America’s Lack of Paid Leave Is Devastating Women and Families

Women can’t wait another 30 years. The time for paid leave is now.

Advocates for paid leave with then-House Speaker Nancy Pelosi (D-Calif.) and Rep. Brenda Lawrence (D-Mich.) on Equal Pay Day on March 15, 2022. (Tom Williams / CQ-Roll Call, Inc via Getty Images)

Thirty years ago, a group of determined women ushered the groundbreaking Family and Medical Leave Act (FMLA) into law after a long fight. It was introduced nine successive years in Congress and vetoed twice by President George H.W. Bush before finally being enacted by President Bill Clinton on Feb. 5, 1993.

The FMLA provides unpaid, job-protected leave to millions of working people for family caregiving or medical needs. While passage of the FMLA was a monumental achievement for its time, coverage and eligibility restrictions mean that over 40 percent of the workforce are excluded from its protections.

Since the FMLA only guarantees unpaid leave, it’s inaccessible to the millions of low-paid workers who can’t afford to lose their paychecks for any period of time. But only one in four workers can access paid family leave through their jobs, leaving nearly 105 million individuals without pay when caring for a new child, aging parent or sick family member. Similarly, just two in five workers have access to paid medical leave for their own serious health condition.

New Census Bureau data reveals that in just the first two weeks of 2023, 6.8 million adults were unable to work because they were caring for a child or an elderly relative. Another 1.7 million people couldn’t work because they were sick with COVID-19 or caring for a family member with the virus. Many experienced economic hardship due to a loss of income—or even worse, job loss—because the U.S. remains the only industrialized nation without a paid family leave program. Bills don’t stop coming just because a person is unable to work.

Women of Color Left Behind

While the need for paid leave stretches across race, ethnicity and gender, the impacts are not borne equally. Working mothers play a critical role in their families’ economic security, and women of color are more likely to have an outsized role. The vast majority of Black mothers—over 80 percent—are primary breadwinners. Research finds that six out of 10 Black women either don’t take the leave or do so without pay, costing them $3.9 billion in lost wages each ​year. Black women’s paid leave needs often go unmet, forcing them to make difficult choices between caring for a loved one or putting food on the table.

The inability to take leave also results in serious health complications. One in four U.S. employed mothers return to work within two weeks of giving birth, forcing back into the workplace mothers who are exhausted from a major medical event, who may have trouble walking up stairs or standing for long periods of time, or who have wounds that are still stitched and healing.

According to the Centers for Disease Control, nearly one-quarter of pregnancy-related deaths occur between 7 and 42 days postpartum, and over 80 percent of all pregnancy-related deaths are preventable. The U.S. continues to face a harrowing Black maternal mortality crisis—Black women are three times more likely to die from pregnancy-related complications than white women. It’s critical we deploy all the tools necessary to protect maternal and infant health, including guaranteed paid leave to recover from childbirth and bond with a new child.

Despite recent gains in women’s labor force participation, rates haven’t returned to pre-pandemic levels. Over 600,000 women are still missing from the labor force. Paid leave can help reverse the economic fallout of women leaving the labor force due to caregiving needs.

Paid Leave Is a Critical Next Step

Advocates hoped the FMLA would lay the foundation for a universal paid family and medical leave program—a social insurance program funded by workers and employers that workers draw on to take paid leave when a medical or caregiving need arises. While the federal government has fallen short of this goal, largely due to a partisan stalemate in Congress, some states have stepped in. Eleven states and the District of Columbia have paid family and medical leave laws. Still, millions of women across the country are left out.

Even with the setbacks, determined women continue to fight for paid leave, as well as access to affordable childcare, reproductive freedom and the caregiving and employment protections needed to ensure all women and families can thrive.

Women can’t wait another 30 years. The time for paid leave is now.

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U.S. democracy is at a dangerous inflection point—from the demise of abortion rights, to a lack of pay equity and parental leave, to skyrocketing maternal mortality, and attacks on trans health. Left unchecked, these crises will lead to wider gaps in political participation and representation. For 50 years, Ms. has been forging feminist journalism—reporting, rebelling and truth-telling from the front-lines, championing the Equal Rights Amendment, and centering the stories of those most impacted. With all that’s at stake for equality, we are redoubling our commitment for the next 50 years. In turn, we need your help, Support Ms. today with a donation—any amount that is meaningful to you. For as little as $5 each month, you’ll receive the print magazine along with our e-newsletters, action alerts, and invitations to Ms. Studios events and podcasts. We are grateful for your loyalty and ferocity.


Sapna Mehta is a senior policy analyst at the Center for Law and Social Policy (CLASP) and a member of the executive committee for the Paid Leave for All Campaign.