Family impacted by Colorado's FAMLI plan

At long last, January 2024 and the full implementation of Family and Medical Leave Insurance (FAMLI) Program marks a new day for maternal and infant health in Colorado!  Our organization is thrilled that Colorado voters took the step to move forward with paid family leave several years ago and that this essential benefit is finally here.  

I currently serve on the National Taskforce for Maternal Mental Health led by the federal health, mental health, and human services agencies. My assignment as part of the subcommittee on the prevention, screening and diagnosis of perinatal mental health concerns is to work with my committee members on a short list of recommendations for policy, practice, and federal engagement that will significantly impact these components of maternal mental health care. My number one recommendation to the subcommittee is paid family leave. 

Here are just a few reasons why that is my number one recommendation, and it isn’t just about mental health. Paid family leave impacts so much for both caregivers and their infants. 

  • A recent article in the Obstetrics and Gynecology journal found that “respondents from states with strong paid family and medical leave had a greater likelihood of breastfeeding and had lower odds of postpartum depression symptoms, with stronger associations among respondents with deliveries covered by Medicaid insurance. Despite major potential health benefits of paid family and medical leave, the United States remains one of the few countries without federally mandated paid parental leave.”
  • The PN-3 Policy Impact Center, a clearinghouse for effective policy solutions for parents and young children, documents the research demonstrating a robust array of benefits from paid family leave of at least six weeks that affect the health and well-being of both the parents and infant.
    • Increases the likelihood and length of leave-taking for mothers and on maternal labor force attachment
      • Increased maternal labor force participation in the months surrounding birth by up to 8 percentage points.
    • Reduces racial disparities in leave-taking, and
      • Increased the rates of leave-taking by 14.4 percentage points among Black mothers and 6.4 percentage points among Hispanic mothers.
    • Has beneficial effects on postneonatal infant mortality, parent and child health, and nurturing and responsive parenting.
      • Reduced postneonatal mortality (infant death between 28 and 364 days of life) by 12%.

As we are well aware, the result of the long-standing, national unpaid Family Medical Leave Act (FMLA) is that only the economically privileged could afford to take the time to care for themselves or their family. The vast majority of American families were locked out of the policy’s job protection for time away because it was too much of a financial strain to forgo the income.  This policy also only applies to a limited segment of employers. If ever there was a policy that furthered inequalities, FMLA is one. FAMLI corrects much of what FMLA lacks and it also includes a broad definition of family that includes those with whom you have significant personal bonds, as evidenced by shared finances, emergency contact designations, geographic proximity, and expectations of care if you fall ill.

CPCQC is committed to advancing systems-level changes for birthing people, families, and infants across the state. As an organization, we are proud of Colorado for prioritizing equitable access to paid family leave during the early postpartum period through FAMLI. CPCQC looks forward to partnering with families during the “fourth trimester” as they receive additional time to heal physically, mentally, and focus on bonding through FAMLI. Across the continuum of care, CPCQC’s programs in perinatal mental health screening and connection to support, neonatal health and NICU family engagement, and substance use identification and treatment will be working alongside fourth trimester families and providers to support better outcomes.  

I hope that funding partners will support research on maternal and infant health in Colorado pre- and post-implementation of FAMLI. We need to assess the health equity effects in our state and how this policy can further enable support for increased care during the fourth trimester and throughout the first year postpartum. This period is one of the most vulnerable times for maternal mortality and a chance for a focus on prevention.  

No doubt, there will need to be improvements in the functioning and continuous training for users and facilitators of this essential benefit. But this is a HUGE step forward in the work to improve maternal and infant health across the state!