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The United States has a lot of catching up to do when it comes to supporting working parents. The U.S. doesn’t provide universal health care or a nationwide federally subsidized child care program. And it’s one of the only countries in the world without federally mandated paid family and sick leave, which studies have shown is vital to health and well-being. But while the federal government stalls, many state governments have stepped up to the plate to require employers to give workers paid time off — which is great.

But it reveals a major problem: When there’s no federal paid leave, the health outcomes that new working parents can expect from having paid leave are an accident of location — like living in Colorado, which has a generous state-run paid leave policy that kicks in on January 1, 2024, or just across the border in Wyoming, which does not. The research is clear: Health, financial, and overall outcomes are better for employees in states with paid leave, and worse for those without it, according to a new study published in the journal Obstetrics and Gynecology.

Researchers examined data from 143,131 people collected for the Pregnancy Risk Assessment Monitoring System across 43 states. To compare outcomes for states with leave and those without, the research team looked at breastfeeding rates six months postpartum, evidence of postpartum depression, and attendance at the postpartum OB/GYN visit in states with paid leave and states without.

The team found that almost 60% of respondents were still breastfeeding at six months, but those in states with little or no state-mandated family leave reported almost 10% less breastfeeding than those in states with generous leave. Similarly, respondents in states with little to no leave were more likely to develop symptoms of postpartum depression than those in states with generous leave, who were 15% less likely to have postpartum depression symptoms.

“By increasing mothers’ ability to breastfeed and reducing postpartum-depressive symptoms, strong state paid family and medical leave laws provide a major boost to the health of postpartum women and infants,” study author Joe Feinglass, a research professor of general internal medicine at Northwestern University Feinberg School of Medicine, explained in a statement. “The differential generosity of these laws is one reason states differ so widely in health status and life expectancy across the U.S.”

Previous research has shown that paid leave improves outcomes that go far beyond breastfeeding longevity, especially when paternity leave is entered into the mix. Many white-collar employers do offer paid leave, but there’s no universal coverage. Parents without job-dependent paid leave or state-run paid leave can get six weeks of unpaid leave through FMLA if they qualify, but that’s only if they can afford it. Meanwhile, data finds that most dads do take time off after the birth of their baby — but usually only a few days, leaving mom and baby to do the best they can with the limited support our system offers.

“While [the Family and Medical Leave Act] has been associated with an improvement in some postpartum outcomes, these improvements are only seen in a higher-income population,” said corresponding study author Dr. Madeline Perry in a statement. “Countrywide [paid family and medical leave] is critical to advancing health and economic equity.”

When both parents can stay home, things turn out better for everyone. When dads can take paternity leave, they better bond with their child, start learning how to effectively co-parent with their spouse or partner, and experience firsthand the day-to-day life with a newborn.

There have been attempts to implement a paid leave program at the federal level, but maybe unsurprisingly, they’ve been stonewalled in Congress. President Biden proposed 12 weeks paid leave as part of the Build Back Better Plan, then whittled that down to four weeks to appease GOP lawmakers and a couple of holdout Democrats who ultimately put the kibosh on the entire paid leave portion of the proposal because of social safety net spending concerns.

All of this governmental pushback on paid leave comes despite the fact that an overwhelming number of Americans want paid leave, and many businesses support providing paid leave to workers.

Without federal intervention and a paid leave mandate that’s the same in Alabama and Mississippi as it is in Massachusetts and California, families in the U.S. will continue to experience vastly different outcomes based on geography alone.