The percentage of women in the American workforce has been falling for the last 20 years. Why? In one poll, 61% of women said family responsibilities were the main reason they weren’t working.

To retain more women and eliminate the high costs of employee turnover, leading employers are recognizing the importance of creating family-friendly workplaces by implementing progressive parental leave policies and family benefits programs. Yet shifts in office culture often lag far behind changes to company policy, meaning parents lack the support they need during the critical return-to-work transition and beyond.

Any comprehensive family benefits program must include training for managers—and that’s where Maven’s checklist comes in.

Here are four reasons why employers need to train managers to retain talent and create a truly supportive workplace for working parents and families.

1. Bias against parents—especially mothers—in the workforce is a problem, and it’s hurting retention.

There is widespread evidence proving bias against mothers is a systemic problem: mothers are viewed as less competent and less committed to their jobs (though that myth has been debunked time and again), and they face a lack of professional advancement termed the “maternal wall”. Consider this alongside the reality that pregnancy discrimination remains a major issue at some companies. As a result, 42% of women worry that growing their family will hurt their career.

For far too many new parents, these norms play out in their day-to-day through inflexible corporate cultures and managers who are unaware of the challenges involved with childcare, sleep training, pumping and feeding, and the like. As Maven Career Coach Mary Beth Ferrante, an expert in manager training and balancing career with parenthood, puts it, “The first step for managers is simply to become aware of how new motherhood can put a lot of stress on their employees and simply be aware of their own maternal bias.”

“The really innovative companies are doubling down on the return-to-work and manager training pieces.”

2. Our experience tells us that managers don’t have the resources or know-how they need to support and empower working parents who are their direct reports.

Sitting at the intersection of parenthood and career, we know firsthand from our experience with employers and employees that managers often don’t know where to start when it comes to supporting parents on their team. For example, we conducted a survey at a global business consulting firm that proved this: 67% of managers reported they did not have adequate knowledge of resources to address the needs of new or expecting parents who are their direct reports.

“One thing I often hear from Maven members who struggle with returning to work is that there is pressure from managers to resume a business as usual mindset, ignoring the significant shift in their lives,” explained Maven Career Coach Mary Beth Ferrante in her recent piece for Employer Benefit News.

How a manager responds to the news that a direct report is becoming a parent is absolutely critical and sets the tone (for better or for worse)—but that is only the beginning of what will be a shift in their working relationship. Managers should initiate partnerships with expecting parents at key moments before, during, and after parental leave to make space for transparent discussions around flexibility, transition planning, pumping needs, support or schedule needs around childcare and pediatrics, career goals, and more.

3. Managers are essential for attracting and retaining talent, and they have a key role to play when it comes to creating the family-friendly culture you want.

According to LinkedIn Learning, 76% of working professionals say that liking the boss they’d be reporting to was “essential” when considering a job offer, and nearly half reported that they have quit a job because of their manager. Training managers is key so they can help prevent biases, drive employee satisfaction and productivity, and attract and retain more talent.

4. The benchmarks are changing, and offering parental leave is not enough.

As the just-released Great Place to Work 2019 list of the Best Workplaces for Parents reveals, taking a holistic view of supporting new parents is key, and the top companies are doing more than just offering paid parental leave. Plus, a new study on the economic impact of paid parental leave policies in California—the first state to offer paid family leave—drives this point home as well.

As Kate Ryder, Maven’s Founder and CEO, discussed with Fortune, the best organizations for new parents take a holistic approach by offering benefits like career coaching, access to lactation consultants and breast milk shipping, and courses designed to increase leader empathy for employees coming back from parental leave. As Kate shared in the article: “The really innovative companies are doubling down on the return-to-work and manager training pieces.”

Now that you know the why, check out the how: Download Maven’s new Checklist for Managers today.

Consider our checklist a go-to playbook to equip managers with every step they need to take to support and empower parents before, during, and after leave. If you’re an HR leader, provide copies of this checklist to your managers and encourage them to use it as their guide when direct reports share the news they are becoming parents. Download the checklist now.

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In our Maven Insights series, we dive into what our data tells us about our impact and approach, and what we’re learning from how our members interact with Maven. As a data-enabled women’s health and family benefits solution, we’re always thinking about what our members’ engagement tells us about how we can improve.

DID YOU KNOW?

2 out of 3 members seek care on Maven after they welcome their baby to the world.

The weeks and months following the arrival of a new baby can be overwhelming, exciting, emotional, and anxiety-inducing for new parents and their infant. There are countless questions and challenges popping up for parents at all hours. As they navigate their first weeks and months at home, our members are turning to Maven’s providers in our virtual clinic to seek the care they need most, including access to:

• Lactation Consultants
• Sleep Coaches
• Mental Health Specialists
• Career Coaches
• Pediatricians
• Breast Milk Shipping

Maven’s comprehensive care delivery model aims to fill gaps in postpartum care left by the traditional healthcare system. The on-demand, unlimited access to a variety of doctors and specialists that Maven provides makes all the difference for parents navigating their new, sleep-deprived reality once their baby enters the world.

As we dive deeper into exactly how our members are using Maven in the postpartum period, we see the value that Maven’s holistic care provides in terms of filling gaps in access and driving healthier outcomes for both new parents and their infants.

Why postpartum care matters

The postpartum period is a critical period of change and adjustment for new parents. Of course, once the baby arrives, attention shifts almost entirely to caring for and meeting the baby’s needs (and trying to decipher the meaning of their every coo or cry).

But postpartum care for new parents themselves—especially women who have carried and delivered a baby—is vital and often forgotten. According to the American College of Obstetricians and Gynecologists (ACOG), many women who have given birth never attend a postpartum visit, which is problematic for long-term health outcomes; as ACOG states, “underutilization of postpartum care impedes management of chronic health conditions and access to effective contraception, which increases the risk of short interval pregnancy and preterm birth.”

As of its recent updated guidance published in 2018, ACOG recommends postpartum care that is both immediate—within the first three weeks postpartum—and ongoing for new mothers. It recommends holistic support that is emotional, physical, and mental and individualized to meet a woman’s needs— exactly what Maven provides.

Maven ensures that new parents are equipped with the information they need to navigate the so-called “fourth trimester” and beyond, and provides much-needed access to specialized care for themselves and for their new infant.

“According to the American College of Obstetricians and Gynecologists (ACOG), many women who have given birth never attend a postpartum visit, which is problematic for long-term health outcomes.”

Putting baby first with Maven’s specialists

Our data shows us what any new parent would already guess: our members are actively seeking care and guidance on Maven for their new baby—to complement and augment in-person care, as well as speak to specialists on-demand as soon as issues or questions arise. Here are two key ways that this plays out in terms of our member engagement.

Getting help from Lactation Consultants

In the month immediately following delivery, nearly half of member engagements in our virtual clinic are with Maven Lactation Consultants. Members continue to turn to Lactation Consultants throughout their postpartum journey, as they cope with the challenging physical and emotional demands of breastfeeding and pumping.

Why this matters: ACOG recommends breastfeeding for 6-12 months, as it helps babies get the ideal nutrition for healthy development and provides long-term health benefits for the mother: lowering the risk of developing breast and ovarian cancer, type 2 diabetes, heart disease, and postpartum depression. But, as any new parent knows, breastfeeding can be painful, time-consuming, and logistically challenging when it comes to pumping on-the-go. New moms have questions and need support while they are nursing, and there are major gaps in access to Lactation Consultants in terms of geography and cost, in part because traditional insurance carriers don’t cover this specialty. A video appointment with a Maven Lactation Consultant can make all the difference for a new mother navigating the complex world of breastfeeding and pumping, and provide helpful guidance on milk supply, latching issues, pain, mastitis, or other issues.

Turning to Pediatric Sleep Coaches to help manage baby’s sleep

When a baby turns three or four months old, sleep regression often hits. Not surprisingly, this correlates to a spike in members using Maven around this time: 40% of engagements at three-months postpartum are with Maven Pediatric Sleep Coaches.  

Why this matters: Pediatric sleep coaches provide tips and guide new parents through sleep training, and address any sleep issues infants struggle with. By providing unlimited virtual access to sleep coaches, Maven meets members where they are, so they can talk to someone from the comfort of their baby’s nursery in the middle of the night. It also eliminates high out-of-pocket costs for new parents—as appointments with sleep coaches typically range from $300+ for virtual consultants through $7,500 for in-home training.

Improving access to care for new parents

“The fourth trimester is a vulnerable time for new moms, with many physical, anatomical, and hormonal changes, as well as new, and sometimes overwhelming, emotions in relation to caring for a newborn” - Jane van Dis, Maven’s Medical Director and OB-GYN

Our members tell us that Maven’s Care Advocates act as their gut-check, counselor, and personal trainer all-in-one—answering questions, anticipating needs, providing helpful tips and resources, and guiding them to the care they may not even realize they need at every step of their parenting journey.

After a member has their baby, their dedicated Care Advocate helps ensure that they are taking care of their own body and mind, too. They check in on new parents regularly and book appointments for them with providers in Maven’s virtual clinic based on clinical guidelines and individual needs—all the while helping to fill in gaps in access to postpartum care. As we look to our engagement data in the postpartum period, we see two key learnings about how Maven is providing value for a new parent’s well-being and long-term health.

Honing in on mental health

Mental health is critical for new parents in the postpartum period—and Maven is filling gaps in care, with our members engaging with Maven Mental Health Providers frequently after delivery throughout their postpartum journey.  

Why this matters: According to the Seleni Institute, as many as 1 in 5 new mothers in the United States suffer from postpartum anxiety, depression, obsessive-compulsive disorder, or (more rarely) postpartum psychosis. And data shows that between 5-10% of new fathers experience depression. But while these are extremely common, in a national survey Maven conducted of 700 new mothers, 54% said that they were never given the chance to discuss any mental health issues, as they were not screened during pre- and postnatal care. Mental health is a key piece of Maven’s holistic approach at any point in an individual’s journey—and we follow-through from screening to treatment. Our providers and Care Advocates ensure there is continuity of care on our platform so that a member has appointments with mental health providers in Maven’s virtual clinic when they need them.

Preparing for the transition back to work

Our data also reveals that members are turning to Maven Career Coaches to help them prepare for the return-to-work transition, and after they’re back at work adjusting to their new reality as working parents. The rate of member engagement with career coaches increases throughout the postpartum period—proving the critical role they play in this transition.

Why this matters: Becoming a parent is one of life’s biggest changes, and while access to parental leave allows for a great period with a new baby, when it comes time to transition back to work, there is increased pressure on parents to resume business as usual without acknowledging that this transition into working parenthood is a major adjustment. Maven’s Career Coaches help prepare new parents so they can return to work with confidence, and provide important tips and insights for parents to navigate challenging situations at work once they’re back—making all the difference for retaining new parents in the workforce.

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By Dr. Jane van Dis, OB-GYN and Maven Medical Director

It’s not uncommon for women to give birth later in life these days. Women are giving birth in their 50’s and even 60’s. Complications are aplenty, however, in these older gravidas—in large part because the older we get, the harder it becomes for our arteries, blood vessels, and heart to respond to the demands of pregnancy.

Heart disease—a broad term that includes a variety of heart and blood vessel conditions like heart attack, stroke, or high blood pressure—is the leading cause of death in women over age 25 in the U.S. And while the death rate from cardiovascular disease has decreased among men, it continues to increase in women.

Cardiovascular disease and hypertensive disorders in pregnancy take on new—and sometimes frightening—meaning for older women in pregnancy and during birth. And maternal heart disease is a key threat to safe motherhood and women’s long-term cardiovascular health.

Pregnancy puts the heart under pressure

As The American College of Obstetricians and Gynecologists (ACOG) highlighted in a May Practice Bulletin, cardiovascular disease is now the leading cause of death in pregnant women and women in the postpartum period. Cardiovascular disease affects approximately 1-4% of the nearly 4 million pregnancies in the U.S. each year. Critically, there are racial and socioeconomic disparities in cardiovascular outcomes with higher rates of morbidity and mortality among nonwhite and lower-income women.

Pregnancy, itself, is a cardiovascular “stress test”—something I experienced when I was pregnant with my twins at 39. I had premature arterial contractions and had to wear a holter monitor for 24 hours: my heart was saying, “Jane…. Jane…. I’m struggling to keep up with all this extra blood volume, twins, and advanced maternal age!.”

In pregnancy, a woman’s blood volume increases (massively) by 50% to support the pregnancy, meaning more volume and more work for the heart. By the end of pregnancy, 20% of a woman’s cardiac output goes to the uterus—that’s a whole lotta blood, folks!

“Pregnancy, itself, is a cardiovascular ‘stress test’—something I experienced when I was pregnant with my twins at 39.”

Clinical learnings & considerations

There are some helpful learnings we can gather from a study led by the California Maternal Quality Care Collaborative, which found that of the approximately 2.7 million women in California who gave birth between 2002 and 2006, 864 died while pregnant or within one year of pregnancy. Of those who died, 25% were due to cardiovascular disease (comparatively, 18% died from preeclampsia and 10% from postpartum hemorrhage).

It’s important to break down heart disease diagnoses by stages of pregnancy. In this study:

• 3% of the women had a known history of cardiovascular disease when they entered prenatal care;
• 8% were diagnosed during pregnancy;
• 40% were diagnosed during labor or birth; and
• Nearly 50% were diagnosed in the postpartum period, the majority of which were in the first 42 days after having given birth.

In order to learn from and prevent these outcomes in the future, it’s also helpful to understand patient risk factors and underlying medical conditions. In this research, risk factors included:

• Underlying medical conditions (64%), such as hypertension
• Delay in seeking care (31%)
• Obesity (28%)
• Presumed or potential lack of awareness regarding the significance of their condition (22%)
• Substance abuse (19%)

How access to specialists can help improve outcomes

This study points to how important it is for women to have access to comprehensive cardiovascular screenings in preconception, prenatal, and postpartum care. When a woman is identified with maternal heart disease, it’s essential she sees specialists like a Maternal Fetal Medicine (MFM) physician and a Cardiologist (heart doctor) to help direct her care. She will need to deliver at a tertiary care center that has all of the services and staff that she and the fetus/infant may need. After pregnancy, she will need to follow up with a Cardiologist and/or her OB-GYN or PCP (primary care physician) for long-term cardiovascular care.

At Maven, thanks to our Care Advocates and our virtual network of physicians and specialists, we are uniquely positioned to help improve maternal cardiovascular health outcomes. During pregnancy, we regularly assess risk factors and ask about symptoms women may be experiencing, and can immediately refer them to a specialist on Maven or an in-person physician for evaluation.

In addition, our high-touch care in the postpartum period (aka, the fourth trimester) means that we are in conversation early and often with women as they are transitioning from labor to postpartum—a time when women are often focusing all their efforts on the newborn baby and ignoring symptoms in themselves like shortness of breath or palpitations.

Always listen to your heart

As you bundle up this Fall, remember to ask about your loved ones’ heart health. Ask your friends who are pregnant whether they’ve talked to their doctors about cardiovascular risks and screenings.

Eat well, exercise everyday if you can, and practice some self-love for your own beautiful, bleeding, hard-working heart. You only have one!

Dr. Jane van Dis is Maven’s Medical Director, a board-certified OB-GYN, and a frequent writer and speaker about gender equity in medicine. Follow her @JanevanDis.

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