Things the U.S. Could Do To Make Pregnancy More Appealing

I’m in the waiting room for a doctor’s appointment — again — so I finally have a second to get out my thoughts on pregnancy. Specifically, how hard it is under our current system in the U.S.

So, here are things we could work toward, besides abortion, that would maybe help more pregnant people decide it was worth it to keep a baby.

Necessary Improvements

• Expand FMLA coverage to cover everyone, regardless of how many employees are at the company or how long the person has been employed there.
  • FMLA only hold’s someone’s job for three months, IF they work for a company with more than 50 people and if the person in question has worked there more than a year. So a lot of people fall through the cracks.
• Make work accommodations for pregnancy mandatory.
  • An employer should have to make a reasonable accommodation for pregnant people to keep working while avoiding either hazards or challenging situations. Ex. I do not know how anyone in food services makes food of any kind in the first trimester.
• Change work culture so it is acceptable to discuss pregnancy with a boss or HR beginning at the first trimester. Accommodations should start then.
  • The first trimester is no joke. Fatigue making you fall asleep in your desk, constant nausea. Some people have to be hospitalized or miss work. Add to that the social pressure to keep quiet about it? That’s a real struggle.
• Encourage physicians to offer off-hours prenatal appointments and/or require that these appointments are automatically considered “excused” time off work.
  • I had no idea prenatal doctors’ appointments were both so frequent (1x a month for six months, then 2x, then weekly) and so ridiculously impossible to schedule around regular work hours. At least at my doctor, I don’t get a choice for a time of day that won’t interrupt my workday. They say show up, and I just have to do it. My work is accommodating, but not everyone’s is, and I still have to get my work done, despite having to be out so often.
• Make insurance coverage for pregnancy mandatory.
  • This really shouldn’t have to be said, but of course it does. Pregnancies aren’t always planned, and they are challenging in many unforeseeable ways. It should be covered by every insurance, especially if you want a culture that supports people having kids.
• Mandatory maternity leave of six weeks, minimum.
  • Ideally this would be handled with some kind of federal funding or disability insurance, but no one should have to go back to work while their body is completely wrecked, they are sleep-deprived, and leaking. Some kind of payment to help people continue to get fed and housed during this traumatic time would go a long way.
• Distribute baby boxes to encourage safe sleep and provide supplies to new parents.
  • Other countries do this; it’s a small box with a firm mattress, and frequently comes with a few small baby items and personal care items for mom. The box is used as a safe space for newborns to sleep in proximity to the caretakers, and the supplies guarantee that every new parent has the fundamental supplies they need for baby’s first weeks.
• Strengthen existing support systems to ensure pregnant people are able to be housed and have access to care.
  • No one should be homeless and pregnant.
• Support for breastfeeding.
  • Obamacare mandated that every employer have a secure place for pumping, which is a start, but breastfeeding is hard no matter what. People need support and realistic expectations at work if you want people to continue to do it.

Would Be Great To Have

• Parental leave for both parents.
  • Fathers and partners are every bit as important to newborns as moms. Moms need help. And the “pregnancy risk” employers take by hiring young women would be nullified if everyone had the option for leave.
• Paid leave.
  • Having your job held is a start, but a pretty weak one. If we were serious about supporting parents, we’d copy other countries and provide some kind of income support. For everyone.
• Provide qualified childcare.
  • I had no idea I needed to start thinking about childcare, and how to pay for it, and its availability, while I was still in the first trimester. It can cost more than college tuition. If you want people to have kids, you need to find ways for them to be able to afford them and protect them while the parents work.
• Provide pregnancy leave before the baby arrives.
  • Maybe it is just my insurance, but the time I am in the hospital laboring/in surgery does not count toward my maternity leave. It’s considered regular time off, as if I just didn’t feel like going to work instead of am literally in the hospital. How is that ok? Add in all the days someone may be really struggling with a pregnancy side effect, and you could have many days of missed work — which counts against the number of days that person now has available for leave. This system is broken.
• Make prenatal care and labor and delivery costs actually affordable.
  • We need to overhaul our healthcare system in general, but all these prenatal appointments and tests (so many tests!), plus the cost of actually having a baby — it is astronomical, even with someone who is prepared and has “good” insurance. If you want people to keep their unplanned pregnancies, you’ve got to bring these costs down.
• Provide additional/flexible food stamp/EBT options for pregnant people.
  • The first few months, I could basically just eat crackers, fruit, and cereal. After that, I got incredibly hungry, just all the time, but still somewhat picky about what sounded actually edible. If I had limits on what I could buy because I were on EBT, I would have been hungry a lot. I support people not being hungry.
• Provide a small clothing stipend for lower-income people.
  • This is a true nice-to-have, but any illusions I had about continuing to keep wearing my regular clothes were gone by the third month. I have a small maternity wardrobe because I am loathe to spend on clothes for a few months… but I have had to buy all new clothes, from undergarments up. It’s not just a matter of being unfashionable (I still am!), but literally not being able to put clothes on my body. If I had to choose between pants I could sit down in and eating, I don’t know what I would have done.
• Offer free or low-cost family classes.
  • Some places offer this, but it should be standard. Babies don’t come with instructions, and neither does pregnancy. My doctor is great, but I see her for maybe 10 minutes. The public needs resources to be able to support pregnancy and new parenthood.
• Encourage vaccinations.
  • A newborn is basically restricted to the home for about three months until they can receive fundamental vaccinations and get protected from truly deadly maladies. The general population needs to step up and protect these vulnerable folks — which will also help the parents with childcare and mental health, because they will be able to get out more.
• Offer maternity support home visits.
  • Perhaps it’s just that I’ve watched a ton of Call the Midwife, but I am incredibly jealous of that system. A nurse visits pregnant and new moms several times throughout the pregnancy, providing not just healthcare support, but also emotional check-ins and general social needs (is the home environment safe? Are there other programs the expecting family may benefit from? Etc.) The availability of a supportive environment is one of the strongest factors in reducing medical interventions in labor and in reducing the risk for post-partum depression. It absolutely seems worth it.

If supporting families and encouraging people to have children is a social goal of the country, implementing any of these changes would have a positive effect — and possibly the side-effect of reducing abortions (which banning doesn’t actually do — women just find a different, not always safe, way).