In 1839, a midwife in Manchester, England, was asked a simple question during a government inquiry: how long did women work in the factories before giving birth? Her answer unsettled the men in the parliamentary session. She told them that women in the cotton mills worked right up until the day of delivery itself. Some, she said, worked until the very last hour before labor began.

That was 1839. The first national maternity leave law would not arrive for another 44 years. In some countries, including the United States, real protection would take more than 150 years after that midwife’s testimony. Manchester, England, 1837.

The cotton mills operated six days a week, fourteen hours a day. Inside the brick buildings along the River Irwell, women stood before mechanical looms in rooms so thick with cotton dust that their lungs turned black before age thirty. Pay was a fraction of what men received. Rest breaks were nearly nonexistent.

And if a woman was eight months pregnant, the expectation was exactly the same: show up, do your shift, do not slow down. This was the reality for hundreds of thousands of women across industrial England. To understand how it got so bad, one must look back to the world before factories. For most of recorded history, birth took place at home, surrounded by other women.

In medieval Europe, wealthier women followed a tradition called “lying-in. ” For about a month after childbirth, the new mother remained confined to a dark room. The walls were sometimes draped in heavy fabric to block light and noise. Men were barred entirely.

Relatives, neighbors, and midwives cared for the mother, brought food, managed the household, and helped tend the newborn around the clock. At the end of the month, the mother went to church for a ceremony of “churching,” a rite of thanksgiving marking her official return to normal life. Only after that was she considered recovered, and only then was she expected to resume her domestic duties. Margaret Beaufort, mother of King Henry VII, left detailed instructions in the 1480s on how to prepare the lying-in chamber for a queen: blue cloth on every wall and ceiling, carpeted floors, and a single uncovered window so the woman could have light when she wanted it.

The purpose was to mimic the womb itself—dark, warm, quiet, and sealed. A medieval queen received a full month of rest in a dark, quiet place, attended by a team of women, shielded from the outside world by custom and church. A peasant woman working in the fields nearby got nothing, because that was the way of class division. If you were rich, childbirth came with a guaranteed period of rest, enforced by your family, church, and community.

If you were poor, and most women were poor, you returned to the fields as soon as you could stand. There was no one to replace you. There was no income if you stopped. The class divide even extended to who attended the birth.

A noblewoman prepared her birthing chamber weeks ahead. She chose her own midwife. She had assistants ready with clean linen and warm water. A peasant often gave birth in the same room where the family ate and slept, attended by whoever was available—a neighbor, a sister, sometimes no one at all if the timing was bad and everyone was in the fields.

If it was harvest season, a peasant woman might endure her first labor pains while working, because the family could not afford to lose a pair of hands at the most important time of the year. Records exist of women giving birth in barns, in fields, and on roadsides while traveling to market. Childbirth itself was dangerous regardless of wealth. In the Middle Ages, roughly one woman in fifty died in childbirth.

The women who attended births were other village women, experienced but completely self-taught. There were no sterile instruments, no anesthesia, no emergency interventions. If a baby was breech or the umbilical cord was wrapped, the options were prayer, herbal remedies, and hope. Some midwives were accused of witchcraft if too many births they oversaw went wrong.

The same women who helped bring life into the world could be burned at the stake for it. Then came the turn no one expected. When the Industrial Revolution arrived in the late eighteenth century, conditions for pregnant women did not improve. They became dramatically worse.

Before factories, most women worked from home. The family operated as one economic unit. A woman spun thread while watching her children. She managed the household and contributed to the family income in the same place.

Pregnancy was difficult, of course, but the work adapted to it somewhat. She could sit. She could rest between tasks. She could nurse her baby while combing wool.

The factories ended all of that. The invention of mechanical cotton spinning moved production from homes into massive brick buildings. The large spinning machines needed constant attention. They did not require skilled labor, just bodies standing at stations, pulling levers and feeding cotton for hours on end.

The noise was deafening. The floors were slippery with oil. The air was so full of fibers that workers inhaled cotton dust with every breath. The only light came through a few windows, often nailed shut to maintain proper humidity for the machines.

Women and children flooded into the factories because owners wanted cheap, controllable labor. By the early nineteenth century, women made up a large part of the industrial workforce in northern England, and almost none of them could stop working due to pregnancy. Poverty was the rule. Losing a week’s wages meant no food on the table.

Testimony from the era reads like it belongs to another world. Elizabeth Woodhouse, a midwife who testified before Parliament in the 1830s, said factory workers left their children with anyone they could find. She explained that some of those children suffered greatly from the arrangement. Mothers worked up to the moment of birth, sometimes delivering on the factory floor between the looms.

Most returned to work two weeks after giving birth. Two weeks after fourteen-hour shifts in a room full of cotton dust and machines that could sever a hand in an instant. The timing of what happened next was perfectly grim. Because these mothers were so exhausted from their shifts, they needed their babies to stay quiet at night.

A whole cottage industry of soothing babies grew up in the factory towns of northern England. Chemists sold mixtures of laudanum and sugar water, or opium mixed with molasses. The most popular product was called “Godfrey’s Cordial,” nicknamed “Mother’s Friend. ” Mothers, or the women caring for the children, gave these mixtures to infants so that everyone would sleep long enough for the mother to get up and repeat the whole ordeal the next morning.

The babies were so drugged they would not eat. Many became malnourished. Some starved to death. Others survived but grew up sickly and stunted, their development permanently damaged because they spent their infancy in a drugged haze while their mothers worked at the looms in a factory that did not care whether they lived or died.

It was legal, simply because there were no laws regulating what a caregiver could give a child, no regulations on the sale of opium, and certainly no laws granting a mother any leave to raise the child she had just borne. It got worse in the coal mines. Young girls, some not yet teenagers, were sent underground to pull sleds loaded with coal through tunnels too narrow for horses or adult men. They crawled on hands and knees for twelve hours at a stretch, dragging loads with chains attached to leather belts around their waists.

The physical strain deformed their pelvises over months and years of this work. When those girls grew up and tried to have children of their own, many of them died in childbirth. Their bodies were permanently damaged by the labor they had done as children. The coal industry was killing mothers before they ever became mothers.

After years of campaigning by reformers, the British government passed the Factory Act of 1847, which reduced the workday in textile mills to ten hours for women and young people under eighteen. It was a beginning, though a small one, but it said nothing about pregnancy, nothing about leave before or after birth, nothing about a mother’s right to return to her job. A pregnant woman in 1847 had exactly the same legal protection as a woman in 1247, which is to say, none. The first real attempt to address motherhood through law came from an unexpected direction.

In 1883, German Chancellor Otto von Bismarck pushed through a national health insurance law. Bismarck was not motivated by sympathy for working mothers. He was trying to undermine the growing socialist movement by proving that the German state could care for workers better than the socialists promised. The law required employers and workers to pay into insurance funds.

Among its provisions, listed alongside sickness pay and medical treatment, was a small but significant detail: maternity assistance for women after childbirth. This was the first time any national government officially recognized that women who gave birth needed financial protection tied to their work. Enrollment in Germany began with 4. 3 million workers in 1885.

By 1913, that number had jumped to 13. 6 million. The system was incomplete—farmworkers and domestic servants were excluded, two categories employing enormous numbers of women—but the principle had taken root. The government had officially said, in writing and backed by law, that working women and childbirth were a matter of public policy.

The rest of Europe took notice. Austria passed its own health insurance law in 1888. Hungary followed in 1891. The British National Insurance Act of 1911 included a one-time maternity grant of thirty shillings for insured women.

In today’s prices, that grant would buy roughly the equivalent of £119 worth of goods. It was not exactly generous, but it put motherhood on the political agenda in Britain for the first time. That decision would later be seen as the seed of something much larger. Then, in 1919, the International Labour Organization held its first conference in Washington, D.

C. The organization had just been created as part of the Treaty of Versailles that ended World War I, founded on the belief that lasting peace required social justice. One of the first things the organization did was adopt a Maternity Protection Convention. It was the first international labor standard focused on gender equality in world history.

The convention called for six weeks of leave before childbirth and six weeks after, cash benefits to compensate for lost income, medical care, the right to nursing breaks during the workday, and the right to keep one’s job throughout all of it. All of that was put on paper in 1919, more than a hundred years ago. The problem was enforcement. At the time the convention was adopted, not a single country on earth actually met the standard it set.

Countries in Europe and Latin America began signing on during the 1920s and 1930s, but signing a convention and enforcing its terms were two very different things. Spain is the clearest example of the gap between what the laws said and what actually happened for working women. In 1929, Spain passed a maternity insurance law that technically gave women the right to stop working in the final weeks of pregnancy and the weeks after birth. On paper, the law was progressive.

In practice, it provided no meaningful financial compensation. A professor at the University of Madrid, writing about the law at the time, said it gave working women the right to rest, which in practice meant the right to hunger. The government told women they could take leave, but without pay, taking leave meant choosing between recovery and putting food on the table. Factory inspectors did not even try to enforce the mandatory rest period.

They knew exactly what would happen to the women they were supposed to protect. This pattern repeated itself for decades. Governments recognized that pregnancy and work posed a problem that needed solving. They wrote laws that looked progressive, then left working women to fend for themselves under those laws.

World War II temporarily broke the pattern, but only because governments needed women in the factories building tanks and ammunition. In Britain, the number of nurseries jumped from just 14 in 1940 to 1,345 by 1943. For a brief period, the state acknowledged what working mothers had always known: you cannot work a full shift and care for an infant at the same time. Someone has to help.

But those nurseries were wartime measures, not permanent policy. When the soldiers came home, many of those nurseries were closed. The women who had kept the wartime economy running were expected to return to their kitchens and pretend the previous five years had not happened. The concept later named the “second shift” had been visible for centuries, but World War II threw it into sharp relief.

Women were not just workers. They were workers raising children, running households, cooking meals, and handling every domestic task their husbands did not do. The workplace provided no accommodation for any of it. You finished your shift, went home, and began your second job every day—unpaid, unacknowledged, and uncomplained about, because complaining meant losing the paid job entirely.

Here the story becomes harder to justify, because whatever was happening in Europe at least hinted at protection, however incomplete. In the United States, for most of the twentieth century, nothing was happening at all. No federal maternity protection, no national sickness insurance, no legal recognition that pregnancy had anything to do with labor law. The consequences were harsh.

In the 1960s, only 44 percent of American women worked during pregnancy. That number looks low, and it was. But the reason was not that women chose to stay home to prepare for their babies. Companies routinely and openly required women to resign when they became pregnant.

They did not ask; they demanded. A woman could perform her job brilliantly for years, and the moment her pregnancy began to show, she was fired. There was no law against it. There was no way to appeal.

You were pregnant, and therefore you lost your job. Teaching was one of the worst professions in this regard. Through the 1960s and into the early 1970s, it was standard practice for school boards across the country to force pregnant teachers to leave the classroom. Some districts had written policies requiring women to leave by the end of the first trimester.

Others operated on the implicit understanding that a pregnant teacher simply would not be asked back. School principals would call teachers into their offices and ask what kind of birth control they used. Nobody at the time thought to question whether that was appropriate. And when a teacher became pregnant anyway, her job was quietly given to someone else.

In 1971, a young teacher named Elizabeth Warren was working as a speech therapist for children with disabilities in Riverdale, New Jersey. She had studied at the University of Houston to become a public school teacher. After she showed signs of pregnancy with her daughter, she was not offered a job for the following year. Decades later, she told that story during her presidential campaign, and thousands of other women came forward with nearly identical experiences from the same era.

The American Federation of Teachers had condemned mandatory pregnancy firings at its annual convention in 1970. But condemning a practice and stopping it were, again, two very different things. The legal framework was moving slowly and often in the wrong direction. In 1976, the Supreme Court ruled in General Electric v.

Gilbert. The ruling held that employers were legally entitled to refuse disability benefits to pregnant women. The case had been brought by the International Union of Electrical Workers, arguing that excluding pregnancy from disability coverage was a form of sex discrimination. But the Court disagreed.

That ruling did something its authors probably did not intend: it united people and organized their ranks. Labor unions, which had been lukewarm toward women’s issues in the workplace, made pregnancy protection a top priority overnight. The United Auto Workers passed a resolution at their 1977 convention declaring that women’s issues were union issues, with special focus on the rights of pregnant workers. Civil rights organizations and women’s groups launched coordinated campaigns to name and shame employers and school boards with discriminatory pregnancy policies.

The organizing was fierce and specific. Union stewards were trained to take up the cause of pregnant colleagues on the shop floor. Women filed formal complaints. Some organized strikes.

The American Civil Liberties Union worked on building legal cases. Within two years of the Gilbert decision, the political ground had shifted enough for Congress to act. In 1978, Congress passed the Pregnancy Discrimination Act. The law amended the Civil Rights Act to prohibit workplace discrimination on the basis of pregnancy, childbirth, or related medical conditions.

For the first time in American history, firing a woman because she was pregnant was explicitly against federal law. But the Pregnancy Discrimination Act had a loophole everyone noticed immediately. It did not require employers to provide any leave at all. It said they could not fire you for being pregnant.

But if your employer did not provide disability leave for any employee, it was not obligated to give you anything extra because of pregnancy. You could keep your job title in theory, but you had no right to any leave before or after birth. That gap meant something concrete for millions of women. A factory worker in Ohio who gave birth in 1980 could not be fired for being pregnant, but she could not take a single day off without using her sick leave balance.

When that ran out, she was left to fend for herself. Many women returned to work days after giving birth, not because they wanted to, but because they had no other financial choice. Others quit because the math simply did not work. By the early 1990s, 52 percent of mothers were returning to work within six months of giving birth, up from just 14 percent in the 1960s.

The workforce had changed. The law had not. Closing that gap took another fifteen years of struggle. The first draft of what would eventually become the Family and Medical Leave Act was written in 1984.

The bill was introduced in Congress that year and was blocked. It came back in 1985 and was blocked again. For nine consecutive years, the bill was introduced, debated, and defeated in the face of strong, well-funded opposition from business lobbying groups that claimed mandatory leave would destroy the economy. Two presidents vetoed versions of the bill before it finally passed.

Congress passed the Family and Medical Leave Act in both chambers in late January 1993 with bipartisan support. On February 5, President Bill Clinton signed the law at a ceremony in the White House Rose Garden. It was the first bill he signed as president. Clinton said at the ceremony that the United States was almost the only advanced industrial country without a national family and medical leave policy.

The law gave eligible employees the right to take up to twelve weeks of leave for the birth or adoption of a child or for a serious health condition. Employers had to hold the job open. Health insurance had to continue during the leave. But there was one problem that undercut the entire achievement: the leave was unpaid.

Twelve weeks without any income. For a single mother or a family already struggling financially, unpaid leave was not a benefit. It was a luxury they could not afford. The eligibility rules also excluded millions of workers entirely.

You needed to have worked at least 1,250 hours in the past year for an employer with fifty or more employees. Part-time workers, small business employees, new hires, seasonal workers, anyone who had not been on the job long enough or whose employer was too small to qualify—all of them were simply excluded. By some estimates, roughly 40 percent of the American workforce did not meet the eligibility requirements when the law took effect. In 2015, the Department of Labor estimated that only 12 percent of private sector workers in the United States had access to paid family leave through their employers.

Since then, some states have created their own paid leave programs. California was first in 2004. New York, New Jersey, Washington, and a few other states followed. But to this day, no federal law requires any American employer to provide a single day of paid maternity leave.

Compare that with what exists elsewhere. Estonia offers more than eighty weeks of paid leave. Bulgaria offers nearly sixty weeks. Even countries with economies far smaller than the United States provide months of paid maternity leave funded through national insurance systems.

The latest ILO data, covering 185 countries, shows that about a third of all nations now fully meet the standard the organization set in its updated 2000 convention: fourteen weeks of leave, with at least two-thirds of previous pay provided through social insurance or public funds. The convention that no country met in 1919 is now routine policy across almost the entire world. The United States is a glaring exception. It is not alone, but it is the richest country in that category by a wide margin.

The story of maternity leave belongs to no single country or century. It is the story of economies built on the assumption that workers do not get pregnant. That assumption shaped the factories of Manchester, the farms of medieval France, and the courtrooms of Washington, D. C.

It shaped them for centuries, and when women entered the workforce in numbers too large to ignore, the systems meant to support them barely existed. The protections that emerged did not come from generosity. They came from political pressure—from unions, activists, and women who refused to accept that pregnancy meant unemployment, hunger, or silence. A medieval queen got a month in a dark room with midwives and embroidered curtains.

A factory worker in 1839 got two weeks and a bottle of laudanum for her baby. An American teacher in 1971 got fired. A working mother in a country without paid leave gets twelve weeks of nothing. The laws changed.

The assumption underneath them never fully did.