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Something to dream of?

How does 12 weeks of maternity leave at full pay and up to a year at 60 percent pay sound? How about 98 percent of newborns being exclusively breastfed when they leave the hospital and 72 percent exclusively breastfed at 4 months of age? Consider an infant mortality rate of 5 per 1000 live births. What about requiring men, by law, to share equally with their wives and partners in household chores and the care and nurturing of children?

Something for the United States to dream of?

Some of you are probably thinking, there she goes, touting the benefits of the Canadian system again. But no...I'm talking about Cuba.

It is shocking that infant mortality is higher and increasing in the United States, while it is lower and declining in Cuba when you consider the per capita health expenditures of the two countries (around $7000 for the United States and $251 for Cuba). An article in Midwifery Today credits the lower infant mortality rate to the concept of health care as a right, not a privilege. In the United States, the Centers for Disease Control (CDC) explain that "infant mortality is one of the most important indicators of the health of a nation".

The Baby-Friendly Hospital Initiative has made a significant difference in breastfeeding rates in Cuba. According to a UNICEF report on breastfeeding breakthroughs, between the time it was introduced in 1990 and the writing of the report in 1998, the rate of newborns being breastfed when they left the hospital  increased from 64 percent to 98 percent.  The same report said that 72 percent were still exclusively breastfed at 4 months while a different United Nations report claimed the amount was 46 percent (not sure what the discrepancy is from - perhaps the first stat is only for babies born in Baby Friendly Hospitals?). While I couldn't find a comparable statistic for the United States, I did find that 31.5 percent were exclusively breastfed at 3 months of age (so lower than Cuba in any case). There are 57 baby-friendly hospitals in Cuba and only 25 in the United States. That is one such hospital per 122 million people in the USA and one such hospital per 198,000 people in Cuba. Another provision that helps mothers continue to breastfeed is the additional two daily rest periods of 30 minutes each that are given to lactating mothers that have returned to work.

Maternity leave was introduced in 1934 in Cuba and extended in 1963. It has been expanded and improved several times and now:
Cuba's maternity and parental leave legislation is among the most progressive in the hemisphere: pregnant women are entitled to 18 weeks fully-paid leave (six weeks before birth and 12 after), plus an additional 40 weeks at 60% pay, assured of returning to their same job.

Compared to 12 weeks of maternity leave at no pay in the United States, this is pretty good! Until recently, fathers that wanted to stay at home with their babies didn't have that option. However, in 2003 the government changed the law to allow either the father or the mother to take the additional 40 weeks at 60% pay, but few fathers have taken the leave so far.  This, and other machismo traditions in Cuban society demonstrate that despite a law dating back to the 1970s that "required men to share equally with their wives and partners in household chores and the care and nurturing of children, regardless of whether each contributed equally to the family's financial support", the stereotypical role of women as the caregiver to babies and children remains.

Sure, Cuba isn't perfect. I recognize that. But when it comes to advancing the rights of mothers and babies, perhaps the United States could learn something. We can dream, can't we?

« Pediatricians attitudes about breasfeeding deteriorating | Main | Safe or unsafe? »

Reader Comments (16)

"In any case, there is clearly more going on the breastfeeding vs. formula feeding debate than just worrying about who can make which choices. For some, their choice is already made for them.

*For more perspectives on paid maternity leave and breastfeeding, you can visit this blog and that blog. "

April 2, 2009 | Unregistered CommenterEmily Jones

This is really interesting! Go Cuba!

Here is little old backwater NZ, we don't have it too bad. We get a government subsidy (its not as much as my pay would be but its better than a kick up the bum) for 14 weeks and you can start that 14 weeks up to 6 weeks before having bubs. We get up to 52 weeks unpaid on top of that.

Your job MUST be kept open for you up to a year. Also because I am a council minion and our council is trying to be all 'progressive' they offer us up to 12 weeks paid leave on top of the government subsidy out of the goodness of their hearts (to entice you to come back to your job basically). The catch to the 12 weeks paid leave from work is that you get 20% when you leave, 40% 3 months after you come back and another 40% 6 months after you return to work...but still its above what it law here so its really not bad.

All hospitals and birthing centres are huge advocates of breastfeeding and are very supportive of it. As ive mentioned in my own posts about my formula feeding - formula is under lock and key. By law here, employers MUST provide somewhere to breastfeed or express and you can take a number of unpaid breaks throughout the day to do this.

We are also lucky in that when you have a child (or more) here you are eligible for tax credits each week. So thats really helpful.

We are not Cuba, but we are not doing too bad i think!

September 20, 2009 | Unregistered CommenterKate

[...] mortality data: UNICEF Info by Country). Cuba, a poorer country than the United States but with substantially higher breastfeeding rates and much better breastfeeding support, has an under-5 mortality rate of 7 children per 1,000 live births (better than the United [...]

October 17, 2009 | Unregistered CommenterNestle Answers: Don’t mi

In Norway Mum gets 42 weeks with 100% or 52 weeks with 80% of your full wage. Mummy must take 3 weeks before birth and 6 weeks after birth off work as a minimum. Dad is entitled to 10 weeks fully paid paternaty leave. You get a monthly payment of about 180 us$ pr. child until the child is 18, if you're single you get paid for one child more than you actually have. There's also a payment of about 600 us$ pr month if you choose not to leave your child in kindergarten but stay at home with your child instead. (this last one is for unemployed mums). + you get about 6500 us $ as a one time payment at birth, which applies to all.

And yes, we do have a high tax level :-) being socialists and all....

October 19, 2009 | Unregistered CommenterNina

[...] countries with a larger percentage of baby friendly hospitals than we have in Canada and the United States also have higher breastfeeding rates.  I think one of [...]

I certainly think there is a strong link between maternity leave policies and breastfeeding rates, but there is also a confounding factor in the case of Cuba and that is poverty and the availability of goods. Infant formula is expensive and hard to find; breastmilk is not. There are not many women in Cuba who can afford formula and so they use what they have, which is breastmilk. Which is great; don't get me wrong! But let's not just assume that if we took everything about the US and left it the way it is, except that we added maternity leave, we would see such wonderfully high breastfeeding rates.

November 30, 2010 | Unregistered Commenterbhn

This summer I attended a reading and (very animated) discussion with The War on Moms author Sharon Lerner, and she said that the fight for decent maternity/paternity leave here in the U.S. has to happen state by state by state. If I recall correctly, a couple or three states offer paid leave — sort of. The employer is required to provide it; the state does not. On the one hand, I don't see a policy like this one going federal — wouldn't small businesses want exemptions, and so on? And what about independent workers like me — where would my maternity leave come from? On the other hand, I don't see the federal government stepping up to pay right now. (Extend unemployment insurance? No way! Extend tax cuts for the rich? Sure thing! Ugh.) Too many Americans just don't see the benefit to the community or wider public of taking good care of the next generation. They think that those of us who have children should just suck it up.

November 30, 2010 | Unregistered CommenterRachael

Rachael, maternity leave is a luxure norwegian self employed women don't see either. I'm thinking this is because they are not classed as employed, and all the welfare arrangments are for the employed. You don't get a pension from being self employed either, this is the primary reason why we founded a company that is an entity by itself, and we're employed by it. The reason I wanted to comment again was to show a study conducted in regards of the effect of maternity leave here in Norway. I'm guessing it would be applicable over the western world.

Here's a Google translation: http://translate.google.no/translate?hl=no&sl=no&tl=en&u=http%3A%2F%2Fwww.forskning.no%2Fartikler%2F2010%2Fjanuar%2F239298

Hope this is useful

November 30, 2010 | Unregistered CommenterNina

I find this so very sad. I've known for a long while that there are countries in the world that provide this type of amazing infrastructure to support families, but seeing it laid out like this is heart breaking. I really don't understand how the US has ended up here. Why are the people not rising up and fighting for what they deserve? If Cuba can do this, then ANYONE can! All it takes is people to have some vision, and to FIGHT. I hate feeling like the situation is so hopeless, and it will never change. Deep down I really hope that one day we see a revolution.

C'mon people - start demanding what you deserve from your government and from your society. Nothing worth fighting for comes easy!

November 30, 2010 | Unregistered CommenterChristie

Dear PhD, my fervent wish for you in the New Year is that your dream will come true and you will be able to experience the bliss of being a mom in Cuba (though I hope your children are spared). You and any children you bear will indeed enjoy long life. You will earn $8 a month and your husband may be a doctor in the admirable social healthcare system, but it would be better if he were a waiter as he would then earn 10 times as much and you might be able to afford a car. You would receive rations of basic foods and household goods like oil, flour and paraffin to cook with, but you would not be able to afford much else. Your children would receive a free indoctrination, er, education. Do not try to escape to the US - it is a horrible place where Nestle forces mothers to feed their children breastmilk substitutes. Unfortunately we will not be able to share your dream come true as you would not able to blog (home PCs, guffaw) or indeed allowed to blog or criticise institutions of society. Your reading matter and that of your children would be severely restricted too, so this might be our last communique. Solidarite!

December 1, 2010 | Unregistered Commenterhedda

This thread is about maternety leave, not about marketing strategies, wages or educations. Any number of statitics that are under par cannot cancel out the good ones, nor hide the good ones. Better statistics in the areas mentioned by hedda cannot hide the value of the good ones presented by Cuba either. We should all try to learn from Cubas good statistics in maternerity leave rather than trying to hide this by pointing out the areas where they do not score as well.

December 1, 2010 | Unregistered CommenterNina

Well, you see I wasn't talking about statistics at all. I was talking about the difference between freedom and oppression. Any statistic taken in isolation from the context can be used to justify a predetermined point of view.

December 2, 2010 | Unregistered Commenterhedda

Maybe some people would think the US maternity leave system, and the fact that the majority in the US is 6 weeks away from loosing their home is oppression ;-)

It's all a matter of point of view.

December 2, 2010 | Unregistered CommenterNina


If we are going to take it in context then, we could muse that perhaps in the United States doctors are so obsessed with making money that they don't care about health outcomes and are just looking to perform the procedures that will make them the most money.

December 2, 2010 | Unregistered Commenterphdinparenting

By all means lets both obliterate context and then follow up by generalising that while all Cuban doctors are noble, selfless healers who are completely disinterested in money, all one million plus doctors in the US are obsessed with money, which causes them to actively seek opportunities to commit patient assault and malpractice.

December 2, 2010 | Unregistered Commenterhedda


Oh good, I'm glad to see that you didn't object to me generalizing as a follow-up to your generalizations.

In seriousness though, the fact that the context is different in Cuba than it is in the United States does not mean that there is nothing the United States can learn from Cuba. Personally, I live in Canada, which sits somewhere in between the two. I wouldn't opt to raise my children in Cuba, I wouldn't opt to raise them in the United States, and even though I have opted to raise them in Canada, I think there are still things we could do better here.

December 2, 2010 | Unregistered Commenterphdinparenting

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