Extending Parental Leave

ADJOURNMENT MOTION

The Government Whip (Mr Chan Chun Sing): Mdm Speaker, I beg to move, "That Parliament do now adjourn."

Question proposed.

Extending Parental Leave

5.04 pm

Mr Louis Ng Kok Kwang (Nee Soon): Madam, last year, I shared with this House that my wife and I were expecting twins. In that speech, I said, "Just saying 'twins' makes me feel tired already."

My twins were born in February this year, 10 weeks early and, honestly, the word "tired" does not even begin to describe our preterm twin parenthood journey over the past five months.

It has been a tiring, exhausting, sleepless five months. My eye bags are now almost permanent and bigger than my eyes most of the time.

But at the same time, in between the crying, the screaming, the burping, the poo and pee, the nappy leaks and the vomits, the past five months have bought us so much happiness, smiles, love and made me appreciate things a lot more.

Madam, allow me to share this journey and how I hope our policies can change so that parents with preterm babies and/or birth of multiples can get more help, essentially for a start, more precious time with their babies.

Madam, I will also share the journey of many, many other parents with preterm babies and/or birth of multiples who have shared their often very painful stories with me, in the hope as well that our policies can and will change.

On 23 February, my wife called me telling me her water bag broke. I will never forget that call but, honestly, the rest of that day was a complete blur. I did rush home, picked her up and rushed to the hospital. That evening, they performed an emergency caesarean and Katie and Poppy were born, 10 weeks premature.

I wanted to be in the operating theatre with my wife but the doctor did not allow it. He replied that "There will be a lot of doctors and nurses in there as they have to deliver twins and your twins might come out lifeless and will have to be resuscitated. It might be too traumatic for you to see this."

Waiting for them to come out of the operating theatre was one of the most excruciating waits of my life.

My twins were delivered successfully and spent about 10 weeks in hospital, at the SGH Neonatal Intensive Care Unit (NICU) and at the High Dependency Unit, also called the Special Care Nursery. It was a very difficult and painful 10 weeks. It was an absolute emotional roller coaster ride and it was physically draining.

We were at the hospital every day, watching them progress and then deteriorate, progress and deteriorate, progress and deteriorate.

It was painful watching them stop breathing, their heart rates plummet in front of my very eyes and, at times, their lips turning blue. Nothing can properly describe the feeling of watching your babies go through that repeatedly. It is an experience I wish no parent has to go through.

And my babies were not the smallest, the most premature there. There were babies at the NICU who weighed only 800 grammes and I cannot even begin to imagine the amount of stress, pain and trauma their parents were going through.

This first chapter of the journey was also perhaps the most difficult as I did not take my paternity leave. I could not, as I wanted to save the precious two weeks for when Katie and Poppy came home.

Juggling work and family was near impossible. Every time my phone rang, my heart skipped a beat as it might be from the hospital with bad news. It was hard to concentrate on anything.

The dilemma I faced would be the same dilemma all fathers of preterm babies face.

Like Jeremy Chee, who also had preterm twins. In his own words, "Most of the time is spent shuttling between home and hospital and being a Uber milk delivery dad. By the time they were discharged, I had spent most, if not all, of my paternity leave."

This was the same situation for Yeo See Yeong. He said, "Taking care of a preterm baby is already tough, let alone preterm multiples".

Mothers feel the same, too. Pearlyn Ong, a mother of preterm twins said, "As I had a C-section, I really needed the help of my husband at home and to bring the twins to the polyclinic since I was recovering from my wound. However, he has no more leave left by the time both babies came home."

It was the same for Gina Tan, whose husband ran out of paternity leave while her premature twins were still in hospital.

And, worse still, for Agatha Kee who had one twin in hospital and one twin discharged. She had to take care of them in two different places. In her words, "It's mentally and physically straining".

Clearly, two weeks of paternity leave are insufficient for us fathers if our babies are in NICU that entire time.

And mothers face a similar dilemma. The 16 weeks of maternity leave are supposed to be to bond with your baby. This bonding is crucial, as stated by Mr Chan Chun Sing, then-Acting Minister for Social and Family Development, in his closing speech for the Child Development Co-Savings Bill in 2013. He said, "Maternity leave caters to the time required for the mother to physically recuperate from childbirth and nurse the infant before returning to work".

Further, by introducing two weeks of mandatory paternity leave from 2017, MSF had recognised the importance for fathers to have the "opportunity to actively bond with their children from the time they are born" as it is a "critical infant period".

Academic research indicates the same. The first few months with your baby are important few months.

But these 16 weeks of bonding are clearly reduced for parents of preterm babies. Having spent so much time in NICU, I can tell you that proper bonding is almost impossible there.

Babies are often in incubators, making physical contact with them very difficult. Holding the babies is also difficult as most have several tubes attached to them and there is, of course, the risk of passing an infection to the babies, which could be deadly.

My twins spent 10 weeks in hospital and it is little, compared to others. Cecilia Tan's premature son spent 101 days in KK Women and Children's Hospital before being discharged. Stephenie Tan's premature daughter spent 103 days in KK Women and Children's Hospital. She had no choice but to return to work three weeks after her baby came home. Eden Ang's premature daughter was in the hospital during her entire 16 weeks of maternity leave.

I cannot imagine having to go back to work when your baby is discharged after spending 16 weeks in hospital. I doubt anyone can function properly at work in any case. Worse still is going back to work when your baby is still in the hospital.

This was the case for Meiyan Carol who had premature twins. She said, "The twins are my first babies so after giving birth and seeing them with all the tubes and equipment really scared me and I couldn't stop worrying. Every day, I will visit them in NICU for those few short hours, I couldn't help but break down several times."

One of her twins was discharged after three months, the other after seven months. She went back to work after taking her maternity leave and after her elder twin was discharged, she had no choice but to take two months of unpaid leave to take care of her.

And this is the case now for Ng Hui Wen, whose premature daughter is currently warded in KK Women and Children's Hospital for over four months already. She took only two months of maternity leave, as she wanted to save the remaining two months to spend with her baby when she is discharged. In her words, "The daily visits to hospital has taken a toll on my mental and physical health".

And the time the baby spends in hospital is an important time for both fathers and mothers to be together rather than apart. The emotional stress is tremendous and both parents need to be there for their babies and for each other.

Magdaline Lee, a mother of a preterm baby said, "I had to admit I had postnatal depression when I saw my two-kilogramme baby in NICU with tubes over him. The need to have a supporting husband during this period is crucial to the family. Having just two weeks of paternity leave wasn't enough for me, I needed to have someone to be there emotionally and mentally after going through an unexpected early delivery."

Perhaps the most heart-wrenching story shared with me was that by May Leo who had premature twins but one twin caught an infection in her womb and could not be saved. The other twin stayed in hospital for about four months. She said, "My husband and I, especially me, had to manage losing a baby and running to and from the hospital during my confinement to be with my baby boy during his critical days. It was very tiring and sad at the same time".

And it is important to be there for also the babies. Doing kangaroo care or skin-to-skin contact with the baby does help the baby grow better as well. Kangaroo care is commonly prescribed for preterm and low birth weight babies. It has been found to have wide-ranging benefits for both infant and parents, including reducing infant mortality, increasing growth, raising likelihood and duration of breastfeeding, encouraging mother-infant bonding and increasing parental satisfaction.

Madam, I am glad that some companies understand the difficulties faced by parents of preterm babies. Lee-Ling Chow, who has premature twins, told me she was glad that her company allowed her to take no-pay leave.

Similarly, Anitha Narayanan was allowed to take all her annual leave and one month of no-pay leave.

Mdm Sue, whose baby spent 174 days in hospital, said, "Work during this period is practically impossible for me. I exhausted my four months of maternity leave and had to apply for another three months of unpaid leave to take care of my baby."

Rachel Lee's twins spent two months in the hospital before they came home. She said, "Luckily, my boss has allowed me to take another three to four months of unpaid leave to look after the girls until they were bigger and more stable. But what about other moms who didn't have understanding superiors like mine? They could have lost their jobs."

And some do pay the price. Yongle had premature twins and took three months of hospitalisation leave and four months of maternity leave. She said, "I was lucky enough to keep my job but with pay freeze and a 50% cut to my year-end bonuses."

I sincerely hope the Government can make sure parents of premature babies are not penalised. We have enough to worry about already.

For this first chapter of the journey, my recommendation is that we extend the parental leave for both fathers and mothers to at least cover the time the babies spend in NICU, if not the entire time the babies spent in both NICU and at the High Dependency Unit or Special Care Nursery.

Several countries, such as Austria, Denmark, Italy, Germany, France, Spain, Israel, Colombia, New Zealand and India already provide extended leave for mothers and/or fathers of preterm babies. I sincerely hope we can consider this.

In New Zealand, for example, paid parental leave is extended by the period between actual and expected birth, for up to 13 weeks. This leave can also be transferred to the father.

In Denmark, maternity leave is prolonged by the period the infant spends in the hospital for up to three months, if the infant is hospitalised during the first 46 weeks of childbirth.

This change in policy while significant for parents of preterm babies, really would not be a significant change for employers who might be worried about the manpower shortage or the Government in terms of the additional financial resources for the paid leave.

In 2015, out of 42,185 live births in Singapore, only 127 occurred at less than 28 weeks' gestation, which is only 0.3%. Babies born before 37 weeks are considered preterm but, unfortunately, I could not find data on the number of births before 37 weeks in Singapore.

But it is usually babies who are born before 28 weeks who would require a longer stay at the hospital.

It is also clearly verifiable with doctors when a baby needs to be in hospital, especially NICU. So, there need not be concerns about abusive leave applications.

Madam, this first chapter could perhaps be summed up by one word "stress". The next chapter of the journey could perhaps be summed up by one word, too, which is the word I started this speech within the opening paragraph "tired".

On 22 April, Katie was discharged. On 1 May, Poppy was discharged. These two days were among the happiest days of my life. We were overjoyed to bring Katie and Poppy home. We were overjoyed to finally see them without any tubes stuck into them. We were overjoyed to finally introduce Katie and Poppy to Ella, our eldest daughter. For 10 weeks, she could only see them through a glass window and she really wanted to carry them. She has been the best big sister.

This was also the time we realised that our two babies were, in fact, owls. They were full-fledged party owls and completely nocturnal and they partied through the night. And I rarely use the word sleep now as I cannot really remember what sleep is and what it feels like to sleep properly.

In the first few months, the twins needed to be fed every two to three hours. It took about 30 minutes to feed each baby. My wife took about 30 minutes to express the breast milk.

After feeding, it takes about 10 minutes to wash and sterilise all the bottles and pumping equipment. Not forgetting that their nappies have to be changed before each feed and that takes about five minutes.

And it takes another five minutes to burp each baby. It might sound a bit gross but I now absolutely love the sound of burps. Hearing a burp means I can finally rest or sleep.

It means the end of a cycle. But the problem is the end of the cycle is pretty close to the start of the next cycle and, if you can see where I am heading, sleep is a valuable commodity when you have twins.

The problem is not when the twins cry at the same time. In fact, I feel it is better that they do. It is worse when you finally calm one down and the other one starts crying. It does not end.

But I have responded to Minister Ong Ye Kung's call to continually upgrade my skills and I have evolved to meet the changing needs.

I have gone from feeding one twin at a time to feeding both at the same time, holding one milk bottle in each hand to last month, I have mastered the art of feeding both twins at the same time with just one hand. I have a photo to prove this.

Just last week, I managed to feed one twin and burp the other twin at the same time. Now, I have to try and see if I can burp both of them at the same time. But I know my wife would be horrified if I tried it.

But this is the reality each day. Parents of multiple births have to deal with greater challenges than parents of single births. Multiple birth parents are more likely to have less sleep because their babies can have different sleep-wake rhythms and express their needs at different times.

Multiple birth parents have little chance to regain their strength and are more likely to remain tired for an extended period of time.

A study in the United Kingdom showed that only 8% of multiple birth mothers had more than six hours of sleep each night during the first month, while 46% slept less than three to four hours.

Parents of multiple births also have greater need for an extra pair of helping hands, such as from their partner, to help care for multiple babies at once. Thus, 93% of British multiple birth mothers wished that their partners had extended paternity leave to help care for their babies.

Some studies also show that 20% of multiple birth mothers had suffered from postnatal depression, versus 10% of single birth mothers.

Beyond these, parents of preterm babies and multiple births also have much more medical appointments. In the past few months, Poppy alone has had repeated medical appointments with the ophthalmologist, cardiologist, speech and language therapist, physiotherapist and neonatologist. A lot of time has been spent back at the hospital.

Again, as you can see from my eye bags, parents of twins need help. If you see my wife's eye bags, you know that we really, really need help.

My recommendation is that we extend the parental leave for both fathers and mothers with births of multiples.

Many countries already offer extended parental leave in cases of multiple births, some offering it since 1975. These countries include Finland, Norway, Sweden, Germany, Luxembourg, Portugal, Spain, Austria, Belgium, France, Czech Republic, Latvia, Poland, Russia, Israel, Turkey and, closer to home, China, South Korea, Japan, Vietnam and Myanmar.

In France, for example, maternity leave is extended by 18 weeks for twins, by 30 weeks for higher order multiple birth. Paternity leave is extended by seven days.

In Myanmar, maternity leave is extended by four weeks for twin deliveries.

Like preterm babies, this change in policy will not have a big overall impact. Out of 42,185 live births in Singapore in 2015, there were only 1,249 twin births and 21 sets of triplets born. Only 3%.

Parents also cannot choose whether they have twins or triplets and, so, they cannot manipulate the system.

Madam, I sincerely hope that the Government will consider my recommendations, study the positive examples in other countries, do public consultations and, ultimately, help provide parents of preterm babies and/or births of multiples with greater peace of mind and more precious time to bond with their babies.

I cannot end this speech without thanking the amazing doctors, nurses, therapists, cleaners and all the staff members at the delivery suites, NICUs and High Dependency Units at SGH and all the other hospitals. "Thank you" for saving the lives of Katie and Poppy and countless other babies they have cared for.

At times, it was surreal sitting at the NICU, doing kangaroo care with my baby, singing to her while watching the mayhem in NICU. Watching the staff handle a never-ending arrival of preterm babies and a never-ending chorus of alarm bells as babies stop breathing. The staff members handle each situation so professionally, so meticulously and with so much tender loving care. From the bottom of my heart and on behalf of all the other parents, thank you.

I also wanted to highlight the efforts of the Facebook group "SG Parents of Twins and Triplets" which has been the only form of communal support for parents with multiples.

And, Madam, through this journey, I also realised that I have married Wonder Woman. My wife had an emergency caesarean at night and, in the morning, she was up and about, going to see our twins already.

It is not easy expressing breast milk for one baby, but my amazing wife has managed to express enough milk for two babies for five months now. She has also mastered the art of pumping breast milk while feeding both twins at the same time. I also have a photo to prove this but I know she will definitely kill me if I show it to you.

Madam, many people have shared their preterm and/or birth of multiples journey with me and we all hope that, through our sharing of our painful experiences, others will benefit from the changes in policies we are calling for.

We have all been through it and hope that future parents of preterm babies and/or births of multiples will get the additional help they so desperately need.

Unfortunately, I definitely would not benefit from these changes, as my factory is closed. With three daughters, I am heavily outnumbered at home already and this factory is definitely permanently closed.

Let me end with a quote as always. This one I really love.

"Twins will make love stronger,

Days shorter, nights longer,

Bank account smaller,

Home happier,

Clothes shabbier,

The past forgotten and

The future worth living."

Thank you, Madam.

5.23 pm

The Minister, Prime Minister's Office (Mrs Josephine Teo): Mdm Speaker, first let me thank Mr Louis Ng for a very candid speech on his recent experience with the birth of his preterm twins. He spoke from the heart and won us over with not just the strengths of his arguments but also the intensity of his conviction. And I think I can reasonably speak for everyone in the House that we are all very glad to hear that Katie and Poppy are back home from the hospital and that the whole family is doing well, notwithstanding your lack of sleep.

I have a lot of sympathy for all the challenges that parents like Mr Ng go through, having had twins myself and also nieces who were born prematurely. Not everyone appreciates the unique challenges Mr Ng highlighted. After all, multiple births constitute just 3% of all children born in Singapore. In 2016, there were 561 sets of twins and eight sets of triplets. Likewise, the number of preterm births at 35 weeks or below is relatively low, about 4.5% of births. These numbers have remained stable over the past decade.

Although the numbers are not large, the impact on each family is significant; I think we heard from Mr Ng. For this reason, I agree fully with Mr Ng that there is scope to consider how we can better support parents with preterm babies or who have to manage multiple births.

The Government is strongly committed to supporting Singaporeans in their marriage and parenthood journey. In fact, we have progressively enhanced support measures over the years, which include legislating new leave provisions. For example, maternity leave has been increased twice: in 2004, it went up from eight to 12 weeks; in 2008, from 12 to 16 weeks.

To support fathers in playing a more active role, paternity leave and shared parental leave were introduced in 2013 and were enhanced just this year. Fathers now have two weeks of paternity leave and can share up to four weeks of their wife's maternity or adoption leave, as shared parental leave.

Our parental leave provisions are also fully paid. In comparison, while some other countries provide longer periods of leave, much of the leave provisions are paid partially or not at all.

Even so, as Mr Ng has highlighted, parents may have greater care-giving needs when their infants are born prematurely, or if there are two or more babies at one go.

During the Committee of Supply debate this year, I had announced that the public sector will test the viability of longer parental leave for parents of infants, through a three-year pilot. Public sector officers can get an additional four weeks of unpaid leave when they have children below the age of one. This will give parents the option to take more leave if they need to. In total, couples with at least one spouse in the public service can have up to six months of leave between them. Depending on the outcome of the pilot when it ends in 2020, we will assess the possibility of a nationwide rollout in future.

In the meantime, given the significant enhancements made to parental leave provisions recently, we will need to give employers some time to adjust before considering further legislative changes.

While more leave could be useful for parents who have multiple or premature births, we have to be mindful that we do not inadvertently affect their employability if they are absent from work for an extended period of time. Employers have provided feedback that increasing leave provisions could have an impact on manpower and administrative costs, especially in a time of business uncertainties. For practical reasons, we will always need to balance between providing support for employees with caregiving needs and employers' concerns.

Beyond parental leave, there are also other measures in the Marriage and Parenthood Package which support parents, including those with multiple or premature births. As Mr Ng noted, the Baby Bonus cash gift and Child Development Account co-savings are given on a per-child basis. All children receive the Medisave Grant for newborns of $4,000, and are covered under MediShield Life from birth, including for any congenital or neonatal conditions. These measures help to defray the costs of their children's healthcare and medical needs and provide parents with greater peace of mind.

Parents have given the consistent feedback that while the parenthood support measures are helpful, they also need employers to provide a family-friendly work environment. I am glad to hear from the examples that Mr Ng cited, that many employers are, indeed, understanding and helpful. We encourage more employers and co-workers to show understanding towards parents who may have extenuating circumstances and require more time to care for their children after birth.

For example, private companies can join the public sector in taking the lead to provide additional unpaid leave to parents of infants. According to a survey by MOM, in fact, more than half, 54% of establishments in 2016 provided unpaid leave of more than one month for employees to attend to family or personal matters.

Another useful form of support is flexible work arrangements. Employers can tap on various resources to implement flexible work arrangements. The Work-Life Grant provides employers with funding of up to $160,000 each over four years to help employers defray the costs of implementing and sustaining flexible work arrangements. In addition, the tripartite partners are jointly developing a Tripartite Standard on Flexible Work Arrangements, which will help job-seekers and employees identify progressive employers with strong support for flexible work arrangements.

Mdm Speaker, our vision is to make Singapore a Great Place for Families. This requires not just policy measures but also the support of employers, co-workers and family members.

In conclusion, I thank Mr Louis Ng for highlighting the needs of parents who may need additional support and care. We hear you, we appreciate the extraordinary trials and tribulations that you go through and you have my personal assurance that we will study ways to better support your families and we will seriously consider all of Mr Ng's suggestions.

Question put, and agreed to.

Resolved, "That Parliament do now adjourn."

Adjourned accordingly at 5.31 pm.