Paid Maternity Leave

Mamas On Bedrest: FMLA is “Useless” for 40% of The Workforce

February 25th, 2013

Hey Mamas,

I was just cruising through my e-mails and got a Google alert about Family Medical Leave (FMLA). The article, published on Journalgazette.net, chronicles the story of Danelle Buchman of Clarkesville, MD. Buchman lost her job as a result of being out, and nearly dying, giving birth to her second daughter.

Buchman, now a mama of 2 little girls, had a uterine artery rupture while she was pregnant with her second daughter at 32 weeks gestation. Her daughter was delivered by emergency c-section and Buchman had an emergent hysterectomy to save her own life. When Buchman recovered and returned to her job, she was first demoted and given a 33% salary cut. She was subsequently fired. It’s not that Buchman had done anything wrong, quite the contrary. She had an outstanding employment record. But her time off due to illness resulted in her termination.

This is not unusual. The US Department of Labor conducted a study and they found that 40% of employees are not eligible for the unpaid leave with job protection benefit offered by FMLA. While this law has been on the books for 20 years now, a full 40% of US employees cannot benefit from it because they work for companies that employ fewer than 50 employees, were employed for less than a year with the particular company or had already used the FMLA benefit within the past 24 months and are hence exempt from the FMLA provisions. So Buchman who was out fighting, for her life, was legally fired as a result.

The law is also very difficult to enforce. Companies are not always obligated to allow the unpaid leave and there have been nearly 6000 court cases against companies that fired workers or otherwise penalized them for taking advantage of FMLA.

Once again, The lack of any sort of paid family leave is leaving families in a financial lurch. It is a travesty that the United States has such little regards for families. The United States, along with Papau New Guinea and Swaziland remain the only countries out of 177 that offer no sort of paid parental medical leave. And while family friendly organization such as the National Partnership for Women and Families and Working Mother are fighting diligently for paid family leave, that reality is still, by many estimates, years away. And that won’t help people like Buchman.

“I was lucky. My husband had a job, and we went into crazy credit card debt. But so many people who don’t have the support system I had are one accident, one illness away from losing their livelihood.”

And that is the fearful fate of many Americans. We can do better and we here at Mamas on Bedrest & Beyond will continue to support and help those on the front lines continue this all important fight.

Mamas on Bedrest: Make Your Voice Count-VOTE!

October 29th, 2012

I went to vote today, early,  and was surprised that I had to wait in line for about 20 minutes before casting my ballot. They say that this year’s presidential election is going to be one of the tightest in history. The margin of victory is likely to be the smallest every. Every vote counts, so Mamas on Bedrest, make your voice count-VOTE!

Now I know that some of you will be put off by the fact that I am making a “political statement” on what is “supposed to be a health care information website”. Well, as they say, the personal is in fact political. What occurs in this election will have far reaching implications for all Mamas on Bedrest. This election is about more than who will be president and who will run congress. As it relates to Mamas on Bedrest, the following issues are up for grabs:

The Family Medical Leave Act (FMLA): The United States is the only “industrialized” nation that offers no paid time off for workers to care for their own illnesses, a family member who is ill or to have/bring home/bond with a child (through birth or adoption). The FMLA only provides workers with 12 weeks of unpaid leave with guaranteed job security, i.e. no job loss. After those 12 weeks, employers are free to fire employees and at no time are employers obliged to offer any sort of paid leave. While some employers will offer some paid time off, it varies from employer to employer and dramatically from state to state. What is typically uniform is that workers in the lowest paying jobs-often those who need their jobs the most-are at the greatest risk of losing income, financial security and their jobs. If you would like to see FMLA changed, see the work of the National Partnership for Women and Families, MomsRising and WorkingMother Magazine. Also, VOTE and let your elected officials know that this is an issue that is important to you!

Mandatory Obstetrical Care: Now I can hear some of you saying, Whaaaaat????  Yup, many of our mamas became pregnant only to find out that obstetric care is not part of their health insurance policy and care had to be purchased (prior to pregnancy of course!) as a separate rider on their health insurance policy.  So imagine the strain that this places on the family finances when mama has a complication requiring her to be on bed rest?  Yes, I think you get the picture. The Affordable Care Act (ObamaCare) covers obstetrical care. If you think that this is a good thing, VOTE accordingly.

Education: The Department of Education has been targeted for budget cuts as well as complete closure. While our public schools are having their problems, without them, many children will be without any sort of education. Regardless of whether your children (or prospective children) will go to public, private or homeschool, education is an important element for our nations citizens. Voice your VOTE accordingly.

Healthcare Research: The National Institutes of Health grants millions of dollars annually to researchers studying a wide variety of health issues and diseases. Wouldn’t it be great if they allocated some additional funds for research on high risk pregnancy prevention? The federal government in part determines what gets studies by where they allocate funds. If you want more research and treatments for the conditions leading to bed rest, VOTE, make your voice known and let your elected officials know what is important to you.

Medicaid: Thousands of women are uninsured and receive their health care by the government subsidized program Medicaid. While the care is definitely not at the level of private obstetrical care, it is prenatal care none the less; prenatal care that many women would otherwise not have access to and be at increased risk of pregnancy complications, preterm labor, preterm birth and a premature infant with potentially life long health complications. While I agree that the Medicaid program leaves much to be desired, it is providing some benefit. Additionally, it’s a lot easier to fix a broken system than to try to get a whole new system entirely. If you don’t believe me, ask the women of Mamas of Color Rising here in Austin. They worked with several concerned groups and presented a rules change to the Texas Medicaid. The rules change is still being deliberated, but if it passes, Texas women receiving Medicaid will be able to receive prenatal care from and be attended by certified professional midwives, and those midwives will be reimbursed by medicaid. Mamas of Color Rising has also help start a free prenatal health clinic.  To learn more about Mamas of Color Rising, listen to this podcast interview with co-founder Paula Rojas.

These are just some of the issues that come to mind when I think of Mamas on Bedrest. I am sure that there are others, and do correct me on any thing that I have left out or you feel misrepresented. However, don’t miss the point of all of this-VOTE!

I want to end this post with something to think about. In the late teens and early 1920’s, thousands of women took a stand and demanded the right to vote. Some of them were beaten, many were arrested and many even died so that we now have the right to vote.

In the 1960’s, African Americans were the next sub segment of the US population to demand the right to vote. (without absurd, extraneous requirements and qualifications). They marched, they were attacked by dogs, they were drenched by fire hoses and many died in the cause of the Civil Rights act.  When I think of all that so many Americans have gone through so that I have the right to vote, it seems beyond disrespectful to me that I wouldn’t show up at a local voting center and cast my ballot.

But I’m on Bedrest! No worries. Here’s a few ways that you can vote.

Stop by and vote early on the way home from your next OB visit (If it’s on or before November 6th). Since it’s probably your only outing of late, see if you can extend it a bit and stop by an early voting center. The grocery store at which I voted this morning even had chairs for those unable to stand and a voting booth that had a chair and sat low enough for those in wheel chairs.

Absentee Ballot. Here in Texas, you have until tomorrow to request and absentee ballot. The cut off is likely different in different states, so contact your state’s voting board and see if you can still obtain a ballot. In some areas, someone can pick up the ballot for you. Most places will mail you a ballot. Absentee ballots typically have to be in to the election officials by the close of the polls on voting day, so if you intend to vote absentee, get your ballot ASAP and get it in to your state election officials. (Note: someone can also hand deliver your ballot for you! Check with your local officals.)

Ladies, I’m not telling you who to vote for, but I am sharing with you some issues important to Mamas on Bedrest. The bottom line is that you need to vote. This is not the year to sit things out because you are on bed rest. You can and should still vote. In an election where the margin of victory is estimated to be mere points, every vote will certainly count. So “stand up” and be counted. VOTE!

Image Courtesy of Brian Petty Designs.

Mamas on Bedrest: US Maternity Care-Living in a Glass House Throwing Stones

August 15th, 2012

I am increasingly dismayed by the fact that the US seems to think it has no maternal or infant morbidity and mortality issues. The sad truth is that the United States, in many situations surrounding maternity and childbearing, has statistics that rival many developing nations and in some cases are actually worse.

When I read various articles and news briefs, many US researchers with big money grants are reporting data from developing nations and the implications seem to be that we must reduce maternal and infant morbidity and mortality globally-i.e. “in these developing nations” to lower the global statistics. I want to go on the record asking, “How can we even begin to critique issues of maternal and infant morbidity and mortality worldwide when the US has some of the worst maternal and infant morbidity and mortality rates in the world?” In the recent blog post “Minority Mamas are More Likely to Die in Childbirth” I cited data published about maternal mortality in the United States and the disparity between women of color (primarily black women) and white women. It is one of few pieces that has actually noted and questioned high maternal mortality in black women in the United States. While it did not offer much in the way of theories as to why the rates are so unbalanced, the obvious initial steps would be to look at disparities in health care delivery in areas with a high black population and in lower socioeconomic areas.

Hold on, some of you may be saying. The US has exceptional health care, some of the best in the world. This is quite true. But not everyone in the United States has access to the exceptional health care that exists in this country. As evidenced by the heated health care reform debates, millions of Americans are without health insurance and despite the passage of the Affordable Care Act and its many provisions for women’s health care, there will still be a substantial number of people, many of them women and children, for whom our “exceptional health care” is woefully out of reach. Some will argue that saving some is better than saving none at all. Personally speaking, until everyone in this country has access to high quality health care, we as a nation have no business studying and critiquing health care practices in other countries.

In its groundbreaking work Deadly Delivery, Amnesty International shines a glaring light on the maternal morbidity and mortality issues in the United States and raises the questions are race and poverty to blame? Few if any other research groups have deigned to make the connection. But with the numbers such as they are, we are going to have to tread that road.

The United States is one of only 4 nations globally that offers no paid maternity. Out of some 178 nations, The United States, Papua New Guinea, Swaziland, and Lesotho are the only nations that offer no paid maternity leave. Of those nations, the United States is the only industrialized nation, and one of the richest nations in the world. But with all of our riches, the gap between “those who have” and “those who have not” is becoming a gaping chasm with no end to the widening in sight.

The Cesarean Section rate in the United States approximately 32% meaning that almost 1 of every 3 babies born in this country is delivered via cesarean section. This far exceeds the rate proposed by the World Health Organization (WHO) yet, we are far from finding a solution to this problem. Several maternity advocacy groups (Childbirth Connection,International Cesarean Awareness Network (ICAN) and others) are challenging the US health care system, the American Congress of Obstetricians and Gynecologists (ACOG) in particular, to take steps to turn the tide on this quelling cesarean section rate. We’re all waiting to see changes in birth policies and subsequent reduction in the national Cesarean section rates.

And then there is bed rest. How could I possibly not address one of the more controversial treatment practices in all of medicine? To date there is not solid evidence that bed rest in any way prevents preterm labor and premature delivery. We don’t have solid evidence that it in any way improves or strengthens an incompetent cervix, helps lower blood pressure or prevents any of the complications of pre-eclampsia. There is some evidence that bed rest is harmful to pregnant women and may do more harm than good. Yet annually, nearly a 3/4 of a million pregnant women are prescribed bed rest for complications of pregnancy.

I want the US to stop casting stones towards other countries for their maternity practices and to focus instead on how to lower maternal morbidity and mortality rates here at home. Until we have impeccable maternity rates and until all mamas have access to high quality health care we must focus our attention on ourselves and stop pointing fingers of criticism elsewhere.