Caitlin Krouse: Paid family leave is prescription for a healthier Indiana

As a nurse practitioner, board member of Healthier Moms and Babies and mother of three, I have witnessed the profound impacts that maternal and infant health have on our communities. A statewide paid family and medical leave program would address many of Indiana’s most pressing challenges: poor maternal and infant health, economic insecurity and workforce instability. Indiana’s Legislature must invest in the future of our health and well-being.

Indiana has terrible health outcomes, none of which are as shameful as ranking in the top 10 states with the highest maternal and infant mortality rates. Healthier Moms and Babies’ research shows that 43% of mothers return to work within eight weeks of giving birth, with 17% returning in less than four weeks. This is unacceptable for a state that claims to prioritize family values.

Research has proven that paid family and medical leave improves maternal health outcomes by reducing postpartum depression and allowing for proper recovery after childbirth. It lowers infant mortality by encouraging breastfeeding, ensuring timely vaccinations and supporting essential well-child visits. Paid leave decreases parental stress, strengthens parent-child bonds during critical periods of brain development, and reduces cases of child abuse and neglect.

However, the Indiana Legislature declined to pass Senate Bill 115, which would have established a statewide paid leave program and could have transformed our health statistics. States with paid leave programs have seen a 51% decrease in maternal hospitalizations and a 47% decrease in infant hospitalizations. In a state that is looking to reduce health care costs, these reductions in expensive hospitalizations should be incredibly attractive.

Paid leave does not just benefit the young. It enables families to support aging loved ones without resorting to costly institutional care. Paid leave helps balance work and caregiving responsibilities without sacrificing one for the other. In turn, workers are retained, health care costs are reduced, and the quality of life for Hoosiers of all ages is improved.

One common misconception about paid family and medical leave is that it is too costly for businesses. However, SB 115 proposed a state program funded with appropriations from the General Assembly and payroll contributions equivalent to a weekly cup of coffee. Employees would be paid through the state fund while taking up to 12 weeks of leave. This takes the financial burden off small businesses. An employer could then use money that would have been paid to the employee to cover overtime or make temporary hires.

A paid family and medical leave program is different from the federal Family and Medical Leave Act, which provides 12 weeks of unpaid job-protected leave. Only 60% of employees qualify for FMLA, and many workers cannot use FMLA benefits because they cannot afford to go three months without income. This forces the most vulnerable in our communities to return to work quickly at the expense of their health and wellness.

For example, one client was referred to Healthier Moms and Babies three weeks after having a cesarean section because she was facing eviction. She returned to work to keep a roof over her infant’s head. A neighbor watched her baby because day care programs do not accept newborns before 6 weeks of age. Most families enrolled in Healthier Moms and Babies face the same hardships from loss of income and cannot afford essentials like housing, transporta tion and groceries.

Paid leave fills these gaps by allowing widespread access to leave for employees and businesses, regardless of size. Other states have demonstrated that such programs are not only effective but economically viable. An analysis of one state’s program has improved employee retention and reduced turnover costs while requiring only a small payroll deduction. This model can bring the same benefits to Indiana.

Indiana is at a crossroads. We can continue to struggle with high health care costs, poor health outcomes and workforce instability, or we can embrace a forward-thinking policy. Paid family and medical leave offers a chance to prioritize the health and well-being of our residents while strengthening our state’s economy and workforce. As a health care provider, mother and advocate for vulnerable populations, I urge the Indiana Legislature to prioritize this critical legislation.•

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Krouse is vice president of the Coalition of Advanced Practice Registered Nurses of Indiana and member of the Healthier Moms and Babies board.