S1E78: Caregiving as Infrastructure / Stephanie Coontz, Julie Morita, Erika Moritsugu, Sarah Murphy

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“The pandemic has given us an opportunity to finally change this and if we don’t, the economic impact from the fallout of women in the workforce is going to be devastating.” -Erika Moritsugu

The pandemic has upended caregiving and what it means to be a working mom. More than 2 million women have left the workforce because of the cost and effort of caring for children and older family members during the pandemic. In this episode of EPIDEMIC, we’ll hear why the United States is the only wealthy nation not to offer comprehensive support to parents, why caregiving is a critical part of American infrastructure, and what’s at stake if parents and caregivers are forgotten.

This podcast was created by Just Human Productions. We’re powered and distributed by Simplecast. We’re supported, in part, by listeners like you.

Stephanie Coontz: It’s so sad that women and men who idealize the role of motherhood and how important childcare is actually have contempt for it when it is a paid job.

Erika Moritsugu: I think that the pandemic has given us an opportunity to finally change this. And if we don’t the economic impact from the fallout of women in the workforce is going to be devastating.

Céline Gounder: You’re listening to EPIDEMIC, the podcast about the science, public health, and social impacts of the coronavirus pandemic. I’m your host, Dr. Céline Gounder.

Sarah Murphy is an advocate for women and children in Pennsylvania. She’s involved with an organization called the Women and Girls Foundation.

Sarah Murphy: I was the person that would go to Harrisburg and go to the politicians and fight for funding for Pre-K.

Céline Gounder: Sarah grew up with a single mother.

Sarah Murphy: My mother didn’t have a big bank account, never had a savings account. So, she was pretty much living paycheck to paycheck like I am. And people don’t realize when you’re paycheck to paycheck, as soon as your paycheck is cut off, there’s no savings.

Céline Gounder: That experience shaped a lot of her activism. When she wasn’t volunteering, she worked in daycares and afterschool programs and cleaned apartments.

Sarah Murphy: So then I had a son and that kind of shifted my goals towards moms and the things that moms need.

Céline Gounder: She found out that moms needed a lot. Her son was born in 2012. As he grew up, Sarah struggled to balance work and childcare.

Sarah Murphy: The whole summer, my son is off from school, but I still had to work. And so I had to scramble every summer to, you know, find childcare. I put them in summer camps sometimes, but summer camps are like four hours and work is eight hours. So I would have to leave work, you know, at lunchtime to go get him and bring him to my job or take him to someone else. And, like, it’s a lot of maneuvering.

Céline Gounder: So Sarah had to rely on older folks in her community to help watch her son while she worked.

Sarah Murphy: I like to have older people watch my son, because it’s good for them and good for him.

Céline Gounder:  She told me about one person in particular: Miss Linda.

Sarah Murphy: Miss Linda is the person that, even though we’re not related, she never forgets my birthday. She never forgets my son’s birthday.

Céline Gounder: Sarah met Miss Linda when she was cleaning apartments. Miss Linda lived alone. One day she fell while she was shopping.

Sarah Murphy: I told her, you could always ask me to go to the store for you. And so since she came home from the hospital and that was probably like three years ago, three, maybe even four years ago. I’ve been shopping for her every Monday.

Céline Gounder: But when the pandemic hit, Sarah lost this delicate balance of work and childcare.

Sarah Murphy: So once they say, oh my goodness, all the older people can get sick from the kids, that took away my whole support system.

Céline Gounder: Schools were closed. Childcare centers were closed. Her son’s father was a part of his life but he didn’t live with them. He was working in a facility that cleaned hospital linens.

Sarah Murphy: And being that I have asthma, it was the safest thing for him to just pretty much stay away from us until we figure it out what was going on. So, like for months, we didn’t even see his father because we weren’t quarantined together.

Céline Gounder: Money was tight. Sarah had lost her job shortly before the pandemic. She was wary about looking for work because of what might happen if she got sick. When school went online, Sarah had to find money to pay for home internet.

Sarah Murphy: We did not have internet. And our house only had internet on my phone. We didn’t even have a computer at the house.

Céline Gounder: Alone at home with her son, Sarah tried to find ways to protect her son from the emotional strain of the pandemic.

Sarah Murphy: I would joke and tell my son that we were doing the safari, when you driving your car and wave at the animals. So that’s what we would do at the beginning of the pandemic. We would just get in the car, roll the windows up. We could leave our masks off and just wave at people. Like, “hey, how you doing?!” You know, you have to find ways to survive.

Céline Gounder: The pandemic has upended caregiving and what it means to be a working mom. Parents — especially moms — had to take on full-time childcare and school duties, and hold down their jobs… all in the middle of a pandemic. And the repercussions of this disruption could last for generations. More than 2 million women left the workforce during the pandemic. The reason? The cost and effort of caring for children and older family members. This burden falls especially hard on women of color, like Sarah.

In this episode of EPIDEMIC, we’ll hear why the United States is the only wealthy nation not to offer comprehensive support to parents.

Stephanie Coontz: They claimed the childcare would be communist. They vetoed it. And that pulled childcare into the culture wars.

Céline Gounder: How it’s affecting families like Sarah’s during the pandemic…

Sarah Murphy: So there was no childcare because all of the centers were closed down and then all of them. The older people that were my support system were completely just taken away.

Céline Gounder: And how the pandemic has created an opportunity to turn it around…

Julie Morita: And that’s why it’s really exciting to see what’s becoming available through the American Rescue Plan, where resources are being made available to support early child care and early education, because these are the kinds of things that can actually help children recover from some of these traumatic events.

Céline Gounder: Today on EPIDEMIC, caregiving as infrastructure.

Before we get back to Sarah’s story, we need to know the backstory for why single parents like her are struggling with childcare today. The United States is the wealthiest nation on the planet… but it’s also the only industrialized country that doesn’t offer childcare and paid leave for parents and caregivers.

Stephanie Coontz is the Director of Research and Public Education at the Council on Contemporary Families. She says many of our assumptions about how families should be date back to the 19th century.

Stephanie Coontz: Before then, the assumption was that women and men were both caregivers for family life, in association with the groups in which they lived, and that women were equal providers for the family.

Céline Gounder: In many pre-industrial societies, children were cared for communally. Older members of the community would help care for kids.

Stephanie Coontz: I’ve just spent the last three and a half months in Oakland with my own new grandbaby, and so I found a great confirmation of the historical, anthropological theory about why grandparents are so important to human development and socialization.

Céline Gounder: Children might spend half their time with people who weren’t their biological parents. But this started to change with industrialization.

Stephanie Coontz: And so if there were places where real wages were rising for men, it made more sense to send the men — and the children, by the way, this is what gets forgotten — out to earn wages and have someone at home to continue to do the home production that was so central.

Céline Gounder: It was around this time that the work of childcare became increasingly segregated.

Stephanie Coontz: Servants were usually neighbor girls who were doing this for a year or two to save some money so they could get married, have a household and have servants of their own.

Céline Gounder: But factory work provided these women — mostly white women — with other, often better paying opportunities.

Stephanie Coontz: People begin searching for permanent servants, lifelong servants and servants who can’t talk back, can’t pack up and go well, whether it’s because they can afford to or not. And that’s where, of course you begin to get the exploitation of Black, Native American, and then later immigrants.

Céline Gounder: This segregated class of domestic workers reinforced the idea that childcare was unskilled, low paying work.

Stephanie Coontz: Then, you know, it’s so sad that women and men who idealize the role of motherhood and how important childcare is, actually have contempt for it when it is a paid job, despite the fact that it is, you know, one of the most important jobs in our society.

Céline Gounder: Another big change to the workplace impacted women’s roles as caregivers: the abolition of child labor.

Now children were expected to go to school — not to work alongside their fathers.

Stephanie Coontz: Then it turns out that not all women want to be, or need to be, in the home full-time, and we begin to get this move of women into the workplace. And that of course, really, really accelerated during World War II.

Audio Clip from 1943 “Manpower”: Women are called upon to leave their homes and take jobs. Employers find that women can do many jobs as well as men. Some jobs, better.

Céline Gounder: Women entered the workforce by the millions. 

Audio Clip from 1943 “Manpower”: By the end of 1933, one out of every three women will be at work.

Céline Gounder: Stephanie’s mother was one of them.

Stephanie Coontz: My own mother worked in the shipyards during World War II. And the women were so proud that they were doing this work.

Céline Gounder: And with all these women working outside of the home, there had to be programs for their children.

Audio Clip from 1943 “Manpower”: When women with small children take jobs, everything possible will be done to provide day care for the children.

Céline Gounder: The Lanham Act of 1940 provided federal money to set up a nationwide system of daycares for the children of women contributing to the war effort. By the end of the war, as many as 600,000 children received some kind of care through the program.

Stephanie Coontz: My mother used to talk all the time about the pride she felt and the joy she felt at watching this childcare. And then of course, by the time she had me, those childcare centers were gone and she said, wow, she could really feel the difference, you know, of what it was like to just have to do it yourself and not get that help from the outside.

Céline Gounder: These national childcare programs ended after the war. Women were expected to leave their jobs and return to housework. But by the 1970s, there was a push to create a national childcare plan. In 1971, the U.S. Congress passed the Comprehensive Child Development Act. The bill would have created a national system of daycares to help watch the children of working mothers. But President Richard Nixon vetoed the bill.

Stephanie Coontz: And the backstory to that is that Nixon was about to go to China and they wanted cover. So they wanted to set him up as the anticommunist, and they claimed the childcare would be communist. They vetoed it. And that pulled childcare into the culture wars.

Céline Gounder: Just a few years later, the repercussions of that veto would affect Sarah’s family. Sarah’s mom was a single parent. Money was always tight. Her mom often had to make hard choices about what to do so she could keep working to provide for Sarah. In 1976, Sarah was three, and her mother was pregnant. The day Sarah’s mom gave birth, she had to work. Her mom had to make a terrible choice. She gave birth alone, and left the child.

Sarah Murphy:  She simply said she could not get the day off work. She hadn’t accrued any time, any PTO time to take off to have this baby. So what she did, was had this child, cut the cord herself and then went to work. She went to work at Mercy Hospital as a nurse, on her feet, after she gave birth to a child. And so that’s the type of stuff that on a smaller scale that I’ve been forced to do. There’s been times where I didn’t have childcare and I had to sneak in my kid in supply rooms at work because I didn’t have childcare. And that was pre-pandemic. So that’s a struggle I had to mention what happened to my mother because it happened to me too, you know, that I’ve had literally had to put my son in a supply closet so I could work. And so, there was times that I cried, I walked away from my kid and I cried. I still feel terrible about that. And I know that I’m not saying that I made better options than my mother did by not just leaving my kid and walking away, but it’s like, I felt like I was making that same choice that she did every time I had to do that with my son.

Céline Gounder: Decades later, Sarah and her sister were reunited in August 2019. Her sister got to meet their mother before she died. Sarah says the pandemic has kept them apart, but they’re working on building a relationship.

Sarah Murphy: My sister ended up put behind a dumpster because services for mothers were unavailable 45 years ago. That hasn’t changed. Women are still not having adequate childcare, not having adequate resources.

Céline Gounder: Comprehensive childcare wasn’t available for Sarah or her mother. But that might change for future families. The Biden administration announced this spring the American Families Plan. This bill would redefine infrastructure to include things like caregiving support to families and much more.

We’ll hear how caregiving was impacted by the pandemic… why it’s a critical part of American infrastructure… and what’s at stake if parents and caregivers are forgotten again. That’s after the break.


Céline Gounder: Before the break, Sarah told us about the hard decisions she had to make before the pandemic when it came to childcare. This dilemma weighs on mothers like Sarah, but there’s another side to the issue — the children themselves.

Julie Morita: We haven’t really paid that much attention to children during the pandemic, because, fortunately, they haven’t been hit as hard as adults and older people.

Céline Gounder: This is Julie Morita. She served as Health Commissioner in Chicago and is now Executive Vice-President of the Robert Wood Johnson Foundation. She also served with me as a member of the Biden-Harris Transition COVID Advisory Board.

Julie Morita: There’s still millions of children who have been infected by COVID. And there’s hundreds of children who have died because of COVID directly. But then there’s indirect impacts that children have experienced because of COVID and those things relate to problems with social isolation.

Céline Gounder: Sarah’s child was one of them.

Sarah Murphy: He needed the social interaction because he’s a shy child. So pulling him away from his friends… I still worry, long-term, how that will affect him emotionally.

Céline Gounder: Sarah was at a loss for how to explain the situation to her son.

Sarah Murphy: I just couldn’t fix it, and I have to laugh about it because you got to laugh to keep from crying, but it just had me like, so like, angry as a parent that there was nothing that I could do to alleviate what happened.

Céline Gounder: So when Sarah had the chance, she sent her son back to school.

Sarah Murphy: And I jumped at that, like people judged me like I was trying like, I’m trying to kill my child, but mentally he suffered in here. My son started pacing the floors. And he’s eight, you know, because we couldn’t go outside. So he was in here just pacing.

Céline Gounder: These strains are building up. Julie says one way is in the growing rates of mental health challenges for children and adults.

Julie Morita: And that’s why it’s really exciting to see what’s becoming available through the American Rescue Plan, where resources are being made available to support early child care and early education, because these are the kinds of things that can actually help children recover from some of these traumatic events.

Céline Gounder: In March, President Biden signed the American Rescue Plan into law. The $1.9 trillion act included expanded child tax credits…  extended paid leave credits passed in 2020 for employees who had to take time off because of illness or caregiving duties… and billions of dollars to stabilize childcare centers.

Julie Morita: We know that about 20%, 20 to 25% of childcare centers actually closed. And that 40% of childcare centers and childcare givers actually went into debt to maintain operations. Over 60% actually had to lay off individuals or furlough people. So the child caregiving economy was really struck hard during this pandemic.

Céline Gounder: But many of those policies to help caregivers were temporary.

Erika Moritsugu: We can’t keep people safe and healthy and rebuild our economy,  without allowing people the time off from work that they need for their own health or to care for a family member or to welcome a new child.

Céline Gounder: This is Erika Moritsugu. She’s the White House Asian American and Pacific Islander senior liaison. But when we spoke with her for this episode, she was the Vice President for Economic Justice at the National Partnership for Women and Families.

Erika Moritsugu: So our top priority, has been and is, creating a permanent paid family medical leave program. As a permanent national paid sick days standard.

Céline Gounder: Erika herself is a COVID longhauler. But between emergency leave policies Congress passed in 2020… and the unlimited leave she had at her job… Erika didn’t have to make the tough choices many Americans did when it came to choosing between her health, her family, and her job.

Erika Moritsugu: My boring but lucky story helped sharpen my focus professionally on folks who do not have the luxury of working from home, or didn’t have access to paid leave or paid sick days. It’s working people, particularly women who were suffering without these policies before the pandemic, and now they’re even more important.

Céline Gounder: Erika says the lack of paid time off, sick leave, and other policies to support families is driving women out of the workforce. As many as 2 million women left the workforce in 2020 because they lost their job or had to give up their career to meet caregiving obligations at home.

Erika Moritsugu: Access to paid leave in the United States is dismal. Only 21% of working people have access to paid family leave through their employer, and only 40% have access to paid medical leave.

Céline Gounder: And this is especially true for women of color. It’s no surprise by now that the pandemic has hit communities of color especially hard. Many women and women of color are frontline workers. These are often low paying jobs, with few benefits, like paid time off or sick leave, despite their increased risk of exposure to coronavirus.

Erika Moritsugu: The United States is segregated economy and reliance on employers to provide basic health and family supports, including paid leave, have created greater economic insecurity for people of color, and it’s a well-designed national paid family medical leave program that would address those long-standing inequities in health outcomes.

Céline Gounder: That’s where the American Families Plan comes into play. As part of the Biden administration’s infrastructure proposal, the American Families Plan would recast caregiving as part of the nation’s infrastructure, and formalize many of the things we discussed in this episode. Despite bipartisan support for things like paid family and sick leave, there has been pushback against including something like childcare in an infrastructure package.

Julie Morita: I do think it’s appropriate to think about what we mean when we talk about infrastructure, it’s not just limited to the roads and bridges within our nation, but it’s also about the workforce.

Céline Gounder: Julie Morita again.

Julie Morita: Childcare and caregiving are really critical parts of their infrastructure. When you look over the past 40 years, women entering the labor and the workforce, have really contributed significantly to the income gains experienced by the middle-class over the past 40 years.

Céline Gounder: Just like people can’t get to work if there are no roads or transportation services… they can’t get to a job and participate in the economy if they don’t have access to high quality child and elder care. The American Families Plan would make child care free for lower-income families. Middle-class families would not have to pay more than 7% of their annual income. Currently, middle-class families spend twice that amount on childcare every year — roughly 14% of their income. Lower-income families may pay as much as 35% of their income. Sarah supports these kinds of assistance for working moms like herself. But she says COVID has created additional burdens on caregivers in America.

Sarah Murphy: Women were in a deficit before COVID. We have to pull women out of, out of that, we have to provide affordable housing. When I look at how much money that I pay out of my income for housing, it’s everything pretty much everything that I bring in goes towards the rent, the light, the gas, the water, the sewage.

Céline Gounder: Sarah has stayed involved with her advocacy work for mothers during the pandemic… even if it had to be remote. The organization she’s been working with has been developing a resource directory for working moms.

Sarah Murphy: The resource directory would also have information for childcare. We included self care. Options as well, because that’s important because we don’t realize how, you know, our mental health, how important our mental health is to our overall health. And so we also have resources there for mental health, but pretty much anything that you can think of that moms need.

Céline Gounder: Finally, Sarah says she would like to see more moms involved in developing and funding these social programs.

Sarah Murphy: I think that America should give working moms a chance. We are powerful and we have a wealth of knowledge and experience and can be helpful at getting that change done.


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Today’s episode was produced by Annabel Chen, Zach Dyer, and me. Our music is by the Blue Dot Sessions. Our Production and Research Associate is Temitayo Fagbenle. Our interns are Annabel Chen, Bryan Chen, and Sophie Varma.

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I’m Dr. Celine Gounder. Thanks for listening to EPIDEMIC.


Erika Moritsugu Erika Moritsugu
Julie Morita Julie Morita
Sarah Murphy Sarah Murphy
Stephanie Coontz Stephanie Coontz
Dr. Celine Gounder Dr. Celine Gounder