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benefits that were in line—or even more generous than—what many European countries offer. Microsoft, one of my company's long-time clients, announced in 2015 that they would offer 12 weeks of 100% paid parental leave to all parents, in addition to the 8 weeks of maternity disability offered to birthing mothers. In making their expansion, Microsoft also realized that policy alone is not enough. Supporting practices must be put in place to require—and influence—culture change. We worked with Microsoft to develop a program that trains employees and managers around the world about how best to navigate the parental leave transition. They were the first company in the country to offer an employee-manager-aligned parental leave training and support program, a pilot so successful that it was rolled out globally.

Once I began working with companies on these issues, I realized how many challenges they face when it comes to parental leave. For example, beyond talent attraction, retention, and compliance issues, lack of a good leave policy also compounds risk management costs. If exhausted new parents come back to work too soon, they present an increased safety risk. AAA's Traffic Safety Advocacy and Research department reported that “a driver who has slept for less than five hours has a crash risk comparable to someone driving drunk.”⁵ Imagine how a sleep-deprived new parent plays that out in the workplace, especially if heavy equipment or important decisions are involved. Having someone come back to work too soon increases health care costs and jeopardizes health and wellness initiatives. If people don't get the time and support they need to heal and rest, their health suffers and insurance costs and absenteeism rates increase.

Ironically, the current trend of individual states passing paid leave can actually hurt companies, because those that operate in multiple states must keep track of and comply with many different (and complicated) laws. This adds a serious cost and administrative burden. I know many parents who couldn't care less about this administrative burden (like Rachael in the introduction) and are simply angry not to have paid leave through their employer, but that frustration is misplaced. This is something our federal government should be solving, not individual companies. According to the Small Business Administration's Office of Advocacy, 99.7% of companies in the United States are small businesses.⁶ When we think of companies, we cannot just think of the Amazons and Googles of the world, with a sense of what they “owe” us.

      Small businesses are affected more than larger businesses because larger companies can afford to offer paid leave benefits that attract the best talent, and the administrative costs that come with them. Small businesses often cannot. Even though in most states our current system doesn't legally obligate them to provide paid leave, there are other detrimental financial effects—such as having to pay to replace workers who leave after becoming a parent.

Although I see many companies fighting against the idea that parents should be supported with paid leave to take time away from work to welcome children, I think this is largely due to a lack of information on this issue. It is not easy being in leadership at a company of any size, and leaders often push back on anything that could cut into the bottom line and threaten the solvency or the day-to-day functioning of the company. However, forward-thinking leaders realize that supporting new parents through generous policies and strong support practices can literally pay dividends. It costs far more to recruit and train a new employee than it does to retain an existing one (the Society of Human Resource Management reports the cost of directly replacing an employee can run as high as 50% to 60% of their annual salary; total associated costs of turnover can range from 90% to 200% of an employee's annual salary).⁷ Last, studies show that parents who are healthy (and well rested!) are more productive, more innovative, and even more loyal to their company.⁸

      Clearly, the best thing for families and companies would be a generous federal benefit that provides clarity and stability for everyone involved.

When We Get Parental Leave Right

      There is a shortage of data about parental leave in the United States, but the data we do have from progressive organizations and other countries show that providing generous paid leave policies and supporting practices works. Let's look at some of the rewards of getting this right.

       Reward 1: Healthier Kids

It may seem obvious to say that when parents are supported through the parental leave transition, they are able to better care for their children, which means better health outcomes for babies. The data support this: a 2017 study found that providing 12 weeks of paid leave in the United States could lead to 600 fewer infant and post-neonatal deaths each year.⁹ (In 2019, the infant mortality rate in the United States was 6 infants in 1,000 live births, twice that of the European Union, where health care and paid parental leave are widely available.)¹⁰ Breastfeeding (if desired) can be smoothly established and last longer. Parents have time to take their child to get vaccinations and checkups as well as notice any developmental delays when an early intervention can mean a better outcome. Everyone sleeps better and has time for the crucial bonding that we know leads to healthier kids (and parents).

       Reward 2: Healthier Moms and Birthing Parents

Better supported parental leave also means better health outcomes for birthing parents. It's not just babies who suffer under the current state of things. The maternal death rate in the United States is actually on the rise, despite the global trend downward in the last few decades. In 2017, the United States saw 17 maternal deaths per 100,000 live births.¹¹ The European Union saw just 6 maternal deaths per 100,000 live births in the same year.¹² That's right, the maternal death rate in the United States is nearly three times higher than in the European Union and almost twice as high as in Canada.¹³ It's clear that birthing parents are not getting the care and support they need to thrive. Black moms and moms of color are disproportionately affected¹⁴ (more on this in Chapter 16). When moms are supported to take leave, they have the time and rest they need to recover more quickly and fully, and to get the treatment and screenings that prevent medical and mental health complications related to childbirth so they can return to the workforce more effectively.

       Reward 3: Healthier Dads and Non-Birthing Parents

Although dads often face different issues than moms, it is important to highlight their transition. Dads often feel extreme pressure to “provide” for their families, which can lead to overwork and a lack of self-care with serious health impacts. Dads and other non-birthing parents are not immune to perinatal mental health challenges, either. Research shows that 1 in 10 fathers experience depression and anxiety after their child is born.¹⁵ Often, they do not seek help until they are in crisis. Partners of a birthing parent often internalize any emotional or physical difficulties that their partner or child may encounter as a reflection on them and something that they need (and want) to fix. They can be left feeling inadequate and unsure of how to step into their critical role.¹⁶ When we look at outcomes in cases when dad gets paid leave and cultural support for time at home, we see how much

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