News·17 min read

The Reality of Child Care in America Without Paid Family Leave

Family with newborn child.
Image: Getty Images | Design: theSkimm
December 22, 2021

Another day goes by and the US is still the only industrialized country without a federal paid family leave policy. (Reminder: Paid family leave gives parents compensated time off to care for a new child — following childbirth, adoption, or foster care placement — or for a sick family member.) We’ve already Skimm’d the ins and outs of the topic. But since the fate of paid family leave remains in flux, where does that leave parents? Especially moms? 

We’re diving into the American parent experience. And the difficult balance between working and parenting — a dynamic that shouldn’t be mutually exclusive.  

What's Going On With Paid Family Leave?

Most Americans don’t have it. As of March 2021, 77% of private industry employees didn’t have paid family leave. Neither did 74% of state and local government workers, according to the Bureau of Labor Statistics. And these numbers have barely changed since 2008, when BLS began regularly publishing the data.

Graph representing percentage of workers with unpaid leave in 2021.
Design: theSkimm

The Family and Medical Leave Act, which was passed nearly 30 years ago, remains the federal standard for parental leave. FMLA offers new parents 12 weeks of unpaid leave — whether giving birth, adopting, or fostering. This applies to all public agencies and local schools. And private sector workers qualify too. As long as their company has at least 50 employees and the person has worked there for at least a year.

But some US states, like California, Colorado, and New York, have instituted their own paid leave policies. (Note: “Paid” doesn't mean full pay. Employees who use this benefit typically get a portion of their paycheck while they're OOO.)

President Biden tried giving all American workers 12 weeks paid leave (a policy that is already in place for federal employees). Under it, employees would receive at least two-thirds of weekly wages when facing serious illness, caring for sick loved ones, welcoming a child, and more. But in true congressional fashion, a debate about the price tag turned 12 weeks into four. 

Psst…Here’s a quick check-in on what other countries offer: Britain offers 39 paid weeks. Japan allows for at least 52 weeks. Sweden provides 68. And Estonia hands out a whopping 82 weeks paid. Takeaway: Way more than four.

In November, the House approved the nearly $2 trillion Build Back Better package that includes the four weeks of paid leave. But talks in the Senate haven’t been smooth sailing. Republicans have remained opposed to including paid family leave in the bill — specifically because it would require raising taxes on corporations and the wealthy. And there’s one Democratic member who’s put up a fight…

  • Enter, the Man(chin) causing a fuss: Sen. Joe Manchin (D-WV) has thrown a wrench in the plan, giving the Build Back Better Act a ‘no.’ As a moderate Democrat, he's also concerned about the bill’s cost. And in a 50-50 Senate, Dems don’t have a vote to spare. (Think: Some lawmakers in key races — like in Arizona, Florida, and Georgia — could lose votes for failing to pass a paid family leave policy.) 

Still, Senate Majority Leader Chuck Schumer (D-NY) says there will be a vote on a “revised version” of the Build Back Better Act — despite opposition — in the new year. It’s a big endeavor given the split upper chamber. Now, the country waits to see how senators move forward with this. But even if lawmakers approve four weeks for parents to bond with a new child and recover from the birthing process, is it enough time?

How Paid Family Leave Affects New Parents

We’ve already Skimm’d what the weeks after giving birth look like. But here’s a refresher: For birthing moms, it typically takes at least six weeks to start physically feeling ‘normal’ again. Their bodies are healing, resulting in many unpleasant aftereffects like constipation, vaginal bleeding, and chronic pain. Postpartum depression can also begin developing during this time.

For all parents with newborns, the World Health Organization recommends at least four postnatal appointments for the baby in the first six weeks. The sixth week marker is also when birthing parents should head to the doc for a postpartum check-up. And when many child care centers start accepting newborns. But it’s not cheap: About 46% of US parents reported child care costing an average of $750 a month per kid.

Not to mention, parents who breastfeed typically do so for at least six months — every couple hours. If their offices don't have lactation spaces, they might resort to pumping in their car or employee bathrooms. Or, parents opt for formula, which in the US is an average of $1,200-$1,500 the first year. 

Ruth Milkman, a sociologist of labor and a graduate professor of sociology at the City University of New York, said that without paid leave, many parents have to make sacrifices that hurt themselves and their children.

“Many of them go back to work after a very short time, which is not good for their house and not good for their babies," Milkman said. "Bonding with a new baby is an important thing for both the baby and the parents,”

“A decent society would provide people with that opportunity without them having to make some huge economic sacrifice,” she added. “Some people do make that sacrifice, they just choose to do it and they live with the consequences, like going into debt.” 

While COVID-19 exacerbated child care issues, it was a problem for working parents long before that. A Washington Post survey from 2015 found that 62% of mothers and 36% of fathers had “stopped working” or “took a lesser job for child care reasons.” But when the pandemic hit and daycares shut down, many parents were forced to quit their jobs. Mainly women. But especially women of color. And, new parents tried to make it work — with a multitude of sacrifices and the same old family leave policies.

How Do New Parents Make Ends Meet?

Without paid family leave, parents have to play tetris with their options — creating a situation that’s best for their children, but not themselves. And oftentimes, child care looks like a jigsaw puzzle of solutions: paying for care, using paid time off (PTO) and sick days, asking family for help, or leaving the workforce altogether. Many are left financially vulnerable and unprepared for emergencies post-leave (like contracting COVID-19 without any sick days left).

To better understand the new parent experience, we asked Skimm’r moms to #ShowUsYourLeave. Hundreds of messages, posts, and responses poured in. These moms come from different backgrounds, industries, locations, and ages. But each have one thing in common: They’re all dealing with the unfortunate reality of child care in America. Here are a few excerpts from the Skimm’rs we chatted with.

Emily Smith at home with her first child in 2016.

Mothers use short-term disability to take time off

Emily Smith, 39, works for a major oil and gas company in Houston. When she had her first child in 2016, her company wasn’t offering paid family leave. She ended up applying for medical disability, which gave her eight weeks PTO following her C-section. She said she “doesn’t love calling childbirth a disability,” but it was the only option she had. After that, she took four months off — unpaid — under FMLA. 

Her husband, who worked for the same company, was only given one day of paid leave after their first child. We repeat: one day. He was forced to use his banked vacation and sick time to take three weeks off when they came home from the hospital.

“We don't have family nearby. So I was scared for him to go back to work. Even after three weeks, I was really nervous,” Smith said. “I couldn't drive at that point — because of the C-section I was on medications. It makes you feel really vulnerable when you have no one there to help you. And if something goes wrong or there's an was scary.”

Sarah Kaufman at home with her two children.

Mothers quit their jobs to save money on child care

Sarah Kaufman, 32, left her job at the University of Pennsylvania to care for her children — a tough decision, since she really enjoyed her time at Penn. 

“We had already decided when we had the second child, I would probably resign,” Kaufman said. “That was a decision made because of the cost of child care and my take-home salary. The cost of child care was almost equal to my take-home, if you times it by two.”

During her five years working at Penn, the school added four weeks of paid family leave to their employee benefits. She said those four weeks helped, but weren’t close to enough. (Remember: This is the same amount of time the Senate is deciding on for all new parents.) Kaufman still used a combination of her FMLA benefit, accrued sick leave and PTO, and short-term disability to get 12 weeks of paid time off. Better than four weeks, but still not long enough.

The 12 weeks didn’t cover her postpartum depression and anxiety, which she started to feel around that 12-week mark. Kaufman said that time frame is fairly common, as many women undergo significant hormonal changes a few months after giving birth. Aka during the ‘fourth trimester.’

“It took me probably three weeks to admit to myself, ‘I think I'm having [postpartum depression],’” Kaufman said. “And then to go get a doctor's appointment, and all of the work that goes into that... so do I think four weeks is good enough? No.” 

Krystina Wales, holding her second child during her leave in 2019.

Mothers navigate being the sole source of income, while pumping milk at work

Krystina Wales, 34, works for a small, independent community hospital in Baltimore. The hospital has FMLA, but doesn’t offer paid leave. So when Krystina gave birth in 2017, she relied on her accrued sick and vacation time to recover. Luckily, she had 12 weeks saved. And her husband covers their childcare needs as a full-time, stay-at-home dad.

“We did not have to pay for child care. But you know, if he got sick, I would definitely have to take off or figure something out,” Wales said. “It's stressful. And for me being the primary breadwinner, there is a small part of me that's always thinking, ‘I can't mess up. I can't afford to lose this. I can't afford to push my luck with different things because I can't not have a job. There's no fallback.’”

She said the four weeks Congress is discussing would help…as much as any Band-Aid would. “Put aside the physical stuff, it’s the emotional side of it too, just the adjustment period,” Wales said. “It's not just like you have a baby and you can pop right back. You really need that time for recovery and connection.” 

With her second daughter, Wales only had enough accrued time to take 10 weeks off. She said the difference in those two weeks was huge. Her second daughter was still nursing at 10 weeks, which meant Wales was pumping at work. She said she typically had to stop and pump four times a day.

“When you're hearing about all these things, like paid leave or the PUMP Act, if you're not a mom or you're never going to be a mom, you might say, ‘It's really not that big of a deal.’ But it's so much more intricate than you realize,” Wales added. “Until you've had that experience, you have no idea.”

Maria Malagon at home with her son in 2017.

Mothers wait to have children

Maria Malagon, 43, lives in DC with her two children and husband. And works as a manager for the federal government. If her kids were born in or after 2020 — when the gov added 12 weeks of paid family leave to its benefits list — she would have put it to use. But back in 2012 and 2017, Malagon had to get creative about her leave — which meant making a sacrifice.

Malagon and her husband put off having kids for nearly four years. Both working for the federal government without paid family leave, they knew time off would depend on accrued vacation and sick time.

Once their daughter was born in 2012, the Malagons had each accrued three months of time off. They took their leave together, planning on sending their daughter to daycare when she turned six months old. But when the time came, daycare centers were full. And when Malagon did find a daycare facility with an open spot, it came with a hefty price tag.

“We were paying almost $2,000 a month. Mind you, this is a government subsidized daycare,” Malagon said. “Still, they were charging us almost $2,000, which was higher than our mortgage at the time.” She had heard that other daycares near her house were charging as much as $3,200 a month. 

When they were considering having their second child, the Malagons were in a tough spot. They were saving money with the goal of moving to a larger home in a better school district. Looking at that expense combined with child care, they realized baby number two would have to wait. 

“There was no way that we could make those savings to get out of the house and also pay another $2,000 a month for daycare,” Malagon said. “That’s $4,000 a month plus trying to make additional payments to the mortgage. The math was not there.” 

They waited until their daughter was old enough for pre-K to have their second child. Five years later, their son was born. 

Myth busted: Paid family leave actually helps employers

“The concern that’s raised is that people are going to go on [paid] leave, companies won't be able to cover the work, and it's going to be really inconvenient for companies,” Ann Bartel, Columbia Business School’s workforce transformation professor, said. “Especially small ones, where they don't really have a buffer like large companies.”

Bartel, who is an expert in labor economics, co-authored a study in April 2021 that analyzed the impact of paid family leave on businesses. Her team surveyed nearly 5,000 small businesses (with 10 to 99 employees) that offered paid family leave. The findings contradict many of the public’s assumptions

“In the press, you read that small companies are not happy about this. Our study refutes that because we show that there are no negative impacts,” Bartel said. “We don't find more absenteeism. We don't find people missing work. We don't find people not doing their jobs.” 

“What we found particularly interesting was that when the policy went into effect, it made it easier for the companies to manage absences,” she added.

Offering paid family leave has other positive effects in the workplace, like preventing burnout and boosting retention. Enter: Maven Clinic. It’s the largest virtual health clinic for women and families — and offers their employees 16 weeks of paid leave (whether adopting, fostering, or birthing). In December, the company partnered with Great Place to Work and surveyed nearly 500,000 parents in more than 1,700 US-based companies to look at two things: The current state of burnout and how family leave benefits can help. 

  • The results: It found that a national paid leave program could have prevented 4.8 million cases of burnout. BIPOC mothers were also 35% more likely to experience burnout. But employees who felt their organizations offered benefits “special and unique for their needs” were twice as likely to stay. 

“For employers who are concerned about the cost of somebody being out for so long, consider the cost of them not coming back. What does that mean when that institutional knowledge walks out the door?,” Karsten Vagner, senior VP of people at Maven, said. “When those skills walk out the door, and then you have to start all over again? What's the cost of that compared to a robust leave plan, where employees feel supported and grateful to their employers as well?” 

Vagner said that businesses need a major mentality shift — one that supports people as employees and parents. According to the study, companies that offered a holistic approach to wellbeing prevented four out of five working parents from quitting. 

He recalled the strenuous adoption process he and his husband went through, and how having those benefits made all the difference. He’s also seen the impact firsthand with Maven’s employees. 

“We have parents who come back and say, ‘I'm raring to go now, because you took such good care of me. I can't wait to come back and do a great job.' That should be the ideal for other companies.” 

How to move forward — with or without leave

Waiting for change can be excruciating. At theSkimm, we created a go-to page for all things paid family leave. It includes more testimonies from parents, theSkimm’s paid family leave benefits, and actionable resources. While Congress decides if we get four weeks of federal paid family leave, you can help fight for paid leave by signing our petition. Here are some additional steps parents and employers can take:

For employers…

Psst…Check out theSkimm’s sample presentation for pitching changes at your company.

For new parents…

  • Reflect on your current situation. “This pandemic has revealed all the cracks in society in so many different ways,” Vagner said. “One of them should be for moms and dads to really ask themselves, ‘If I'm in a place that doesn't see me and doesn't invest in the things that are important to me, is there another place?’”

  • Pay attention to company benefits. Especially if you’re job hunting. “If paid family leave is important to you, you might be willing to take a lower salary in order to have paid family leave,” Bartel said.

  • Double check your current benefits. Especially if you work remotely or your company is headquartered in another state. Because out-of-state employees may not get that in-state treatment. Meaning: You may not have access to the same benefits. And that’s a surprise no one is asking for. 

  • Don’t be afraid to speak up. “Every year on our employee survey, I wrote that we should have short-term disability as part of our package for benefits,” Wales, one of the Skimm’rs we spoke to, said. “Even when I didn’t know if I would benefit from it.” Last year, Wales’s company granted their employees short-term disability benefits.

Vagner said that most people don’t realize the challenges of being a parent. Workplaces are just more aware now after seeing their employees as both workers and parents via Zoom during COVID, he said. 

“We should reach out to our parents and ask them how they're feeling, what they need,” he added. “And what we can do for them to make sure they're supported.”


The US lags behind every industrialized nation when it comes to paid parental leave. And it’s unclear when Americans will get the much-needed time off from work. The strain placed on parents, however, is crystal clear — especially when they are forced to choose between their career and child. 

P.S. theSkimm has a whole page dedicated to paid family leave, including a petition you can sign for the cause.

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