Jessica Rebeschini was advised to take at least six weeks off work to recover from an emergency C-section surgery and bond with her newborn child, Karter.
But with no paid maternity leave and bills due, the 26-year-old had no choice but to immediately start looking for a job.
Within two weeks, she was working 45-hour weeks as a waitress doing nightshifts. She was earning $4.35 an hour carrying heavy trays and walking several miles a day – pumping breastmilk in the restaurant toilet when she could, and living in fear of her C-section scar reopening.
“The biggest thing was that I was kind of scared. When you have major surgery like that and then you’re pushing your body so harshly,” said the mother of three from Bondurant, Iowa, who is remarkably phlegmatic about the experience.
When she got home, Rebeschini would take over childcare duties from her husband Ron, 33, an optician, so he could go to work.
“I remember every time I had to work I was like ‘please don’t reopen,’” she says of the scar on her abdomen. “I mean I was essentially risking my life.”
Rebeschini’s experience is far from rare for America’s mothers. One in four women in the US return to work within two weeks of childbirth, according to the advocacy group Paid Leave US (PL+US).
Parents just can’t afford to stay home with their babies
The American College of Obstetricians and Gynecologists (ACOG) recommends women take at least six weeks off work following childbirth. But with no federally mandated paid family leave, for many women maternity leave is an unaffordable luxury.
The US is one of only three countries in the world not to offer statutory paid maternity leave, according to analysis by the International Labour Organisation, and only 17% have access to paid leave, according to US Department of Labour statistics.
“If you look at paid leave rates between white families and families of colour, it’s even worse,” said Myra Jones-Taylor, chief policy officer at child development non-profit Zero to Three. “Parents just can’t afford to stay home with their babies.”
Rebeschini, who left her previous job around a month before the birth, said financially she had no option but to work.
“We had two dollars left in our bank account. I remember thinking to myself, had I not been working, my [rent] cheque would have bounced and we wouldn’t have had a place to live.”
Working shifts of up to 12 hours, she found the separation from her newborn agonising.
“I would come home and the first thing I did was make sure that he was breathing … When you’re not physically there you just have to trust that he’s fine. You worry about the bond of being gone for so long … is he going to recognise you?” she said.
She said she didn’t dare tell her new employer how recently she had given birth for fear of being considered a liability. While her manager was supportive of her pumping breastmilk, there was nowhere suitable to do it. “So I had to take my breast pump into the bathroom and hope that no one came in and saw me pumping.”
Karter is now four years old, but Rebeschini worries about the potential impact of her early absence.
“[He] has disabilities and we didn’t catch that until he was over a year old … I don’t know if we would have caught it sooner had I been home more.”
Today she still experiences pain in her abdomen which she attributes to returning to work so soon.
Rebeschini has since had a third child, Brody, who is now one. This time, she took two months off, but with no maternity pay it resulted in the couple falling behind on bills and having to declare bankruptcy – delaying their plan to buy a home.
“You can prepare all you want to be off for a certain time and not have pay but it just doesn’t work. If we had paid leave, we wouldn’t have fallen so far behind that we couldn’t get ourselves out of a hole. We wouldn’t have that stain on our credit.”
Any time we have a mother who is going back to work bleeding that’s not good for mum, it’s not good for babies, and it’s really just not good for the workforce
Dr Rebecca Jackson, professor of obstetrics and gynecology at the University of California, San Francisco, said breastfeeding is one of the biggest challenges for women who return to work early – especially low-wage workers.
“If you’re driving a bus, how do you stop that bus to pump milk?”
After a C-section, she recommends women take eight weeks off and to avoid heavy activity to prevent complications. “A lot of women still have significant pain at two weeks after,” she said.
Kirstin Moody, 36, a waitress from Hattiesburg, Mississippi, could only afford to take one week off after giving birth to her son Alex, now 13, by emergency C-section. The waitress ended up ripping her incision six times and as a result can no longer feel her lower stomach.
“I would feel like I was on fire, like somebody would take a hot poker and just drag it across the bottom of my stomach,” Moody said. “I was on pain medication for some of the time but it generally doesn’t help because you don’t get to fully rest your body.”
As a single mother, Moody depended on the help of family for childcare while she worked nights. Parting with her newborn son was intolerable.
“Oh God it was horrible. I cried and cried and I would sit at work and I would cry.”
Paid family leave has gained broad support and looks set to become a policy point in the 2020 presidential election, though there are still disagreements in Washington on how to pay for it.
In December the White House held a summit dedicated to the subject and recently passed a law to give 2.1 million federal workers 12 weeks of paid parental leave. So far, eight states and the District of Columbia have passed their own family leave bills.
But despite all the momentum, millions of women are still having to return to work after childbirth long before they are ready.
“On the politician front at least there’s progress,” said Jones-Taylor. “But any time we have a mother who is going back to work bleeding that’s not good for mum, it’s not good for babies, and it’s really just not good for the workforce.”
According to National Partnership for Women & Families, the benefits of paid family leave in states that have introduced it include improved worker morale, time for parents to bond with their children, increased breastfeeding, more children getting vaccinations on time, cuts in children’s hospital admissions and reduced probabilities of having ADHD and hearing problems.
It also reports a reduced chance of new mothers having postpartum depression and women who take paid leave are 93% more likely to be working nine to 12 months after childbirth than those who don’t.
Currently, the only national maternity provision falls under the 1993 Family and Medical Leave Act (FMLA), which entitles new parents to up to 12 weeks of unpaid leave. But it depends on the parent being able to afford to take unpaid leave and only 60% of the US workforce is covered.
Although some private companies are starting to catch up by offering paid family leave as a benefit, many women get around the inflexibility of the corporate world by starting their own businesses. But with no paid maternity leave, there is still pressure to go back to work.
Jessica Mann, 35, owner of Chicago-based beauty company Ari Rose Body Care, was back at work five days after giving birth to her one-year-old daughter Lila.
Her partner Bryant Ousley, 33, was working long hours in a new job and did not qualify for any parental leave, so Mann was also doing the majority of the care for their three children.
“Being a small business owner I felt that there was no other way that things were going to continue going without me and so it was more of a necessity than anything,” she said. “And then of course it impacts your income. So we have a new baby and we have three kids, to not work and not have that income would also impact our household.”
Virginia delegate Jennifer Carroll Foy was back on the campaign trail knocking doors two weeks after giving birth by C-section to her now two-year-old twin sons Alex and Xander, who were born premature and spent four months in neonatal intensive care.
“I had tremendous back pain, shoulder pain, and you have to think that you’re just coming out of major surgery where you are literally being sliced open and giving life to human beings, it takes a lot out of your body. But I was in a position where there was no time to rest, I didn’t have an option to relax.”
Caroll Foy, 38, who was then still working as a public defender, was on disability benefits – which in some states can be used for pregnancy – so she was entitled to a portion of her income. But with she and her husband Jeffrey Foy, 38, a supervisor at a non-profit, taking cuts to their paycheque, their finances came under strain.
It was such a wake-up call that she has introduced a paid family leave bill in Virginia. “When you’re bringing a new child into this world and you’re expanding your family, your income shrinks … I want to make sure that other women and families don’t have to make the same painful decisions about being with their newborn baby or paying for their bills and keeping a roof over their head.”