Mitch McConnell continued receiving his Senate salary while recovering from a fall. Millions of mothers have no guaranteed paid leave after childbirth.

Federal law allows members of Congress to retain their salary during illness-related absences. McConnell continued receiving his Senate salary during his absence.

By contrast, the Family and Medical Leave Act generally gives eligible workers up to 12 weeks of job-protected, unpaid leave. It does not require employers to provide paid leave.

The United States remains the only OECD nation without paid maternity leave at the national level. Millions of women cannot rely on guaranteed wage replacement.

Fourteen states and Washington, D.C., have enacted mandatory paid family and medical leave systems, including California, Colorado, Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Rhode Island, Virginia and Washington.

Not all enacted programmes are currently paying benefits. State systems also vary in eligibility, duration and wage replacement.

Eligible federal civilian employees can receive up to 12 weeks of paid parental leave under federal law. Kentucky has no statewide paid family leave system for private-sector workers.

Beth Wanner, founder and CEO of Mother Cover, said employers need plans to cover workers' responsibilities during parental leave. Her organisation provides staffing support for such absences.

Postpartum Recovery and Health

Professor Margaret Quinlan, of the University of North Carolina at Charlotte, said postpartum recovery is a critical period for physical and mental health.

A systematic review and meta-analysis of 21 studies found longer maternity leave was associated with fewer maternal mental and physical health complaints. It also found better mother-child interactions and lower infant mortality.

The review found leave of 12 weeks or more was associated with greater benefits for mothers and infants. Federal law offers no general paid-leave guarantee to workers.

Kentucky's Leave Shortfall

Kentucky has no statewide paid family and medical leave programme for private-sector workers. Eligible residents may instead rely on employer benefits or unpaid FMLA leave.

FMLA eligibility excludes some workers at smaller employers and workers who do not meet its service and hours requirements. Restoration may be denied to certain key employees only under strict conditions.

The Pregnancy Discrimination Act prohibits discrimination because of pregnancy, childbirth or related medical conditions. It does not itself guarantee paid leave.

Thomas Ricotta, an attorney specialising in FMLA cases, has argued that stronger paid leave protections could benefit workers.

Caroline Welles, executive director of The First Ask, has highlighted the contrast between congressional benefits and leave protections available to other workers.

Kentucky Governor Andy Beshear has questioned whether McConnell can fulfil his duties. He has urged McConnell to demonstrate his fitness to serve or resign.

McConnell's absence began after a fall on 14 June at his home in Washington, D.C. He was released from rehabilitation on 6 August and continued recovering at home.

On 14 September, McConnell returned to the Senate and cast his first vote since June. He said he was not yet fully recovered and would continue physical therapy.

According to McConnell, his doctors confirmed he had not broken any bones or suffered a concussion, heart attack or stroke. He also said he developed mild pneumonia during his hospital stay.

McConnell has said childhood polio affects his mobility. His office says he continues physical therapy at home while recovering from the fall.

The case highlights a policy gap: workers may have job-protected unpaid leave, but many lack a federal right to paid leave after childbirth.

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