE NEWSLETTER
Daily news & progressive opinion—funded by the people, not the corporations—delivered straight to your inbox.
5
#000000
#FFFFFF
5
#000000
#FFFFFF
maternal care
The US Needs Paid Parental and Medical Leave
Welcoming a child should never be the reason a family plunges into poverty, especially in one of the wealthiest countries in the world.
Feb 18, 2024
I had a baby in 2021 and quickly learned how parenting and child care expenses add up.
My husband and I had saved up for months to afford my unpaid maternity leave—I kept working even after my water broke because we needed every penny. It was a dream come true to have a career that I was proud of and finally be welcoming a child into our lives.
But I had no idea how hard it would really be.
While I was on unpaid maternity leave that cost us our health benefits, my husband was let go from his job. Already reliant on WIC—the federal food aid program for women, infants, and children—we were forced to go to food pantries, apply for Medicaid, and referred to a diaper bank. We were in survival mode: exhausted, stressed out, and worried.
Congress must put our tax dollars and policies toward strong support for families.
Despite a litany of postpartum complications that continue to plague me more than two years later, I ended up only taking seven weeks of leave before I returned to work out of desperation.
I wondered: Why doesn’t the U.S. have a paid parental leave policy?
Instead, my first and only experience with motherhood was marred by stress and trauma. Again and again, I had to choose between my health and a paycheck, which can feel like a punishment. I’d proudly served my country on a one-year assignment overseas working on foreign aid, and it didn’t matter.
We found child care at a loving, quality child care center, but the tuition kept increasing. Now the monthly cost is almost twice our mortgage. In fact, child care costs exceed college tuition where we live in North Carolina, as well as in at least 27 other states. My stomach gets in a knot every six months when I know the tuition will increase again.
I wondered: Why don’t we invest more in early care and education?
Meanwhile, the crises causing outsized harm to families throughout the pandemic compounded: a diaper shortage, a formula shortage, inflation, and wages that wouldn’t keep up. So many people are struggling to get back on their feet and desperately need balance and some peace of mind. The stress took its toll, and my husband and I separated in spring 2023.
I wondered: If only we’d had more support, would we have made it?
I have an advanced degree and work as a communications director at a nonprofit while also freelancing. After paying for necessities, we have nothing left, so I get food and supplies from neighbors and friends. I work so hard as a single mom to try to achieve the dreams I have for myself and my baby boy—the dreams that all mothers have. I don’t want my child to deal with the stress and constant refrain of “we don’t have the money for that,” like I did growing up.
Families desperately need, want, and deserve better. Welcoming a child should never be the reason a family plunges into poverty, especially in one of the wealthiest countries in the world. We shouldn’t be sacrificing health, quality early learning, or stability in exchange for a roof over our heads and food. Instead, we should be building strong foundations and generational wealth for our kids.
We need federally mandated paid parental and medical leave. We need additional dedicated funding for programs like WIC that support over 6 million families.
And we need to continue expanding the Child Tax Credit. In North Carolina alone, the monthly Child Tax Credits received in 2021 helped the families of 140,000 children lift themselves out of poverty. Nationally, the credit cut child poverty by over 40% before Congress let the pandemic expansion expire at the end of 2021.
Congress must put our tax dollars and policies toward strong support for families. Let’s ensure no parent experiences welcoming a child as a financial catastrophe and make this country a place where families prosper.
Keep ReadingShow Less
One Year Later, the Fall of Roe Is Already Hurting Abortion Care in the US
The scope of reproductive healthcare that women can receive is highly dependent on where they live, creating a system of inequalities and further exacerbating health disparities.
Jun 23, 2023
In the year since the U.S. Supreme Court’s Dobbs v. Jackson ruling struck down the constitutional right to abortion, society has been seeing the results of a post-Roe world.
While there is no law in the U.S. that regulates what a man can do with his body, the reproductive health of women is now more regulated than it has been in 50 years. And the scope of reproductive healthcare that women can receive is highly dependent on where they live.
This creates a system of inequalities and further exacerbates health disparities.
While there is no law in the U.S. that regulates what a man can do with his body, the reproductive health of women is now more regulated than it has been in 50 years.
I am a nurse practitioner who studies women’s reproductive health across the lifespan.
My research found that college women are concerned about pregnancy, but they lack knowledge and skills about navigating sexual consent and often participate in sexual activity without explicit consent, leaving them at risk for not using contraception and exposure to sexually transmitted infections.
These findings indicate that women are at risk of pregnancy at a historic time when women’s reproductive rights in the U.S. are restricted and not guaranteed.
Current State of Abortion in the U.S.
The Dobbs v. Jackson ruling returned decisions regarding abortion to individual states. This has led to a patchwork of laws that span the entire range from complete bans and tight restrictions to full state protection for abortion.
In some states, such as Texas, Louisiana, and Mississippi, abortion is banned beginning at six weeks gestational age, when very few women even know they are pregnant. Other states, such as Massachusetts, Vermont, New York, and Oregon, have enacted state-level protections for abortion.
The patchwork of state laws also results in a great deal of confusion. In the past year, women’s rights organizations and women’s health advocates have brought numerous legal challenges to restrictive abortion laws. These cases have halted the implementation of some of the strictest abortion regulations until additional court rulings are finalized.
Downstream Effects for Healthcare Professionals
Abortion training is considered essential healthcare and a core competency for physicians in obstetrics and gynecology, or OB-GYN, residency programs. Approximately 50% of OB-GYN residency programs are located in states with restricted or highly restricted access to abortion. This will logically result in not only fewer healthcare providers being trained to perform gynecologic procedures for abortion, but also other conditions such as miscarriage, fetal death, and nonviable pregnancies.
In states with changing abortion laws and legal challenges to new laws, physicians are uncertain of what procedures can be legally done. Penalties for violating abortion laws may include arrest, loss of medical license, fines, and discipline by state boards of medicine.
As a result, physicians are choosing to leave states with the most restrictive abortion laws, and clinics are closing, which is contributing to the current shortage of healthcare providers.
Inequalities in Healthcare Access
The unequal access to abortion procedures across the country is most directly affecting the poorest women in the U.S.
Currently, 12 states restrict abortion coverage by private insurance, and more than 30 states prohibit public Medicaid payment for abortion. Women who qualify for Medicaid are among the poorest in the U.S. Lack of access to abortion limits education and wage earning and contributes to poverty. States with the most restrictive abortion laws also have limited access to pregnancy care and supportive programs for pregnant and parenting women.
In addition, traveling to a different state to obtain an abortion is often not possible for poor women. Lack of transportation and limited financial resources reduce or eliminate options to obtain an abortion in a different geographic location.
What’s more, states with the most abortion restrictions have some of the worst pregnancy and maternal health outcomes for women, especially women of color.
What’s more, states with the most abortion restrictions have some of the worst pregnancy and maternal health outcomes for women, especially women of color. Pregnancy itself is associated with a risk of dying.
Maternal morbidity is the term used to describe short- or long-term health problems that result from pregnancy. Maternal mortality refers to the death of women during pregnancy or within the first six weeks after birth.
For example, Mississippi and Louisiana have the highest rates of maternal mortality in the U.S. and also have the most restrictive abortion laws. Black women have the highest maternal mortality of all races and ethnicities. Women in these states who are unable to terminate a pregnancy have a higher risk of dying as a result of the pregnancy than women in other states.
Additionally, research shows that a woman’s risk of dying related to pregnancy or childbirth is about 14 times higher than the risk of death from an abortion.
In addition to the increased risks of death, there are other physical and mental health implications associated with carrying an undesired pregnancy to term. Being denied access to abortion is associated with increased anxiety and fewer future plans for the next year. Research also shows that not being able to obtain an abortion makes women more likely to live below the federal poverty level and to lack partner support.
Conversely, research has shown that there are few if any significant negative mental health outcomes among women who have abortions.
Unsafe Abortions
Restricting legal abortion increases the risk that women will seek out pregnancy termination from unskilled people in unsafe settings. Or they may not seek care quickly for pregnancy complications due to fear of being accused of a crime.
In Texas, physicians are reporting an increase in sepsis, or an overwhelming response to infection, from incomplete abortions. These physicians predict that sepsis will become the leading cause of maternal death in Texas.
“I didn’t know I was important enough to draw boundaries around what people could and couldn’t do with my body.”
Prior to 1973, when Roe v. Wade established constitutional protection for abortion in the U.S., women often resorted to unsafe methods to induce abortion that resulted in a high death toll. Septic abortion wards—or designated areas of hospitals where women were treated for sepsis as a result of illegal abortions—were common. In 1965, 17% of all deaths related to pregnancy were attributed to illegal abortion.
Now that the constitutional right to abortion has been eliminated, more women will inevitably die or become seriously ill due to lack of safe access to abortion services. In states with the most restrictions on abortion, whether a woman meets the criteria for an exemption to save the life of the mother may be decided by a hospital committee. This can delay necessary care and increase the risk to the mother.
Said one: “I didn’t know I was important enough to draw boundaries around what people could and couldn’t do with my body.”
Women Affected by Violence
In the U.S., more than 25% of women will experience physical or sexual violence in their lifetime. Violence from an intimate partner is a leading reason for abortion. My research shows that women affected by violence have a higher risk of pregnancy and that college women are at increased risk of nonconsensual and forced sexual encounters.
Currently, there are 14 states with abortion bans that contain no exception for rape or incest or require that the sexual assault be reported to law enforcement to qualify for exception.
Research has shown that women often don’t report sexual assault due to stigma, embarrassment, or fear of not being believed. Even if women qualify for an abortion as a result of sexual violence, those who have not filed a formal police report lack “proof” that their pregnancy resulted from assault.
While the changes that have occurred since the fall of Roe one year ago are already deeply concerning, the full effect of eliminating the constitutional right to an abortion won’t be known for years. And as laws are enacted and subsequently challenged, uncertainty and confusion regarding women’s reproductive healthcare will undoubtedly continue for years to come.
Keep ReadingShow Less
Witnessing the Resilience of Mothers in Southern Bangladesh
As we celebrate Mother's Day, let us recognize the importance of accessible maternal health services for regions in crisis and the significant role that maternal healthcare plays in driving sustainable socioeconomic development.
May 14, 2023
As we celebrate Mother's Day, I am inspired by the incredible strength and resilience of mothers worldwide. But as an obstetrician-gynecologist who has treated patients in crisis regions around the world, I am reminded of the countless mothers globally who struggle to keep their children healthy and safe, often in the face of insurmountable obstacles. Through my travels, I have witnessed firsthand the devastating consequences that can result when women do not have access to the basic maternal health services they need. The consequences of inadequate maternal health services are heartbreaking, from preventable complications during pregnancy and childbirth to the devastating loss of a child.
It is because of this preventable heartbreak that I decided to travel last fall to southern Bangladesh with MedGlobal, an organization that has established a maternity and birth center in Somitipara, a neighborhood in Cox's Bazar where the maternal mortality rate is 44% higher than the national average. I saw the immense challenges that Bangladeshi and Rohingya refugee mothers face daily, from lack of access to clean water and adequate nutrition to the trauma of being displaced from their homes and communities. It was both painful and inspiring to see the strength and resilience of these mothers as they fought to give their children a better life.
During my mission to Cox's Bazar, I was grateful to train two groups of local doctors and midwives using standard curriculum designed to strengthen their clinical skills and improve maternal mortality and morbidity. I witnessed the incredible need for this work, providing prenatal and obstetrical services to women who would otherwise deliver unattended without any services or safety net. Prior to arriving, I understood the importance of having more practitioners trained in lifesaving obstetrics in order to care for the high volume of refugees and internally displaced persons, and it was a blessing to witness the high-quality, empathetic care these women received at the clinic and its Mother's Club—which educates expectant mothers on sexual and reproductive health.
As a mother, I cannot imagine the pain and suffering these women endure when they cannot provide for their children's basic needs. But I am also inspired by their strength and courage in the face of adversity, and I am more committed than ever to working towards a future where every mother and child has access to the care and resources they need to thrive.
It is up to all of us to work towards a world where every mother and every child not only survives but can live a healthy and fulfilling life.
According to a recent report by the United Nations Maternal Mortality Estimation Inter-Agency Group, there were at least 3,700 maternal deaths in Bangladesh in 2020. Despite significant efforts to reduce under-five mortality rates and maternal mortality ratios in Bangladesh, considerable challenges remain: Half of all maternal deaths are caused by preventable conditions like hemorrhage, infection, high blood pressure, delivery complications, and unsafe abortion. Extremely young mothers are particularly vulnerable to complications such as obstetric fistula. Tragically, 14 newborns die every hour in Bangladesh, many occurring at home and without medical intervention.
Only 41% of the demand for maternal healthcare professionals is currently being met; access to skilled birth attendants and maternal care is limited in many parts of the country, with almost half of all births taking place at home without the help of professionals. Additionally, the lack of preparedness and availability of primary care, including union health and family welfare centers, has left thousands of mothers in rural and hard-to-reach areas without access to standard delivery care.
The situation is even more dire for Rohingya refugees, who have fled violence and persecution in Myanmar and are now living in overcrowded and unsanitary conditions in refugee camps in Bangladesh. Many of these women have experienced traumatic events, including sexual violence, and desperately need maternal health services.
Ensuring access to maternal health services in Bangladesh is crucial for the immediate well-being of mothers and their children but also for the long-term prospects of the entire country. When mothers die, families are left without their primary caregiver, and children are deprived of the nurturing and guidance they need to grow and thrive. This can have a profound impact on the social and economic development of the entire community. Research has shown that investing in maternal health can have a multiplier effect, leading to improved education, greater economic opportunities, and a more prosperous and stable society.
While at the center, I had the privilege of meeting several mothers and their babies. It was heartwarming to see the joy on their faces as they held their newborns and gut-wrenching to realize the alternative had they not received adequate healthcare. It is important to recognize that the situation in Bangladesh is not unique. Around the world, millions of women do not have access to the essential maternal health services that can make all the difference between life and death for them and their babies. This is particularly true for refugees and vulnerable populations, who often face additional barriers to accessing healthcare.
As we celebrate Mother's Day, let us remember the strength and resilience of mothers around the world and recognize the importance of accessible maternal health services for regions in crisis and the significant role that maternal healthcare plays in driving sustainable economic and social growth. It is up to all of us to work towards a world where every mother and every child not only survives but can live a healthy and fulfilling life.
Keep ReadingShow Less
Most Popular