It’s Time to Face the Harsh Economic Realities of Pregnancy in America

On June 24, the Supreme Court handed down its landmark decision in Dobbs v. Jackson Health Organization, ending the constitutional right to abortion and degrading the citizenship of millions across the country, who now face an onslaught of assaults on their bodily autonomy. Over half of all U.S. states are expected to severely restrict or outlaw abortion, and many red states like Missouri and Alabama have already criminalized abortion in these early days of the new, post-Roe era of abortion rights in America. The threat of a federal ban on abortion already looms large in discussions of the upcoming 2022 midterm elections and 2024 presidential election.

Economic injustice has long been a significant threat to pregnant people and their ability to take care of themselves and their families, both during pregnancy and in the long term. Now women and others who are pregnant or may become pregnant, including trans men, intersex people, and nonbinary people, will be forced to carry an unwanted pregnancy and weather the accompanying economic consequences.

In the opinion overturning Roe v. Wade, the Court’s conservative majority dismisses the burden losing access to abortion will pose for many women and other pregnant people, and does so not only in its own argument, but also in how it characterizes the issue as a whole. Justice Samuel Alito provides only a curt mention of these concerns in his framing of today’s abortion rights debate:

Without the availability of abortion, they [advocates for abortion rights] maintain, people will be inhibited from exercising their freedom to choose the types of relationships they desire, and women will be unable to compete with men in the workplace and in other endeavors.

Indeed, abortion rights advocates do fear that the loss of widely accessible abortion services across much of the United States will trap women and others in relationships they may not have otherwise chosen, or even endanger their lives, along with many of the other well-established risks that may come with pregnancy. And with good reason. Research has consistently found a link between pregnancy and a heightened risk of physical abuse against women by their male intimate partners, with the American College of Obstetricians and Gynecologists estimating 1 in 6 women experienced abuse for the first time while pregnant. Women of color and women who are low-income are especially vulnerable to this violence.

But these statistics show only one of the many ways that pregnancy carries profound consequences for a pregnant person’s ability to live with safety and dignity, including by making it much more difficult, or even simply impossible, to meet their own basic needs. From temporary disability to long-term economic disadvantages, Americans who find themselves pregnant face a spectrum of serious risks with too little support from their government. The court’s opinion makes no effort to reflect their experiences. In it, the court’s conservative majority presents a vision of pregnancy in America which flatly denies the reality too many pregnant people have come to know through their own pain and struggles.

The court’s conservative majority presents a vision of pregnancy in America which flatly denies the reality too many pregnant people have come to know through their own pain and struggles.

In answer to the concerns of abortion advocates as he has described them, Justice Alito presents a distorted vision of social and economic progress for women and other pregnant people, which becomes unrecognizable when compared with data on the experiences of real people:

They [opponents of Roe] note that attitudes about the pregnancy of unmarried woman have changed drastically; that federal and state laws ban discrimination on the basis of pregnancy; that leave for pregnancy and childbirth are now guaranteed by law in many cases; that the costs of medical care associated with pregnancy are covered by insurance or government assistance. That States have increasingly adopted “safe haven” laws, which generally allow women to drop off babies anonymously; and that a woman who puts her newborn up for adoption today has little reason to fear that the baby will not find a suitable home.

In writing this opinion with so little grounding in reality or the lived experiences of women and others who experience pregnancy, Justice Alito has obscured the economic struggles they face in carrying a child while trying to chart a professional path, or simply make ends meet and prepare for the heightened financial burden of raising a child. His framing attempts to paint a picture of a present-day policy landscape which insulates the modern American worker from the threats to their professional success they may have feared in decades past, and protects them from the damage to their economic standing which might come with a new pregnancy.

It’s too bad this picture bears little resemblance to reality. Pregnancy and its postpartum aftermath often trigger profound economic insecurity for many pregnant people and new parents. While federal and state laws provide pregnant people with legal protection from discrimination in theory, research shows pregnancy discrimination remains rampant, and that many pregnant people have no realistic expectation of receiving the support or accommodations they need in the workplace. And even after more than two years of a roiling global pandemic, American families have no federally guaranteed paid leave.

While hopes for federal legislative action on paid family leave may have stalled for the moment, Congress must seize every opportunity to stand up for pregnant people, and prioritize passing the Pregnant Workers Fairness Act to protect their rights at work. At the same time, legislation to establish paid family leave and boldly expand the safety net, building on ideas like the generous monthly payments of the short-lived CTC revamp, is desperately needed to ensure pregnant people and their families can thrive.

Pregnancy Discrimination Continues in the Workplace

In 1978, Congress passed the Pregnancy Discrimination Act (PDA), an amendment to the 1964 Civil Rights Act which prohibits sex discrimination on the basis of “pregnancy, childbirth, or related medical conditions” for organizations with fifteen or more employees. Forty-seven states (excluding Alabama, North Carolina, and South Dakota) offer additional legal protection against pregnancy discrimination.

Despite these protections, employers continue to punish employees for their pregnancies. According to a February 2022 poll conducted by the Bipartisan Policy Center, one in five mothers (20 percent) say they have experienced pregnancy discrimination in the workplace. Data from the Equal Employment Opportunity Commission, the federal agency tasked with handling workplace discrimination claims, also shows more than 50,000 pregnancy discrimination claims were filed with the federal government over the last decade.

Figure 1

Pregnant workers in low-wage industries like food services, health care assistance, and retail (industries with workforces which heavily rely on women of color) report disproportionate levels of discrimination. Black women are also disproportionately likely to experience this discrimination, with 30 percent of pregnancy discrimination claims filed by Black women between 2011 and 2015, despite this group only composing 14.3 percent of the female labor force.

Figure 2

Like other types of workplace discrimination, pregnancy discrimination is thought to be greatly underreported, given that employees fear retaliation for speaking up, or even for disclosing the fact that they’re pregnant. That same BPC poll also showed that 21 percent of mothers say they have been scared to tell their employers about their pregnancies due to fear of discrimination or retaliation, which suggests that today’s professional climate sends a message to pregnant workers that their pregnancy is a threat to their job, and thus, their livelihood.

Like other types of workplace discrimination, pregnancy discrimination is thought to be greatly underreported, given that employees fear retaliation for speaking up, or even for disclosing the fact that they’re pregnant.

Besides discrimination and retaliation, workers who become pregnant may also find their employment threatened by a lack of necessary medical accommodations at work. Nearly 1 in 4 mothers (23 percent) report having considered leaving their jobs due to a lack of reasonable accommodations or fear of discrimination from an employer during pregnancy. 1 in 5 pregnant workers hold physically demanding jobs and many low-wage workers have little control over their work schedules. These conditions may pose a serious risk to the health of the mother and the pregnancy, and increase the risk of preterm birth or miscarriage. When employers refuse to provide these accommodations, typically requests like less time standing or exemptions from lifting heavy objects, pregnant workers are forced to choose between their health and their next paycheck. A 2020 study found evidence of a link between pregnant women who experienced a hostile workplace and poorer health outcomes for the worker and baby.

Many Black women experience further hostility in the workplace when asking for accommodations. Racist myths about Black womens’ bodies live on in attitudes which minimize and disbelieve their pain as they seek these accommodations. A recent report released by A Better Balance and the Black Mamas Matter Alliance revealed the suffering Black pregnant women are regularly expected to endure if they want to keep their jobs:

One of our doula clients was actually fired from her job at a gas station…Her feet were getting swollen because she was standing on her feet at the gas station. She asked for a stool and they were like you got to go. She was fired and basically lost out on resources to save up for her child before the child was born…When she became income insecure…her iron levels dropped down really low, where she had to start going to the hospital and getting iron infusions just to get her to a safe level to have a birth center birth.

The Dire Scarcity of Adequate Paid Family Leave

Justice Alito’s opinion hand-waves away concerns about access to paid family leave affecting women’s ability to succeed in the workplace and alluding to progress on securing paid leave for pregnant and new parents. But women know paid family leave is central to their ability to have families without being excluded from paths to a secure economic future, and the lack of a nationwide paid family leave policy remains a major setback in their ability to pursue them. Today, just eleven states and the District of Columbia have paid leave programs at some stage of implementation, leaving more than two-thirds of workers without access based on geography alone, and while some private employers may offer leave, most do not. Overall, only 23 percent of American civilian workers are provided some form of paid family leave and 93 percent of lowest-paid workers lack access to paid family leave. Research also indicates Latinx and Black workers are less likely to have access to paid leave and more likely to take less total paid family leave time than their white counterparts, with Latinx and Black mothers taking two fewer weeks and three-and-a-half fewer weeks of leave, respectively.

Allowing this dire need to go unmet brings serious consequences for pregnant workers’ economic well-being. Without a guarantee of paid leave, most low-wage or middle-class workers are unable to take the time they need to care for their health during and after pregnancy. According to the National Partnership for Women & Families (NPWF), 60 percent of white adults are either eligible for or unable to afford to take even unpaid leave during a pregnancy. For Black and Latinx adults, these numbers are even higher, at 62 percent and 73 percent, respectively. This staggering gap pushes many women to make difficult decisions. Research has found women who do not take paid family leave are more likely to leave the workforce in the year following their child’s birth.

Lacking access to paid leave carries long-term implications for women’s economic security. Women with children who report taking at least thirty days of paid family leave after the birth of a new child are 54 percent less likely to report wage increases. While men’s earnings increase by 6 percent with fatherhood, womens’ earnings decrease by 4 percent with each new child. Because women already face the “motherhood penalty,” a kind of bias documented by research showing employers were more likely to hire female job applicants without children over applicants with identical credentials who had children, these earnings losses are serious burdens for women and their families. Even a decade after childbirth, 82 percent of women who were able to take paid leave during their pregnancy were still in the workforce, compared to 64 percent who did not have paid family leave.

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How We Can Proactively Protect and Support Pregnant Workers and New Parents

While the future of abortion rights in America enters a new period of rapidly increasing regulations, and while many further legal questions continue to arise, advocating for policies to guarantee economic security for pregnant workers has never been more important. As a start, the federal government must make every effort possible to enforce existing pregnancy discrimination laws and work with states as they do the same. These actions must be accompanied by a renewed commitment from the White House and other national leaders to supporting workers’ rights and advocating for workers’ rights to unionize.

In the short term, Congress must take immediate steps to pass the Pregnant Workers Fairness Act to protect pregnant women and other pregnant people in the workforce. First introduced in Congress in 2012, the Pregnant Workers Fairness Act (PWFA) was reintroduced in 2021 with bipartisan support, and would make it clear that employers cannot lawfully force pregnant workers out of their jobs or deny them reasonable accommodations because they suffer from a medical condition or other limitation related to pregnancy or birth. Last year, the PWFA passed the House of Representatives and was voted out of committee in the Senate, sending it to the waiting ranks of the Senate floor. To prioritize protecting the rights of pregnant people, Senate Majority Leader Chuck Schumer must revive this bill for a vote in the Senate.

To guarantee pregnant women and other pregnant people do not risk their economic security as they care for their new baby before and after birth, the federal push for universal paid family and medical leave must also be renewed. The FAMILY Act, legislation introduced in Congress by Senator Kirsten Gillibrand in 2021, serves as a reasonable model for a federal paid family leave program. Advocates for economic justice, gender justice, and equity must ensure that any future federal paid family leave solution prioritizes access to these benefits for workers in low-wage industries in particular.

Beyond these policies to support families through the early years of a child’s life, a substantial expansion of the safety net, such as the American Rescue Plan’s short-lived revamp of the child tax credit, is essential to providing families with the kind of support they need to ensure their children can thrive as they grow. This policy overhaul offered parents a new option to receive advanced monthly payments in addition to significantly more generous payments. While this CTC expansion slashed child poverty by more than 30 percent during its temporary rollout, children are once again facing rising hardship now that Congress has failed to keep these checks coming.

At the beginning of the year, experts at the Center on Budget and Policy Priorities projected nearly 10 million children are at risk of falling below the poverty line with the expiration of payments in January. Now more than six months later, nearly half of all households with children report difficulty affording enough food to feed their families. Not only must women and other birthing parents wade through the inequities of carrying a pregnancy, but they must also raise their children with no practical expectation of support or protection from economic precarity as their child grows.