On January 1, 2025, New York made history by becoming the first state in the country to offer paid time off for prenatal care and medical needs related to pregnancy. This groundbreaking policy represents a monumental step toward maternal and family health equity, particularly for Black and Brown families who have historically faced barriers to adequate prenatal care. By recognizing that expectant parents should not have to choose between financial stability and their health, New York is setting a new precedent for what it means to support working families.

Why prenatal care matters.

Prenatal care is a critical determinant of both maternal and infant health. Access to consistent, quality prenatal care reduces the risk of complications such as preterm birth, low birth weight, and maternal mortality—issues that disproportionately impact Black and Brown women due to systemic health disparities. 

Factors such as economic instability, medical racism, stress, and inadequate social support, all play a role in determining maternal and infant health outcomes. My work specifically explores how chronic stress from racial discrimination impacts Black mothers' physiological health, contributing to higher rates of hypertension, preterm labor, and postpartum depression. Furthermore, I have examined how intergenerational trauma, structural barriers, and lack of culturally competent care influence early attachment and child development in Black families.

In New York and across the U.S., maternal health disparities remain alarming. Black women are nearly three times more likely to die from pregnancy-related complications than white women. These disparities are not only rooted in biological factors but are deeply embedded in social determinants of health, such as access to care, quality of health care interactions, and structural inequities in employment and housing. The cumulative impact of these factors shapes the perinatal experience, influencing both maternal mental health and early parent-child relationships. My research underscores that maternal mental health is not separate from physical health; untreated perinatal mood disorders, often exacerbated by systemic barriers, can lead to adverse birth outcomes and negatively impact a child’s early socioemotional development.

Additionally, my research suggests that Black women who face socioeconomic hardship have to work significantly harder to care for their families, spend quality time with their children, and meet their children's developmental needs, all while managing their own mental health challenges in the perinatal and postpartum period. Many of these mothers are balancing multiple jobs, navigating workplace discrimination, and dealing with inadequate childcare options, which can result in heightened stress, burnout, and difficulty accessing critical mental health resources. The pressure to provide financially often comes at the expense of their well-being, making paid prenatal leave an essential policy to help alleviate some of these burdens.

Prenatal visits allow health care providers to monitor the health of both the mother and baby, screen for potential complications, and provide crucial education on nutrition, mental health, and birth preparation. However, without paid leave, many working parents—especially those in low-wage jobs—struggle to attend these essential appointments, often prioritizing income over health care.

The burden of choosing between work and health.

For too long, under-resourced families, particularly communities of color, have had to make impossible choices between keeping their jobs and caring for their health. Research has consistently shown that Black and Brown mothers are more likely to experience barriers to health care access, including inflexible work schedules, lack of paid sick leave, and financial instability. My research further indicates that many Black mothers delay or forgo prenatal care due to distrust of the medical system, stemming from historical and ongoing medical racism. The lack of paid prenatal leave exacerbates these barriers, forcing many mothers to seek care only when complications arise. This new legislation acknowledges the structural inequities that contribute to adverse maternal and infant health outcomes and takes a crucial step toward eliminating them.

A step toward health equity.

New York’s leadership in passing this policy is a bold move toward health equity and sets an example for other states to follow. Paid prenatal leave is not just a benefit—it is a necessity. It acknowledges the systemic challenges that disproportionately affect communities of color and offers a tangible solution to improving maternal and infant health outcomes.

As we look to the future, other states must follow New York’s lead by implementing similar policies that prioritize maternal health. Ensuring equitable access to prenatal care is a fundamental step toward dismantling health disparities and building a future where all families, regardless of race or income, can thrive.

New York’s commitment to paid prenatal leave is more than just a policy change—it’s a statement that maternal health matters, that families matter, and that equity must be at the forefront of our health care system. Now, the challenge is to ensure that this policy is implemented effectively and that it becomes a model for the rest of the nation.

As a clinician, I see firsthand the impact of inequities in maternal health care. Many of my patients come to me well past the prenatal period, struggling with the long-term consequences of inadequate perinatal support. This legislation is a huge win for them, as it has the potential to prevent disparities in attachment, trauma, and physical health before they take root. Investing in maternal health through policies like this can help break cycles of generational trauma and ensure that all mothers—regardless of socioeconomic status—have the opportunity to thrive.

‍

About the author, Brianna A. Baker, M.Phil

I am a PhD candidate in Counseling Psychology at Columbia University and a Clinical Psychology Fellow at Yale School of Medicine Psychiatry. My expertise lies in family systems and Black mental health, with a particular focus on the maternal health experiences of Black mothers. Through my research, I explore the ways systemic inequities shape maternal health outcomes, birth experiences, and early mother-child relationships. My work is deeply rooted in understanding the unique challenges faced by Black mothers in the perinatal period, including the impact of racial stress, medical mistrust, and structural barriers to care.

‍