Pumping in the bathroom.

In some workplaces, that’s the only option for breastfeeding moms.

In others, even that’s a problem.

Most health experts recommend breastfeeding for the first year when possible and desirable.

Lack of support in the workplace may be one reason that in the United States drop after six months.

Katy Tang, a San Francisco supervisor, recently introduced legislation that could potentially change that, at least in her city.

The ordinance would require private and public workplaces to provide a lactation space with a seat, a surface, an electrical outlet, and access to a sink. All new construction would have to include a lactation space.

The San Francisco Chronicle notes that Tang is open to hardship exemptions for some small businesses.

Under the Affordable Care Act (ACA), federal law currently requires employers to allow break time to express milk, along with a private place to do so. It can’t be a bathroom.

This law applies only to companies with more than 50 employees, and there are hardship exemptions. There are no federal rules for electrical outlets or sinks, although some states have more requirements than the federal law.

With repeal of the ACA on the table, those federal requirements may disappear, leaving the matter to states or individual businesses.

Read more: Breastfeeding gaining more acceptance »

Some concerns

Antonia Townsend is the founder of TheEnclosed.com, which has four employees in San Francisco.

Townsend is also expecting her first child in a few months.

“I plan to breastfeed and pump in the office as needed throughout my first few months. While we will not have a ‘lactation space,’ we are taking a conference room and making it more private with curtains,” she told Healthline.

Townsend acknowledged her privileged situation as the boss. But she’d do the same for any of her employees.

In fact, she believes all employers should do everything possible to help mothers breastfeed or pump at work. She added that it’s a crucial part of keeping these women in the workforce.

Even so, she doesn’t embrace the idea of strict legal requirements for lactation spaces.

For her business, it would be “completely untenable,” she said. “Especially if the requirement didn’t specify the size of the business and other parameters.”

TheEnclosed.com rents space in an office building shared by other businesses.

Townsend’s lactation space will have access to electricity but no sink. This setup, she said, is the only way it’s feasible.

“It [the sink] would require complete re-plumbing of rented space. Landlords wouldn’t pay. We’d have to move or shut down the business if it was really a requirement,” she said.

Townsend is part of Dogpatch Business Association, a group of local businesses including bars, restaurants, accounting services, and others. She said it likely wouldn’t be different for any of them.

“It would be a straight-up deal breaker for the majority of small businesses, especially with rents in San Francisco,” she said.

“I’m hyperaware because San Francisco is legislation-happy. As a result, small businesses are getting squeezed out of the city. We don’t want to squeeze women of childbearing age out of the workforce as less desirable hires,” she continued.

Some of her concerns are informed by the past, she explained. She once worked for a company where, though it certainly wasn’t a written policy, the culture was not friendly toward hiring women of childbearing age.

“That is the implication of this type of legislation,” said Townsend. “It puts this perceived burden of ever hiring women of childbearing age which, to me, is a far more horrible concern. Don’t get me wrong, you have to be able to breastfeed or pump. But it’s the other side of this, that’s what we risk, and it’s a really frightening prospect. This sort of legislation could have a subtle, but material impact on hiring practices.”

When it comes to business, size might matter.

Townsend suggested that any legislation on lactation spaces should at least differentiate between small, medium, and large businesses.

But there’s more to it than size.

“A large office with extra space might be able to handle it. But a large restaurant with a hundred employees on a high-trafficked street — think of the rent on that. Creating a lactation space would be totally prohibitive. They’d have to leave the area. You have to understand the physical setup of each business,” said Townsend.

“That’s why legislation like this is problematic. It comes down to a case-by-case basis.”

Read more: Is breast best? Balancing work, family, and the pump »

A tale of two businesses

Erica Perng, director of communications at Lumos Labs, Inc. (Lumosity) reports a positive breastfeeding-work relationship.

“In addition to offering 12 weeks of paid leave, when I returned to work, I had access to a serene Mother's Room equipped with a comfortable chair, pillows, ottoman, hospital grade pump, drawers to store my pump parts, a refrigerator, sink, and extras like a bottle brush, dish soap specifically for removing breast milk residue, dish rack specifically for pump parts, nursing tea, parenting books, and a bulletin board for putting up baby photos.”

It’s a good way to retain valuable employees. It’s a setup that enabled Perng to breastfeed her son beyond his first birthday.

As Perng points out, businesses in Silicon Valley tend to be supportive of working parents. But it’s probably more than many companies around the country could manage.

Mark Aselstine, founder of Uncorked Ventures, does business just outside of San Francisco. He has a small, part-time staff, and breastfeeding hasn’t been an issue.

He thinks requiring new construction to include lactation space is a great concept. But he shares Townsend’s concerns about business size and older, established buildings.

“The ability of a business when they hire their first employee is dramatically different than say Google, Facebook, or Apple,” he said. “Where I get concerned as a small business owner is that if size isn't taken into account, do I need to create this space, before I can even hire an employee?”

Aselstine told Healthline that his wife had to deal with less-than-ideal setups at work.

“Some of the time, it was the best that an employer or site could do. Other times, it seemed they simply didn't care all that much. It always seems better to me to allow people to make the best accommodation that they can, given the space and monetary requirements at play. But I know that also leads to some percentage of people thinking that means there aren't any real requirements,” he explained.

“It seems like those two are competing concepts, which is why our local ordinance for new construction is pretty important. If I moved into my own space, it would be great to have ordinances like this taken care of already,” said Aselstine.

Read more: One million babies per year die the same day they're born »

Lactation spaces don’t solve everything

Blogger Mary Kathryn Tiller of Texas likes the ordinance.

She told Healthline it would go a long way to improving women’s experiences of pumping in the workplace.

Not that it would solve every problem.

Tiller has had access to a private room in the workplace. She called it a partial win.

When her first child was born, she used the company conference room and brought her laptop in so she could continue working while pumping.

The only thing between her and her co-workers was an “in use” sign on the door.

By the time her second child came along, she had a new job and a private nursing room.

The downside was that her job involved a desktop computer. And she was paid by the hour.

“I needed the mobility, like a laptop, to move my workspace into the private room,” said Tiller. “Otherwise, I would have to clock out and lose pay. Unless the company's culture is supportive of breastfeeding mothers and will not punish them, either socially or financially, it doesn't solve all the problems.”

Tiller credits both employers with being family friendly and supportive of her desire to breastfeed.

“Unfortunately, neither was adequately equipped with the tools to help me blend work and breastfeeding in a way that didn’t detract from my work day. I think you need both, the moral support and the equipment to be successful as a breastfeeding mom in the workplace,” she explained.

Eventually, she and her husband decided things would work out better if she stopped working outside the home. It wasn’t the only reason, but not having to deal with pumping on the job was definitely a factor.

“My advice to mothers who cannot afford to leave their job is pump if you can. It's hard work and terribly inconvenient. But if it's what you desire to do for your child, it's worth it and it's just for a season. If pumping wears you out, or is just not feasible in your job, formula provides a fantastic alternative for your babies. You're working hard to provide for your kiddos, financially and nutritionally, whether you use breast milk or formula,” she said.