When Whitney, a health-care provider at a reproductive rights advocacy organization on the East Coast, became pregnant, she knew she wouldn’t be ready to come back to work after her eight weeks of paid parental leave were up. So she began saving her sick days and skipping vacations.

“I’ve taken two vacation days since last summer, including the holidays,” she told Rewire.News. “I felt a lot of anxiety around that, knowing that I couldn’t take days off while I was pregnant because it meant that was time I wouldn’t be able to spend afterwards, and I worked until the day before I delivered. I would have worked the day I delivered had I not delivered on the weekend. I was hoarding leave.”

Whitney, who asked to use a pseudonym so she could speak without fear of professional repercussions, said she knew she was better off than most workers in the United States, where only a fraction of employers provide paid leave at all. But the amount of time she was able to take off before returning to work still fell below expert recommendations—and her experiences, according to a recent survey, are typical of many reproductive health, rights, and justice organizations.

The survey was conducted by ReproJobs, a website for workers in the reproductive health, rights, and justice movements. In an email to Rewire.News, the site’s staff emphasized that the report, based on a non-random sample of 46 organizations’ parental leave policies, isn’t comprehensive or scientific. The policies were sent to ReproJobs by employees, or directly by organizations in response to an email request. (Only 14 of the 37 employers contacted by ReproJobs responded, according to the survey’s organizers.)

Almost four in five of organizations included in the ReproJobs survey had some amount of paid leave. That’s significantly higher than U.S. employers as a whole: The Society for Human Resource Management found that around 1 in 3 employers offer paid leave, Bloomberg reported in 2018.

According to ReproJobs, the organizations surveyed provide an average of ten weeks of paid leave. A report by advocacy group PL+US found that the nation’s largest employers averaged 4.7 weeks of parental leave and 5.6 weeks of childbirth leave, although the report did not address whether the different types of leave overlapped.

(Rewire.News provides 100 percent of an employee’s salary for family leave for birth or adoption for up to eight weeks, and 100 percent of the employee’s salary for family leave for foster care placement for up to four weeks. In addition to the eight or four weeks, employees can use paid sick leave and/or paid vacation leave instead of unpaid leave, and as applicable receive disability insurance benefits. Any remainder of the available 12 workweeks of family leave would be unpaid.)

But the ReproJobs survey identified shortcomings in many organizations’ parental leave policies. Most of the organizations that provide paid leave limit it by tenure or job type. Most family leave policies in organizations surveyed by ReproJobs did not apply to part-time workers, “forcing them to make the impossible choice between keeping a job, caring for a child, or finding childcare.”

“That’s not what we mean by pro-choice, and it certainly isn’t reproductive justice. Policies should apply equally to all workers, period,” the ReproJobs analysis said.

Thirty of the 46 organizations in the survey “made the amount of leave a worker can take contingent upon how long they’ve worked at the organization,” according to the report. “This is a particularly strange policy since it implies that the longer an employee works somewhere, the more they deserve or earn parental leave,” the authors wrote.

The COVID-19 pandemic has renewed the urgency for comprehensive paid sick leave and parental leave. The coronavirus response package enacted last month mandates 10 days of paid sick leave for workers affected by COVID-19—but it doesn’t cover large businesses with more than 500 employees and it allows exemptions for small businesses. Republican lawmakers limited the reasons employees can seek 12 weeks of coronavirus-related paid family leave, and when U.S. Sen. Patty Murray (D-WA) proposed more sweeping paid leave provisions in response to the crisis, she was rebuffed in the Republican-controlled Senate.

Annie Sartor, director of campaigns for PL+US, told Rewire.News that the coronavirus pandemic only increases the need for paid family leave. “I think, certainly in this moment, people need to look [after] themselves and their families, and they need access to all of these policies,” Sartor said.

Experts typically recommend six months of leave for a new parent, although one physician Rewire.News spoke to said that figure assumes a healthy pregnancy, delivery, and post-pregnancy for both parent and baby. She cited postpartum depression—experienced by more than 11 percent of mothers in the United States, according to 2012 data from the Centers for Disease Control—as just one reason a parent might need more time.

While federal law mandates 16 weeks of unpaid parental and family leave, there is no federal requirement for paid leave in the United States, making it an outlier among 41 nations reviewed by the Pew Research Center. Five states and Puerto Rico mandate some amount of paid family leave, while three states and the District of Columbia have pending paid family leave laws that have not yet taken effect.

In the meantime, when parental leave policies are inadequate, workers like Whitney use sick and vacation leave to fill the gap.

But aside from the difficulty of going without sick days, sick leave typically is accumulated too slowly—the median sick leave is six days per year—to cover much parental leave. Carryover restrictions typically limit the number of days private sector workers can carry from year to year, and more than half of workers can’t carry over sick days at all.

Like Whitney, many new parents still have far less leave than the six months recommended by experts. A 2012 study commissioned by the U.S. Department of Labor shows that 62 percent of women who took parental leave returned after less than two months.

“Last time, I wasn’t ready to come back after 16 weeks,” Whitney said. “I don’t know that I’ll be ready to come back with less time and two kids.”

Whitney said that despite wanting more leave, she’s better off than many workers. Data from the U.S. Bureau of Labor Statistics backs her up. Paid family leave is less common than personal or sick leave, and 24 percent of private industry workers lack access to all three categories of paid leave. For part-workers and low-wage workers, those numbers are much higher.

After a 2018 New York Times story about pregnant workers alleging mistreatment at Planned Parenthood affiliates, the national office released a statement saying it was reviewing its policies. A spokesperson for the organization told Rewire.News last month they would release more information soon.

In the New York Times report, employees described a pattern of discrimination against pregnant workers at local Planned Parenthood offices, most of which provided no paid maternity leave to employees. The CEO of one regional affiliate told the Times that covering maternity leave would cost $2 million a year and force her to close clinics.

Reproductive health organizations are often forced to jump through bureaucratic hoops to get funding for the services they provide. Even in states that provide Medicaid coverage for abortion care, some clinics struggle to get reimbursement. And the Trump administration’s Title X “gag rule” means many reproductive health clinics lost a key funding source for their family planning services as the anti-choice policy forced clinics to withdraw from the program. Complying with Targeted Regulation of Abortion Provider (TRAP) laws, or clinic shutdown laws, is often costly, as well.

Despite the financial challenges, some reproductive rights organizations have made it a priority to offer leave in line with expert recommendations. In April 2019, NARAL Pro-Choice Texas expanded its family leave to six months and added other benefits to align with their mission, including an abortion stipend to cover the cost of the procedure and related expenses for staff.

While the new employee benefits are awaiting board approval, CEO Aimee Arrambide said it was the de facto policy in the interim and funding has already been secured.

“I was apprehensive to bring it up [in fundraising],” she told Rewire.News. “But I think I was happily surprised that people understood. And it makes sense. I think that people funding the work that we do also understand that living in our values, making sure our organization adheres to our values, is really important to be able to do our work.”

Arrambide, who took the reins of NARAL Pro-Choice Texas in 2018, said that her own experiences with “pretty difficult pregnancies” motivated her to expand paid leave once she became executive director.

“I don’t think that I would have wanted to go through a pregnancy and give birth and not have paid leave,” she said.