Women at work: Maternity leave and nursing mothers
From my previous two articles, we know that the Pregnancy Discrimination Act (1978) said you can’t be fired for being pregnant and the Pregnant Workers Fairness Act (2023) said your employer has to actually help you stay on the job. Together, they cover the beginning and the middle: you get hired, you stay employed, you get accommodations.
Then the baby comes.
The only wealthy country without paid leave
The US is the only OECD member country, and one of only six countries in the world without a national paid parental leave policy. The short list of countries that don’t mandate paid maternity leave includes Papua New Guinea, Suriname, the Marshall Islands, Micronesia, Nauru, Palau, Tonga, and the United States.
For comparison: Sweden provides 480 days of shared parental leave. Estonia offers up to 86 weeks, including 20 weeks at full salary. Norway lets parents choose between 49 weeks at full pay or 59 weeks at 80 percent. Even Canada provides up to 78 weeks funded through its employment insurance system.
Family and Medical Leave Act (1993)
To be precise: the US does have the Family and Medical Leave Act, passed in 1993. The FMLA allows eligible employees to take up to 12 weeks of unpaid, job-protected leave for the birth or placement of a new child, to care for a seriously ill family member, or to recover from a serious illness. Your job is protected and your health insurance continues. You just don’t get paid.
That’s the first problem. The second is who the law actually covers. To be eligible, an employee must have worked for their employer for at least 12 months, have worked at least 1,250 hours over the past 12 months, and work for an employer with at least 50 employees. Run that math and the FMLA only reaches about 56 percent of the workforce due to those exclusions. Workers at small businesses, workers in their first year at a job, part-time workers who don’t hit the hours threshold are all unprotected at the federal level. The other half of the American workforce, when they give birth, has whatever their employer chooses to give them, or nothing.
The patchwork
States have tried to fill the gap. Fourteen states and the District of Columbia have enacted mandatory paid family leave systems. California was first, in 2004. New York, New Jersey, Massachusetts, Washington, Colorado, Connecticut, Oregon, and others have followed. Across all 15 states with programs, nearly 50 million private-sector workers have or will soon have access to paid leave.
That sounds significant, and it is, relative to nothing. But it means two-thirds of American workers are still not covered by any state paid leave program. Whether you get paid leave after having a baby depends significantly on your zip code. A worker in California gets up to eight weeks of paid leave at a wage replacement rate that scales with income. A worker doing the same job across the border in Nevada gets whatever her employer offers, which may be nothing.
Break Time for Nursing Mothers (2010)
For workers who return while breastfeeding, there’s a separate layer of protection in Section 4207 of the Affordable Care Act(ACA). The provision amended the Fair Labor Standards Act to require employers to give nursing employees two things: reasonable break time to express breast milk as frequently as needed, and a private space to do it in, shielded from view, free from intrusion, and not a bathroom. For up to one year after birth. The ACA provision only covered hourly, non-exempt workers. Salaried employees like teachers, nurses and managers were left out entirely.
PUMP Act (2022)
The PUMP for Nursing Mothers Act expanded the legal right to receive pumping breaks and private space to nearly 9 million more workers, including teachers, registered nurses, and farmworkers, closing the exemption that had left salaried workers uncovered for 12 years. It also made it possible, for the first time, for employees to file a lawsuit against an employer that violates the law.
Employers are not required to pay employees for lactation breaks, so long as the worker is completely relieved of duties during the break. The law doesn’t stop an employer from making those breaks inconvenient or quietly career-penalizing it just says the space can’t be a bathroom.
Congress has proposed federal paid leave legislation repeatedly. It has not passed. Despite proposals to expand access to the FMLA, Congress has not expanded the law since 2009. The political coalition required, that is, resolving how to fund it, who it covers and whether it applies to small businesses, has not materialized in over 30 years of trying.
As of 2025, only about 31 percent of private sector workers have access to paid family leave insurance, with rates much lower among part-time workers and low-wage earners. The companies that offer competitive paid leave do so voluntarily, as a talent retention tool, which means it’s concentrated among workers who already have the most bargaining power. The worker who most needs a paycheck during leave is the least likely to have one.
Where that leaves us
The three-part arc of this series maps to three different legal eras and three different types of protection. Article 1 covered the right not to be penalized for being pregnant. Article 2 covered the right to ask for help staying at work during pregnancy. This one covers what happens after, and the answer is: you’re on your own.
Other countries figured out how to fund paid maternity leave through social insurance. The US has argued that the cost is too high, the mandate too burdensome, the politics too complicated. Meanwhile, research consistently links paid leave to lower infant mortality rates, increased breastfeeding rates, and improved maternal mental health outcomes.
The law protects you while you’re at your desk. The moment you leave to actually have the baby, you’re on your own, unless you happen to live in the right state, work for the right company, or have the right kind of job. For a country that talks a lot about family values, that’s a peculiar policy choice.