Measuring Progress: A New Standard for Reproductive & Maternal Health at Work

When we launched the initial version of the RMH Compass Performance Standard in 2024, our goal was simple: to help employers better understand how their reproductive and maternal health policies were showing up in the day-to-day lives of their workers, and activate them to take action to implement improvements.

For many employers, it was the first time these interconnected issues had been viewed together through one cohesive framework. It was intentionally foundational and opened the door to deeper conversations.

Over the past two years, our work alongside employers and HR and benefits leaders has given us a unique vantage point into how reproductive and maternal health support is actually designed, delivered, and experienced across workplaces. Through advisory engagements, benchmarking, and ongoing collaboration, we have been able to identify consistent patterns in how employers are excelling, where they are seeking guidance, and how to solve the friction for workers between what exists on paper and what is usable in practice.

One insight emerged again and again: reproductive and maternal health is not a single benefit or moment in time. It is a life-cycle of needs that unfolds over years and across the course of a career, and is shaped by how medical coverage, workplace culture, scheduling realities, access to clear information, and manager support intersect at each stage.

Why This Matters Now

As expectations around workforce health continue to evolve, employers are increasingly evaluated not just on whether benefits exist, but on whether they actually work for employees during critical life moments. Fragmented or outdated approaches to reproductive and maternal health can create real risk, including risks to retention, employee satisfaction, and an employer’s ability to compete for talent.

Leading organizations are moving beyond surface-level benefit checks toward more integrated, experience-based assessments that reveal where systems reinforce one another and where gaps may undermine impact. Looking ahead to 2026, many employers are placing greater emphasis on the holistic well-being of their workforce, considering not only how health coverage supports workers, but also how workplace policies, practices, and conditions within an employer’s control shape day-to-day experience.

The RMH Compass Performance Standard reflects this shift, offering employers a best-in-class framework to understand where they stand today and what it takes to lead as expectations continue to rise.

Evolving the RMH Compass Performance Standard

That understanding guided the evolution of our work updating the RMH Compass Performance Standard. This newest iteration builds upon our initial evidence-based framework, reflecting what we have learned through conversations with employers and industry experts, as well as the continued evolution of workplace policy norms and employee benefits offerings.

Rather than evaluating individual policies or benefits in isolation, the updated framework is designed to capture how benefits, policies, and workplace conditions interact in practice. This approach more accurately reflects real employee experience and provides employers with clearer insight into where their support systems reinforce one another and where gaps may emerge.

At its core, the RMH Compass Performance Standard evaluates how an employer’s health plan, workplace policies, and work environment collectively support employees and their families across the reproductive and maternal health life-cycle. It examines family formation, pregnancy, postpartum care, paid leave, and the transition back to work, alongside factors that shape day-to-day quality of life, including living wage commitments, shiftwork practices, accommodations, and manager support. The latest standard also introduces two new topics to our framework – supporting workers through the menopause journey and in the critical return-to-work period after pregnancy. Together, these additions provide a more accurate picture of how reproductive and maternal health support is actually experienced by employees.

Pillars of Impact

The newest iteration of the RMH Compass Performance Standard is organized around three core Pillars of Impact. These pillars reflect how RMH support manifests in the lives of American workers, where healthcare access, workplace policies, and job conditions are deeply interconnected.

The Pillars of Impact include:

1. Offering Comprehensive Reproductive and Maternal Healthcare
   This pillar of our standard evaluates the breadth and depth of clinical support offered through employer-sponsored health plans (ESHPs). It includes contraceptive benefits, mental health care, infertility and family-forming support, prenatal care, pregnancy loss and termination, postpartum care, and menopause benefits. The focus is not only on whether coverage exists, but on whether care is accessible, affordable, and usable across the reproductive and maternal health life-cycle. By examining quality, cost-sharing, and access barriers, this pillar helps employers better understand how health plan design impacts real-world care experiences for employees, connecting the dots between cost and health outcomes.
   

2. Creating a Flexible and Supportive Work Environment
   This pillar examines the workplace conditions that influence an employee’s ability to care for their health while thriving professionally. It includes shift scheduling practices, accommodations during pregnancy and returning to work after giving birth, support during the menopause journey and other workplace expectations that acknowledge how RMH needs can be supported on the job. The updated performance standard places greater emphasis on how workplace design and management practices affect access to care during critical and often fragile periods across the reproductive and maternal health life-cycle.

3. Providing Inclusive RMH Policies
   This pillar evaluates how workers’ ability to care for their reproductive and maternal health needs across their professional life-cycle is articulated through workplace policies. It includes paid parental leave, inclusive sick and bereavement leave policies, clear benefits communication, health-data privacy standards, alternative reimbursement mechanisms for healthcare expenses, and wage-related commitments. Our standard recognizes policies that create predictability, transparency, and fairness in access to ensure that support is not left to individual managers or informal practices.

Equitable access is woven through every pillar of the standard. We evaluate not only whether a benefit exists, but whether it is affordable and accessible to the full workforce. A benefit that is technically available but financially or logistically out of reach – particularly for part-time and hourly workers, the most economically vulnerable portion of the workforce – does not create meaningful support. This principle has been central to the framework from the beginning and continues to guide how we assess health plan design, alternative reimbursement mechanisms, and workplace practices.

From a Strong Foundation to Emerging Best Practices

The newest RMH Compass Performance Standard reflects a deepening of the original framework, shaped by emerging consensus, new research, and what we continue to learn through direct engagement with employers as workplace norms evolve.

Menopause support offers a clear example of this progression. When the initial framework was developed, we conducted extensive research and did not find consensus on what meaningful workplace support should include. Since then, the conversation has accelerated. Increased awareness, new research, and growing adoption of specific practices by leading employers have helped define what best-in-class support looks like today. The standard now reflects this shift, incorporating menopause as a core component of reproductive and maternal health and grounding it in practices that are increasingly recognized as essential rather than optional.

A similar evolution can be seen in how employers support workers returning to work following pregnancy and parental leave. Earlier versions of the framework addressed workplace accommodations more broadly, reflecting the norms at the time. What we now see is a more intentional focus on this transition period, one that data shows is a critical period in keeping workers engaged and participating in the workforce. Employers are investing more thoughtfully in phased returns, flexibility, and manager support, recognizing the role this period plays in retention, performance, and long-term well-being. The updated framework reflects these emerging practices and elevates them as markers of leadership.

The standard also brings greater clarity to how maternal healthcare access is evaluated. Rather than stopping at whether prenatal and postpartum services are covered, the framework looks more closely at how care is actually accessed and experienced. This includes examining the availability and affordability of options such as midwifery care, doula support, birthing centers, lactation consultation, and pelvic floor physical therapy, alongside traditional hospital-based care. Employers are encouraged to consider not only coverage, but cost-sharing, network adequacy, authorization requirements, and how clearly this information is communicated to employees.

Taken together, these examples show how the RMH Compass Performance Standard continues to evolve alongside the field itself. It captures emerging norms, brings blind spots into focus, and translates complexity into actionable insight. By refining the framework in this way, the standard offers employers a clearer picture of what comprehensive, equitable support looks like today and where targeted improvements can make a meaningful difference for their workforce.

Reshaping the Future of Reproductive and Maternal Health

Reproductive and maternal health support is not a niche consideration. It is foundational to workforce health, stability, and employees’ ability to thrive at work and at home. As workplaces continue to evolve, our aim is to help every employer build an environment where employees feel supported at critical moments in their lives.

Whether you’re just starting to assess your current approach or looking to lead with best-in-class practices, RMH Compass serves as a strategic partner. We combine data-informed insights, policy expertise, and practical tools to help employers move from uncertainty to action.

A great first step is engaging with the RMH Compass Performance Standard, which offers a clear picture of how your benefits, policies, and workplace practices come together in practice, and where targeted improvements can have the greatest impact.

To learn more about how the Performance Standard works and how we partner with employers, visit Get Started or reach out to us at info@rmhcompass.org.