As obstetrician-gynecologists in training, we are committed to advocating for policies that promote reproductive health, freedom and justice for all. Reproductive justice is “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” We can cultivate reproductive justice through policies that empower and enable people to become parents if they wish, regardless of their race, class, gender or sexual orientation.

That is why the four of us — Laura Knapick, D.O., of South Portland; Courtney Hargreaves, M.D., of Portland; Katherine Davis, M.D., of Portland, and I — urge the Legislature to pass paid family and medical leave, and want to offer our perspective on the importance of this policy as it relates to our work in reproductive health care. Paid family and medical leave is a policy that the American College of Obstetricians and Gynecologists endorses as essential for new parents and one we recognize as essential for all.

The 12 weeks following childbirth — or the “fourth trimester” — are a time of enormous physical and psychological transition. The postpartum period lays the foundation for the future health and well-being of mothers, infants and families. Yet approximately 40% of women do not attend a postpartum visit. When people do not receive comprehensive postpartum care, they are at increased risk of having subsequent unintended pregnancies, postpartum depression, suboptimally managed chronic diseases and lactation difficulties. Mothers who return to work without adequate time to heal and bond report worse health outcomes for themselves and their babies. The lack of a paid family and medical leave policy is a barrier that impedes people — especially those with limited resources — from getting the postpartum care they need and deserve.

The United States is the only high-income country in the world that does not guarantee paid maternity leave, let alone all-encompassing paid family leave. The health benefits of these policies are well documented and include increased initiation and duration of breastfeeding, which has both physical and psychosocial value.

Breast milk contains essential nutrients and contributes to a healthy immune system, and the act of breastfeeding enhances the relationship between the parent and child. It is associated with decreased rates of postpartum depression, which is among the most common and costly complications of pregnancy and can have long-term negative consequences on child development. People who breastfeed have lower rates of breast, ovarian and endometrial cancers, hypertension and diabetes. Breastfed infants acquire fewer infections and are less likely to develop childhood asthma, obesity and diabetes. Put simply: When children are breastfed, both parents and children are less likely to get sick and require medical care over their lifetimes.

Despite these well-known benefits, rates of exclusive breastfeeding (meaning infants do not consume formula, water or other food) for the first six months of life are only 25% and 29% in the U.S. and Maine, respectively. Furthermore, there are enormous racial and economic disparities, with breastfeeding rates of only 19% among Black infants and 19% among infants in households experiencing poverty. The surgeon general has put forth a Call to Action to Support Breastfeeding, in which they identify the lack of paid leave as a significant barrier to breastfeeding, particularly for parents with lower incomes.

Opponents of a paid family and medical leave policy policy claim such a program is too costly. The truth is, the benefits for Maine’s economy outweigh its costs. Paid family and medical leave would foster a stronger, more satisfied labor force by providing an attractive incentive for young people to live and work in Maine and protecting against women exiting the workforce altogether. It is common for women to leave their jobs around the time of having children, and paid family and medical leave has been shown to significantly reduce maternal labor force detachment in the year of birth and for up to five years afterward. We feel that the cost of this program is a small price for investing in a policy that would sustain those living, working and raising children in Maine, and ultimately lead to happier, healthier and more equitable communities statewide.

Copy the Story Link