According to recent data, there are more mothers of young children in the workforce now than pre-pandemic. While this progress is promising, women in the workforce face significant challenges throughout their pregnancy and postpartum journeys, according to a new Maternal Health in the Workplace report from Carrot Fertility. As the leading global fertility and family-building platform, the company commissioned a survey of 1,260 women in the U.S. to understand the full impact of the pregnancy journey – from prenatal preparedness to return to work – on mothers in the workplace. The results highlight specific obstacles they face and the need for more comprehensive maternal health support.

Among mothers who were surveyed, preparedness for pregnancy at all stages is lacking. Just 50% of all respondents felt prepared going into the prenatal stage, with the percentage declining to 38% in the postpartum stage, and 39% upon returning to work. The report also highlighted consistent racial disparities across many areas of maternal care, with preparedness for Black and Hispanic mothers falling behind other groups at each stage. 

As a potential contributor to feeling unprepared, Black and Hispanic respondents express higher levels of dissatisfaction with their professional medical care at each stage of the pregnancy experience. In fact, 34% of Hispanic mothers are dissatisfied with their medical care during the return-to-work phase, compared to 21% of white mothers.

Multiple challenges, including financial, mental health, and workplace concerns, are encountered throughout pregnancy, with minority women impacted differently

A majority of respondents faced challenges across multiple aspects of the pregnancy experience, including availability of information about prenatal care procedures, tests, and guidelines (55%); inflexible work schedules and the inability to take time off for appointments (65%); comfort levels asking questions and/or voicing concerns with their doctors (52%); cost of care (67%); getting sufficient help/support from family members (55%); and mental health (66%).

Racial disparities impact the types of serious challenges working women experience during pregnancy. Hispanic mothers are most likely to be seriously challenged by the cost of care (35%), while white mothers are most likely to have serious mental health challenges (32%), and Black mothers have the greatest challenge getting sufficient help from family (26%). The dynamic of disparate serious challenges extends into the postpartum phase with Hispanic mothers remaining seriously challenged by the cost of care (29%), and Black mothers are still challenged most by lack of sufficient help/support from family (26%). For Black mothers, 55% also have a different racial/ethnic background from their OB/GYN and among these respondents, 46% had at least one challenge as a result or would have preferred a doctor with the same background.

The geographical location of respondents also impacted care, with challenges heightened for rural mothers who are especially likely to miss OB/GYN appointments (68%) compared to 55% overall. Rural mothers are also most likely to report severe complications while giving birth (25% compared to 16% overall) and are least likely to be educated on all birthing options (49% compared to 66% overall). They also face serious challenges regarding the cost of childcare and transportation for appointments more often.

Maternal mental health challenges are reported, but not always addressed

While two-thirds of respondents share that their mental health was a challenge while pregnant, not all sought help. Among those who did not seek mental health support, cost is the most common barrier for white mothers (44%) and Hispanic mothers (43%). Black mothers (37%) and Asian mothers (43%) most often report not knowing where to find support.

Another factor is the upcoming presidential election. The majority of respondents expressed concerns, with 57% saying the election may impact their mental health and 68% worrying that political rulings could negatively impact maternal care. There is also agreement among respondents (74%) that candidates' maternal health policies will strongly impact how they vote.

More than 9 out of 10 women cite major difficulties returning to work

Lack of flexibility at work is a dominant obstacle facing working mothers. The majority (55%) miss OB/GYN appointments during the prenatal or postpartum phase due to a combination of inflexible scheduling (31%) and the inability to take time off from work (29%).

More than half of all respondents were eager to return to work (52%), yet also overwhelmed and nervous (51%). Nearly all mothers (91%) cited at least one major challenge returning to work, including child care (35%), balancing workload with other demands (32%), and continued career advancement (30%).

How employees responded to return-to-work challenges also differed by race with white mothers the most likely to explore other job options with better postpartum and return-to-work benefits (29%), Black mothers most likely to simply not return to work (20%), Hispanic mothers most likely to consider leaving the workforce (25%), and Asian mothers most likely to negotiate a flexible return-to-work arrangement (42%).

"We have an opportunity to support mothers throughout their pregnancy and postpartum journeys and help them successfully transition back into the workplace," said Tammy Sun, Founder and CEO, Carrot Fertility. "This report highlights the many maternal health challenges women face and the importance of investing in more workplace support to help ease this burden for employees so they can live balanced lives, in and out of the office. At Carrot, we support our members throughout their pregnancy and postpartum journeys. With our guidance, 9 out of 10 members who have a pregnancy Carrot Plan return to work after their pregnancy."

Workplace benefits, throughout the pregnancy journey and returning to work, positively impact employee attraction and retention

Fewer than half of respondents (43%) say the majority of their return-to-work needs were met, with 19% citing they lacked the employer support needed to succeed in returning. This dynamic increases for Black and Hispanic mothers, who express higher levels of dissatisfaction with their employer support levels at each stage of the pregnancy experience. Especially notable is that 34% of Black mothers are dissatisfied with employer support during the return-to-work phase, compared to 26% of white mothers.

Less than half of all respondents receive employer benefits that cover a variety of pregnancy and postpartum services, such as a birthing doula or midwife, lactation support, and access to pregnancy-related classes like prenatal yoga and meditation.

The vast majority of working mothers (84%) agree that more pregnancy, postpartum, and return-to-work support would make them more likely to stay at their company, with 79% stating pregnancy-related benefits are important when assessing future job opportunities, and 57% emphasizing they're very important. Flexible work scheduling is the workplace benefit most commonly cited as important for a successful return to work, with return-to-work plans second highest, and dedicated breast pumping workspace third. Notably, 80% of working mothers want access to both telehealth and in-person maternal care.

"The medical and emotional needs of working mothers can be complex and their care should be highly personalized," said Asima Ahmad, MD, MPH, FACOG, Co-founder and Chief Medical Officer, Carrot Fertility. "This report highlights that offering additional support in key areas such as workplace flexibility and affordability and accessibility of care can greatly impact not only the emotional and physical well-being of mothers, but also the health of the company through increased attraction and retention of talent. I hope more companies realize these dual benefits and help address this critical gap for employees."