The US is still the only wealthy country in the world without national paid family leave. But if you ask someone who’s postpartum, they’d probably say that returning to work right after giving birth sounds harder than…well, giving birth.
Only about a quarter of US workers have access to it. Because as we mentioned there isn’t currently a federal law guaranteeing paid leave. The Family and Medical Leave Act of 1993 granted 12 weeks of unpaid leave for eligible employees. While a bill that went into effect in 2020 gave federal government employees 12 weeks of paid parental leave. As for everyone else...the Senate is still debating a social spending package that narrowly passed in the House, and could include up to four weeks of paid family and medical leave for eligible US workers. A drop in the bucket compared to the paid time off that parents can take in some other countries (see: Britain’s 39 weeks, Norway’s 49 weeks, and Estonia’s 80+ weeks). But in the US, family leave might look like a puzzle made up of sick days, short-term disability insurance, vacation, and PTO. That’s if leave is available at all.
It depends on the person. But maternity leave shorter than 12 weeks has been associated with worse long-term mental health for mothers. Thing to know: Studies show that about six months of parental leave is ideal for most families. And there’s this: Research on heterosexual couples shows that when fathers take leave, it benefits maternal health. And FWIW, some studies have shown (and Google’s workforce has suggested) that moms are more likely to return to work after having a baby if they have ample paid leave.
We broke down what being postpartum could look and feel like, so when we talk about parental leave — and the viability of returning to work after having a child — the discussion has some context and a little humanity. Note: The info in this guide applies to all birthing people, but the words “moms” and “women” are used when citing data that’s specific to gender.
Right after childbirth…You could be feeling blue. Not just because your body went through trauma (see: pushing out a baby) and your vagina or abdomen is stitched up, but also because hormones are going haywire. Estrogen and progesterone often drop off a cliff, a change which is often correlated with depression. Up to 80% of postpartum mothers get the baby blues. Think: crying and bouts of anxiety. It can last from a few days to a couple weeks. And here’s a postpartum problem people don’t often talk about: serious constipation. And then there are plenty of other physical and mental symptoms (see: vaginal bleeding, trouble concentrating, and chronic pain) that can creep in due to childbirth.
Weeks 1-5…The body doesn’t ‘get used to’ getting less sleep. And yet, you’ll be sleeping less. A hallmark of the fourth trimester is exhaustion. If the blues haven’t gone away after a few weeks — and a low mood is interfering with your life — that could be a sign of postpartum depression, which about 15% of new moms experience. For mothers who gave birth in the early days of the pandemic, that number was even higher. A survey of 670 postpartum moms, who gave birth between February and July 2020, found that one in three met the criteria for postpartum depression. There’s the physical ailments to contend with, too. You might deal with achy breasts if you develop painful mastitis — which is when the milk ducts get blocked. That happens to 10% of breastfeeding moms (more detail on breastfeeding challenges here). D-MER, a condition where lactating makes you feel sad, might also be your reality. And you may experience vaginal dryness from breastfeeding (thanks, hormones). Some other things you might experience: night sweats (yep, hormones again) and accidental peeing. And then there’s cramping. Because your uterus that carried a baby doesn’t magically shrink overnight. It’s no wonder that some cultures have a tradition of letting new moms take it easy for at least a month.
Weeks 6-10…You’ll be closer to feeling physically “normal” around this time. Which is a relative term. This is when you might see your regular period return, vaginal tears and ab incisions will be mostly healed, and you might feel ready for sex again. Many birthing parents will have their standard postpartum OB-GYN exam around six weeks, because that’s when health insurance often covers the visit. And it could also be when your pregnant “pooch” — sometimes caused by your left and right abs separating for pregnancy — gets back to how it was before. Cross your fingers that your pregnancy and postpartum back pain starts to get better by now, too. And just FYI: Many child care centers will only accept babies once they're at least 6 weeks old.
Weeks 11-12…Your fourth trimester is winding down. One popular theory (from Harvey Karp, author of this best-selling parenting book) holds that babies are born three months earlier than they’re developmentally ready to be out in the world. So, after being alive for three months, they finally start getting better at the whole eating and sleeping thing. The good news: Your little one might start sleeping for longer stretches at this point. The not-so-good news: That’s around the same time you may shed a considerable amount of your hair from postpartum hormones dropping off. Thing to know: Democrats initially proposed 12 weeks of paid family leave in the social spending plan.
After the 4th trimester…You might start feeling “normal” again. On average, moms surveyed for the book “The 5th Trimester” said it took about six months after giving birth to start feeling normal physically and emotionally. (The book also noted that this tended to happen a few weeks after babies’ naps became more regular.) But even more changes are likely on the way over the next few weeks: At six months, babies can typically begin eating some solid foods as they slowly begin to rely on more than just breastmilk and formula (although they'll still rely on breastmilk and formula for their nutrition needs until at least 12 months). It can sometimes be an emotional experience for the baby and parent (because yes, more hormones). By around seven months, the moms surveyed for "The 5th Trimester" said that their babies could typically sleep for about seven hours in a row. You can read that again: It took seven months for them to get seven straight hours of sleep. Of course, this (as with everything) might not be the same for everyone.
Glad you asked. Although pregnant people are often offered subway seats and open doors, postpartum people don’t tend to receive the same considerations. Breastfeeding parents might still be stigmatized for pumping at work. And when it comes to health care, insurance usually takes care of regular doctor’s appointments for pregnant people and newborns. But coverage might expire by the time birthing parents are two months postpartum — especially if you have pregnancy-related Medicaid. Hear us loud and clear: New parents should still seek help. If you have symptoms of postpartum depression, look for a reproductive psychologist (read on for more about finding a therapist). If you want to breastfeed but it’s painful, consider hiring a lactation consultant (this breastfeeding guide has more on that). If sex hurts and you’re having a lot of bathroom trouble, it might be time to schedule an appointment with a pelvic floor physical therapist. And if you’re losing a lot of hair, check in with an OB-GYN or dermatologist.
Parental leave isn’t just important because it allows for family bonding. It also allows postpartum people to take a few moments (in between tantrums and feedings and figuring out parenthood) to take care of their mental and physical wellbeing. More paid time off means employees are more likely to return to work. And they’ll be healthier when they do.
theSkimm consulted with Dr. Marta Perez, OB-GYN and assistant professor at WashU School of Medicine, for this guide.
Skimm'd by Carly Mallenbaum, Becky Murray, Anthony Rivas, and Jane Ackermann
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