The Family Medical Leave Act (FMLA) is a federal law that revolutionized the relationship between the American work force and medical care. The law grants employees the right to up to 12 weeks of unpaid leave from work due to the birth of a child or to take care of serious health needs for themselves or their immediate families. However, FMLA omits much of the American work force and only guarantees unpaid medical leave. This means that the protection offered by FMLA is unavailable and inadequate for many American families, leaving the health of millions of American children is at risk. As pediatricians we can advocate for our patients by supporting legislation that expands FMLA.
Having the safety to take time off from work to care for a newborn child is essential for the health of both the child and the parents. Many medical conditions arise such as bleeding problems, infections, and depression for the mother, as well as congenital anomalies, feeding problems, and infections in the child. All of these issues, and many more, require medical attention that may restrict one or both parents from returning to work. Additionally, even for healthy mothers and babies, there are tremendous benefits to spending time together: enhanced bonding experience, decrease in maternal depression, establishment of healthy feeding/sleeping routines, adjustment to the new lifestyle, and an increased likelihood of breastfeeding to promote the health of mother and baby. The American Academy of Pediatrics reports that this interaction is crucial for the developing child, and that society should provide assistance to make medical leave more available (https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/FAMILYLeaveAct.aspx).
The specifics of FMLA can be read here. It allows employees to take up to 12 weeks of unpaid medical leave per year due to the birth of a child, a serious health condition, or to take care of an immediate family member. However employees only qualify for FMLA if they meet the following requirements:
- Have worked for current employer for at least 12 months
- Have worked at least 1,250 hours over the past 12 months
- Work at a location where the company employs at least 50 employees within 75 miles
Various states have attempted to rectify the gaps in FMLA. Maine state law reduced the minimum number of employees for a company to qualify from 50 to 15, allowing employees who work for small businesses to be eligible. New Jersey state law reduced the minimum number of hours an employee needs to have worked in the past year to 1000, allowing more part time workers to qualify. Oregon state law expanded the scope of medical leave to include care for children who have had non-serious injuries but require home care, and it also expanded the definition of family to include grandparents and grandchildren (http://www.ncsl.org/print/employ/fam-medleave.pdf). Colorado state law has clarified that domestic abuse and sexual assault are to be considered serious health conditions (https://www.legalmomentum.org/sites/default/files/reports/Employment%20Final%20June%2017%202013%20(2).pdf).
In 2002 California became the first state to offer paid family leave, granting much needed flexibility for working families to take care of their newborns and sick children (http://paidfamilyleave.org/ask-us/what-is-paid-family-leave). This issue is being addressed at the federal level as well. A bill is currently pending in the U. S. Senate to offer paid medical leave to all qualifying employees across the nation (https://www.congress.gov/bill/114th-congress/senate-bill/786).
Advocating for your patients starts with education. As a pediatrician you have the opportunity to make sure parents are aware of their rights. Check here to see your state’s medical leave laws. However to fully address this gap, change needs to made at a policy level. Both state and federal legislation offer opportunities to expand FMLA. You can advocate for your patients by writing to your congressmen and supporting new legislation that improves job security for working Americans.
Zachary Most, MD