parental mental health may be the key to improving retention, RTW, & wellbeing
Shannon
Malloy | Lead
Research & Data Associate | Ovia
Health
Allison
Gabriel, PhD, MSIO | Professor
& University Distinguished Scholar,
Management & Organizations | Eller
College of Management, University of
Arizona
Laura Little,
PhD, MBA | Synovus Director of
the Institute for Leadership Advancement,
Associate Professor, Management | University
of Georgia
One of the workforce’s most vulnerable populations is
women, and particularly working moms. With external
conditions as they are, employers need to focus on
improving and strengthening the internal programs and
policies they have control over to keep existing and new
employees — especially female talent — engaged,
supported and employed.
One area of focus
employers can easily impact and improve is return to
work (RTW) and parental leave planning. Data indicate
that postpartum and perinatal depression (PPD)
drastically reduces RTW rates, but exactly how is still
in question. So, what can organizations do to help
reduce PPD, and improve RTW rates for working parents?
In this episode, we review a new study that better identifies the drivers behind PPD, how it discourages women from returning to work, and how to prevent it.
Relevant resources, hand picked for you
If you enjoyed this podcast episode, check out the full Ovia Asks podcast series, or other content for more insights from leading employer organizations.
Q&A: What's Worrying Working Parents & How You Can Help
Employee Guide:
The
Parental Mental Health Toolkit
Article: Celebrate Women’s History Month By Making Real Change
Podcast transcript
parental
mental health may be the key to improving retention,
RTW, & wellbeing
Shanon Malloy [00:00:44] Hello,
everyone, and welcome to another episode of the Ovia
Asks podcast. I'm Shannon Malloy, a clinical researcher
here out of your health and your host. And I'm so
thrilled to tell you about today's episode. It's
centered on a group of people who are a crucial
component of Ovia's audience. New parents. So today
we're going to dive into parental mental health,
specifically perinatal depression and new moms, and how
this has tremendous rippling effects on return to work.
So why is it important to pay attention to
parental mental health? Well, the reasons are pretty
clear. The COVID 19 pandemic has uncovered what society
has successfully repressed for far too long. Parents and
specifically working moms are under pressure and their
mental health is suffering the most. And this has
manifested in ugly ways in the employment market and
landscape and a tsunami of employee departures. The
great resignation, the big quit, or as I like to think
of it, the great reassessment. It's real and it's not
going away, and it's disproportionately stealing away
employees who are also moms. Since March 2020, millions
of working moms have left the workforce. Mental health
conditions like postpartum depression or PPD are
partially to blame for these departures. So if your
workforce is looking to retain and attract top talent
(like working women) or if you're a health plan trying
to improve mental health for your members, you need to
look at the moments that matter most to your
populations.
Growing your family is one of those
moments. New parents, especially moms, face many
challenges that are unique, and many describe those
first few weeks with a new little one overwhelming,
bittersweet, disorienting and more. It can also change
their outlook on life and put a new perspective on what
matters.
If you want to keep working parents,
you need to help them understand and take care of their
physical and mental health and transition back to work
after parental leave in a way that's manageable by
making parental leave easy and understandable and
ultimately making sure they know that employees aren't
going to be forced to choose between their family and
their career.
So what can organizations do to
help reduce postpartum depression and improve return to
work rates for working parents? In this episode, we
review a new research effort that better identifies the
drivers behind postpartum depression, how it discourages
women from returning to work and how to prevent it. So
thanks again for being here, Allie and Laura, we've
worked together for a while, but I'd love it if you
could tell listeners about yourselves as well.
Allie Gabriel [00:04:10] So
again, hi, everyone. My name is Allie Gabriel, and I am
the McClellan professor of management and organizations
and university distinguished scholar in the College of
Management at the University of Arizona. And I'm an
organizational psychologist by training and primarily
study employee wellbeing. And lately, the focus has
really been on how we can best support and build the
well-being of working women and particularly mothers in
the workforce.
Laura Little
[00:04:38] Hi, I'm Dr. Laura Little. I'm so
happy to be here and talking about these important
issues. I'm an associate professor at the University of
Georgia and also the senior west director of the
Institute for Leadership Advancement. I study a variety
of work family issues, and I particularly look at women
dealing with pregnancy in the workplace.
Shanon Malloy [00:05:17] Great.
Thanks for those introductions. So let's just dove right
in and talk about return to work. Laura, do you know why
this is so difficult today? And also, how has it changed
post-pandemic?
Laura Little
[00:05:30] Absolutely. So return to work is
is absolutely a challenging time for women who are
navigating the workforce, navigating a new child. They
are also navigating a new identity where they are new
mothers. Even if they've had a child before and have
navigated work family issues and returning to work
before, it still can be challenging because anybody that
has more than one kid knows children are different and
they can present very different challenges as you return
to work.
We recently did a study on Return to
Work, and we found that mothers are also critical
members during this time, meaning that they carry the
lion's share of the work in the family and so are more
responsible at home, but also trying to adjust to the
workplace that they're returning to. And one of our
participants in one of our studies actually called this
latent work, which I really liked a lot because it is
work that is not always visible, you know, stuff that's
constantly going in your brain or physical work like
breastfeeding. And it's it's not always something that
people realize you're engaged in, but it can be really
draining and time consuming.
If you think about
the physical aspects of caring for any child, I
mentioned breastfeeding, but also the cognitive aspects
of understanding new divisions of labor and how to
handle all of that in the workplace. The emotional
aspects of leaving your new child with with, you know,
potentially another caregiver. And you know, you're
coming back to work after being gone for a while, and
you may have quite a lot of accumulated work that hasn't
been taken care of. And so there's just a wide variety
of stressors at this time that can make it quite
difficult for women to return.
Shanon
Malloy [00:07:23] Thanks for that important
background, Laura. So, Allie, why is it important to
address postpartum depression and what impact does it
have on health, productivity and quality of life?
Allie Gabriel [00:07:38] So
when we think about the things that can happen to women
postpartum, it's estimated that at least 15 percent of
mothers are going to be diagnosed with PPD after birth.
And that actually means that postpartum depression is
one of the most common complications of childbirth. And
I know when I first saw that statistic, that was pretty
astounding to me to think about it in that way.
And the effects of PPD are just pretty profound.
It affects women's emotions, their cognition, how
they're thinking about their own life, their child,
their family and then the behaviors. And these really
culminate in their ability to not only maintain their
own well-being, but also maintain the well-being of
their children. Right? And also just maintain high
quality relationships with the people around them. And
so while they're on parental leave, that could be
obviously their immediate family unit. Then we could
start to think about this down the road during the
return to work of how that might affect relationships
with coworkers, for instance.
Shanon
Malloy [00:08:37] Wow, that's a shocking
proportion of new moms, and also I love how you phrased
that as a complication of birth, you know, normally we
think about complications as being physical
manifestations like caesarean section or preeclampsia,
but the mental adverse outcomes are just as important
and impactful. So can you help me better understand how
PPD is different from general depression?
Allie Gabriel [00:09:00] That's
a really good question. So, what makes PPD different and
really impactful compared to generalized depression
(which is also really important to understand how it's
going to affect people in the workforce) but PPD, it's
it's the suddenness and then the coinciding with
childbirth that make it really profound.
First
of all, the onset can be really, really quick. So it can
be, you know, minutes after childbirth. Some people feel
that hormonal shift immeditely. It could also build over
the first one to three weeks or so that women are home
with their children. That sadness is pretty shocking and
jarring in a lot of cases, but it's also coinciding with
this period where they have a new child, and it's
supposed to be this really joyous occasion, right? It's
supposed to be full of joy and happiness. And all of a
sudden, you have all of these depressive thoughts and
episodes co-occurring with that. So that juxtaposition
of really happy, joyful time in your life paired with
extreme depression is what makes PPD really, really
impactful for women and really important to try to study
and understand.
Shanon Malloy
[00:10:07] That makes sense. So how does
PPD relate to return to work?
Allie
Gabriel [00:10:14] Yes, it's a timing
piece, right? So there's estimates that the onset of the
symptoms that are going to really cue somebody up, that
something is wrong, that maybe they're experiencing PPD
beyond just the baby blues kind of feeling low during
those first weeks. It's happening in the first one to
three weeks. And for most women, they're going to be
going back to work sometime in six to 12 weeks
postpartum, which is just so soon in of itself.
So that means that reentry women are not only
coping with the newness of being a mother, even if you
are a mother of multiples, you're still going back now
and you have two kids or three kids and you're trying to
reconfigure all of those things. So you're dealing with
all of those common struggles of being a working mother
of child care, of the new routines, of finding clothes
that fit in. Now you're trying to manage PPD symptoms on
top of that. So it's just kind of like to think of it as
like this layering effect that under good circumstances,
the return to work is going to be really, really
challenging emotionally and just draining for women. And
now you've layered this really traumatic mental health
experience on top of that that women need to process and
cope with.
Shanon Malloy
[00:12:46] Wow, that is a lot to balance
right after having just given birth, so it makes sense
why you're doing this research. So speaking of, can you
tell us a little bit about what's already known about
PPD and returned to work today and maybe what your study
contributes on top of that?
Allie
Gabriel [00:13:06] Sure. So the focus when
we started going to the literature to try to understand
what is already out there, organizational research on
postpartum depression to date had really focused on how
different elements of work, mostly different sources of
social support, for instance, or on the negative side of
that pregnancy discrimination, how that relates to the
incidence of postpartum depression or symptoms
associated with postpartum depression. But really, PPD
was kind of the end point for a lot of the studies. We
didn't really know or we weren't seeing a lot of
research on what happens for women when they return to
work and they do have postpartum depression. Are they
still coping with those symptoms?
This was
really the impetus for our study. How did the emotional
and the cognitive, physical and behavioral symptoms
associated with PPD affect women's work and their
non-work their family lives and in what ways? For me,
this was personally meaningful because I was a I am a
new mom. Well, I'm not new anymore. It was March 2020.
But she's closing in on almost being two.
And I
had PPD. And these were questions that I was asking
myself. How is how am I going to make sense of my work
now? How am I going to make sense of my family? How am I
going to restructure things to fit together and make
sense for me? And that was when I actually reached out
to Laura and her other colleagues on this project (Jamie
Ladge, Rebecca MacGowan, and Ellie Stillwell) kind of
out of the blue just to see if they would have any
interest in trying to help me make sense of my own
experience and then just study a broader group of women
to build out what we think is a really important
narrative.
So what we decided to do was to
conduct interviews. So we have interviews of 41 women
who were diagnosed with PPD in the last five years or
so. And they also had to be working at the time of the
diagnosis. And what was nice is that we have a wide
range of applications, different types of jobs, both
full time and part time work being represented here. And
then we each of these interviews lasted an hour. Then we
ran these interviews, these stories, by different key
stakeholders, Ovia being one of those, to really make
sense of our model and to see how representative it
might be of women's experiences.
Shanon
Malloy [00:15:31] And what do the
preliminary data say from those interviews?
Allie Gabriel [00:15:36] Yeah,
so there's a lot to unpack his results, and I think it
speaks to the complexity of PPD and how it affects women
at work, so our results as they stand right now suggest
that the symptoms associated with having postpartum
depression ultimately culminate in an event or a series
of events that trigger women to seek help, to get a
diagnosis, to obtain treatment, to come up with a care
plan.
And that's really, really important that
diagnosis for women in our sample really was that kind
of aha moment of realizing, Hey, you know, the way I'm
feeling, it doesn't have to be like this. You know,
here's what it is. It's PPD. It's not just me. You know,
I can come up with ways to feel better. And that also
just related to a lot of complex sense making that women
went ahead and had to sort through.
So, we were
trying to figure out how are their work roles going to
fit together with being a mother and having this
identity now as being somebody who has postpartum
depression. How is that identity going to shape them.
The ways that they approach their work and their
non-work goals and everything that is really important
for these women. How are they going to build up
resilience and coping skills that can actually help them
reenter the workforce more powerful than they were
before?
That's the really nice takeaway of this.
Even though PPD is really difficult and certainly has a
lot of hardship that comes with it, the women in our
sample felt really empowered to kind of reclaim aspects
of their lives. To say, "I really want to lean into this
element of my work." or "I want to become a mental
health advocate in my workplace and break down the
taboos of not talking about mental health."
I
want to talk about it, and I want to help other people
and support other people who might be suffering at work.
And also women. We're talking about really prioritizing
their well-being. A lot of the women in our study said,
you know, I finally realized I need to put me first,
right? That's self-care. I hear this all the time and
some of the podcasts I listen to. Self-care is not
selfish, right? And I think having this diagnosis and
kind of the rattling that comes with that of processing,
it helps women really reclaim that.
So in a lot
of ways, then PPD does contribute to women. Having that
rock bottom moment of this is a really low point in my
life, in my motherhood experience. But it can have this
possible bright side of generating a lot of strength
that allows women to reenter the workforce and then
really kind of reclaim who they want to be in a variety
of aspects of their life.
Shanon Malloy
[00:18:20] I love that you are building
upon that narrative where the literature just stopped at
the diagnosis, but you're actually sharing that the
diagnosis is the pivotal moment where these women are
experiencing drastic change and of course comes
alongside with negative implications, but also positive
change too. So that's really, really powerful from this
study. So after interviewing these 41 women and their
diverse experiences and building out this new framework
for understanding PPD and how it relates to return to
work, what's the next step for your research?
Laura Little [00:18:55] The
question so, you know what, as Allie mentioned, one of
the things that we found so interesting was this this
idea that the diagnosis was so important, you know,
conducting these interviews was was it at times
difficult because it was heart wrenching and women were
suffering quite a bit in that the pain that they were in
and the things that they were going through was was
really, you know, heart wrenching.
And so one of
the things that we want to understand better is what
happens when there's not a diagnosis, what happens when
people have the symptoms of PPD, but they don't actually
get diagnosed since that was such a pivotal part of our
original study.
So we're going to go on to
collect some quantitative data. We hope to really study
this at a larger scale. We're going to look at both from
a quantitative perspective, looking at what the
diagnosis can mean more long term. We'll be working out
what the diagnosis can mean in terms of other work
outcomes. But then importantly, I think study women who
have not been diagnosed but who do have symptoms and how
they're dealing with that and how we can better support
them in organizations.
Shanon Malloy
[00:20:52] That makes sense that you want
to build upon better understanding diagnosis and more
importantly, women who aren't diagnosed because we know
that there are so many disparities in women who are
under screened and underdiagnosed for postpartum
depression, and that has rippling effects on not only
themselves, but their families. And we know that the
current guideline is one screening for postpartum
depression at your six week postpartum visit.
But we know that as I mentioned earlier, the
symptoms of PPD can begin to present, you know, minutes
after birth or much later than six weeks. So if you're
not presenting those symptoms at that time of the
screener, you're falling through the cracks. So it's
really important to understand this kind of shadow under
diagnosed population.
So given that, what
opportunity does this new research present to
organizations looking to improve parental mental health?
Laura Little [00:21:48] It is
probably twofold here, at least twofold.
First
of all, as we've been talking about the last few
minutes, diagnosis is so important, and that's what
we're seeing in organizations certainly can help with
that. And can they provide some resources to help women
get diagnosed if they're suffering. And, as you
mentioned, people can have these symptoms when they're
back to work. It can come on, you know, after those
screening checkups and so they could be back at work
showing symptoms and organizations might be able to
recognize that and to be able to help.
I think
the other thing that's important that relates back to
what Allie said earlier: women are sense-making during
this process, and as they do so, they are reconsidering
some of their values, some of their beliefs. When
organizations aren't aligned with those, we have seen
that some women will leave that organization or want to
move on to other types of work. So I think it's a really
important time for organizations to work with women in
this sense making process and work with them to try to
help support them as they go through these moments. As
Allie said, there's some really hard things that come
out of a PPD diagnosis, but there's also the silver
lining.
And for organizations, if they can
encourage that and help support that, they can really
build that commitment in women who will stay within
their organization and thrive and not only thrive
themselves, but help other people who may be also
suffering. And so I think that's a big lesson in
organizations to be aware and to be understanding, and
it can be a great benefit for them to do so.
Shanon Malloy [00:23:30] Yes,
and PPD has been around for a very long time. But the
pandemic is layered on this new job market where we have
record levels of job openings, record levels of people
leaving their jobs for things other than just income,
you know, they're not happy with their employer. They're
not happy with the benefits. They're not happy with with
the culture. Their employer isn't family friendly and
these women have options and they're leaving.
So that is really important to know. That they have the power to do so and that employers should really be paying attention to, like you said, sense-making with their employees during this time rather than abandoning them to experience it on their own. I love that.
So given that, what are the most important things for
employers to do to reduce the risk of their employees
developing PPE or exacerbating it? I mean, we know that
there are indicators for PPD that are beyond their
control. But are there things that they can do to
identify these issues and connect to care?
Allie Gabriel
[00:24:37] I think so. And we actually ask
the women because they're the ones going through it, and
so the concluding question we had as part of our study
was what they would recommend.
What would they
tell organizations and managers and even coworkers to do
to help better support women who have returned to work
generally, but of course, with more specifically? So
there were a few unique suggestions that they brought up
that I haven't seen discussed as frequently, although
this first one is related. So leave - paid leave - to
take the financial burden off of women could be a huge,
huge improvement.
But what was interesting is, I
think going into this research, I had the assumption
that the answer was going to be more leave, right? So
longer durations of leave. And that's actually not what
we were hearing. They were saying no, it's it's about
having access to leave and unique configurations of the
so kind of a staggered return to work. Hey, I want to
come back and I'm going to try this out for a couple of
days, but I may then need to take a few days off. And so
having kind of that flexibility to maybe come into the
office more part time still have time to recuperate and
care for themselves and their child. That was really,
really helpful to really let women ease back in versus
what we see for a lot of full time jobs, which is if you
have access to you, leave the second, it's over. You are
just back, right and you are back full throttle. So that
easing in would be really, really helpful.
Some
other pieces, though, were creating touch points with
women while they're on leave. So I think there is kind
of this assumption that when women are on parental leave
that we should not talk to them and not engage them
right and separate say like, you're not here, you're not
employed right now with us. But that's actually the
opposite. A lot of women said, you know, it'd be nice to
have had somebody check in on me and just see how I'm
feeling. Talk to me, listen to me, validate me as this
new mom and just hear how I'm doing to really feel still
connected to their coworkers and their organization. But
also maybe for somebody else to hear them and say, you
know, "Hey, it sounds like having a really hard time.
Have you thought about trying to access some resources?
Here are some things maybe we could do to support your
well-being and your transition back to work."
I
can speak from my own experience that that was something
that happened here where one of my colleagues talked to
me and he could tell I was having a really hard time and
he was like, "Hey, have you talked to anybody or have
you thought about what this is going to look like? What
can we do to make this easier for you?"
And then
the other thing that I think is a really big deal is to
just talk about these issues. There is a lot of taboo,
not just about motherhood. And you know, all these
misconceptions that when people have babies, they're
less dedicated to their work all of a sudden are less
available. But there's also a lot of taboos just about
mental health in general. And I think we just need to
talk more openly about this.
Women in our study, like I said, talked a lot about how
when they return to work, they talked pretty openly
sometimes about their own mental health diagnosis
because they saw other people suffering in different
ways and realize, you know, you don't have PPD, but
you're struggling with depression or anxiety or this
other huge life issue. And let me tell you about my
experience, what I went through, and here's where I am
now, and this is why it's OK.
The more we break
down the taboo of all of those things, the better
organizations are going to get in terms of really
holistically caring for people and proactively managing
and helping support people's well-being.
Shanon Malloy
[00:28:10] Yes. Yes, and I love that all of
your tools came straight from the horse's mouth. You
took them from the women who are experiencing PPD, and
you are using those to inform actionable things that
employers can do to support their employees.
Just absolutely love that excellent work. So we
have the tools that employers can use to help support
their employees who might be experiencing PPD. What
impact might using and utilizing these tools have on
employee retention or productivity or loyalty to our
company?
Laura
Little [00:28:46] Well, I think, in short, a
great deal, and in fact, I think what we have found from
a from a large body of research that has studied various
different types of events is that people go through
these sort of critical time periods in their work lives
or in other lives where they develop a sense of trust
and loyalty. So, you know, trust can develop over time.
But also we can see these critical moments of important
events to people where people's reactions,
organizational reactions, supervisor reactions are going
to be even more important and really dictate the
relationship going forward.
In another study, we
found that just the disclosure of pregnancy can be one
of these critical instances so that if my supervisor
reacts in a positive way, that can improve our
relationship for long periods of time. If my supervisor
reacts in a less positive way that can have detrimental
effects on the relationship.
So we imagine that
here with PPD, when women are struggling, it's a
critical time period in their lives. It's, you know, an
opportunity for organizations to really pay attention.
It's that critical moment. Support here in this critical
moment is going to really facilitate that commitment.
That loyalty, that retention and a lack of
support in these critical moments when women are really
suffering is going to have the opposite effect. And so
really, I think organizations need to think about these
critical moments and be extra attentive and supportive
when these moments occur.
Shanon Malloy
[00:30:13] Wow. Well, thank you so much,
Laura and Ali. This has been probably one of my favorite
of the Asks podcast episodes. It's been so fruitful and
inspiring, and I'm just really, really grateful that you
are digging into this issue very thoughtfully and
intentionally, and you're working to empower and uplift
working women through your findings. So thank you again.
It's been such a joy working with you. And also just
hearing your thoughts today.
Allie Gabriel
[00:30:44] Thank you so much, and thank you
definitely for this partnership and helping support this
work and bring it to life. We couldn't do it without
this, so we're really, really grateful as well
Laura Little
[00:30:55] Yes I just want to echo what Ali
said. We really appreciate the partnership and we
appreciate all the support they've given us in this
process, and we are super excited to be talking about it
today. So thanks for having us.
Shanon Malloy
[00:31:06] Great. Wow. Well, we covered so
much ground today from learning about how and why
perinatal depression manifests and how managers and
organizations are in a unique position to do their part
in reducing it.
The lack of family friendly
positions in the workplace, combined with caregiving
shortages driven by the pandemic, have created an awful
she-cession. We learned that more than three and a half
million women have already left the workforce since the
pandemic began, which has left a giant talent gap to be
filled.
So right now, today women's labor force
participation is at a 33 year low. We cannot afford to
sink further. We know that one of the workforce's most
vulnerable populations is women and particularly working
moms. With external conditions as they are, employers
need to focus on improving and strengthening the
internal programs and policies they have control over to
keep existing and new employees, especially female
talent, engaged, supported and employed. So now is the
time you can easily impact and improve return to work
and parental leave planning. Right now, we're
celebrating Women's History Month, so help us celebrate
by helping your employees or members who are new moms.
Help them understand, identify and address
mental health conditions like PPD and support them to
have a restorative and re-energizing parental leave
experience and make return to work flexible and
supportive.
If you're looking for ways to do
this that we haven't covered today. Feel free to reach
out. Ovia is happy to help you work through these
issues. I want to end by thanking you again for
listening today to the Ovia Asks Podcast, and I wish
everybody a Happy Women's History Month. Until next
time.