References

Avendano M, Berkman LF, Brugiavini A, Pasini G The long-run effect of maternity leave benefits on mental health: evidence from European countries. Soc Sci Med. 2015; 132:45-53 https://doi.org/https://dx.doi.org/10.1016/j.socscimed.2015.02.037

BBC News. Mums of premature babies call for more maternity leave. 2016. http://www.bbc.co.uk/news/uk-37750548 (accessed 21 November 2016)

London: Bliss; 2014

What is the difference between justice and fairness? Which is more important?. 2012. http://tinyurl.com/hfycm8g (accessed 21 November 2016)

Gov.UK. Maternity pay and leave. 2016. http://www.gov.uk/maternity-pay-leave/leave (accessed 21 November 2016)

Premature babies and maternity leave: what's the legal position?. 2016. http://tinyurl.com/zrpa8md (accessed 21 November 2016)

Warnock M The Right to Life. Proc R Coll Physicians Edinb. 1996; 26:148-55

Preterm birth and maternity leave

02 December 2016
Volume 24 · Issue 12

According to the UK charity Bliss (2014: 4): ‘There are 78 000 babies born too soon, too small or too sick in Britain each year.’ Apart from the parental fear and anxiety accompanying a premature infant's hospital stay of weeks or months, the financial strain, according to a Bliss survey, translates to ‘an average of £282 a week, or £2256 over the course of [the] baby's stay in hospital’.

A further dimension was highlighted with the launch of a petition by mother-of-two Catriona Ogilvy, founder of www.thesmallestthings.org, who is campaigning for mothers of premature babies to be given an extra week of maternity leave for every week spent in hospital with their child. On 17 November, World Prematurity Day, she and her supporters handed the petition—which had 115 230 signatures and remains open— to Parliament. ‘For me,’ she said, ‘as the mother of two small boys born too soon, World Prematurity Day was an oppor tunity to reflect on and highlight the realities of neonatal intensive care; a chance to shine a light on a hidden world and a journey that lasts long after bringing your baby home from hospital. Our message is that neonatal intensive care is not maternity leave.’ And it is a message that prompted Ogilvy's local MP, Labour's Steve Reed, to raise the issue in Parliament (BBC News, 2016), proposing a Maternity and Paternity Leave (Premature Birth) Bill.

The well-documented benefits of maternity leave for the whole family need not be listed here, although it's worth noting the findings of Avendano et al (2015: 52) which ‘imply that maternity leave benefits do not only protect mothers and their children around the period of childbirth, but may contribute to healthy aging among women during the last decades of life.’

The UK Government's current position (Gov.UK, 2016) is that maternity leave extends for up to 52 weeks, and from ‘the day after the birth if the baby is early.’ Simpson (2016) notes that there are two options for changes to statutory maternity leave that would take account of premature birth. The first option is that proposed by Ogilvy (an extra week of maternity leave for every week spent in hospital); a second option, advocated by Bliss, ‘is that mothers who give birth early could be guaranteed 12 months' leave starting from their original expected week of childbirth.’

Regardless of these options, the position of the Department for Business, Energy and Industrial Strategy is that ‘the UK's maternity system is one of the most generous in the world. The current system strikes the right balance between the needs of new mums, including those whose baby has been born prematurely, and employers' (BBC News, 2016).

The Department's assertion, however, is wrong. It fails to acknowledge Ogilvy's point that ‘neonatal intensive care is not maternity leave’. This self-evident truth means that, far from striking the right balance between ‘the needs of new mums’ and employers, the Department ignores the needs of mothers whose infants are in neonatal intensive care.

The word ‘needs’ requires us to navigate some challenging philosophical waters. For example, when does a ‘want’ become a ‘need’? As Warnock (1996: 149) noted: ‘An economist is once alleged to have said, in despair, when seeking a definition of need, “a need seems to be something you want but are not prepared to pay for”.’ And a devil's advocate might ask, does a need for something automatically generate the right to have it? This, in turn, raises the issue of what constitutes a right, with Warnock (1996: 148) arguing that although people might assert what they consider to be natural, or moral, rights, a right is essentially a legal concept and ‘one could well argue that legal rights would not exist unless they were backed up by a kind of consensus morality.’ And it seems to me that the best hope for those supporting Ogilvy's campaign is to build up precisely the ‘kind of consensus morality’ posited by Warnock (1996).

It is tempting to judge the present maternity leave situation for the mothers of premature babies as unfair; and at one level, of course, it is unfair. But then, as our devil's advocate might remind us, life wasn't meant to be fair. Which brings us to an important consideration, which is not whether something is ‘fair’, but whether it is ‘just’; two words often thought to have the same meaning. Cooke (2012: 2) illustrates the difference by considering the example of charitable giving, where it is only ‘fair’ that the relatively well-off give some of their goods to the disadvantaged, but Cooke reminds us that ‘justice is concerned only with what it is morally required to do as opposed to what it is morally commendable to do… It is the principles of justice, not of fairness, that society must adhere to because justice is about doing what is morally required.’

In which case, it seems to me that, while employers' rights need to be acknowledged, it is ‘just’ to confer on the mothers of premature babies a right to full maternity leave when their infants are no longer in neonatal intensive care.