This story was originally published by North Carolina Health News. Story by Rachel Crumpler

Within months of returning to work after giving birth in July, Paula Harwick said she felt her breast milk supply start to dry up. 

Harwick said that was because she had no time to pump throughout her day as a high school Spanish teacher in Durham.

a white woman smiles while holding her smiling baby in her arms
Paula Harwick, a high school Spanish teacher, holds her daughter Evelyn DeNunzio. She faced challenges pumping at work.

On top of teaching her normal course load of three classes, she covered two classes due to a teacher vacancy. Sometimes she taught two classes at once. Meetings, regular lunch duty and subbing for other teachers also took up her time. Her schedule was full. 

That meant no time for pumping.

Most days, she only got to pump before work and when she got home after 5 p.m. But without consistent pumping throughout the day, her body produced less milk.

In December, Harwick reached her breaking point and asked her principal for accommodations to allow her time to pump at school.

“I can’t find the minutes to sit down and, frankly, empty my boobs,” she remembers telling her principal. “My milk is drying up, and I can’t feed my daughter. I worked really hard to be able to do this.”

She asked to be relieved from substitute teaching duty and lunch duty to give her a window of time to pump. Her principal agreed, but Harwick said she was shocked to learn that accommodations to allow nursing or pumping weren’t legally required at the time.

That’s changed. 

Due to recent federal legislation, nearly all lactating employees will now have protections that allow reasonable breaks to express milk. Pregnant workers also gained the right to reasonable accommodations thanks to two measures included in the $1.7 trillion federal government spending package passed by Congress and signed by President Joe Biden in December.

Tina Sherman, senior campaign director for the Maternal Justice Campaign at MomsRising, said the bills are “game-changing” and “life-changing” for expecting and new mothers in North Carolina and across the nation.

“We know what the doctors’ recommendations are,” Sherman said. “But when we don’t actually provide the societal backdrop to set women and families up for success, then it’s a false choice because women and families can’t do what they need to do and can’t do what they want to do. I think these two new legal protections — expanded protections — will help to stop making it a false choice and now help to make it more of a real choice.”

PUMP for Nursing Mothers Act

The American Academy of Pediatrics and other health organizations recommend infants be exclusively breastfed for about the first six months of life, with continued breastfeeding alongside other foods up to age 2 — or even longer. 

Infants who are breastfed have reduced risks of asthma, obesity, Type 1 diabetes, lower respiratory tract infections, severe diarrhea, ear infections and sudden infant death syndrome, according to research aggregated by the Centers for Disease Control and Prevention. Breastfeeding can also help lower a mother’s risk of high blood pressure, Type 2 diabetes and ovarian and breast cancers.

While breastfeeding isn’t possible or preferred for all families, some don’t even have the option. Many barriers, including returning to work, have kept breastfeeding rates fairly low — particularly for Black women, who can face a disproportionate number of obstacles to practicing breastfeeding.

The majority of women initially begin breastfeeding, but that percentage tapers off significantly over time. Only about one in four women in the United States exclusively breastfeed to the recommended age of 6 months. In North Carolina, only 22.1 percent of infants born in 2019 were exclusively breastfed to the six-month mark, slightly lower than the national average. 

Sherman said that’s understandable when more than half of mothers return to work before their child is 3 months old, with many returning within just two weeks of giving birth. 

Harwick said she knows at least three teachers at her school who returned to work and, shortly after, stopped breastfeeding.

“They tried it, and it just wasn’t manageable,” she said. “They couldn’t find time to pump. They couldn’t advocate for themselves, and so they had to stop breastfeeding.”

A federal law titled Break Time for Nursing Mothers was adopted in 2010 and granted protections to some lactating employees to ensure that they had reasonable break time and a private place to pump. While it was a good first step, Sherman said it left out many types of employees, such as teachers, software engineers and nurses.  

The newest protections signed into law in December — Providing Urgent Maternal Protection (PUMP) for Nursing Mothers Act — requires that nursing accommodations extend to nearly 9 million more women.

Under the PUMP Act, nearly all lactating employees are entitled to reasonable break time and a private location — other than a bathroom — to express breast milk as needed for two years after the birth of a child. 

There are some limitations to the new law. Employers do not have to pay employees for the time spent pumping unless the employee is “not completely relieved from duty” during the entirety of the break. Additionally, employers with fewer than 50 employees may be exempt from complying with the PUMP Act if they can establish that doing so would impose an undue hardship on operations. 

That’s a lot of employers. According to data from the U.S. Census, there are close to 16 million businesses with fewer than 50 workers.  

Another notable exemption from the PUMP Act is airline workers. Sherman said advocates will continue to push for those workers to be granted protections.

A covered employee must first notify their employer if they believe they are not in compliance with the PUMP Act and allow 10 days for the employer to remedy the situation before taking action for noncompliance. Enforcement takes effect on April 28.

Pregnant Workers Fairness Act

Women make up nearly 60 percent of the workforce, and the majority work during their pregnancies. 

The Pregnant Workers Fairness Act, also signed into law in December, extends the same protections available under the Americans with Disabilities Act to pregnant workers seeking workplace accommodations. The law states that employers with 15 or more employees must make reasonable accommodations to a qualified employee related to pregnancy, childbirth or related conditions unless the employer can prove the accommodation would impose an undue hardship on operations.

A pregnant woman holds a hand on her belly as she sits at her desk analyzing a document.
Pregnant employees will benefit from expanded protections in the workplace.

Reasonable accommodations can include no heavy lifting, extra bathroom breaks, having a water bottle at a workstation and sitting on a stool, Sherman said. These changes should be easy for most workplaces to implement, she added.

Under the new law, an employer cannot force an employee to take time off due to being pregnant — whether paid or unpaid — if reasonable accommodations can be made in the workplace.

Before this new federal law, at least 30 states passed similar legislation protecting pregnant workers. North Carolina’s legislature had not enacted protections. However, Gov. Roy Cooper signed an executive order in 2018 extending workplace protections and modifications to pregnant employees of any state agency under the purview of the Governor’s Office.

Expectant moms who believe an employer has violated their rights can file a complaint with the U.S. Equal Employment Opportunity Commission and/or state and local fair employment practices agencies for investigation. The law takes effect on June 27.

Need for family-friendly workplaces

These new legally required accommodations help create family-friendly workplaces, which are also good for business, said Lisa Finaldi, community engagement leader at Family Forward NC, an initiative of the NC Early Childhood Foundation. Family Forward NC has worked since its launch in 2018 to promote family-friendly workplace policies that improve child and family health and provide business benefits to employers. 

Finaldi reminds business leaders that family-friendly policies, such as breaks for breastfeeding and paid leave, boost workplace productivity and morale as well as staff recruitment and retention. To date, Family Forward NC has reached close to 8,000 local employers through panels, presentations and workshops, and she said they’ve generally been receptive to the ideas.

A May 2020 report by the state health department on employers supporting breastfeeding families argues that lactation accommodations at work provide a 3-to-1 return on investment for employers. Those benefits include lower health care costs, reduced rates of absenteeism caused by infant illness, lower turnover, improved productivity and company loyalty.

The pandemic and the mass exodus of people from the workforce reinforced the need for family-friendly workplaces, Finaldi said.

And as a result of the pandemic, 67 percent of North Carolina employers surveyed by Family Forward NC say they have added or are considering adding family-friendly benefits, according to the group’s 2020-2021 biennial report.

Finaldi added, however: “We’re lacking workers for many reasons, but one of them clearly is parents making choices about their work based on their responsibilities for their children.”

While the accommodations provided in the PUMP Act and the Pregnant Workers Fairness Act are meaningful and fairly easy to implement, Finaldi said other benefits, such as affordable child care and extended paid parental leave, are also needed.

This article first appeared on North Carolina Health News and is republished here under a Creative Commons license.

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