The Best Present for Minnesota Mothers: Paid Family Leave

As a mother and a psychologist helping very ill children at the Mayo Clinic, I thought I understood what it was to be a caregiver. But in April 2020, as the COVID-19 pandemic was rapidly spreading across the world, my daughter was diagnosed with cancer. In less than 24 hours I went from being Dr. McCarthy, providing psychological services to children in our pediatric hospital, to the mom of a very complex cancer patient. Even with all the possible advantages—access to a world-renowned hospital, good health insurance, a supportive husband—I found that caring for my medically complex daughter was one of the hardest things I have ever done. 

As a mother and a health professional, then, I welcomed Biden’s executive order increasing support for caregivers, who are mostly women. And I am thrilled that my home state of Minnesota just approved paid family and medical leave—joining 11 other states and the District of Columbia in offering this program.

“At the core of this bill, we are reinforcing humanity for Minnesota workers,” said state Rep. Ruth Richardson (D), the bill’s chief sponsor in the House. “Creating a statewide family and medical leave safety net for families and workers is critical for our overall workforce development, retention and economy.”

Signed into law on Thursday by Gov. Tim Walz (D), Minnesota’s new plan recognizes the incredible labor that family caregivers—the vast majority of whom are women—put into caring for their loved ones, often at financial, physical and emotional cost to themselves. Giving Minnesota workers up to 12 weeks of paid time off for medical or family reasons will increase access to paid leave for 75 percent of the Minnesota workforce who previously did not have access to this benefit, including Minnesota’s lowest wage workers.

But access to paid leave shouldn’t be dependent on a person’s zip code. Today across the U.S., almost 45 percent of workers are not eligible—and these workers are disproportionately women and people of color.

The next step is for Congress to pass federal paid leave and expand access to the U.S. Family and Medical Leave Act (FMLA). But making this a reality will require Congress to pass paid FMLA—an uphill battle in a split Congress

Writing as both a clinical psychologist who works with severely ill children, and as a mom with years of experience caring for a young child with cancer, we know the importance of paid family medical leave. 

My daughter had the best care modern medicine can offer—but still, much of that care depended on me and my family. At one point, I was giving upwards of 20 medications each day, in addition to 4-6 hours of IV medication each night. I was constantly monitoring her for symptoms, worrying that any change may be the start of a serious complication. The days and weeks blended together in a blur of clinic appointments, transfusions, and walking up and down the hospital hallways, my child in my arms.  

In many ways, I was fortunate. While not mandated to do so, my employer provided access to 12 weeks of paid caregiver leave, plus the option for more unpaid leave, and flexibility in my schedule. This meant that while our family incurred significant out-of-pocket expenses during her treatment, we did not experience food, housing or energy insecurity, like many other families whose child has cancer. 

Caring for a child with medical needs often impacts both parents’ employment. One study demonstrated that 75 percent of primary family caregivers and 53 percent of spouses experienced employment loss attributed to care for their child.

The lost income due to family caregiving has been estimated to be $522 billion each year

There is also emotional strain involved in family caregiving. While caring for a child with a serious medical illness is rewarding, it takes a toll on the emotional and physical health of the parents.

When I discussed our home care plan with my daughter’s medical team before discharge, the care seemed difficult, but manageable. Yet there were so many things I hadn’t thought about—like the anxiety that comes with knowing that contamination of her line could result in serious complications. Or how I would be sleep deprived from diaper changes every two hours. And that I would be doing this on top of everything else—the oral medications, her 3-8 appointments each week, transfusions and more. Despite my type-A personality, my lists, my alarms, my privilege, I missed many things. I was trying so incredibly hard, but I was “non-adherent” to aspects of my daughter’s care. 

In addition to emphasizing the importance of paid family leave, Biden’s executive order emphasized the importance of engaging and supporting family caregivers, focusing on programs and infrastructure to ensure family caregivers can access appropriate services. Greater funding and availability of support for caregivers will relieve stress while improving the quality of care for patients. 

Some may argue that providing paid leave for workers in Minnesota and across the country and providing more support would increase cost and invite abuse. However, studies examining the impact of paid family leave in states which have already adopted this policy, such as California, show these policies had a positive impact on productivity, profitability and decreased turnover

Investing in family caregivers benefits everyone—but especially women and especially mothers. Minnesota’s new guarantee of paid leave honors the impossible work done by all mothers and other caregivers by ensuring Minnesotans have access to paid family and medical leave.   

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Dr. Sarah McCarthy is a Harvard-trained board-certified pediatric psychologist who is the director of the pediatric psychology consultation liaison service at Mayo Clinic. She is also the mother of twin 6-year-old girls, one of whom died from complications related to cancer treatment in 2022. McCarthy is a public voices Fellow of AcademyHealth in partnership with TheOpEd Project.