Beyond Birth: How Moms in Health Care Can Make It Work

00;00;00;24 - 00;00;30;24

Tom Haederle

Many health care providers have an equally important caregiving job at home. They’re moms, dads, and parents to young children. As the health care field continues to experience workforce shortage issues, hospitals need to ask themselves, what will it take to prevent burnout and keep new parents, and especially moms in the health care workforce?

00;00;30;26 - 00;00;53;01

Tom Haederle

Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle with AHA communications. In this final episode of the award winning series Beyond Birth, we're exploring how health care organizations can better support new parents to enable them to thrive at work and at home.

00;00;54;19 - 00;01;25;18

Michelle Yu

So prior to having kids, I was super invested in my career. And it's not to say that I'm not invested now. I think it's more so that it really defined me and I loved it. I loved my clients. I loved my career. It was a lot of fun. And in hindsight, I realized that my self-worth was very much enmeshed with myself as a professional.

00;01;25;20 - 00;01;38;20

Michelle Yu

That was my value that I brought to the world, and without it, I really wasn't sure what value I had. Now that I can look back and reflect, I was really trying to operate in the exact same way as I did before.

00;01;43;13 - 00;02;06;17

Yara Mikhaeil-Demo, M.D.

,: 10:00

00;02;06;20 - 00;02;20;03

Yara Mikhaeil-Demo, M.D.

And that's when I was like, this is not just a me problem. This is every working woman in general, all parents, to be honest with you. Because a lot of times now, the dads are also the primary childcare provider.

00;02;20;05 - 00;02;42;24

Julia Resnick

There are 24 million working moms in the United States. You just heard from two of them, Michelle Yu and Dr. Yara Mikhaeil-Demo. Both are professionals in the health care field and moms of young children. Dr. Mikhaeil-Demo is an assistant professor of neurology at Northwestern's Feinberg School of Medicine, as well as a physician well-being coach. Michelle is the co-founder and CEO of Josie.

00;02;42;27 - 00;03;07;26

Julia Resnick

They guide new parents in making the transition into working parenthood through mental health support and other services. I'm Julia Resnick, director of strategic initiatives at the American Hospital Association. In this final episode of the Beyond Birth series, we'll be exploring how health care organizations can support new parents in their workforce. Health care field is experiencing an ongoing provider shortage that is projected to only get worse.

00;03;07;28 - 00;03;39;17

Julia Resnick

t all specialties by the year: 2036

00;03;39;18 - 00;04;01;24

Julia Resnick

we observe both Women's Health Month and Mother's Day, so we're recognizing the dual provider roles played by many people in the health care field. Their medical professionals and parents will be discussing what it takes to create an environment where new parents can do what they love at home and at work. Michelle and Yara, who you heard from at the top, both have intense health care careers.

00;04;01;26 - 00;04;08;27

Julia Resnick

I asked them what it was like going back to work after becoming a parent. Hear what Michelle had to say about her return to work.

00;04;08;29 - 00;04;34;16

Michelle Yu

When I was transitioning back to my big career after baby, I faced a lot of mental emotional challenges and also career related challenges. A lot of questions around, you know, how do I view myself now as a professional and what are my goals? And how do people view me? Did that change at all, and if so, how do I navigate that?

00;04;34;19 - 00;04;57;21

Michelle Yu

And I just had a hard time kind of finding my stride in working motherhood. And I asked other parents. I started to ask other parents if they felt the same, because this is something that I never talk to others about before. And I quickly realized that I was not alone. And that's when I decided to also start doing some research about just becoming a working parent

00;04;57;21 - 00;05;27;12

Michelle Yu

today, and I quickly found that it has shifted a lot in just the last few decades. There's everything from more dual income households. There's more women in the workforce than ever. There's changing family structures, single parent households, blended families, multiracial families. People are also delaying having children, until they are further along in their careers. So what that means is they're going back to these really big roles after baby, and that could be a lot of pressure.

00;05;27;14 - 00;05;56;24

Michelle Yu

to me the most is there was a: 2019

00;05;56;26 - 00;06;18;18

Michelle Yu

I think that speaks to health equity issues as well. And so I love how some of your prior guests have said that health equity is so important in the perinatal period, and you can't have health equity without a diverse health care workforce, and you can't have a health care workforce that's diverse without women.

00;06;18;21 - 00;06;36;12

Julia Resnick

Yara has had to navigate her new life as a physician mom. And with that comes a multitude of questions. How do you navigate the pressures? What about the time commitments of medicine, all while being a new parent? She certainly isn't alone in facing those challenges and shared her experience with me.

00;06;36;14 - 00;06;56;09

Yara Mikhaeil-Demo, M.D.

So how do we make coming back to work easy? How do we make that transition easier so that we don't feel like we're alone or isolated? I think there's a lot of isolation that comes with coming back to work, struggling with a newborn, and trying to function at the same level that you had before. Without just slowing down and noticing the difference.

00;06;56;11 - 00;07;23;15

Yara Mikhaeil-Demo, M.D.

I think that the biggest thing is community. Having group programs for women who are parents, I think is huge. I've led two different, group, of women physicians. and just sharing the experience, sharing the struggle, normalizing it, realizing that we're not alone is huge. One thing that I did was one of the groups was we wrote mission statements about our roles as moms and our roles as physicians.

00;07;23;18 - 00;07;40;10

Yara Mikhaeil-Demo, M.D.

And every time we have that mom guilt, we can go back to the mission statement and be like, overall, I am meeting my mission statement. If I was five minutes late to pick up, it's not a big deal, right? But trying to take a step back, see the big picture rather than focusing on the small things that we're not doing.

00;07;40;12 - 00;08;03;19

Yara Mikhaeil-Demo, M.D.

So I think just having that group dynamic where people can come together and share is important, but then also having some guidelines and policies in place to account for that. So my biggest stressor, for example, was childcare. Like unexpected sickness or school closures or things like that. How do you have a policy that allows for, you know, things like that when you have a last minute cancellation?

00;08;03;22 - 00;08;20;16

Yara Mikhaeil-Demo, M.D.

How do you allow for promotions not to be affected by maternity leave, or by the time that you spend pumping, for example, when you come back? How do you account for that when it comes to productivity? There's a lot of things that systems can do to help parents, especially new parents.

00;08;20;18 - 00;08;34;29

Julia Resnick

So now that we understand the pressures that moms in health careers are facing, what can healthcare organizations do to support their team members that are new parents? Yara and Michelle proposed some minor changes that would make a huge impact on working out.

00;08;35;01 - 00;08;56;29

Yara Mikhaeil-Demo, M.D.

I think there is a huge push now and understanding of how many new parents struggle. there are support groups that are on system that account for productive for leaves, that block time for parents, for a woman that choose to pump and things like that. Just keeping in mind parents when making decisions. Simple things as meeting times, right?

00;08;56;29 - 00;09;30;03

Yara Mikhaeil-Demo, M.D.

Like sometimes we have 7:30 meetings or 5:00 p.m. or 6:00 p.m. meetings. And if you have to pick up your, you know, your child, having a virtual option really makes a big difference, right? Like you're still involved but can also able to pick up your child. Or noticing the need for community and providing space for that. We have a program called Ignite where right now I'm leading a woman physician group where we meet once a month and is sponsored by the hospital, and we pay for our meal and we get to talk about our struggles and how are we approaching our days and how can we get better.

00;09;30;06 - 00;09;46;04

Yara Mikhaeil-Demo, M.D.

So just I think creating that community and encouraging it and also making decisions with the struggles in mind. I think most leaders want to make a different, but just taking the parents voice in consideration when making decisions will be really helpful.

00;09;46;07 - 00;10;13;10

Michelle Yu

Community is just key here. And also just the small things like the meeting times. Yara I hear that all the time. The other thing I will say is I actually recently spoke with a physician executive at UC Davis Health, and this person pointed out to me that there was a study by physician moms group that found nearly 40% of physician moms returning from leave will experience exclusion from administrative decision making or important projects.

00;10;13;12 - 00;10;47;26

Michelle Yu

So I think the other thing here to note is manager and supervisor awareness and training to ensure that they play, because they play such an important role in that individual's overall experience, and making sure that they're equipped to support them. So particularly for clinicians who may have responsibilities outside of direct patient care, you know, having a manager proactively reorients you back to work and take the care to re-onboard you after the return from leave.

00;10;47;28 - 00;11;05;26

Michelle Yu

And also being able to proactively invite you back into those meetings where those decisions are being made. And it's one thing to have you say like, oh, can I go back to this meeting? They're not in my calendar anymore. Versus someone actually saying, hey, we really missed you during these meetings and you bring such an important voice to the table.

00;11;05;29 - 00;11;26;24

Michelle Yu

I'm going to ask that you come back and we'd love to have you join us or something like that. You know, that just that tone that approach is so different. And then on the clinical side of things, I interviewed a few clinicians recently about their struggles and their return to work and something that, especially in primary care, happens is that you're missing this window of time to see your patients when you come back.

00;11;27;02 - 00;12;01;26

Michelle Yu

Sometimes you're taking on their emotions as well, on top of your own emotion, emotions, and your mental and hormonal changes. One primary care physician said that she experienced from her patients, abandonment issues, where they felt they were abandoned by them during that maternity leave. And so just making sure that your workforce is aware of any mental health supports or emotional supports and helping them maybe on-ramp back in a more measured way, so that they can kind of take that on, more slowly.

00;12;01;26 - 00;12;27;08

Michelle Yu

could be really, really helpful. And there's also, policies around blocking time. However, that being said, that doesn't necessarily account for some of the cultural aspects of that actually happening. I.e., is the pumping room actually close enough for me to get to so I can pump in the break time that I have. And as my team and my supervisor support me in taking that time off.

00;12;27;12 - 00;12;49;08

Michelle Yu

1 in 3 physician moms actually face discrimination when it comes to breastfeeding and pregnancy. So again, being able to train your supervisors to know that this is protected time. And then it's important to the organization that you all feel that way. That's part of your values as an organization is so important. And then being able to actually get there and use those spaces is also important.

00;12;49;11 - 00;13;05;10

Julia Resnick

Cultural changes around returning to work after pregnancy need to be ingrained across health care organizations, and new parents should feel empowered to ask for what they need to feel supported. Yara and Michelle shared stories from their own lives of what this looks like in action.

00;13;05;12 - 00;13;20;14

Yara Mikhaeil-Demo, M.D.

I would say I was lucky when I came back, I think was my second child. My biggest stress was pumping like Michelle was saying. Where am I going to pump? How am I going to pump? And thankfully my my team was like, okay, we're going to block like you tell us what times you want to block and we'll block it.

00;13;20;14 - 00;13;41;21

Yara Mikhaeil-Demo, M.D.

And I wasn't asked or expected to like make up the time or, or place anything like that. I've heard stories of clinicians being asked to stay extra later or come earlier to make up for the time that they blocked in clinic, which I think is just too much to add to a new parent. so I think this has been really helpful.

00;13;41;22 - 00;13;59;18

Yara Mikhaeil-Demo, M.D.

I've heard a lot of women now being empowered to really ask for what they need when they come back. Whether it is, like Michelle was saying, graduated duties and you're not, you know, on call your first week in back or you're not on a full panel your first week back. but more and more parents are actually becoming more empowered to ask for what they need to make it work.

00;13;59;21 - 00;14;27;22

Michelle Yu

And I would say there's a lot of organizations outside of health care that I think health systems can learn from in terms of small and actually low hanging fruit, ways to support working parents that don't require significant amounts of investment. One of those things, like I said earlier, we just work with a company, a financial services company, in training their managers on just understanding what are some of the challenges new parents go through when they have a new baby.

00;14;27;25 - 00;14;52;29

Michelle Yu

What are some biases to watch out for. What are some things you can say to show your support. And what are some things maybe you shouldn't say. to someone who may be going through that. That was something that they had. Once they can record it, they can share it with others in the organization. And it's small things like that that I think really signal that you care and that you really want to see a cultural shift.

00;14;53;02 - 00;15;15;02

Michelle Yu

My husband actually works for a bio-tech company, here out in D.C., and they actually have parking spots, for pregnant women, that are a little bit closer to the building, to support them. They also have an on care daycare facility that is has just been such a lifesaver for so many of the team members there.

00;15;15;02 - 00;15;28;01

Julia Resnick

Much like working moms, health care organizations have lots of priorities to juggle. So Michelle and Yara each offered a simple action hospitals can take to change the culture to better support new parents.

00;15;28;03 - 00;15;49;23

Yara Mikhaeil-Demo, M.D.

I think having a committee of parents to brainstorm ideas that are relevant to that organization would be helpful because I think every organization is unique and different, and academic is different than private practice and different than community practice. But having that be part of their mission, like we're going to include parents, we are going to have a committee, their voice will be heard.

00;15;49;26 - 00;15;51;21

Yara Mikhaeil-Demo, M.D.

I think that will be helpful.

00;15;51;23 - 00;16;17;02

Michelle Yu

This is really hard to pick one thing, but if I had to choose one thing, I think it would go back to that supervisor manager training component and being able to support them and equip them with understanding how to be more empathetic to this population and how to show your support for this population, how to get creative and solutioning with this population.

00;16;17;02 - 00;16;33;29

Michelle Yu

How to navigate all the tricky scenarios that come with it is one thing that I think a lot of health systems, who probably already invest in a lot of training, to just leverage what you already have and do something in this particular area.

00;16;34;01 - 00;16;55;22

Julia Resnick

A big thank you to Michelle Yu and Yara Mikhaeil-Demo for sharing your expertise and passion for supporting working moms. Your work is paving the way for future moms and parents in health care. We appreciate your dedication to making it better for everyone. This is our last episode of Beyond Birth, but don't worry, we'll continue to cover important topics in maternal health.

00;16;55;25 - 00;17;13;06

Julia Resnick

You can listen to all of our previous Beyond Birth podcasts on the Advancing Health Channel wherever you get your podcasts. And for more resources on maternal health visit www.aha.org/betterhhealth formothersandbabies.

00;17;13;08 - 00;17;21;19

Tom Haederle

Thanks for listening to Advancing Health. Please subscribe and write us five stars on Apple Podcasts, Spotify or wherever you get your podcasts.