The Trickle Down Economics of Paid Leave: Professional Organizations Can Lead the Charge


More women than men are now pursuing graduate degrees, according to the latest numbers from the American Enterprise Institute. While it’s generally assumed people with advanced degrees make a higher income and therefore can sustain the body-blows that come from unpaid leave, it’s important to consider what it took to get them there, and what financial obligations they may have from their education.

The median debt from graduate school sits at $57,000, with one in four borrowers owning $100,000 or more. On top of that, consider the fact the age in which many are pursuing their higher education often coincides with their biological clock and/or the needs of aging parents. 

The reality of school debt and the timing many choose to start a family is not an issue unnoticed by professional organizations. A 2018 Journal of the American Medical Association (JAMA) study surveyed 15 graduate institutions for medicine and found that seven of 15 institutions had an institutional policy providing paid designated childbearing leave with an average duration of 5.7 weeks. That means that roughly half of those surveyed offered no paid leave following the birth of a child. 

According to the American Medical Association, more than 40 percent of medical students plan to have a child while still in training – a decision often driven by their age, and desire to fulfill their personal goals at the same time as their professional ones.The American Medical Association’s recommended policies ask that residency programs offer a minimum of six weeks maternity leave, but make no mention of family leave.

Megan Foureman, a nurse working in Chapel Hill, shared in an  interview for this article, “As a healthcare provider, I have always found it strange that we are not more lenient towards new mothers.” Foureman took unpaid leave for her first two children, and for her third she had benefits through her employment at Duke and accrued paid time off.

The American Veterinary Medical Association (AVMA) recently took a step backwards in its policies. The AVMA Life Trust Short Term Disability policy (a policy used by many veterinarians around the country) dropped from six weeks to one month for maternity leave. 

Denise Henry of Asheville had her first daughter while on summer break in veterinary school. In an interview she shared for her second daughter she took her leave unpaid, which she shared placed a tremendous burden on her family. “After Loralei was born the stress of not being paid for three months but a huge strain on our family – both logistically and emotionally. My husband was not allotted any family leave after either of our girls which certainly made the physical and emotional demands on me much higher since I did not have any help during the day,” Henry adds, “The majority of young vets (under 45-50) are women and many are the primary income for their families so unpaid leave can make it very difficult for families to survive without it for 2-3 months.”

Anecdotally, the legal profession appears to be making the biggest strides in the area, due in part to firms’ desire to remain competitive and attract the best talent. Recently the large national law firm, Sidley Austin, increased paid time off for U.S. Associates and counsel to 14 weeks for all new parents and 22 weeks for birth mothers. 

But do people who work for practices and firms that offer more robust paid leave policies feel they can take them without someone being penalized or limited in their career if they pursue a healthy work-life balance? A study by the Hazelden Betty Ford Foundation found a prevalent sentiment among attorneys they couldn’t take their paid leave or paid time off, without paying the price for it in their career. Researchers found a growing number of addiction and other mental health related issues because of the stress. 

According to the Pew Research Center, workers with household incomes of $75,000 or higher are more likely than those with lower incomes to say they didn’t take time off when they needed or wanted to because they felt no one else could do their job. 

Kathryn Duarte is in a nursing management position and sees the issue from both sides, as a manager accommodating employees needing leave, and as a women in need of leave at times in her career. “Challenges include running out of PTO, the feeling of abandoning your co-workers and letting down your unit (especially when you receive texts asking for OT on a day you have called out), being absent during roll-outs of new policies, protocols, and products, and quite frankly, there’s a culture among nursing (which is shocking given that it’s predominantly women) in which women will roll their eyes when they talk about how many nurses will be out of work at the same time having babies and how that will impact their own work life,” she shared in an interview for this article.

Among health and legal sectors, two of the professions that require graduate education, the percentage of people who receive paid leave are among the lowest, according to the Bureau of Labor Statistics. Interestingly enough, the financial sector has the highest percentage of people employed with paid leave.

So why should we care about people who generally are paid higher wages, and their plight to take leave for their own medical needs or that of a family member? One answer is removing a disincentive for people to pursue graduate and higher education. Another comes from the principle, “a rising tide lifts all ships.” 

While she has not specifically studied how professional sectors may influence industries across the board, Anna Gassman-Pines with the Sanford School of Public Policy at Duke is paying close attention to the increasing number of municipalities and counties in North Carolina pushing forward with paid family leave policies for public employees. 

“North Carolina localities are leading the way. I do think they are at the leading edge, and the way that paid family leave has gotten passed at the state level has really been more about a really concerted statewide organizing effort,” she shared.

This year North Carolina Governor Roy Cooper signed an executive order extending paid leave to state employees. Ironically, the NC Department of Labor was one of two agencies that did not adopt the policy. Both offices who opted out are run by elected Republicans, a party that by in large has not supported any additional requirements on the private sector. In a press release the DOL stated, “The Commissioner simply feels that there are sufficient leave programs already available to state employees to address such absences.” 

With the executive order, 59,000 state employees are benefiting from the Governor’s executive order.  Unfortunately there are hundreds of city and county employees impacted by policies in their local jurisdiction, separate from any state directive. The extension of paid leave to some state employees certainly creates a “selling” point for jobs in the public sector, and makes them more competitive with the private sector which could help push the needle across the board, even if statewide public policy doesn’t yet dictate an across-the-board measure. 

For professionals like Foureman, the issue of paid leave weighs heavy on her mind at times. “I have some raw feelings about this topic. Much of it just makes me shake my head. But I hear about leave programs in other countries and honestly wonder how that can possibly be sustainable.”

But it is sustainable in all but a handful of countries who are members of the United Nations, including the United States. The United States and Suriname are the only countries in the western hemisphere that don’t offer any paid maternity or paternity leave for either parent. 

Beyond the need for leave when expanding ones families, a majority of countries in the western world offer some form of paid leave. The United States is a member of the Organization for Economic Co-operation and Development (OECD), an intergovernmental economic organization with 36 member countries, founded in 1961 to stimulate economic progress and world trade.  The U.S. and South Korea are the only members that don’t mandate some form of paid sick leave. It’s important to note that according to the OECD, member countries that provided generous paid leave for personal illness had no evident differences in GDP growth.

The analysis underscores what Henry, a veterinarian in Asheville already believes.

“A more widespread acceptance that maternity/family leave is important for our continuation as a society. I think that nearly all families need to have both parents working in order to provide the basic needs at this point in time. Without paid leave many families are not able to maintain their standard of living while one or both parents are out of work caring for a newborn,” said Henry.

Regardless of whether you work for a professional sector or public sector and could benefit from internal changes in paid leave policies, we all have the potential to benefit from changes. Like many societal changes, the more we can normalize the expectation of paid leave, the more it will come to be expected by workers and provided by employers. At the same time, those public and private sector jobs currently transitioning paid leave are proving that they don’t have to sacrifice profitability to provide employees work-life balance.

Stephanie Carson is an Emmy-award winning producer based in Asheville with 20 years of experience in television, radio and print.

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