The former manager said her colleagues felt they couldn’t afford to promote someone only to lose them for several weeks.

Financial pressures also explain why 49 of Planned Parenthood’s 55 regional offices — which each manage a set of local clinics — do not provide paid maternity leave. Employees in about 20 of those regions can use short-term disability to earn a portion of their salaries while on leave. The New York headquarters provides six weeks of paid parental leave.

Last year, Christine Charbonneau, who runs the regional office in Seattle, asked her human resources department to find out how much it would cost to cover maternity leave for the region. The estimate: $2 million a year. That is the entire annual budget of some clinics.

Ms. Charbonneau’s office, which oversees 27 clinics in the Northwest, generates $77 million a year in revenue. But states like Washington and Idaho have cut government funding in recent years. Paying for maternity leave, Ms. Charbonneau said, could force her to close clinics.

“It is easy to accuse someone of hypocrisy if you’re not the one trying to find $2 million out of thin air,” she said. “You try to be the Planned Parenthood that donors expect, and yet it is unattainable.”

Planned Parenthood’s policies, though, can make it hard for employees to scrape by after giving birth.

In August, Marissa Hamilton, an employee at Planned Parenthood in Colorado, gave birth to a baby boy. He was eight weeks premature, weighed less than four pounds and spent weeks in neonatal intensive care. The office doesn’t provide paid maternity leave.