Editing Postpartum depression (section)

=== The 21st century ===

The first quarter of the 21st century has brought about regression in many women's health gains of the 20th century. As 21st-century legislation has led to deep divides and debate in regard to abortion politics and who makes decisions over a woman's body and in regard to a woman's health.<ref name="Hoffman_2018">{{cite web |last=Hoffman |first=Charity M |date=2018 |title=21st Century Motherhood: Navigating Work, Family, and the Struggle to Have it All  |url=https://deepblue.lib.umich.edu/bitstream/handle/2027.42/145984/charityh_1.pdf |website=University of Michigan Library |location=Ann Arbor, Michigan |publisher=Department of Social Work and Sociology, University of Michigan |access-date=April 8, 2025}}</ref> There needs to be more advocacy for universal parental paid leave, more equality and increases in women's pay where discrimination continues to persist, and additional opportunities for paid time off for family needs, medical needs, and mental health needs. For new parents, better health insurance plans and leeway and lenience for parents need to be tolerated and respected, especially during the first five years, until a child enters school systems. With this, there also need to be better options for childcare—a program that often ends mid-day—and more flexibility from employers on employees to decrease the stress of working obligations and the need to pick up a child from childcare, which can exacerbate postpartum mental health conditions (PMHCs). Additional after-school care programs that do not leave parents feeling like they are neglecting their children simply in financially supporting the family would also help alleviate PMHCs, especially for working women who are the primary financial provider and/or go from previously one full-time job to two full-time jobs, with only one being paid and financially compensated.<ref name="Scholar_2016">{{cite web |last=Sholar |first=Megan A. |date=2016 |title=The Politics of Motherhood: The History of Family Leave Policies in the United States |url=https://www.oah.org/tah/november-3/the-history-of-family-leave-policies-in-the-united-states/ |url-status=live |archive-url=https://web.archive.org/web/20250513092939/https://www.oah.org/tah/november-3/the-history-of-family-leave-policies-in-the-united-states/ |archive-date=May 13, 2025 |access-date=April 8, 2025 |website=OAH.org |publisher=Organization of American Historians |location=Bloomington, Indiana}}</ref><ref name="Coombs_2021">{{cite web |last=Coombs |first=Sarah |date=2021 |title=Paid Leave is Essential for Healthy Moms and Babies |url=https://nationalpartnership.org/report/paid-leave-is-essential-for/ |access-date=April 8, 2025 |website=NationalPartnership.org |publisher=National Partnership for Women and Families |location=Washington, DC}}</ref><ref name="Lojek_2024">{{cite web |last=Lojek |first=Christina |date=July 31, 2024 |title=Majorities of U.S. women agree - there isn't enough focus on postpartum healthcare for mothers, they are often forgotten once baby arrives |url=https://www.prnewswire.com/news-releases/majorities-of-us-women-agree---there-isnt-enough-focus-on-postpartum-healthcare-for-mothers-they-are-often-forgotten-once-baby-arrives-302210520.html |website=PRNewswire|location=Washington, DC |publisher=The Harris Poll |access-date=April 8, 2025}}</ref><ref name="WHOPostnatalPostpartumCare_2008">{{cite web |last=Matthews |first=Matthias |date=2010 |title=WHO Technical Consultation on Postpartum and Postnatal Care based on the Conference held in October 2008 |url=https://www.ncbi.nlm.nih.gov/books/NBK310591/pdf/Bookshelf_NBK310591.pdf |website=NIH|location=Geneva, Switzerland |publisher=World Health Organization Department of Making Pregnancy Safer |access-date=April 8, 2025}}</ref>

In a visual timeline by the Maternal Mental Health Leadership Alliance (MMHLA), a 501(c)(3) nonpartisan nonprofit organization leading national efforts to improve maternal mental health in the United States by advocating for policies, building partnerships, and curating information, there have been numerous advancements in services and legislation,<ref name="MMHLA_2025">{{cite web |author=<!-- not stated --> |date=2024|title=Maternal Mental Health Federal Legislative Summary |url=https://www.mmhla.org/legislative-history |website=MMHLA.org |location=Washington DC |publisher=Maternal Mental Health Leadership Alliance Inc. |access-date=April 8, 2025}}</ref> including the 21st Century Cures Act signed into law in December 2016.<ref name="Congress_2016">{{cite web |author=<!-- not stated --> |date=2016 |title=H.R.34 - 21st Century Cures Act Public Law 114-255 of the 114th Congress (2015-2016) |url=https://www.congress.gov/bill/114th-congress/house-bill/34/text |website=Congress.gov |location=Washington D.C. |publisher=Congress |access-date=April 8, 2025}}</ref><ref name="Women's Healthcare_2016">{{cite web |last=Foley |first=Susanne |date=2016 |title=Reaching postpartum women in the U.S.: Demographics and generational characteristics |url=https://www.npwomenshealthcare.com/wp-content/uploads/2016/03/0216WHNP_Postpartum-1.pdf |website=npwomenshealthcare.com|location=Philadelphia, PA |publisher=Women’s Healthcare: A Clinical Resource for NPs |access-date=April 8, 2025}}</ref><ref name="Policy Center_2025">{{cite web |author=<!-- not stated --> |date=March 2025 |title=Paid Family and Medical Leave and Maternal Mental Health [Issue Brief] |url=https://policycentermmh.org/app/uploads/2025/03/Paid-Family-and-Medical-Leave-MMH-2025.pdf |website=Policy Center for Maternal Mental Health |location=Washington, D.C. |access-date=April 8, 2025}}</ref> And, as of 2024, family and medical leave has been cleared for use of PMHCs, including postpartum depression.<ref name="Applewhaite_2024">{{cite web |last=Applewhaite | first=Helen M |date=August 21, 2024 |title=Yes, you can use FMLA for PPD and other postpartum mental health conditions |url=https://www.mother.ly/postpartum/can-you-use-fmla-for-ppd-and-pmhc/ |website=Motherly |location=Washington, D.C. |access-date=April 8, 2025}}</ref> This is a start, but there is still much progress to be made, given the consideration that of 41 countries, only the United States lacks paid parental leave, though it offers unpaid leave under the Family and Medical Leave Act (FMLA).<ref name="Livingston_2019">{{cite web |last=Livingston | first=Gretchen |date=December 16, 2019 |title=Among 41 countries, only U.S. lacks paid parental leave |url=https://www.pewresearch.org/short-reads/2019/12/16/u-s-lacks-mandated-paid-parental-leave/ |website=Pew Research |location=Washington, D.C. |publisher=Pew Research Center |access-date=April 8, 2025}}</ref><ref name="Nonacs_2023">{{cite web |last=Nonacs | first=Ruta |date=March 14, 2023 |title=Among 41 countries, only U.S. lacks paid parental leave |url=https://womensmentalhealth.org/posts/paid-parental-leave-a-novel-approach-to-improving-maternal-mental-health/ |website=MCH Center for Women's Mental Health  |location=Cambridge, Mass |publisher=Massachusetts General Hospital and Harvard Medical School |access-date=April 8, 2025}}</ref><ref name="Williamson_2024">{{cite web |last=Williamson | first=Molly W |date=January 17, 2024 |title=The State of Paid Family and Medical Leave in the U.S. in 2024 |url=https://www.americanprogress.org/article/the-state-of-paid-family-and-medical-leave-in-the-u-s-in-2024/ |website=The Center for American Progress  |location=Washington, D.C. |access-date=April 8, 2025}}</ref><ref name="Williamson_2025">{{cite web |last=Williamson | first=Molly W |date=January 15, 2025 |title=The State of Paid Family and Medical Leave in the U.S. in 2025 |url=https://www.americanprogress.org/article/the-state-of-paid-family-and-medical-leave-in-the-u-s-in-2025/ |website=The Center for American Progress  |location=Washington, D.C. |access-date=April 8, 2025}}</ref> There is currently no federal law providing or guaranteeing access to paid family and medical leave for workers in the private sector, especially during the postpartum period. However, some states have their own paid leave programs and requirements for companies to provide paid parental leave.<ref name="Women's Bureau_2025">{{cite web |author=<!-- not stated -->  |date=2025 |title=Paid Leave |url=https://www.dol.gov/agencies/wb/featured-paid-leave |website=Women's Bureau in the Department of Labor  |location=Washington, D.C. |access-date=April 8, 2025}}</ref> Paid leave advocates realize that paid leave, as opposed to unpaid leave, helps to alleviate some of the stress and overwhelming burden tacked on to the postpartum period that can exacerbate PMHCs and can inhibit or make it more difficult to return to work after maternity leave.<ref name="Franzoi_2024">{{cite journal |vauthors= Franzoi IG, Sauta MD, De Luca A, Granieri A |date=April 5, 2024 |title= Returning to work after maternity leave: a systematic literature review |url=https://link.springer.com/content/pdf/10.1007/s00737-024-01464-y.pdf |journal=Archive's of Women's Mental Health |volume=27 |issue=5 |publisher=Springer Nature |pages=737–749 |doi=10.1007/s00737-024-01464-y |pmid=38575816 |access-date=April 8, 2025}}</ref>