Sunday, March 10, 2024

Keeping women in the picture



In the big picture, we want to take maternal health seriously. We want to minimize harm to our nation’s pregnant and postpartum patients. And through laws like Paid Family and Medical Leave, we have helped to ensure parents can afford to welcome and care for the new lives they labor into the world.


But what happens when that picture never develops? 


For women like Cassidy Perrone, who delivered her daughter, Olivia, stillborn in 2022, the tragedy is compounded by flaws in the system designed to support them as they recover and try to care for themselves and their families. 


Perrone, the primary breadwinner, learned after the birth that she was ineligible for Paid Family Leave. 


In New York pregnant people who experience stillbirth are currently excluded from receiving Paid Family Leave (PFL), despite their partners being eligible. In some instances having their approved cases revoked after they suffer a fetal loss.


This is why PUSH for Empowered Pregnancy (PUSH), a group of parents and medical providers advocating for those who have experienced stillbirth, is convening in Albany this coming week to call for legislation that would bring awareness to the need for more equity in how paid family and medical leave benefits are determined.


Since PFL is intended for bonding with new babies, caring for ill family members, or managing issues arising from military deployments, a postpartum patient who suffers stillbirth becomes ineligible to obtain PFL because they are no longer categorized as caregivers. Instead, postpartum patients must rely on Temporary Medical Disability Insurance, which pays considerably less as they recover. 


In New York state, temporary disability offers roughly 50 percent of workers’ wages but caps the benefit at a legal maximum of $170. In comparison, PFL offers as much as 67 percent of the claimant’s usual wages.


The disparity, like all disparities in maternal health, disproportionately affects under-resourced families of color, who are more likely to be forced back to work during the most dangerous postpartum weeks.


Women who experience stillbirth are also almost five times as likely to suffer severe maternal complications compared to those who deliver living infants. And experts indicate that using best practices, at least  25% of US stillbirths may be preventable


Since the 1940s, improvements in maternity care have resulted in a dramatic reduction in the occurrence of stillbirth; however, more recently, the decline has slowed or halted. In 2020, the latest year statistics are available, the CDC reported about 21,000 stillbirths in the United States. According to the National Institutes of Health, there are approximately 1,400 stillbirths in New York State each year. 

 

“New York’s current Paid Family Leave law forces parents of stillborn babies to make the awful choice between a paycheck and taking time to safely recover during the early postpartum period – a critical time in maternal health when moms are at significantly higher risk of life-threatening medical complications,” says PUSH Executive Director, Samantha Durante Banerjee. 


“This puts these families in an even more precarious situation, literally being forced to choose between their physical and financial health. And it's only exacerbated by the fact that it is totally unexpected, happening in the immediate wake of an immense trauma, and at a time when this family is grappling not only with the loss of a child but also significant financial impacts (funeral and burial expenses, autopsy and testing which often is not covered by insurance after stillbirths, mental health support, etc.) that come along with this devastation,” she said.


“Mothers need at least six weeks to recover physically from pregnancy loss, not to mention to recover emotionally. There have already been too many close calls where mothers with no choice return to work too soon and risk their health. We need a solution now – before a New York mother loses her life,” urges PUSH Policy Director Allie Felker.


PUSH is asking Gov. Kathy Hochul to fast-track legislation that would grant the birthing parent 12 weeks of paid time off regardless of whether labor resulted in a live birth.


Honestly, I don’t know whether PFL is the best vehicle by which to do this or if medical disability should rise to meet the realities of our times since the consequences of lost wages can wreak havoc on all patients and their families. A part of me worries that in either scenario, anti-abortion politicians will always try to weaponize good-faith legislation in their continuing efforts to diminish reproductive rights or dictate to families how they should be configured.   


But I don’t see how we can claim to hold family values in high esteem if we carelessly erase the value of a woman’s financial contribution to her family or the realities of her continued caregiving role even as she convalesces. 


Twelve weeks is a small price to pay if it keeps women in the bigger picture. It’s simply what’s fair. 

——-


 PUSH for Empowered Pregnancy (PUSH) will gather outside the Governor’s Executive Mansion (138 Eagle Street) on Thursday, March 14, 2024, at 2 p.m. 


No comments: