Without paid leave, exhausted American NICU parents are relying on patchwork solutions. Here’s what can be done to help families cope

After pushing back, this particular mother — one of the comparatively lucky few with paid maternity leave — was granted an additional two weeks off. After that, she told USA Today, her employer told her she would need to work mornings, only visiting her baby in the NICU in the afternoons, and take the rest of her leave only once her daughter was discharged (1).

This story highlights a systemic mismatch between medical reality and workplace policy. About one in 10 newborns in the U.S. is admitted to a NICU, according to the National Center for Health Statistics (2). Yet most leave policies cater to healthy births and predictable timelines — not weeks or months spent commuting to hospital while juggling postpartum recovery, work obligations and life-or-death medical decisions.

What rights do parents have?

In the U.S., mothers of newborns are guaranteed surprisingly few rights by law. At the federal level, eligible workers are entitled to up to 12 weeks of unpaid, job-protected leave under the Family and Medical Leave Act (FMLA), but only if they work for a qualifying employer (generally one with 50 or more employees in a 75-mile radius), have worked there for at least 12 months, and logged at least 1,250 hours during the previous year (3).

Beyond unpaid leave and continued health insurance coverage during that time, there is no national requirement. Any additional benefits largely depend on the employer or the state of residence.

A growing number of states have enacted paid leave programs, but coverage remains uneven (4). According to the U.S. Bureau of Labor Statistics, in 2023 only 27% of private sector workers had access to paid family leave, while 90% had access to unpaid leave, largely through FMLA (5). Those left out tend to be the lowest-earning, disadvantaged workers — meaning the people who need help the most are often the least likely to receive it (6).

When it comes to NICU-specific protections, options are even more limited. Colorado is currently the only state that offers paid NICU leave, providing up to 12 weeks of paid neonatal care leave in addition to its existing paid family leave program (7).

The only other state to have passed NICU-specific laws is Illinois. There, starting in June, employers with at least 16 employees will be required by law to provide job-protected unpaid NICU leave: up to 10 days for small employers and 20 days for larger employers (8).

How parents are coping

Many mothers attempt to stack whatever leave they can, using paid leave first, if available, then unpaid FMLA and potentially vacation time, sick days or short-term disability benefits, which can provide partial income replacement. Sometimes, all of these can be exhausted while the newborn remains hospitalized.