Like dozens of other countries in the world, the US is celebrating Mother’s Day this coming Sunday. Except for Christmas, this is the holiday on which Americans spend most. This year, a projected $23.1 billion will be splurged on gifts for mom, for a day marked in some way or the other by 86% of the country.
But during the rest of the year, America isn’t so generous toward its mothers. According to Save the Children’s latest State of the World’s Mothers report, published in 2015, the US ranks 33rd (pdf, p. 11) for quality of life for mothers—behind all other industrialized countries.
The report focuses on health and other social markers such as the likelihood of losing a child who’s under five, access to education and female representation in government (something that tends to be associated with more family-friendly policies), but the reasons that make motherhood harder in America go beyond that.
The US has a maternal mortality crisis. With an estimated 26.4 deaths for every 100,000 live births in 2015—it lacks the solid data to measure the true size of the problem—the US is an outlier not just in rich countries, but worldwide. With few exceptions, countries have drastically reduced the number of maternal deaths since the 1990s. In America, that rate has increased.
For every woman who dies at childbirth, an estimated 50 to 100 almost die. By a conservative estimate, that adds up to 50,000 or more near-misses per year.
Things are even worse for women of color, particularly black mothers, whose chances of dying are four times higher than white mothers.
Not only is it more dangerous to give birth in America than anywhere else in the rich world, it’s also more expensive. A lot more expensive. The average uninsured woman could spend dozens of thousands of dollars, and American hospitals are notorious for itemizing costs that are outright absurd, such as charging mothers for holding their own babies.
In comparison, the three recent UK royal babies were a bargain to deliver.
Alongside the unconscionably high rate of maternal mortality in the US is another number that amounts to zero: The number of days a mother who works outside the home is legally entitled to take as paid leave before or after giving birth.
Unless they are privileged enough to have good workplace benefits, American women aren’t guaranteed the basic right to rest before they give birth, or to recover properly after delivery, without worrying about job security or income.
This is reflected in poor maternal health—both at delivery and postpartum—and can add difficulties at a time when many mothers face mental health challenges, with one in seven suffering from postpartum depression.
The US is not alone in this. According to the International Labour Organization (ILO), one other country denies paid leave rights to new mothers: Papua New Guinea.
In many American states, the cost of full-time childcare can equal half the average salary of a parent. Given the complete absence of public options and effective support to cover the cost, families often end up having to resort to one parent staying home to take care of the children, typically the mother.
Stepping out of the paid workforce has important consequences for the mother’s future earnings potential. According to the Center for American Progress, a 26-year-old mother making the US average salary for her age, who stops paid work for a year, for instance, will lose over $124,000 in earnings through her career.
If the same mother leaves the workforce for five years—or until a child is old enough to access public schooling options—her lost income is over half a million dollars.
This is if a mother goes back into the workforce at all, which is by no means the norm: Around 43% new mothers never go back to work.
The number of women in the American prison system has skyrocketed since the 1970s. The number of women detained—whether in federal or state prisons, or local jails—has gone up at least 1o times in the past four decades, and women are the fastest-growing demographic of prison inmates. In 1970, an estimated 4.7 women were in federal prisons every 100,000; in 2015, the rate was 57.1; similarly, the rate of detention in local jails was 7.6 in 1970, and 60.8 in 2015.
Amongst the women in jail, 80% are mothers—many single mothers. Women who are pregnant at the time they’re arrested often lack access to adequate prenatal care, proper nutrition. In most states women who deliver in community hospital can be kept in shackles during and after birth.
After the birth, not only is postnatal care often sporadic and insufficient, but mothers are typically separated from their babies as detention centers don’t allow them to be with their infants.
Children of incarcerated mothers are typically put in foster care, and depending on local laws, child welfare agencies can file to remove a mother’s right to parent their child after a determined period of time. In New York state, this can happen as soon as 15 months.
Undocumented pregnant women, too, are being detained in record numbers. Until recently, pregnant women in Immigration and Custody Enforcement (ICE) custody would be automatically released from detention, while still being under surveillance. President Donald Trump’s administration has changed this policy. Since December 2017, more than 500 pregnant women have been detained.