You’re at home—not at work—and you just changed your baby’s diaper. Three hours later, they’ve pooped again, except this time it has seeped up and over the diaper’s edge. You change your baby’s diaper again, switch their outfit, and maybe run the laundry if you have the energy and if the clean-clothes pile is dangerously low. But now the baby is crying uncontrollably, and you aren’t sure why. You feed them, change them again just in case, and walk around the house. Nothing is working, so now you’re crying. (Just a little. Or maybe a lot.) You don’t want to take them outside because that could put them at risk for infection. On top of that, if you’re breastfeeding, it might feel daunting to consider exposing your breasts in public, especially if this is your first child.
You’re stuck pacing the halls of your home, endlessly rocking and shushing. When you finally get a chance to look at the clock, you realize you’ve spent hours stuck in this cycle. Or maybe only minutes have crawled by, making it feel like this is how you’ll spend the rest of your life. As for sleep? You barely remember it as a concept, much less a reality.
Vacation, this is not. And yet so many new parents are confronted with the stereotype that maternity leave is, more-or-less, a vacation. A break from work. Time off. This is quite the opposite of what I’d consider a vacation.
The very word “vacation” conjures images of escape, relaxation, and other things not synonymous with caring for a crying newborn. My typical vacation activities don’t include waking up every two to three hours, or spending six weeks with bleeding and pain from a recovering uterus and torn-apart vagina. But given the common comments and connotations around maternity leave, you’d think that as soon as you have a baby, someone hands you a plane ticket for an all-expenses-paid trip to some tranquil, sandy beach. Fun fact: They don’t.
I, for one, spent the beginning of my maternity leave standing in front of the bathroom mirror, staring at my breasts in anguish. I’d been trying to breastfeed, but four days after my first child came into the world, my breasts started to feel hot and achy. Along with the burning pain, they were hardening, getting larger, and I saw some redness on the left. This new development (and, in retrospect, a case of postpartum blues) made me cry. I didn’t feel like this was my body.
Although I have a lot of medical knowledge—I’m a neonatologist, or a pediatrician who specializes in newborn care—I am not a gynecologist, obstetrician, or lactation expert. My pediatric medical training didn’t prepare me for the rigors of breastfeeding. Thus, I had no idea what was going on with my breasts. Was I experiencing mastitis, an infection that can happen when milk ducts become blocked or engorged? Was this just my milk coming in? I kept returning to one question over and over: Is this normal?
As it turns out, it was. Ultimately, my chest was engorged because I was suffering from a clogged milk duct (without an infection), which is frustrating and painful but common and not a major cause for concern. I was able to unclog the duct with warm compresses and massage, and I was also able to breastfeed as I’d hoped. Eventually, my bout of postpartum blues also dissipated as I fell into a rhythm of caring for my baby.
This kind of disorienting, distressing experience is a natural part of having a newborn. This can all become even more complicated for the new parent with a mental health issue like postpartum depression, which is more severe than the baby blues I and many other people have experienced. While baby blues impact up to 80 percent of new mothers, according to the National Institute of Mental Health (NIMH), when symptoms last for more than two weeks at a more intense level, it might be postpartum depression, which is estimated to affect up to 15 percent of new moms.
Regardless of a new parent’s mental health status, caring for a new baby can be overwhelming and draining. Vacation it is not.
Lucille T., an internist, remembers returning from maternity leave and having people ask how her vacation went. “I told them it wasn’t a vacation,” Lucille tells SELF. “I had a baby. Taking care of a newborn does not equal a vacation!”
Sure, maternity leave can be a precious, life-changing time to connect with and care for a new baby, but time off? Hardly. Maternity leave is hard work. Some mothers even relish a return to their jobs over the intensive care and time spent with a newborn.
The cruel joke is that taking vacation days is often the only option available to provide people—especially mothers—with compensation while they are away from work to recover post-delivery or welcome adopted children, manage the health and safety of their infants, and bond with their babies.
The lack of support for new parents in the United States is shameful. We are the only industrialized nation with no federal laws mandating some level of paid parental leave. In places where paid maternity and family leave is the expectation, studies have shown better maternal and infant health outcomes, according to a 2018 report from the World Policy Analysis Center at the UCLA Fielding School of Public Health. Those who are able to start paid leave before birth may be at lower risk of preterm labor due to stress and may have babies less prone to low birth weight. Paid leave also makes it easier to start and continue breastfeeding, which can help bolster a baby’s health and increase bonding (which paid leave also appears to help facilitate overall). Being able to take a longer maternity leave, which can be easier when it’s paid, also seems to be linked to better maternal mental health.
In the absence of a federal paid parental leave program, the Family Medical Leave Act (FMLA), established in 1993, ensures that eligible employees can take unpaid leave for up to 12 weeks each year while maintaining insurance benefits. Eligible employees are also supposed to have a guarantee of returning to the same role or one of equivalent standing.
But the main issue here is that many parents don’t qualify for FMLA. In order to be eligible, you need to have worked at least 1,250 hours in the year before your leave, among other requirements, and your employer also needs to meet certain coverage criteria. Even new parents who do qualify for FMLA may opt out of it because they simply can’t afford to take that time off without pay.
Some private companies across the nation offer paid leave programs for new parents, but they’re in the minority. Only around 16 percent of people working in either the private sector or state and local government had access to paid family leave in December 2017, according to a Bureau of Labor Statistics survey released in March 2018. In an effort to push for change, some states such as California and Rhode Island have implemented paid family leave insurance programs that offer compensation to new parents who are out on FMLA. Although there’s not a lot of data on these programs, this has not been shown to significantly burden California employers with consequences such as increased turnover, according to a 2016 study performed by faculty at the University of California at Santa Barbara’s Department of Economics for the California Employment Development Department. There were also indicators that the program had the potential to enhance employees’ future productivity and morale.
All of this is promising, but a nationwide smattering of exceptional programs and pockets of progressive employers do not address the larger issue at hand: There’s an overarching societal lack of acknowledgment and respect for what people—primarily those who identify as women and mothers—go through when having and caring for a baby.
When it came to my own maternity leave, I was lucky enough to be able to take a full three months away from work. I did not travel, relax on the beach, or enjoy any true downtime. I put my time and energy away from work into shaping my baby’s first few months of life.
I did this in part by working extra before giving birth. I work in shifts that necessitate a certain number of hours and weeks completed within a year, and I was fortunate enough to be able to complete my 12 months of clinical duties in nine. I also banked all of my vacation and sick days to look after my baby. Even though I had to do significantly more work in a shorter period of time and also use vacation and sick days, I did technically receive pay. I also benefitted from planning and cooperation from co-workers and schedulers.
A vast support network including my colleagues helped me to make all of this happen. They appreciated the dedication required to recover physically from a delivery, care for a very dependent newborn, navigate an abnormal sleep schedule, and try to understand my changing family life and body. No one questioned my need for that time away or kept me from spending as much time with my new baby as I’d hoped. Not everyone is this fortunate.
New parents deserve nothing short of sweeping and massive policy change to ensure that they are protected and supported after welcoming a child. This is essential in respecting the responsibilities of caring for new life. Without this, new parents, primarily women, often bear the overwhelming stress of caring for a baby under potential economic duress.
We as a society must combat misconceptions surrounding maternity leave. It’s not a luxurious respite. It’s an essential time for parents to address their health and happiness, along with that of their babies. Partaking in parental leave without added financial worries should be a right, not a privilege.
Joanna Parga-Belinkie, M.D., is a neonatologist, pediatrician, podcaster, and mom. She is an attending neonatologist and a clinical assistant professor of Pediatrics in Philadelphia. She and a colleague co-host the podcast Baby Doctor Mamas, a podcast for new moms hosted by physician-mothers and focusing on newborn medicine.
This content was originally published here.