HOW do US women physically manage to back to work so quickly after birth?!

[boboismylove]

I was watching The Good Fight the other day and one of the characters said she was planning on returning to work THREE DAYS after birth. I know this is fictional but I looked it up and apparently 1 in 4 American women return to work within 10 DAYS.

This is obviously awful. But I don't actually understand how it's physically possible?! I couldn't sit up properly for a month after birth, and was limping for around the same time. I didn't have a C section, and technically had a relatively smooth birth - so I can't imagine going back earlier! How do women in the US manage it physically?! What about prolapse risk? Looking after stitches? Extremely heavy bleeding? - and again, this is only with a "normal" birth.

I know even in quite a few developing countries they have 6 weeks leave - maybe connected to the idea women should rest and be housebound for 40 days.

Where’s the problem?

Exactly - a year isn’t compulsory in the uk. It sort of is where I am because daycare is almost all state run, and won’t take under ones. The minimum mandates period osbfor insurance and safety, after that if you want to hire a couple of nannies and go back, you can. No one is chaining you to the sink.

Where I am men DO take a lot of the parental leave. Two men in my office took almost the whole allocation and no one batted an eyelid.

I don't know how they do it. Necessity, I guess, but it leads to massive inequality. Loads of US women just end up giving up work. US lack of employment rights is disgusting, and they are seriously out of step with civilised countries, also in health care and gun control. But as with those things, clearly the US are right and everyone else is wrong.

Earlier in the thread several people said

"I’m sure the ridiculous early return to work contributes to the high death rate."

?? How exactly?? Not that I think [the early return] is a good thing but surely the death rate in childbirth is unrelated to how soon mothers go back. Both intuitively and statistically impossible to be linked (because of the way the data would be collected).

The early return to work could increase perinatal morbidity and mortality for the woman yes - someone going back to work in a physical job with an infection or a bit of retained placenta for example.
In childbirth I suppose the link could be to poorer care for uninsured women ? The cause is not the going back to work, the cause is poor care that means that a women who has to go back immediately is more likely to be un or under insured. So a correlation butcthe causation would be poverty/no insurance

I also work for a US company (I'm uk based) and the men in the Us office never take even 2 weeks paternity. 3 days max. I'd be livid if my DH did that!

I also had to tell them several times that I'm not taking the full year off (they expect that uk women take a year and I don't think it works in our favour - hope to see more couples doing SPL so there is less bias).

@Hypermice thank you for explaining. I still think the first link is a bit tenous (the vast majority aren't back at work in a physical job or even an office job in less than 2 weeks). But yes it makes sense that it's correlated, even if not the cause.

The research suggests it takes 18-24 months to fully recover from a birth. After two weeks a small subset of women might feel ok but they are absolutely nowhere near meaningful recovery.
Most cultures have lying in periods that reflect the minimal ‘out of comission’ Period (usually a month or so) and after that it’s a gradual return. The USA is unique in the developed world in how it treats new mothers and medically, it’s not good.

After birth, even an uncomplicated one, you’re still bleeding and open to infection - a placenta detaching leaves an open wound the size of a dinner plate and the cervix is not fully closed . Huge infection/haemorrhage risk if you overdo it. And there will now be women jumping on with the ‘I birthed to whale music upright while managing my five businesses and then climbed Everest) but on average, even an uncomplicated birth needs recovery time. Roughly a quarter of uncomplicated births have pelvic fractures for example. 2 weeks, 4,weeks physiologically is not enough.

I know after my first birth (complicated c section, 2l blood loss) I was in hospital a week and after two weeks I’d have been completely useless at work.

I feel very sorry for my colleagues in the USA. Several have just saved for a few years, quit their jobs and returned to the workforce once their kids were 6m or so. Obviously that’s not possible for everyone.

I worked for a big American company in a very senior role (based in the uk) and took 5 months which was a bit of a first for the company for a senior exec to do that. The only other vaguely senior woman took 2 weeks so am sure I suffered by comparison. She managed by moving house so she was a 5 min walk from the office, & her dh became a sahd for 3 months.

The good bits - I was actually totally ready to go back to work at 5 months. I remember I was so nervous about my first day back and then I sat at my desk and just felt pure happiness and relief to be back. When I was in the US pumping provision was great - my firm paid for me to transport the milk back to london as well.

The bad bits - I got a lot of stick in BOTH the US and UK - in one for taking so long off, in the UK for returning to work “so early”! You can’t win. One of my US based colleagues did a massive land grab on my job about 3 weeks after I left. Which was awful. And my son didn’t take a bottle so all that pumping wasn’t too effective and I spent all my nights breastfeeding so was pretty exhausted until he hit the 1 year mark.

Want2b Are you saying that these women have to work outside the law to make a decent living?

IStill, did you mean this from Want2b:
The pay is what it is. I have not met one nanny willing to work on the books. This is so they qualify for maximum welfare. Drives me nuts but actually works out. The women in these low paid roles are not badly paid if you consider its cash in hand and it's basically their disposable income.

To chip in my tuppence worth, many have to do that. Many parents hiring a nanny as opposed to doing daycare want less than full time care as they are often cobbling together a patchwork that may include a granny or a neighbour plus nanny plus a little flexitime for one of the parents. Nannies who get a 40-50 hour week or more are rare (at least where I live).

The downside apart from living with the threat hanging over them of prosecution for claiming welfare while earning undeclared income is that the nanny gets no social security in old age (unless she pays self employment tax plus social security payments).

Part time work will not pay your way in most urban areas unless you have a two income household. I wouldn't classify it as disposable income - it is bread and butter for most. Many nannies have several part time gigs going on with different families or in other fields like driving for Uber, and may pay tax on only one of them - maybe they get health insurance too - eg. supermarket cashier on weekends and nanny during the week.

I really don't know. I was still projectile crying at that point (traumatic birth including major, life threatening surgery) and struggling to BF. I was a total zombie. It's a really, really unkind approach.

... though p/t supermarket work probably wouldn't offer health insurance.

One of the really big issues with low pay or p/t work, or work for a small company or small-scale self-employment is that health insurance is not going to be a part of your life. Therefore, getting Medicaid is really important.

I had a meeting yesterday with one of my team. First baby is due August and he wanted to discuss his paternity leave. He has also asked to take two weeks of his annual holiday entitlement so that in total he will be at home for the first month of his baby’s life. Although he didn’t need to justify his request, his comment was’ I want to spend the time with my new baby and look after my wife’.

I’ve approved his holiday request and will work with him now to reallocate his work for that period. He’s a senior manager so it will take some time to work out his client commitments but it was good to hear about him putting his family first.

Istill These women don't have to work outside of the law but if they didn't they wouldn't qualify for welfare. Its important that their housing, childcare and medical costs are covered otherwise they wouldn't be able to afford working. Our sitter makes $9/hr working for daycare and she makes $15/hr working for us. She didn't want to be on the books and I'm fine with that. We pay her 52 weeks a year but work with her to take vacation. Our sitter goes home every week with $200+ a week in their pocket. She is supporting family with this money.

math Where I am very very few nannies are working PT hours like that. If they are it's $25+ an hour. Someone coming to help me out in the morning for an hour, I pay them $40. Anything less and it's not worth their time.

How does it work in the US if you want to take more maternity leave that the FMLA protection limits? Do you need to agree individually with your employer?

I imagine there are regional differences in hourly rates, based on what constitutes enough to make it worthwhile for the nanny, taking into account cost of housing, transport, etc.

The setup is no different from the way companies like Walmart pay minimum wage, offer poor or no health insurance (depending on p/t of f/t status) and employees qualify for food stamps and/or medicaid if they have low enough income and enough dependents to put them under the threshold, even though they pay taxes and Soc sec deductions and can perhaps claim earned income credit. Basically, the taxpaying public contributes to the employer's bottom line.

Can't remember the title but I watched a documentary about the USA health care system.

The mum was discharged post partum and was found dead at her home following a hemorrhage. The baby was also found dead.

Another reason why going back so early contributes to worse outcomes for the baby is they generally attend less check-ups and are more likely to miss immunisations

Between health visitor, vaccines, the newborn tests and rushing to doctors with a fever/ an infection, I'd say my baby prob ended up seeing a health professional at least once a mont for the first 6 months. And then there was my own doctor's visits/ checks about my own post-birth issues.

I can imagine this stuff would be a nightmare to schedule if working long hours in a family unfriendly environment.

Maternal mortality includes deaths attributable to complications from childbirth, which can happen several weeks later.

Parker yes but they could say no. Therefore, you could be fired for breach of contract if you don't have holiday to use. I knew a family who was living in Germany when their son very sadly became gravely ill and as part of his treatment had to spend several weeks at a specialist hospital several hours' drive away. They could only come back for certain weekends. The father in the family was working for an American company and his boss asked him to work on one of those weekends, fully aware of this situation. Didn't apparently give a shit that it was the first time he would have been able to see and support his wife and potentially dying son in weeks. He ended up losing pay as a penalty for refusing IIRC.

(Thankfully the little boy is doing very well now :))

Monthly 'well baby' visits with doctor are common in USA. Plus vaccination visits. American babies of well-insured parents get lots of medical checks & observations in first year.

American babies of well-insured parents get lots of medical checks & observations in first year.

And what about babies of parents who are not well insured?

god Knows, Pyong. People on welfare (Medicaid) probably get offered lots of monthly checks, too. It's the squeezed middle & other types of socially excluded that probably miss out (some will like being more off grid, I suppose). In a rich state with decent Medicaid (CA), 62% of ppl get at least 6 of these checks in first 15 months.

Low income healthcare assistance is state specific. New Jersey doesn't allow a child to go without healthcare. It's provided at no cost which is why so many parents will work for cash as a nanny rather than take on work which is on the books.

Preventative care has a zero copay. The government program here in NJ is at no cost for those who earn less than a certain threshold.

Those who have a household income of $60-100k a year are the squeezed middle. They qualify for nothing and don't earn enough to pay for it. Generally speaking, where I live in New Jersey, you need a household income of at least $150k to properly support 2DC if both parents are working.