Congress is forcing parents of premature babies to choose between their newborns and their paychecks.
When Marlon White waited in a hospital hallway while doctors stabilized his two-pound newborn daughter Olivia, he didn’t get to just be a father. He had to go back to work. In this country, the moment your baby is placed in a neonatal intensive care unit, the clock on your unpaid leave starts ticking. If you stay to hold them, you miss rent. If you work, you miss the only time they might recognize your voice.
A baby born at 29 weeks weighs about two pounds. A baby born at 24 weeks weighs about a pound and a half. According to the Centers for Disease Control and Prevention, nearly one in ten babies born in the United States is admitted to a NICU. The average stay, for the babies who survive, runs from a couple of weeks to several months. The federal law that governs whether a parent can be at the hospital with that baby is the Family and Medical Leave Act, signed in 1993, which provides twelve weeks of unpaid, job-protected leave for eligible workers. The 1993 law was not written for the modern NICU. It has not been updated for the modern NICU.
The math on a NICU stay is the math on a family budget being set on fire. A NICU bill can run into the thousands of dollars a day before insurance adjustments. Parents who are eligible for FMLA can take twelve weeks of unpaid leave, which means they keep their job but lose their paycheck. Parents who are not eligible for FMLA — and the law’s eligibility rules, which require employers of a certain size and a minimum tenure, leave a large share of the private-sector workforce outside the law’s protection — lose both. A baby who spends ninety days in the NICU, which is on the low end of a micropreemie stay, has used up the family’s entire federal leave allotment by the time the baby comes home. The parent goes back to work while the baby is still learning to swallow, still learning to breathe, still learning to regulate body temperature. They pump breast milk in a hospital pumping room and try to remember whether they remembered to freeze any from yesterday. They drive back to the hospital after their shift ends. They do not sleep. The country’s policy is, in plain English, asking them to do what one song title names — I Can Do It With a Broken Heart — finishing the shift while the inside of your life is collapsing. The performance is the work-self. The broken heart is the baby still in the NICU.
I have done the math on what a NICU stay would have looked like in my house. Eva was born at 39 weeks and Ben at 38. Neither spent a night in the NICU. If either of them had arrived at 29 weeks, like Olivia, my FMLA leave would have started the day of delivery and run out before her due date. My daycare for two children now runs $2,400 a month, which I cover out of an $8,800 monthly net. The hospital bills from a NICU stay would have been added to the column where I have no remaining budget. The federal leave that is supposed to be there for the family would have been gone before my baby was ready to come home. I would have gone back to work while the baby was still being tube-fed. I would have been in the kind of cognitive-load asymmetry that the journalist Brigid Schulte named contaminated time — technically on shift, mentally at the hospital, the kind of presence that the research shows is not really presence at all.
But the policy is starting to move, in pieces. Colorado enacted the first paid NICU leave law in the country in January 2026. The law gives parents of newborns in intensive care up to twelve weeks of paid leave, on top of the state’s twelve weeks of paid family and medical leave. Colorado’s director of the Family and Medical Leave Insurance Division said that nearly 800 people applied for the new neonatal care benefit in the first months the law was in effect. One of the first applicants was an oil field mechanic named Stevie Madden, who told a reporter that she would not have been able to keep working in a risky job while her son was fighting for his life, and called the benefit “life changing.” Illinois, scheduled to begin its own NICU leave program in June 2026, will guarantee between ten and twenty days of unpaid leave, a measure the bill’s sponsor has called an opening bid. The Illinois bill drew Republican co-sponsors whose own children had spent weeks in intensive care. The Colorado bill passed mostly along party lines. One lawmaker said the opposition was “the quietest opposition you could hear.” Rep. Brittany Pettersen is drafting federal legislation to add twelve weeks of NICU leave to the Family and Medical Leave Act, on top of existing parental leave. Both of the state laws exist because the federal law that was supposed to cover this moment has not.
The structural failure here is not new. The United States is one of four countries in the world — alongside Papua New Guinea, Suriname, and Tonga — that does not guarantee any paid leave for new parents. The federal unpaid-leave entitlement, written when the largest private employer in the country was General Motors, has not been amended to add the kind of leave that parents of premature, low-birthweight, or medically fragile infants actually need. In France, mothers get a year of state-paid maternity leave with the option to extend it, and infant care is subsidized from the first months of life. In Germany, parents share a year of paid leave at two-thirds of salary, plus a means-tested parental allowance that runs up to fourteen months. In Sweden, parents get 480 days of paid leave to split between them. The U.S. is the only wealthy country in the world that has decided the birth of a child is not a reason to update a 1993 law.
The two state laws that are now on the books are a template for what the federal law should have been all along. The federal Family and Medical Leave Act should be amended to provide paid leave for parents of newborns admitted to a NICU — twelve weeks, on top of the existing twelve weeks of family and medical leave, paid through a social-insurance fund the way the state paid-leave programs in California, New York, Washington, and Colorado already work. A federal NICU leave benefit would replace the current patchwork in which a parent in Denver gets paid leave and a parent in Des Moines gets a prayer. It would replace the patchwork in which some employers — Morgan Stanley, Pinterest, the formula company Bobbie — offer private NICU benefits, and the rest of the working public gets whatever their HR department is willing to negotiate. It would replace a policy framework in which the people who can least afford to lose a paycheck are the ones the policy is most indifferent to.
The cruelty of the current system is that it forces parents to perform a brutal triage. Sahra Cahoon, who lost her daughter Lily after three and a half months in the NICU, described the guilt of working because she couldn’t afford to give up her income while hoping her baby would survive. Rebeca Herrera-Moreno and Martin Moreno had to hoard their limited paid leave in California, saving it for when their son Nico came home, leaving them entirely unprepared for the emotional and medical transition. The state’s failure to guarantee paid NICU care doesn’t just extract money; it extracts the time required to learn how to keep a fragile infant alive.
The corporal works of mercy — feed the hungry, shelter the homeless, visit the sick — were not handed down as abstract theology in my grandmother’s parish. They were the operational rhythm of the community, the baseline of what people owe one another. To visit the sick was not a heroic, optional act of charity; it was the basic requirement of remaining human. Dorothy Day, who founded the Catholic Worker movement in 1933, used to say that the gospel “takes away our right forever, to discriminate between the deserving and the undeserving poor.” The instruction to visit the sick is not conditional on whether the sick person is a productive worker, or whether their caregiver is a productive worker, or whether the sick person’s family has a high enough household income to absorb a ninety-day unpaid absence. The instruction is to be there. A federal NICU leave benefit is what it looks like when a country decides that the visit-the-sick instruction is for the people it covers, not just for the people it can afford to remember.
The mothers in the Colorado applicant pool, the lawmaker in Springfield whose twins were born at 27 weeks, the family who drove back to the NICU after every shift, the mother who told a reporter that going back to work while her baby was still in the hospital was “one of my biggest regrets” — they did not need a law to tell them that a parent belongs at the bedside of a baby who is learning to breathe.
They need a law to make sure the next parent does not have to choose.