Last week I met with Ariana. This isn’t her real name of course, but it’s her story that matters. Ariana was about 8 weeks postpartum, and I had been seeing her in order to treat her bipolar disorder. Although she had been psychologically well throughout her pregnancy, she had suffered from postpartum depression several weeks after she gave birth. In fact, she had only recently started to feel better. That’s why I was surprised when she came to the appointment with paperwork from her employer that she needed me to complete.

“I have to go back to work next week,” she explained.

“Are you sure you’re up for it?” I asked her. “Remember, it was only a few weeks ago when you couldn’t even leave the house. Why not take more time?”

“I can’t,” she replied. “They’re holding my pay, and we need the money.”

I also met with Leah in the same week (also not her real name). She was 7 months pregnant and was working a job that was intolerably stressful to her. Still, she felt she was unable to leave the job.

“Who’s going to hire someone who’s pregnant?” she asked. “And besides, I can’t quit. I’ll lose my health insurance.”

Leah, like Ariana, didn’t really have a choice, or at least not an acceptable choice.

Helping mothers to navigate the psychological stresses of pregnancy is what I do, my area of expertise. Nonetheless, I sat with Ariana and Leah and felt so helpless and frustrated. It’s hard enough to be a mother, but being a working mother is even tougher.

In Massachusetts, there is some good news for pregnant and postpartum women in the workforce.  The Pregnant Workers Fairness Act went into effect on April 1, 2018. Despite the passage of the Pregnancy Discrimination Act 40 years ago, pregnant women in the workplace continue to face discrimination.  Women who are pregnant experience greater job insecurity, and they may experience discrimination in terms of hiring and promotion.

To better protect protect women in the workplace, the Pregnant Workers Fairness Act  basically gives pregnant women the same kind of protections that disabled workers have under the Americans with Disabilities Act.  Employers cannot discriminate on the basis of pregnancy or pregnancy-related conditions, and they must make appropriate accommodations for pregnant and breastfeeding employees.

The Act, which goes into effect on April 1, 2018, expressly prohibits employment discrimination on the basis of pregnancy and pregnancy-related conditions, such as lactation or the need to express breast milk for a nursing child.  It also describes employers’ obligations to employees that are pregnant or lactating and the protections these employees are entitled to receive. Generally, employers may not treat employees or job applicants less favorably than other employees based on pregnancy or pregnancy-related conditions and have an obligation to accommodate pregnant workers.

I was hoping that this legislation would address some of the difficult issues related to maternity leave; it is disappointing that this act makes no mention of maternity leave.  In the United States, maternity leave, or the lack thereof, contributes to gender inequality in the workplace, and most working mothers in our country — especially those who work in less skilled, less secure positions — are not adequately supported.  Only 13 percent of the private workforce has access to paid leave, and only 60 percent are eligible to receive unpaid Family Medical Leave Act protection. (Look at this document to see what maternity leave looks like in other countries.)

It will be interesting to see see how this legislation plays out.  Will this legislation cover accommodations for infertility treatment? (Is infertility is a pregnancy-related condition?) And will this legislation be beneficial to women who suffer from perinatal mood and anxiety disorder? Time will tell.

Ruta Nonacs, MD PhD


Read More:

40 Years After the Pregnancy Discrimination Act, Pregnant Employees Still Face Workplace Discrimination (Marketplace)

MCAD Guidance PREGNANT WORKERS FAIRNESS ACT  Issued 1/23/2018 – Massachusetts Commission Against Discrimination

MCAD Q&A PREGNANT WORKERS FAIRNESS ACT Re-Issued 2/27/18 – Massachusetts Commission Against Discrimination

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