The burdens of family planning and support are having a profound effect on workers and their employers. According to a new report, 92% of parents feel overwhelmed balancing family and work obligations. The stakes are high for their employers: Parental stress drives many workers to take extended leaves or to quit the workforce altogether.

The stress of having a family can begin before employees even have children. According to the latest State of Women’s & Family Health Benefits Report by Maven, 28% of employees pursuing fertility treatment have incurred debt to cover health care costs. Many (56%) said they weren’t clear on the costs before starting treatment, and 46% reported having received a surprise healthcare bill or paying more than expected for a treatment.

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