The beginning of any year is a time of reflection and change—and in the case of motherhood, radical transformation. Mothers across the country are burdened in unprecedented ways, across the spectrum of experiences.

That’s why Motherly and Mom Congress are declaring 2020 the Year of the Mother.

It’s time to reflect on all that is not working and to dive into solutions. And I’ll be frank—there’s a lot that is not working. But that means the potential for change is huge.

Here are some of the biggest issues we face and what we can do about them.

1. Maternal mortality

When we think of the advancement of time, it is natural to assume that the advancement of the medical field comes with it—tragically, that is not the case with maternal health.

Maternal mortality in the United States is rising. From 1991 to 2014, the rates of maternal deaths related to pregnancy, birth and the postpartum period more than doubled. And the worse part? It is estimated that two-thirds of those deaths are preventable.

So why aren’t we preventing them?

What needs to happen:

This new decade must bring a hard look at the root cause of these deaths, with swift action to address them. Interdisciplinary collaboration across the medical fields, and between the medical community and policymakers is required—quickly.

2. Racial disparities in maternal health

The maternal mortality crisis is everyone’s crisis, but we need to understand that it does not impact women proportionately. Black women are three to four times more likely to die from pregnancy, birth or postpartum-related complications. Systemic racism and bias are largely to blame. Nope, it’s not education or socioeconomic status. It’s racism. And we need to own it and fix it.

For example, experts have found that it takes health care workers longer to respond to a reported concerning symptom when that symptom is being reported by a woman of color. This means that potentially life-saving treatment is delayed or never comes.

Remember Serena William’s infamous story? For every one of these celebrity stories, there are hundreds, even thousands more we don’t hear about.

What needs to happen:

We need to spend time examining our own bias, bothin the medical community and beyond. And, we need to work to dismantle the systemic racism, which is deeply rooted in our society.

As I shared with Blood and Milk, “The alarm has been sounded, there is so much more work to be done, including hard looks at the causes of these preventable deaths, along with swift, decisive action to reverse the atrocious trend.”

3. LGBTQ+ rights

Rights for the LGBTQ+ community are improving, but not nearly fast enough—particularly when it comes to parents. Certainly, bias is a reality for many LGBTQ+ people, which can have a significant impact on health and well-being. For example, in many states, LGBTQ+ partners do not have the same access to Family Medical Leave of Absence (FMLA) that people in heterosexual partnerships do. The Human Rights Campaign states, “the FMLA does not require employers to provide an employee leave to care for a same-sex partner or spouse.” This means that many partners do not have access to leave should their partner have a birth complication and need prolonged medical attention—or when they adopt a child.

What needs to happen:

It’s incredibly simple: Every right that is available to a cis-gendered, heterosexual person must be available to a member of the LGTQ+ community. End of discussion.

4. Parental leave

The United States is the only country in the Organization for Economic Cooperation and Development (OECD) without paid parental leave and it’s frankly unacceptable. The benefits of paid leave have been documented, and yet its presence is far from reality.

For many families, when a baby is born, they are forced to choose between going into debt or compromising their health. It is estimated that 23% of women return to work within two weeks of birth. The health and emotional consequences of this are profound.

In her TEDx talk, Jessica Shortall states, “procreation on a national scale is not optional. The babies that women… are having today, will one day fill our workforce, protect our shores, make up our tax base. Our procreation on a national scale is not optional.”

She points out that women make up 47% of the workforce. “These aren’t choices. We need women to work. We need working women to have babies. So we should make doing those things at the same time at least palatable, right?”

What needs to happen:

Paid parental leave at a national level must become a priority if we expect families to keep having children. We must put pressure on our elected officials and let them know that parental leave is necessary for a thriving society and economy.

5. Prenatal and postpartum mental health

As many as 25% of women experience a prenatal or postpartum related mood disordered, such as postpartum depression or anxiety. We’re getting better at diagnosing and treating mental health conditions, but we have a long way to go.

It is estimated that more than half of postpartum depression cases go undetected. This means that a significant percentage of mothers deal silently with this potentially fatal illness every day—which has real consequences not only for them and their families but our society at large.

What needs to happen:

Health care workers need to screen women more frequently and thoroughly for mental health disorders. Policies must be developed to support people with disorders. And, as a culture, we must continue to work on decreasing the stigma of mental health, so that those impacted can feel confident seeking help.

6. Affordable childcare

The 2010s was the decade that made childcare unaffordable. As our News Editor, Heather Marcoux reported, childcare costs should be at about 7% of a family’s income to be considered affordable. According to recent data from Child Care Aware of America, the cost of center-based infant care is between 7.6% to 17.6% of median household income for married couples, and 36% for single-parent families.

No wonder families are struggling. How can families hope to stay afloat financially, when such a significant percentage of the income goes to childcare?

What needs to happen:

Policy reform that increases access to low-cost, quality childcare is essential. And, as we consider this burden, we need to remember that every family has a different set of circumstances. We cannot make blanket statements like, “One of the parents should just stay home then,” because, for so many families, that simply is not possible.

7. Feed-shaming

The way a parent chooses to feed their baby is an incredibly complex, multifactorial decision.

We know that breastfeeding has significant benefits for babies. Women who choose to breastfeed need to be fully supported with education, access to services (like lactation counselors and consultants), and community support (in other words, please stop telling women to cover up when they breastfeed. It’s hard enough as it is.)

We also know that a lot needs to ‘go right’ in order to make breastfeeding happen—and much of what needs to happen is not readily accessible in our society.

How, for example, is a woman who needs to go back to work two weeks after giving birth (when her milk supply is not fully established), expected to exclusively breastfeed?

How is a woman expected to pump every two to three hours if her company does not provide the time or place to do so?

How is a woman without access to a lactation consultant expected to address her baby’s latch issues so that she can keep breastfeeding?

What needs to happen:

We need to do everything in our power to support the women who breastfeed and to increase the number of women who do so. But we also need to up our compassion and empathy around the issue and understand that for so many reasons beyond our control, breastfeeding simply can’t happen at the rates we’d like it to—and those women deserve just as much respect and support.

8. Mom burnout

Burnout is now recognized as a diagnosable occupational phenomenon by the World Health Organization (WHO)—and it’s impacting mothers deeply.

In the 2019 State of Motherhood survey, we found that 85% of mothers do not believe that our society does a good job supporting them. The aforementioned shortcomings, along with cultural pressures, lack of support, and overall inattention to the needs of mothers and families, are resulting in critical burnout of mothers.

What needs to happen:

In addition to the steps named here, we as a society need to recognize the tremendous value of mothers and work intentionally to incorporate that value into our society. We need to be kinder to mothers—and ourselves. We need to understand that without mothers, we are nothing.