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Dr. Harvey Karp: National paid leave is an economic and moral imperative

Without a national paid leave policy, the next generation of parents are at enormous risk, writes the renowned pediatrician.

Dr. Harvey Karp: National paid leave is an economic and moral imperative
[Photo: RobertPetrovic/iStock]

Democrats recently returned four weeks of paid parental leave to President Biden’s proposed social spending bill, which is currently being considered by Congress. 

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The policy was initially dropped from the legislation because opponents said we couldn’t afford to give this small cushion to new parents. So how did paid leave come back to life? Was it the public outrage? The realization that it will actually save taxpayers money and slow our declining birth rate? The embarrassment that America is the only wealthy nation with so little love for its families that it has never made paid leave a priority?

I believe all of these had a role, but the most compelling reason for paid leave coming back into play is the growing realization that American parents have hit a breaking point. 

Through my decades of practicing pediatrics, I’ve met far too many women who have described the first months of motherhood as the hardest experience of their lives. Thousands of couples confided in me that they felt unprepared and unsupported when they began their families. Exhaustion, breastfeeding struggles, colicky crying, and lack of childcare all conspire to make new parents feel overwhelmed.

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Having cared for young families for over 40 years, I am very worried that we are witnessing a gradual shredding of our social fabric. Over recent decades, as more Americans moved to urban centers and away from extended families (and the free childcare and parental mentoring they provided), the need for a national paid leave policy became more pressing. And now, with the COVID crisis, the high human and economic cost of this shredding has ballooned even further, making the need an urgent priority.

For example, a recent study from Boston’s Brigham and Women’s Hospital found that postpartum depression, or PPD, jumped from 15% of new mothers to an all-time high of 36% during the pandemic. In 2019, an investigation of PPD estimated the U.S. cost at $14 billion per year, and that was just for the first five years after giving birth. The lifetime cost of developing PPD in America is estimated to exceed $60 billion per year (extrapolating from a 2014 study by the London School of Economics). And that cost study was made pre-pandemic! One can only imagine what the cost is today now that the simple act of having a baby pushes one million American mothers—and many fathers—into significant mental illness every year.

The United Nations notes that of 185 countries, only the United States, Suriname, Papua New Guinea, and a few islands in the Pacific have no national paid leave. Canada provides 50 weeks. The U.K. gives 41. And Swedes can get 78% of their paycheck for up to 71 weeks. 

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Offering support to families after they bring home a baby is a global public health standard—and is proven to be smart policy. We know it takes a village to raise a child, but it also takes a village to support a parent. However, rather than having a caring village around them, the 86% of American new moms with zero paid leave feel more like they’re living in a ghost town. 

Our poor policy is wasting enormous resources. The lack of paid leave leads directly to expensive health problems (like postpartum depression!), expensive work problems (like the exodus of talented women from the workforce), and expensive social problems (like a declining birth rate, which threatens to hamper industry, military readiness, and tax rolls in the next 10 to 20 years).

Yet despite the obvious wisdom and morality of providing national paid leave, the usual group of cranky naysayers are complaining that parents don’t need help and should just pull themselves up by their bootstraps. They’re scolding new moms by saying, “Just suck up your exhaustion and C-section pain and stop whining about having to work full-time, plus do 24/7 baby care!” These curmudgeons—mostly older men—seem to have forgotten that the bedrock of America is mutual support. Our Founding Fathers’ motto wasn’t “Every man for himself.” It was “E pluribus unum—out of many, one.” 

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Our pioneers didn’t shut the door on those in need, they helped their neighbors with barn raisings, quilting bees, and volunteer fire departments. Today, we help our senior citizens with social security and join together in emergencies with FEMA and our armed forces. America is—and has always been—stronger when we help each other.

Both political parties say they support the health and stability of the American family. Corporate leaders, too, are calling on Congress to make this investment in American families. A survey of businesses by PL+US found that paid leave helps “ensure greater employee morale and workplace satisfaction” as well as reducing attrition and turnover, boosting productivity, and saving employers money.  

It’s time for our great country to join every other modern nation, and the world’s smartest corporations, by offering all new parents paid leave during the first months after birth. Doing so will reward America with healthier and stronger communities, and it will honor our nation’s most valuable resource: our families.

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Dr. Harvey Karp is a pediatrician, child-development expert, and assistant professor at the USC Keck School of Medicine. He is the author of the celebrated Happiest Baby and Happiest Toddler books/videos and the creator of the SNOO Smart Sleeper, used in homes and hospitals to improve infant sleep and safety. 


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