Postpartum University® Podcast

EP 158 Maternal Mental Health and Returning to Work with Dr. Emily Guarnotta

• Maranda Bower, Postpartum Nutrition Specialist

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It's no secret that mothers in the U.S. return to their careers after childbirth way too early. 

Today's conversation dives into the effects of returning to work on maternal mental health. 

I'm speaking with Dr. Emily Guarnotta, founder of Phoenix Health who brings her expert perspective as a licensed clinical psychologist and certified perinatal mental health specialist. 

In this episode, we're sharing:

  • The perspective mothers can take when returning to work to ease the effects of the transition on their mental health.
  • How changes in breastfeeding correlate with the timing of returning to work and what to expect emotionally with this experience. 
  • Thoughts on whether maternal mental health conditions are caused or exacerbated by returning to work. 
  • 5 steps to take to make the most of returning to work. 
  • Whether or not to discuss your mental health condition with your colleagues or employer. 

Until paid family leave is part of our society in the U.S., we'll continue to deal with the reality of returning to work too early and the effects it has on maternal mental health.

This episode is packed with tips that will help you make the most of whatever situation you find yourself in and remind you that you're not alone.

To learn more about Emily and her expert tips, head to:
https://postpartumu.com/maternal-mental-health-and-returning-to-work-with-dr-emily-guarnotta-ep-158/

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Maranda Bower:

Depression, anxiety and autoimmune symptoms after birth is not how it's supposed to be. There is a much better way, and I'm here to show you how to do just that. Hey, my friend, I'm Miranda Bauer, a mother to four kids and a biology student turned scientist obsessed with changing the world through postpartum care. Join us as we talk to mothers and the providers who serve them and getting evidence-based information that actually supports the mind, body and soul in the years after birth. Hey everyone, welcome to the podcast. Today I have a very special guest. Her name is Dr Emily Gornada. She is a licensed clinical psychologist and certified perinatal mental health specialist. She is the co-founder of Phoenix Health, which is an online therapy practice that specializes in treating maternal mental health conditions like postpartum depression and anxiety, and she's also a mother herself.

Maranda Bower:

Dr Emily understands the challenges that motherhood can bring as a passionate supporter and supporting parents' rights through every step of the journey. She's here today to really speak on the experience of returning back to work after maternity leave, which is such a huge conversation, because I feel like, especially in today's world and today's society, that we are almost we don't have much of a choice, right Like there's. We're two working parents and a home is almost necessary in order to survive these days, and our healthcare system is pushing people to go back to work very quickly. We don't have really great healthcare standards for mothers and it's kind of a mess. So I'm so glad that you're here to have this conversation with us today. Thank you so much for having me. Yeah, so I'm very curious about your own experience and what got you into this world and having this conversation here today. What brought you to do, what's what made it so passionate for you? I should say.

Emily Guarnotta:

My work as a psychologist works with a lot of mothers who are going through this transition and who are feeling like they're having to go through this transition back to work way sooner than they feel ready for. And on top of that, I've also personally experienced what that's like. So I know I can really empathize with how difficult that transition is, especially when it feels like it's something that you have to do before you're really ready to. So that's that's kind of given me this drive to want to talk more about how we can support parents that have to go back to work.

Maranda Bower:

Yeah, yeah. I would love to to go deeper into this conversation, Like what is the experience of returning back to work for maternity leave? You know what is that experience like for the typical mom.

Emily Guarnotta:

It's definitely a unique experience. So, no, you know, no two moms are going to be like and what that transition is experience like. But for a lot of people it's very stressful. Like I mentioned, a lot of people feel like they have to go back to work really before they feel ready. I don't think in our, I don't think we have any stats on when the average, what the average length of maternity leave is like, because there's such wide variability in it. But at least in my practice, I usually see moms having to go back around 12 weeks or so and that's pretty consistent with my own experience. And 12 weeks you're just kind of figuring out the newborn schedule. Maybe you're getting a little bit more sleep. You're just kind of feeling like you're getting the hang of things and then all of a sudden it's like boom, there's another transition. Then now you have to figure out how to do all this while now working outside the home. So, to sum it up, it's pretty stressful for a lot of people.

Maranda Bower:

Yeah, yeah, and I think that's a really common thing.

Maranda Bower:

And if 12 weeks is kind of the average that you're seeing, that's also the time when, if somebody is breastfeeding, major shifts are changing within the milk and breastfeeding production. I think a lot of women feel like at that particular time, if they're breastfeeding, that all of a sudden they are not making enough, or whatever the case may be, because letdown feels differently. The way that their bodies are producing is a little bit different. Babies are taking more as well, and so you have, like this, also this really stressful period of kind of a new phase in breastfeeding, and so if you add that on top of it, it can be quite a whirlwind. And we know that when women return back to work, breastfeeding rates drop significantly because there's so many challenges with that on top of it and that impacts the way a mother feels about who she is as a mother, especially if she's tied that into breastfeeding, or her identity as a whole. Would you agree with that Like? Is that something that you are seeing in your practice as well?

Emily Guarnotta:

Absolutely. Yeah, I mean, even with all the legislation in place around around breastfeeding and moms in the workplace, it's still it's very difficult to be able to ensure that you're you're pumping every two to three hours and you're producing enough. And especially if you're an anxious type A mom like I tend to be, you want to do everything perfectly and it's it's really hard. It's trying, you know, you're trying to be, you're trying to be the best when it comes to providing food for your child, plus the best in the workplace, plus be present when you're back at home. It's almost impossible to do 100% in each of those different places.

Maranda Bower:

That's so true. How can experiencing postpartum depression or any other maternal mental health condition really affect a mother's transition back to work as well?

Emily Guarnotta:

Experiencing postpartum depression or postpartum anxiety or OCD or any really any maternal mental health condition can definitely make it a lot more stressful to go back to work. A lot of the symptoms of these conditions involve difficulty concentrating. If you're feeling very anxious, it's going to be hard to stay focused in the workplace. These conditions can also affect your sleep, so even if your baby's sleeping, you might not be getting quality sleep at night. And then having to go to work the next day and function and feel like you're at your best can be really challenging. So I think it really complicates it. It makes something that's already challenging so much more challenging.

Maranda Bower:

I wonder how much is actually contributing to postpartum depression and anxiety Just the very fact that we're being forced back into the workplace, where we feel forced. You know, we have this huge elephant in the room right Persistent gender age gaps, workplace discrimination against moms. You know, yes, we have all of these laws and legislation around protecting breastfeeding and all of those things, but those, those, all of this stuff still exists on top of the challenge of, you know, financially having to provide as well as doing all the other things, as you said as well. So I'm wondering if the opposite is true it's not just postpartum depression and anxiety and other maternal mental health existing and then we're having to go back to work, but also going back to work and now having this develop because we're feeling forced, like we don't have a choice.

Emily Guarnotta:

That's a really good point. It's kind of like what came first the chicken or the egg. Did the postpartum depression come prior and then get exacerbated by that return to work, or you know, or vice versa. And what I see is a lot of moms have a lot of anticipation about anxiety and anticipation about that return to work, so much so that it either can seem like it triggers a condition or it exacerbates one that's already there. But there's so much anxiety just tied to like, how am I going to return back to work? How am I going to do this? And I mean, I see moms that start talking about this and fearing this from the second they bring their baby home from the hospital. They're already thinking, you know, in 10 weeks, 12 weeks, how am I going to go back to work when I'm feeling this way? So it definitely, I agree with you. I think it definitely contributes to a lot of those symptoms.

Maranda Bower:

Yeah, yeah, I know my sister-in-law just had a baby not too long ago and she had to return to work and immediately I think it began for her, even in pregnancy. She's like I don't even know what I'm going to do. What am I going to do about childcare? What am I going to do about childcare? Like it was a constant thing on her mind and she, thankfully, is not the one in seven who's experienced postpartum depression and she's not experiencing postpartum anxiety, but she did have a lot of anxiety and fear over where is my child going to go, and I'm not ready for that to happen. Um, even in pregnancy, right, like that was a huge part of her, her story and thankfully, this, actually this is like super fresh Her, her baby had Her baby had his first days at childcare and they went wonderful, it was absolutely amazing.

Maranda Bower:

But she's like I haven't pumped before. Like you know, every time I try, I wasn't able to, and so now the worry and anxiety has kind of shifted from okay, now I have the childcare that I need, which was the huge concern in the very beginning but now how am I going to provide what my baby needs through breastfeeding if I'm not able to pump or do what my body needs, and I was the same way. I could not pump at all for the life of me, and I know so many people experience that too. But you know, the the concern of postpartum depression and anxiety is really on her mind now more than ever, when it wasn't so before and vice versa, like it's just something that we're consistently having to go through and deal with, which is very frustrating right, absolutely.

Emily Guarnotta:

You know your, your story about your. You said it was your sister-in-law, yeah yeah, it reminded me of when I was, when I had my first daughter, who's about to turn six next week. I was preparing to return back to work and I realized a couple of weeks before that she, she just wasn't taking bottles, she would only um, she would only breastfeed. And I tried having a lot of family members give her bottles. We were trying to get her used to it because we knew she was going to be in childcare and I had.

Emily Guarnotta:

I had so much fear around what's going to happen when she's not with me, and is she just going to not not consume any breast milk anymore? Is she not going to be able to take in any nutrients? And fortunately it was okay. It did take her a couple of days to adjust to bottles being in childcare, but that was something that I would have never anticipated would have been an issue or a concern. So it's kind of like you can't even prepare for all of the different factors that contribute to this transition. But that's great news that the baby's doing doing well in childcare. It's always a relief.

Maranda Bower:

Yeah, you know, and before doing this and in my previous life I like to tell people because I've sometimes feel old but I worked in childcare. I worked in childcare for a really long time, my son that's. I was a single mom and my I was able to go to work with my son. Like that was very, very important to me and I was so blessed with that opportunity to do that when I was forced to go back to work and you know, being a teacher and seeing how truly easy it is for a lot of children to go back into that space has been really helpful for me and I see it. But I also understand the challenges and the frustrations and the fears around that huge step. Hey, I'm going to be 100% straight with you.

Maranda Bower:

The postpartum world is changing right now and I know you feel it. It's in the politics, our community spaces. There is an urgent need to implement a different approach to postpartum health. If you're an alternative provider or postpartum advocate, you need to be with us in the Postpartum University Pro Membership, get the method, the tools, the handouts, the advanced trainings and so much more to not only help your clients and your business grow, but to help you grow too. Marketwatch says that the afterbirth services and nutrition and support is set for extraordinary growth by 2030. Don't miss your opportunity to help women and families who desperately need your holistic support. Go to wwwpostpartumucom. Slash membership. We're accepting registrations right now and we can't wait to see you there. I would really like to understand a little bit more about what mothers can do if they are struggling with this transition.

Emily Guarnotta:

I think one of the most important things is to know that you're not the only one that's having a hard time with this. So that whole saying of just you're not alone is really, really important, because it feels when you're in it. It feels like you're the only person that's having a hard time going back to work or a hard time postpartum. And then, I think, trying to remember that it is a journey that, as much as we like to jump right into things and feel good on day one, that's probably not going to happen when you go back to work. It's going to be this transitional phase that is going to take time and it might even feel like you're starting over at work, almost like it's your first day back in the job, and that's completely normal.

Emily Guarnotta:

Leaning on colleagues if you have them that are supportive, can be extremely helpful. If you are blessed to have a good support system at work and it's really important to just notice the signs If you really if you're struggling and things are not getting better and you're feeling like, if you're feeling worse over time, just don't delay getting the help, because the treatment for postpartum anxiety or postpartum depression or just even more general stress is out there. So a lot of people will want to hold off and say I'll give it another month, I'll see how I feel, and then I'll give it another month, and then it just it just goes on and on and often gets worse before it gets better. So I always tell people, as as a psychologist, as a therapist, it's never too early to seek help. So I just encourage moms, like if you are struggling, don't, don't delay, yeah.

Maranda Bower:

And that, and I think that is so important and so true. So, even if this is something that you're experiencing, the anxiety of, and pregnancy, as my sister-in-law did, right, that is a beautiful time to go help, get some support and help and kind of work through those emotions and fears, like you don't have to wait until you go through the process of being, you know, having to go back to work and dealing with all of that stress, because, let's face it, it's a lot that's on our shoulders and and it's not OK that we're experiencing all of that frustration and anxiety and and fear. Get help, that's that's beautiful. Should I? I'm I'm curious should a mom share her struggles with her employer or or keep it to themselves during this time? Because I know there's a lot of questions in regard to that.

Emily Guarnotta:

Yeah, that's definitely a question that comes up a lot and it's it's really tough to answer because I think it kind of depends.

Emily Guarnotta:

It's kind of a case-by-case basis and it depends on what your needs are or what you're looking for.

Emily Guarnotta:

So if you're really struggling and you're dealing with a maternal mental health condition like anxiety or depression, and you feel like maybe you need some more time off and you want to explore the Family Medical Leave Act, FMLA, to extend your time, or you need some accommodations at work because of your condition, or you need time off to attend therapy appointments, things like that, you are going to have to disclose that to your employer, to your human resources department, in order to find out if you're eligible for some of those things.

Emily Guarnotta:

If you're not exploring any of those options and you're just kind of wondering, should I be open with my boss or with my colleagues about what I'm going through, because maybe they'll be more supportive or helpful? I think it really depends on how comfortable you feel in your relationship with your colleagues and the workplace culture. You certainly don't have to disclose anything that you're not comfortable with, but if you do work in a supportive environment and you do believe that it'll be received well. It could be helpful to be honest about that and give people an opportunity to kind of rally around you and support you.

Maranda Bower:

Yeah, yeah, so true. Do you feel like someone should be extending their maternity leave if they're struggling with perinatal mood or anxiety disorders?

Emily Guarnotta:

I think that's kind of another case-by-case basis. For some women it is very helpful to take more time off if they're able to, just in order to kind of work through things better, get a better handle on their symptoms, especially if maybe they just started treatment, they just started their peer medication and they need a little bit more time for those things to start working. I've seen it be very helpful to extend leave, and then there are some cases where women just feel like they're so in their heads that they need to, they need to keep busy in that way, and that going back to work can actually be helpful for them. So it really does depend, but it's definitely something it's. It's worth considering if you feel like it would be helpful for you to have a little bit of extra time to work on things before adding another transition to the mix.

Maranda Bower:

Yeah, so true, so true. And I think the big takeaway message here is like this is this is a huge conversation and it is a really massive transition, and so if you're feeling this or you know somebody who might be going through this, it's okay to reach out to them. It's okay to reach out for support, because you're not alone. And this experience and this is difficult times for many people where we're feeling like we've, we don't have a choice. This is something that we have to do and it does take a toll on our mental and emotional health. So thank you so much for sharing this. And where can people reach out and find you, especially if they want to have this more of a conversation or ask specific questions for you?

Emily Guarnotta:

Yeah, well, thank you so much for having me be part of this discussion. You can find me on Instagram at Dr Emily E-M-I-L-Y underscore G-U-A-R-N-O-T-T-A.

Maranda Bower:

And if you want to learn more about my company, phoenix Health, and our maternal mental health services, you can find us at wwwjoinphoenixhealthcom and we have all of that information in the show notes. Go, take a look at Dr Emily, and thank you so much for being here and having this conversation. I'm so grateful for you.

Emily Guarnotta:

Thank you.

Maranda Bower:

I am so grateful you turned into the Postpartum University podcast. We've hoped you enjoyed this episode enough to leave us a quick review. And, more importantly, I hope more than ever that you take what you've learned here, applied it to your own life and consider joining us in the Postpartum University membership. It's a private space where mothers and providers learn the real truth and the real tools needed to heal in the years postpartum. You can learn more at wwwpostpartumucom. We'll see you next week, thank you.

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