WEBVTT

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Welcome to Our Voices Our Future, the podcast

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where we amplify the voices driving change and

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equity within medicine and beyond. Brought to

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you by the Gender Equity Task Force, a committee

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of the American Medical Women's Association,

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we're here to challenge norms, break barriers,

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and ignite conversations that matter. I'm Megan

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Etsy, and in each episode, we'll bring you candid

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discussions with leaders, change makers, and

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advocates working to create a more inclusive

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and just world. No more silence, no more waiting.

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You're listening to Our Voices Our Future. Let's

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get into it. Today's guest is Stephanie Fernaro,

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who became a mother for the second time she experienced

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postpartum depression, an outcome that affects

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up to one in seven mothers, yet is rarely discussed

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alongside the structural realities that fuel

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it. Like many women, she was carrying the invisible

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labor of caregiving, household management, and

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emotional load, work that remains largely unpaid,

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unmeasured, and unsupported. One intervention

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shifted everything. hiring a mother's helper.

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What seemed like a personal solution revealed

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a much larger truth, that access to caregiving

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support is not a luxury, but a determinant of

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mental health, workforce participation, and family

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stability. Today Stephanie is the founder of

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Hello Nanny, a nationwide child care agency designed

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to close the gap between families who need support

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and systems that fail to provide it. By offering

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flexible, scalable child care solutions at multiple

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price points, Hello Nanny challenges a market

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where professional care has historically been

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accessible only to the wealthy. Stephanie's work

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reframes child care as infrastructure, not indulgence,

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and positions investing in care as an economic

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and public health imperative, not a personal

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failure. So Stephanie, to start off, can you

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kind of just tell us a bit about your work and

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what initially drew you to examining motherhood

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through the lens of numbers, data, and systems

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rather than just your personal experience? Yeah,

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absolutely. Thanks for having me today. My background

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actually comes from medical device and software

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sales. So I spent years thinking about systems,

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where they break down, and how to design better

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solutions. And in my previous roles, I ran my

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work operationally, almost like a business inside

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of a business. So my brain naturally goes to

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root causes and scalable solutions. When I became

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a mother while working full time, I realized

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very quickly that what I was struggling with

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wasn't just personal, it was structural. So I

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was experiencing the mental load of motherhood

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in a very real way, trying to manage a demanding

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career, a newborn and everything in between without

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reliable support, expecting my husband to do

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it all. But he was an entrepreneur, he traveled

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a lot. So that expectation that I had on him

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as an entrepreneur who had a very demanding job,

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it was really unrealistic. And so that's what

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ultimately led me to found Hello Nanny in 2022,

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I wanted to help families build sustainable caregiving

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systems instead of constantly operating in crisis

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mode. Absolutely. I love that you hit on the

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mental load. I know some people still aren't

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quite familiar with what that is. Do you mind

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kind of talking a little bit about what mental

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load is considered? Yeah, absolutely. So it's

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the invisible labor that goes into planning and

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executing everything on the home. So who's thinking

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about birthday presents, who's purchasing the

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Valentine cards that are coming up in February,

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who's thinking about, I need to purchase Valentine

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cards for my child's classroom. I need to, like

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all of the things behind the scenes that happen,

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like I need to purchase groceries for the week.

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I need to plan for the meals this week. All of

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the invisible labor that is managed in the home

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is what refers to as the mental load. Thank you

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so much. So when we talk about the hidden math

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of motherhood, what are the key numbers that

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people tend to overlook, whether it's time, unpaid

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labor, caregiving cost, or lost economic opportunity?

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Yeah, that's a great question. When people hear

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math, they often think money. But the hidden

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math of motherhood is really about time, cognitive

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load, and unpaid labor in the home. The mental

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load of motherhood is the constant invisible

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work planning, coordinating, anticipating needs,

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as I mentioned, that runs in the background all

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day every day. So that labor isn't tracked or

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valued, but it has a very real consequence for

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stress levels, mental health, and long -term

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career outcomes. So for example, time spent coordinating

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child care, scheduling medical appointments,

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managing household logistics often happens outside

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of paid work, but it directly affects performance

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and well -being. So once you start looking at

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motherhood through that lens, you realize this

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isn't about individual capacity, it's about systems

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that aren't designed for modern life. So when

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we look at these invisible calculations, especially

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the uneven distribution of caregiving that show

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up in women's mental health, burnout, and long

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-term career trajectories, what does the data

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tell us? What do we know about this? The data

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tells us that it's just disproportionately leaning

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on on women and women are carrying that that

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burden exponentially. And so it's just a cultural

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expectation that we have. I think that we've

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just always done it. We continue to do it. And,

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you know, in the 1960s, it was a dynamic where

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primarily men were in the workforce, women were

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at home. And that is just not our reality anymore.

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and our culture hasn't shifted alongside that

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new infrastructure that we have today where you

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have dual working homes, modern families, and

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our society and culture hasn't adapted to that

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shift. So you kind of emphasize and talk about

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how investing in care is not an expense, but

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it's an economic imperative. Can you kind of

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walk us through how inadequate childcare, unpaid

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labor, and burnout create that ripple effect

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that extend far beyond individual families? Yes.

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So essentially, when care systems fail, the costs

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don't stay inside the home. We see ripple effects

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in workforce attrition, increased healthcare

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utilization, and reduced productivity. So burnout

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is expensive, not just emotionally, but systematically.

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So childcare infrastructure and investing in

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care improves mental health outcomes, workforce

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stability, and long -term economic health. This

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is especially relevant in healthcare, where burnout

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is already high and caregiving demands often

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compound existing pressures. So on a more personal

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and practical level, what role do things like

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hiring help, redistributing household labor,

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or setting boundaries actually play in protecting

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mothers' mental health, and why shouldn't these

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be seen as individual luxuries or failures? Well,

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child care and mental health are deeply connected,

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and they say that if you look at the mom's mental

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health and her well -being, it directly ties

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to the developmental outcomes for their child.

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So if mom isn't okay, then the development of

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the child is not going to be okay. So the two

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have to coexist. So hiring a nanny for me was

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a turning point, not because I wanted to do less,

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and I actually had to set aside my pride and

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get out of my own way, because initially, When

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my husband proposed this idea, I was absolutely

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against it. In my mind, I thought, I'm not letting

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someone else raise my child. And so when I was

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able to get that out of my mind, What I found

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was that I needed the system around me to work.

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And when I was able to get out of my own way,

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the system started to work because I had the

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support and the infrastructure in place to make

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it work. So that support allowed me to recover

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mentally. It allowed me to be more present as

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a parent and function better professionally.

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It didn't just help me. It stabilized our entire

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family system and support systems. are shown

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to reduce burnout in the same way that preventative

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care does. They protect long -term health. These

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aren't luxuries. They are protective factors.

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And that's why I started this agency was because

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what I realized is, as someone who's been married

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and divorced, I'm on my second marriage, was

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that I really believe that if more families had

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support, there would be fewer families that are

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broken and divided as a result. So that's actually

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something your kind of mindset that you had at

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the beginning of that is still things that I

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say to myself is I want to raise my children

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myself. I'm not a mother yet. And so it's very

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interesting to hear you say that. What what pulls

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you out of that funk and thinking that and what

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made you say, OK, actually, it's OK to have some

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help. You know, my pediatrician had a little

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part in that. She asked me one day we were in

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my son's pediatrician appointment and Our pediatrician

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could overhear us arguing in the room and she

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comes in and she says, hey, you too. And she

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goes from pediatrician to marriage counselor.

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And my husband's like, I've been telling her

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let's hire a mother's helper. And she refuses.

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And my pediatrician said, are you crazy? Your

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husband's offering to hire a nanny and you're

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telling him no. And I said, well, yeah, because

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I don't want someone else raising my son. And

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she goes, someone's not. someone else isn't raising

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your son. It's just accepting support and help.

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And hearing it from a pediatrician, I think,

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for me, rather than my husband, we become immune

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to our husband's advice. But when it's someone

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who's a professional, it's more logical. And

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so it just resonated with me. And so hearing

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it from my pediatrician was like, OK. she's a

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professional. I hold her in high regard in her

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professional opinion. And so she's telling me

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that there is nothing wrong with me hiring support.

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And so she allowed me to do that soul searching

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that I needed to come to that revelation. That's

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great. I'm glad that she was there to support

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you. That's incredible. How would you say we

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move this conversation from just the household,

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you and your husband just talking about it, into

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more public policy, more workplace structures,

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what kind of systemic changes would you say would

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help? I would say it would be things like paid

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leave, affordable child care, flexibility without

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penalty, or not just maternity leave, but also

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paternity leave and normalizing paternity leave.

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I actually had a colleague of mine who I worked

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with many years ago. I noticed he posted something

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on LinkedIn a few weeks ago. And he said he had

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taken a sabbatical or he had not a sabbatical.

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He quit his job for a year while he was there

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for his family during a really hard and difficult

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time for his family. after the loss of his mother

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and, you know, finalizing her estate and then

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being there for his wife and his family through

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that, he said he felt like he was letting down

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his organization. And so for him, he felt like

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the solution was just to resign from his position

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because he didn't want to let his company down.

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And I thought, you know, that right there, I

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think is it sends a it's a huge message, right,

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that. The men in our society also have a ton

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of pressure on them culturally as well that if

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they are supposed to work as though they don't

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have families as though they don't have responsibilities

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because the assumption is they have a spouse

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at home who's taking care of all of those things.

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And so I think if we normalize paternity leave,

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we normalize dads being a large part of their

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family systems and a large part of rearing and

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raising and developing their children, that the

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imbalance will shift that way as well. I love

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that. That sounds incredible. So for anybody

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listening, whether it's mothers, partners, employers,

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policymakers, what's one of the biggest kind

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of mind shift or action you believe would most

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immediately help reduce this mental load and

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better support caregiving equity? I would say

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allowing families, because families are expected,

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when they hire support, they're expected to pay

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legally. Above board, they're an employer, they're

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W -2 -ing the person that they hire in the home,

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and yet they are not allowed to write that expense

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off as an operational expense as a business would.

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So I would say the first thing is policy reform

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as it relates to how we treat families as an

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employer and the tax liabilities that they have

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by being an employer and that if they are operating

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as a business that they are also able to be seen

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in a tax perspective as a business and that the

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operational expense of hiring support in their

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home, whether that be a nanny or a family assistant.

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And I'm not saying a full staff. I'm saying one

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person in the home that that is an operational

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expense that can offset tax liability. Do you

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know if people who like have personal LSEs or

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something do this? Is this something that people

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who run their own business can do for themselves?

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No, you cannot write. You cannot employ your

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nanny or your family assistant under your LLC

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or under your business. It's not legal. Gotcha.

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Right. So that's the issue. Right. Exactly. And

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so I think that if there was policy reform that

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says, look, every family, if you hire someone

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in the home, whether it's a family assistant,

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a nanny, one employee, not multiple, not a team,

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but just want that because in order for me to

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go to work, I need that support at home. And

00:14:48.350 --> 00:14:53.049
it is a necessity. I cannot go to work if I don't

00:14:53.049 --> 00:14:56.389
have this infrastructure at home. It is an operational

00:14:56.389 --> 00:15:00.049
expense that is contingent on my ability to contribute

00:15:00.049 --> 00:15:02.830
to the workforce. So it's an operational expense,

00:15:02.830 --> 00:15:04.809
but it's not treated as that. So I think that

00:15:04.809 --> 00:15:08.370
would be the biggest impact right away if we

00:15:08.370 --> 00:15:11.779
had policy reform in that regard. I love that.

00:15:11.919 --> 00:15:14.360
Thank you. That's such a perspective I've never

00:15:14.360 --> 00:15:16.820
even heard anything about before. And that's

00:15:16.820 --> 00:15:19.519
so incredible. Thank you for sharing that. Yes,

00:15:19.519 --> 00:15:21.840
I'm happy to share it. And I'm hoping that more

00:15:21.840 --> 00:15:24.440
people can hear about it. And it's just an out

00:15:24.440 --> 00:15:27.580
of the box way that as I've been doing this,

00:15:27.700 --> 00:15:29.580
I've been doing it for almost five years now.

00:15:29.600 --> 00:15:31.899
And I eat, sleep, and breathe this industry,

00:15:32.059 --> 00:15:36.590
which I never imagined I would. hiring support

00:15:36.590 --> 00:15:40.090
became such a revelation for me and my life that

00:15:40.090 --> 00:15:43.289
I was like more people need to know about this

00:15:43.289 --> 00:15:47.250
and how can I fix it and make it better so that

00:15:47.250 --> 00:15:50.049
families are functioning and by starting this

00:15:50.049 --> 00:15:53.669
work, I realized there is a systematic issue

00:15:53.669 --> 00:15:56.769
that we have and I'm determined to resolve it.

00:15:57.129 --> 00:15:59.929
So thanks for including me on this conversation.

00:16:00.620 --> 00:16:03.639
Yeah, it's kind of so cool to hear how you came

00:16:03.639 --> 00:16:06.399
from being postpartum from your second child

00:16:06.399 --> 00:16:08.519
and like not believing in the help at all to

00:16:08.519 --> 00:16:12.100
now being like the pro advocate for it. Yeah,

00:16:12.120 --> 00:16:18.129
I went from one extreme to the other and I actually,

00:16:18.789 --> 00:16:21.149
one part of my story that I've shared publicly

00:16:21.149 --> 00:16:23.870
as well is that my biological mom left when I

00:16:23.870 --> 00:16:27.470
was five years old. And I spent my entire life

00:16:27.470 --> 00:16:29.809
really not understanding how a mom could just

00:16:29.809 --> 00:16:33.830
leave her children. And it wasn't until I had

00:16:33.830 --> 00:16:36.870
my son that when I went through my postpartum

00:16:36.870 --> 00:16:39.990
depression period, I was like, it makes sense

00:16:39.990 --> 00:16:43.929
now. Now I understand because leaving felt easier

00:16:43.929 --> 00:16:47.259
in that moment. And the difference in what I

00:16:47.259 --> 00:16:49.879
realized was the difference between my biological

00:16:49.879 --> 00:16:53.159
mom and myself was that I had a supportive partner

00:16:53.159 --> 00:16:56.480
and access to resources that she didn't have

00:16:56.480 --> 00:17:00.240
access to. And that if more moms had access to

00:17:00.240 --> 00:17:03.860
this type of support, that there would be fewer

00:17:04.860 --> 00:17:08.519
There would be less trauma in this world. There'd

00:17:08.519 --> 00:17:11.640
be more families that stay together. There would

00:17:11.640 --> 00:17:14.579
be more children that have parents that are grounded

00:17:14.579 --> 00:17:18.640
and healthy. And so I think this is a systematic

00:17:18.640 --> 00:17:23.660
issue that if we can find a solution for culturally,

00:17:23.859 --> 00:17:26.920
there will be a shift and a much healthier shift

00:17:26.920 --> 00:17:29.980
in our society. That's incredible. Thank you

00:17:29.980 --> 00:17:31.900
so much for sharing that. This has been a great

00:17:31.900 --> 00:17:35.730
conversation. Thanks for having me. Yeah. So

00:17:35.730 --> 00:17:37.750
that's a wrap on this episode of Our Voice is

00:17:37.750 --> 00:17:40.470
Our Future. We hope today's conversation inspired

00:17:40.470 --> 00:17:43.109
you, challenged you, and reminded you of the

00:17:43.109 --> 00:17:45.549
power of raising your voice. The fight for equity

00:17:45.549 --> 00:17:48.150
doesn't stop here. Join us in the movement, subscribe

00:17:48.150 --> 00:17:50.089
wherever you get your podcasts, and if you love

00:17:50.089 --> 00:17:51.950
this episode, share it with someone who needs

00:17:51.950 --> 00:17:54.670
to hear it. Until next time, stay bold, stay

00:17:54.670 --> 00:17:56.769
vocal, and keep the conversation going. This

00:17:56.769 --> 00:17:57.990
is Our Voice is Our Future.
