Child care: problem or solution?
Child care: problem or solution?
When it comes to stress, it's both.
I often find myself struggling with how to categorize child care in the context of maternal stress.
Aligning any of the basic needs related to child care – affordability, accessibility, quality, stability, safety – for so many parents in this country is often just out of reach. The sacrifices are tangible. The stress is daily. But this stress can be relieved… by a better child care system.
So, is child care both a problem and a solution when it comes to stress?
Quick recap: the stress related to day-to-day child care issues — precarity, instability, insecurity — has links to long-term maternal health effects:
Issues with child care also deeply affect other sources of stress in a person’s life (e.g. job security, financial stability, mental load):
When we map the factors fueling maternal stress, child care is so deeply connected that it seems like a clear target for stress-reducing solutions.
Lighten the stress load related to child care, lessen the severity of all connected stressors.
To lessen the load, the obvious goal should be fully eliminating child care issues as a stressor node by establishing a comprehensive and functioning child care system. Since that will likely not happen in the next ten or 50+ years, how do we start addressing this source of stress today?
Put another way — How do we eliminate or at least mitigate the key factors related to the stress load of child care?
There is a field of research dedicated to “parenting stress” and from what I have read1, this field, in very vague ways, interweaves elements of child care and offers glimpses into how potential stress-reducing solutions might work. I especially love this weird quote:
“Having children is stressful for most parents, especially mothers, who are often the primary carer. However, for some it can become very taxing indeed, creating an associated subjective reaction that has been described as ‘parenting stress’” — Craig and Churchill, 2018
According to that review, parenting stress often relates to the financial stress associated with existing in the world and having to pay for all the things that kids need (for survival and happiness… although the latter might be subjective on the parents side) but it also “involves multiple components, such as feeling overwhelmed by responsibilities, feeling trapped and exhausted, finding parenthood more work than pleasure, and experiencing strains in the parent–child relationship”
Like most fields of research on parental effects on kids and the effects that kids have on parents, the research predominantly studies moms. So, it’s really maternal parenting stress that we’re talking about here.
Through the lens of child care as an interconnected stressor and solution, let’s think through the opportunities to mitigate the stress and lighten the load of whatever is“very taxing indeed” for mothers.
First – additional connections
We often think about child care stress as an issue of money and jobs, but it weaves through the web of stressors in less discussed and expected ways.
A few additional child-care-relevant connections that I’ve added (or need to add) to the stressor map since starting this project:
Identity conflict
Sense of self/identity is a theme that comes up often, but very subtly, in the context of child care and I think it is worth a closer look. The stories tend to start something like this: “I moved from [insert city, state, far away place] back home to be close to my parents so they help with child care.” Alternatives tend to include moving somewhere less expensive in order to afford child care. Usually the conversation includes mention of how “I never wanted to move” or “I took a local/remote job that isn’t satisfying.” Regardless of the why or the exact source of tension upon arrival, the tone is the same – I had to sacrifice something about “me” in order to access child care.
I am certainly not an expert here and this stressor node alone is worth its own deep dive. From what I can see from a quick literature review, the stress related to concepts of “self” relate broadly to how we perceive other stressors, how we internalize stress, and how effective stress buffers can be at reducing our stress load. And the stress related to identity has very real health consequences when it comes to mental and physical health.
Housing
This one is a stressor on its own level of stress. As
points out in her excellent report on eviction and Black maternal health:“higher eviction rates for families with young children track with how expensive child care is for the same demographic.”
I had the opportunity to interview Julia (and be interviewed by Julia!) and will have more on the stress of housing insecurity soon.
Abortion access
This beautiful and heartbreaking piece of photojournalism by ProPublica anecdotally shares a powerful visual of stress-related impacts on health at the intersection of limited abortion access + infant child care + financial instability. The story captures the life and health repercussions of a forced birth, resulting in a series of pregnancy complications, an extreme premature birth, the need to find specialized infant care and, navigating work to pay for the mounting bills:
“She could make about $600 a week installing insulation. But first they had to figure out child care. Elayna was still too fragile for full-time day care. According to care. com, an experienced nanny in their city would cost about the same as Mayron’s weekly paycheck.”
The work-to-pay-for-child-care conundrum feels omnipresent as a theme related to stress.
Intimate partner violence (domestic abuse)
This one still needs to be added to the map but will require more careful thought. The importance of considering this stressor came from a comment on the childcare = healthcare Op-ed that Lucy Hutner and I published in January. The comment read:
“I work for a domestic violence shelter in the Chicago suburbs. Childcare is often the #1 issue for the victims. I can't tell you how defeating it is to see women with two kids under the age of 5 find childcare so they can work....only to realize the cost of that childcare would eat more than 50% of their earned income away... The simple math removes all hope from the equation.”
Abusive relationships do directly affect women’s health, including physical, mental, sexual, and reproductive health, and links to causes of death (due to homicide and suicide). And while some of these health outcomes are caused by the abuse, some are also closely tied to the stress associated with it. The stress related to child care would only compound this.
Solutions to mitigate child care stress
POLICY SOLUTIONS
- Make child care a public good -
Yep, this is when I call for public funding for child care2. And not just some funding, or subsidized funding, or support for more employer-based funding – full funding for FREE child care for ALL.
Am I dreaming? Maybe. But I’m following the lead of folks in the space that I deeply respect:
“Most politicians aren’t striving to make child care free; they’re striving to make it affordable. This framing accepts the damaging premise that child care should be a private market commodity. It’s time we instead see child care as the vital service it is—one that undergirds national prosperity and should be universal and free.” – Elliot Haspel
Right now, the US seems to be making every attempt to fit the square peg of child care neatly into our round hole of capitalism. But that does not actually work well for anyone… except, maybe the private equity firms making money off children3.
For now, let’s consider that the stress of financial strain/instability/insecurity is one of the more thoroughly studied stressors that modern humans face. And the health implications are clear – financial stress is unhealthy. Shocking, right?
You know what contributes the most to financial stress? Children. And the most expensive thing about having children? Child care. The link between paying for child care and financial insecurity is then compounded by the financial insecurity due to workplace discrimination (mostly against mothers) or job loss (that is often linked to failures of child care and the expense… and again… mostly for mothers), the benefits cliff continuing the cycle of poverty (discussed in interview with Siran), and/or other expenses that cycle back to bringing that kid into the world to begin with (fertility, pregnancy/birth complications, or just childbirth in America in general).
Policies like universal preschool are a great start but that leaves out parents who have recently birthed a new human and need care coverage for that new human. Free child care that extends into infant care could have exponential effects on the long-term health of new mothers. It would reduce how the financial stress (and every stressor connected to it) piles on during the exact window when it's critical to avoid as many stressors as possible.
“I can afford to have a child, I just can’t afford to pay for their care for the first three years of their life.” – Amy Deveau, mother, as told to Time Magazine
If you can’t give us FREE (or at least inexpensive, accessible, safe, stable) child care that starts with infants, at least give us…
- Federal paid leave for EVERYONE -
(yes, this one will be a solution for each stressor on the map4. Buckle up.)
Infant care is the most expensive type of child care. Infant care is the hardest type of child care. The messiest, the scariest (see below), the hardest to secure for parents, and the hardest to staff during a budget crunch-related teacher shortage. Infant care is also unavoidable for a majority of working parents who do not have access to paid leave.
The birth parent is predominantly the one shouldering the burden related to infant care and/or navigating complex paid leave options. And, again, this stress coincides with a time of increased vulnerability to stress-related illness.
The other option – leaving a job to care for your infant – isn’t always great on the stress side either. Choosing5 to leave a job or being forced to leave a job due to child caregiving constraints has been linked to both increased levels of parenting stress and increased depressive symptoms6.
As a solution, paid parental leave for both birth and non-birth parents gives the biggest health boost. We know that maternal access to paid leave improves perinatal mental health. Early data suggests that when dads have access to (and take!) paternity leave, their partner’s stress and depressive symptoms were lower than those in couples without paternity leave. The direct connection to child care is not clear yet but I’m going to venture a guess that sharing the caregiving load at this stage of life may contribute to these improved outcomes.
- Standardize safety regulation and transparency -
Recently, the 19th News did an excellent in-depth report on child care safety – the history of federal regulation, a dashboard to check your state’s compliance, and a guide to sourcing child care options. You can also listen HERE to journalist, Chabeli Carrazana, talking about her reporting on the broken system and how lack of funding for child care has compounded safety issues, stability, cost, and everything in between:
“This is a system that we just have not invested in in this country - child care - and, when you don't invest in a system, cracks start to open.” – Chabeli Carrazana
Vigilance about a baby’s safety is an expected part of new parenthood. It’s primal. It taps into our fear response. But the brain cannot always distinguish real versus potential threats before sounding the alarm bell.
Excessive fear can become problematic for our health. Excessive fear drives anxiety disorders.
Handing your baby over to child care providers is terrifying enough for many parents. Even more so when we can’t trust the system that is supposed to provide safeguards.
Chabeli’s reporting is chock full of solutions around child care safety and addressing the child care crisis in general – get on it, America.
COMMUNITY SOLUTIONS
- Change the narrative -
As discussed above, identity as a connected stressor node ties in the internal tension caused by choices (or false choices) that a parent makes when they sacrifice aspects of identity in order to have, find, and/or afford child care. An additional connection winding through both stressor nodes is the social narrative stressor. And this one has a community solution.
The language of “working mother” vs “non-working mother” is broken. I’m not the first one to call this out.
In the case of stress and health and child care, society’s attempts to categorize mothers in a binary way bleeds into the personal and political debate about who needs child care. The former affects the internalization and perception of child care as a stressor. The latter affects how we actually achieve the solution above to finally see federal funding to support a comprehensive system.
When
and I wrote about child care as healthcare, the story we started with focused on Julia, whose child care center closed with a month’s notice right before summer started. One bit of editorial feedback was to include her job title in order to give the problem a “sense of urgency”. But Julia did not have a job title. She was not doing any paid work at the time. My simple response to the feedback was “I would prefer to avoid adding a job title because I do not want this piece to immediately categorize the problem as a ‘working mom’ problem.” I never mentioned that Julia did not have a professional job title to list.What I keep in mind as anecdotal evidence for the intersection of identity + child care + narrative + stress (at least until the research catches up) came from the conversation with Julia that we did not have space to get into for that piece. How not working added another layer to the way she described the stress she experienced in that moment. In our interview, I heard a lot of:
“I’m not working so it shouldn’t have been a big deal”
and
“I felt guilty and ashamed for feeling anxious about this because I could have them home with me for the summer.”
The reality was that she had her older son (4) in the child care center already and her younger son (2 at the time) was all signed up to join him in a couple months. They had them enrolled for a few hours a day, a few days a week…. and… and… you know what? The specifics don’t fucking matter.
Ripping any form of child care arrangement out from underneath anyone is an unnecessary stressor and having a mother question whether or not she “needs” it is an extra, unnecessary layer of stress.
Every person has their own internalized turmoil that affects their stress perception, which relates to how they ramp up or tamp down how their brain responds and how their body responds to that stressor.
The connected web of the stressor map reflects this internal turmoil on a very high level, but, within each stressor, a deeper layer of personal narrative feeds in. And so much of that personal narrative comes from societal expectations and cultural pressure.
Narrative shift could be a community-based way to help quiet the internalized turmoil that far too many women face.
Narrative shift could also combat the many political repercussions of categorizing mothers on a binary, which only serves to make the problems we face even more intractable.
Let’s start with this narrative: EVERYONE needs child care. Stable, accessible, affordable, quality, safe child care. Everyone needs it. Hard stop.
(Because kids don’t take care of themselves.)
-Decrease the mental labor of accessing services and subsidies-
Making the math math, as discussed with Siran Cao, is a complex maze embedded within all the other issues related to the paperwork of finding and keeping subsidized child care (when government subsidies even exist for you.)
“It is a full time job to be poor in America and to get government benefits. And that is one of the goddamned worst full time jobs in the world.” – Siran Cao
Another great example of personal stories navigating this disheartening maze comes from this episode of the always amazing No One is Coming to Save Us podcast. In the beginning of that episode, panelists share personal stories of coming up against the benefits cliff, navigating the endless and impossible paperwork, and long-term financial repercussions.
I expect that as more research focuses on the stress and health outcomes related to mental load, we will see clear benefits of the companies and community services that streamline the process for parents, like Siran’s Mirza. Especially when they connect the key sources of stress for parents to reduce the flimsiness of the unnecessarily stacked house of cards.
Another example that I love is what Neighborhood Villages is testing alongside five early learning centers in Boston. In their model, the child care center not only serves the most basic function of safe, affordable, quality child care, it also serves as a hub for parental support. With grant funding from Neighborhood Villages, each child care provider employs a family navigator who works directly with parents to gauge their needs and guide them to and through the services that would lighten their stress load (e.g. housing insecurity):
“We work with early childhood education programs who serve lower-income families and communities, helping to build their capacity to hire family navigators and offer full-scope wraparound support to children and families. When parents tell the family navigators at their child care programs ‘I’m worried about the heating bill’ that is a pathway to the conversation about housing security. Or they’ll say ‘I’m worried about rent’. Now we can work upstream [to help secure housing] so that we don’t have housing insecure parents. It's a model for putting supportive services in a location where the trust is already built.” – Lauren Kennedy, co-founder, Neighborhood Villages.
Another valuable goal of Neighborhood Villages is demonstrating how the model can be adopted and scaled with government funding. With help from their advocacy work, they have already seen big wins in the state of Massachusetts.
PARTNER/FAMILY SOLUTIONS
- Share the load and share the leisure -
Time, and how parents spend their time, is gendered7.
When it comes to time distribution of all things home and children, as
, author of Equal Partners, notes in her chapter dedicated to inequality with kids:“After the first baby, even couples who had previously achieved parity fell into traditional gender norms. After the baby came, the women were doing thirty-seven hours of work in the home, and the men were only doing twenty-four hours. (I don’t know about you, but I can think of a lot of things I could do with thirteen extra hours a week.)” – Kate Mangino
A good chunk of that time relates to child care in the home. It is worth pointing out that, yes, historically women shouldered even more of the child care time burden. However, it might actually be worse for modern day mothers. Most mothers in America today don’t have access to the informal infrastructure of yesteryear that could free up portions of the unequal time allotment – for example, nearby relatives or neighbors who watch kids, free/safe outdoor space, the freedom to say “come home when the street lights come on”, etc.
The time distribution related to physically caring for children only scratches the surface. Sourcing, securing, and managing child care (especially non-parental care) requires an ungodly amount of personal mental load – cognitive and emotional8. And the lopsided load not only gets in the way of working, it can also get in the way of doing nearly anything else. As it relates to stress, having outlets – access to nature, creative pursuits, or social support – are key stress buffers, but these outlets require time that is often coded as leisure. For mothers more than fathers, time dedicated to leisure is often the first thing to go or the quality of leisure time is degraded by other responsibilities (and we’re right back to child care!)
Issues of time/load imbalance may also relate to the studies on health effects of child care precarity/insecurity.
Child care precarity is a health-affecting stressor while access to emergency back up child care is a health-improving stress buffer. Two sides of the same coin. The reported health effects may relate to how mothers shoulder the burden given that the study only captured the maternal response to the questions — e.g.: “if you needed help during the next year, could you count on someone to help you with emergency child care?”
That someone could be the father of the child(ren), a partner, other family/friends. Having more than “mom” as the go-to option – when child care falls through on any given day, or even the name listed as the emergency contact at school – could bring in the sense of control related to stress buffering rather than the lack of control that adds to stress load.
The solution here is to do a better job sharing both the physical and mental load related to child care. Sharing the default parent role — for pick up/drop off and day-to-day, sharing or owning the management of non-parental child care — could free up time. In addition, changing the in-house narrative around time for leisure could give space for accessing stress buffers and relate back to the connected stressors of identity + isolation.
As Kate points out in her book:
“We have set the caregiving bar too high for mothers and too low for fathers. And it is time to recalibrate.” – Kate Mangino
A recalibration to establish a less lopsided distribution of time could lift the weight across the maternal stress map.
Kate’s book not only has a series of exercises to help with this recalibration, it also analyzes 40 examples of true equal partnership for themes, lessons, and strategies. Another excellent resource for determining how to divide the work from start to finish is Eve Rodsky’s Fair Play book and methodology.
My call out for partners is not to wait until the breaking point. Society already puts a disproportionate expectation on women and every step towards more equal distribution of the load at home works to counterbalance that. Recognize the needs and step up today.
Woof. That was a long one. And, honestly, there are a bunch of other solutions that I could add in (workplace flexibility; culture shift to support caregiving employees). What else did I miss?
And just to emphasize one last time:
When we lighten the stress load related to child care, we will lessen the severity of all connected stressors.
That makes fixing our broken child care system a very important target for reducing maternal stress and improving women’s health in this country.
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I fully acknowledge that I need to spend a lot more time in this literature.
To get a better handle on the problem with private equity + child care and why public funding is absolutely critical, check out Elliot Haspel’s report for Early Learning Nation or his great discussion with
HERE. I have lots of thoughts on how the whims of private equity and employer-based childcare can set parents up for greater precarity and a sense of insecurity that will add to parental stress load and impact their health…but I’ll save that for its own deep dive."Choosing" is a relative term here. When “choice” is in the context of not having the right support to truly choose, more often than not, even perceived “choice” is actually a false or forced choice.
More research is needed, of course.
For more on time, time use, gendered coding of time, and what to do about it, I LOVE LOVE LOVE Brigid Schulte’s book Overwhelmed: Work, Love, and Play When No One Has the Time.
The other side of Julia’s story that I love and didn’t have space to share was on the solution side. When she became overwhelmed. When she could no longer sleep. When her anxiety spiked. She remembered that she was not alone in this. She fully passed the baton to her husband. He is the one who found a child care center with openings, toured, and signed the boys up.
This post is long and complicated. Maybe consider separating child care coverage from paid maternity leave. But again, as you point out - they are all connected! Thanks for all the great info.