Maya Warren sat in a hospital bed, clutching her stomach. Through the contractions, she tried to focus on the baby. But she thought instead of her bank account.
“Hand me my backpack,” Warren told her mother, crouched at her bedside. Earlier that November day, she had paid a dollar for a scratch-off card, worth up to $777. Now she scraped away the silver.
“Oh, damn it,” Warren said, wiping sweat from her forehead. “I didn’t win.”
“How you gonna be in labor and scratch on a scratch-off?” her mother teased.
Warren laughed, blinking back tears.
She wasn’t supposed to give birth to her first child with no money. She had held the same full-time job in Washington for five years, living paycheck to paycheck. She’d wanted to stash away some financial cushion, and now . . .
“We needed that,” she said, flinging away the worthless card. “We needed that.”
Like an estimated quarter of working mothers in the United States, Warren will return to work less than two weeks after childbirth, whether she’s ready or not.
That’s partly because the United States is the only industrialized nation not to guarantee any paid time off to new parents.
For years, Democrats have championed a stronger safety net, one that would replace lost wages as life’s expenses surge. Republicans have called such a federal mandate a “job killer” that would burden businesses.
During the campaign, however, Donald Trump became the first Republican presidential nominee to pitch a national paid family leave program, proposing new mothers could apply for the benefit through the country’s unemployment insurance system. Now his older daughter Ivanka, recently installed as a West Wing adviser, is tasked with aiding the administration’s push to turn the idea into law.
Meanwhile, low-income women are exploring their own alternatives to paid maternity leave, with some turning to the gig economy.
But for Warren, a lottery ticket still seems a better bet.
$20,000 a year
Maya Warren, who turned 32 last week, is a home health aide for Maxim Healthcare Services, a medical staffing company in Washington.
She gives elderly patients baths and reminds them to take their pills. She monitors their comfort, fluffing pillows and pouring glasses of water. As an hourly worker, she usually earns about $300 a week. Even with overtime, her annual pay of about $20,000 last year ranks her among America’s working poor.
Warren accepted the job because she sees herself as a natural caretaker. After high school, she took general education classes at a community college before landing at an air force base, watching kids at a day-care center.
She quit to tend to her cancer-stricken grandfather — “my favorite person,” she called him. She stayed with him until he landed in hospice. For those two years, to make ends meet, she worked at a nightclub in Maryland.
In 2010, Warren googled “home health aide jobs,” found Maxim and scored an interview. She didn’t think to ask about benefits. She prioritized a regular schedule.
She can’t rely on much help from her baby’s father, who she said lacks steady income. She sees herself as a single mother.
The country provides one protection to bread-winning parents, and it comes with caveats. The Family Medical Leave Act, enacted in 1993, ensures workers can take up to 12 weeks of unpaid leave after a birth, as long as they’ve logged at least a year at a company that employs more than 50 people.
Some businesses cover the gap: As of 2016, 58 percent of firms replace at least some wages during maternity leave, and 12 percent do the same for paternity leave.
Moms and dads who lack paid family leave typically rely on savings or loans or credit cards to get by. An estimated 30 percent of workers who take leave slip into debt, according to a 2012 federal survey.
Myra Strober, a labor economist at Stanford University, says low-income parents are the least likely to have any paid leave — and the most likely to encounter financial hardship as their family grows.
“They’re easier to replace,” Strober said. “The employer hasn’t had to invest much in training that worker.”
According to the Labor Department’s latest breakdown, construction workers are the least likely to receive paid family leave (5 percent can get it), followed by hospitality workers (6 percent), utility laborers (7 percent) and those in the service industry (8 percent). In education and health services — the category into which Warren’s job falls — 19 percent of such laborers have the benefit.
Maxim, her employer, has roughly 60,000 workers across the country and doesn’t provide paid family leave to home health aides, a profession with a median annual wage of $21,920.
Maxim declined to comment on Warren’s situation or why it does not provide paid family leave. The company said, “Maxim follows strong and appropriate policies to ensure that all employees — including pregnant employees — are treated fairly and protected from discrimination.”
The company gives workers the chance to buy temporary disability insurance, a spokesperson said, and the cost “depends on the amount of coverage selected.” For Warren, that would have been $300 monthly. She felt she couldn’t afford it.
She was at work when pain gripped her lower belly. She blamed the fibroids, the tumor-like masses that crowded her uterus. She had dealt with them for seven years.
This time, though, the discomfort led her to the emergency room, a visit her Medicaid insurance would cover.
She told the doctor about the fibroids.
The doctor told her the baby was fine.
She didn’t think she could get pregnant. Her condition made it tough to conceive and carry a child, according to her googling.
Disbelief gave way to joy. This was it: her chance to become a mother.
All at once, the scramble to save money began.
A campaign promise
Two months before Election Day, before a suburban Philadelphia crowd, Trump unveiled his plan for paid maternity leave. He credited Ivanka Trump, a mother of three, with inspiring the idea. He also was polling poorly among female voters (and ended up losing among women to Hillary Clinton by 12 percentage points).
As president, Trump said, he would open the unemployment insurance system to new mothers. Currently, the state-run programs float cash only to laid-off workers.
Under his policy, the average weekly maternity benefit, per his campaign, would be roughly $300 for up to six weeks — enough to replace Warren’s lost wages. She could apply for the aid with a recent pay stub.
Adoptive parents and fathers, according to Trump’s blueprint, wouldn’t qualify.
Democrats slammed his proposal as too narrow. Republicans, for their part, generally don’t support expanding entitlements, saying it is costly to taxpayers and likely to add to the national debt.
House Speaker Paul D. Ryan (R-Wis.), for example, has voted against paid leave programs, instead supporting measures that would allow workers to accumulate time off in lieu of overtime pay.
“I don’t think that sticking up for being a person with balance in your life, for wanting to spend your weekends in your home with your family . . . I don’t think that means signing up for some new unfunded mandate,” Ryan told CNN in a 2015 interview. (He hasn’t commented on Trump’s plan.)
Some business leaders, especially at small firms, would rather not absorb the cost. But others see the value in offering the benefit, since research has shown it can increase worker loyalty and reduce turnover.
Trump said the plan wouldn’t cost an extra penny, that he would fund it by quashing fraud in the unemployment insurance system, which government estimates put at $3.2 billion in 2015. That, Trump said, would be more than enough to support his program, priced at $2.5 billion.
However, no more than $900 million of the overpayments — benefits sent to deceased or employed folks, for example — were clawed back in 2015.
The president hasn’t mentioned his paid maternity leave plan since taking office, but Ivanka Trump has been hosting Republican lawmakers at the White House in an attempt to drum up support for it.
As of now, enthusiasm appears to be scarce.
Sen. Kirsten Gillibrand (D-N.Y.), the left’s de facto leader on paid family leave, has introduced a bill on Capitol Hill that would give new parents, regardless of gender, 12 weeks of paid time off at two-thirds of their pay. To fund the program, workers would give up 0.2 percent of their salary, and employers would match that — an average contribution of $2 a week, she said.
The paid leave movement is spreading. California, New Jersey and Rhode Island all cover wage loss for new parents, and San Francisco, New York and the District have approved similar measures.
New parents without the public benefits rely on employer generosity or family members or luck. Warren threw herself into work.
Hours — and money — dry up
Before Warren’s pregnancy started to show, she said, her home health aide shifts began dwindling — from five a week to three, sometimes two.
Maxim said that, in general, hours depend on demand. “Because they are paid by the hour, full- or part-time employment status is driven by a combination of client need and employee preference,” the company said.
Warren’s weekly pay shrank to $150.
The expenses — for food, gas, her $400 monthly rent, clothes for her growing body, baby wipes, the occasional manicure when life felt heavy — piled up even as she tried to save.
She needed a side hustle.
Warren knew people who drove for Uber and enjoyed the extra cash, so she pawned a gold ring to rent a car through the ride-sharing service.
For one payment of $350, she could drive away in a Nissan Altima. Then $215 would be deducted each week from her Uber paycheck. If she didn’t drive enough to cover the payments, Uber’s partner in the deal, Enterprise, would charge her card on file.
In Washington, Uber drivers pull about $15 an hour, on average, according to Glassdoor salary data. Because they’re contractors, though, the money arrives pretax, so Warren would have to remember to set aside some earnings for Uncle Sam.
She signed the contract.
By October, Warren planned to care for her patients by day and morph into a chauffeur at night. She aimed for 75 rides each week.
She still owed about $5,000 in student loans, $500 from old hospital visits and $300 in overdue cellphone bills.
Debt had trailed her for years, and interest swelled over time. She wanted to pay it all off before the baby came. Banish the collectors, the stress.
But the week before Warren went into labor, a cashier at Chick-fil-A said her debit card had been declined. She prayed it was a mistake, but deep down, she knew: The cash was gone. She couldn’t even buy a chicken sandwich.
Warren went into labor at the end of November, right after she had moved back in with her mother in Southeast Washington.
The baby didn’t budge for two nights, so the doctor advised a Caesarean section. Some 90 minutes later, he eased into her arms. She cupped his tiny feet. She kissed his nose. She named him Kortez Isaiah.
It was a major surgery. The doctor recommended 12 weeks of rest — four more than usual because of her fibroids.
Again, Warren thought of money.
She had a car seat from a Capitol Hill charity, a breast pump from her neighbor, a bassinet from her mom, and food stamps.
She had been driving for Uber as much as she thought she could. From Oct. 10 to Nov. 21, according to her pay statements, she had banked $1,458 — an average weekly wage of $243. That barely covered the rental cost. Not to mention the gas.
Back to work
Six days after leaving the hospital, Warren sat at her mother’s kitchen table, staring at her car keys. Kortez slept nearby in his bassinet.
Home health aide shifts — eight-hour days on her feet — were out of the question. Her boss had told her to come back after six weeks.
Driving, Warren thought, was probably a better option — though the doctor had told her not to slide behind the wheel for two weeks. She would not take any pills for the pain.
Her mom, she thought, had been so generous. Without her, Warren figured she would be homeless.
She was breast-feeding Kortez, so baby food came free. Soon, though, they would run out of diapers.
She wanted to be the one to buy more. She hadn’t gotten her mom’s ring back, either. She wondered if it was still at the pawnshop.
Warren stood up. Her swollen stomach burned. Every step brought a new jolt. “Ow,” she would say to no one.
She put on her black jacket with a faux-fur hood. She shuffled to her mother’s driveway. She opened the car door (“ow”), eased into the driver’s seat (“ow”) and started the engine (“ow”).
Warren picked up a woman with a suitcase who wanted to go to a house in Temple Hills, Md. — a 15-minute ride. That would net her $7.03.
She willed herself to ignore the bumps in the road. She hoped the passenger didn’t expect her to pop the trunk and hoist out the luggage.
Six weeks later, pain would still sting her abdomen, and Warren would owe Uber $1,400 for the rental car. (Uber, which looked into Warren’s account for The Washington Post, said she began missing rental payments after her fourth week of driving.)
She would also face a $600 damage charge. Someone had sideswiped the Altima while it was parked on her mother’s street.
The crash would coincide with her postpartum checkup, the six-week medical milestone, where the doctor would tell her to get more rest — she needed more time in bed to recover.
Warren knew she’d be back on the road that afternoon.
Correction: An earlier version of this article incorrectly reported workers’ contributions under Sen. Kirsten Gillibrand’s bill. They would average $2 a week.