Welcome to Our Voices Our Future, the podcast
where we amplify the voices driving change and
equity within medicine and beyond. Brought to
you by the Gender Equity Task Force, a committee
of the American Medical Women's Association,
we're here to challenge norms, break barriers,
and ignite conversations that matter. I'm Megan
Etsy, and in each episode, we'll bring you candid
discussions with leaders, change makers, and
advocates working to create a more inclusive
and just world. No more silence, no more waiting.
You're listening to Our Voices Our Future. Let's
get into it. Today's guest is Stephanie Fernaro,
who became a mother for the second time she experienced
postpartum depression, an outcome that affects
up to one in seven mothers, yet is rarely discussed
alongside the structural realities that fuel
it. Like many women, she was carrying the invisible
labor of caregiving, household management, and
emotional load, work that remains largely unpaid,
unmeasured, and unsupported. One intervention
shifted everything. hiring a mother's helper.
What seemed like a personal solution revealed
a much larger truth, that access to caregiving
support is not a luxury, but a determinant of
mental health, workforce participation, and family
stability. Today Stephanie is the founder of
Hello Nanny, a nationwide child care agency designed
to close the gap between families who need support
and systems that fail to provide it. By offering
flexible, scalable child care solutions at multiple
price points, Hello Nanny challenges a market
where professional care has historically been
accessible only to the wealthy. Stephanie's work
reframes child care as infrastructure, not indulgence,
and positions investing in care as an economic
and public health imperative, not a personal
failure. So Stephanie, to start off, can you
kind of just tell us a bit about your work and
what initially drew you to examining motherhood
through the lens of numbers, data, and systems
rather than just your personal experience? Yeah,
absolutely. Thanks for having me today. My background
actually comes from medical device and software
sales. So I spent years thinking about systems,
where they break down, and how to design better
solutions. And in my previous roles, I ran my
work operationally, almost like a business inside
of a business. So my brain naturally goes to
root causes and scalable solutions. When I became
a mother while working full time, I realized
very quickly that what I was struggling with
wasn't just personal, it was structural. So I
was experiencing the mental load of motherhood
in a very real way, trying to manage a demanding
career, a newborn and everything in between without
reliable support, expecting my husband to do
it all. But he was an entrepreneur, he traveled
a lot. So that expectation that I had on him
as an entrepreneur who had a very demanding job,
it was really unrealistic. And so that's what
ultimately led me to found Hello Nanny in 2022,
I wanted to help families build sustainable caregiving
systems instead of constantly operating in crisis
mode. Absolutely. I love that you hit on the
mental load. I know some people still aren't
quite familiar with what that is. Do you mind
kind of talking a little bit about what mental
load is considered? Yeah, absolutely. So it's
the invisible labor that goes into planning and
executing everything on the home. So who's thinking
about birthday presents, who's purchasing the
Valentine cards that are coming up in February,
who's thinking about, I need to purchase Valentine
cards for my child's classroom. I need to, like
all of the things behind the scenes that happen,
like I need to purchase groceries for the week.
I need to plan for the meals this week. All of
the invisible labor that is managed in the home
is what refers to as the mental load. Thank you
so much. So when we talk about the hidden math
of motherhood, what are the key numbers that
people tend to overlook, whether it's time, unpaid
labor, caregiving cost, or lost economic opportunity?
Yeah, that's a great question. When people hear
math, they often think money. But the hidden
math of motherhood is really about time, cognitive
load, and unpaid labor in the home. The mental
load of motherhood is the constant invisible
work planning, coordinating, anticipating needs,
as I mentioned, that runs in the background all
day every day. So that labor isn't tracked or
valued, but it has a very real consequence for
stress levels, mental health, and long -term
career outcomes. So for example, time spent coordinating
child care, scheduling medical appointments,
managing household logistics often happens outside
of paid work, but it directly affects performance
and well -being. So once you start looking at
motherhood through that lens, you realize this
isn't about individual capacity, it's about systems
that aren't designed for modern life. So when
we look at these invisible calculations, especially
the uneven distribution of caregiving that show
up in women's mental health, burnout, and long
-term career trajectories, what does the data
tell us? What do we know about this? The data
tells us that it's just disproportionately leaning
on on women and women are carrying that that
burden exponentially. And so it's just a cultural
expectation that we have. I think that we've
just always done it. We continue to do it. And,
you know, in the 1960s, it was a dynamic where
primarily men were in the workforce, women were
at home. And that is just not our reality anymore.
and our culture hasn't shifted alongside that
new infrastructure that we have today where you
have dual working homes, modern families, and
our society and culture hasn't adapted to that
shift. So you kind of emphasize and talk about
how investing in care is not an expense, but
it's an economic imperative. Can you kind of
walk us through how inadequate childcare, unpaid
labor, and burnout create that ripple effect
that extend far beyond individual families? Yes.
So essentially, when care systems fail, the costs
don't stay inside the home. We see ripple effects
in workforce attrition, increased healthcare
utilization, and reduced productivity. So burnout
is expensive, not just emotionally, but systematically.
So childcare infrastructure and investing in
care improves mental health outcomes, workforce
stability, and long -term economic health. This
is especially relevant in healthcare, where burnout
is already high and caregiving demands often
compound existing pressures. So on a more personal
and practical level, what role do things like
hiring help, redistributing household labor,
or setting boundaries actually play in protecting
mothers' mental health, and why shouldn't these
be seen as individual luxuries or failures? Well,
child care and mental health are deeply connected,
and they say that if you look at the mom's mental
health and her well -being, it directly ties
to the developmental outcomes for their child.
So if mom isn't okay, then the development of
the child is not going to be okay. So the two
have to coexist. So hiring a nanny for me was
a turning point, not because I wanted to do less,
and I actually had to set aside my pride and
get out of my own way, because initially, When
my husband proposed this idea, I was absolutely
against it. In my mind, I thought, I'm not letting
someone else raise my child. And so when I was
able to get that out of my mind, What I found
was that I needed the system around me to work.
And when I was able to get out of my own way,
the system started to work because I had the
support and the infrastructure in place to make
it work. So that support allowed me to recover
mentally. It allowed me to be more present as
a parent and function better professionally.
It didn't just help me. It stabilized our entire
family system and support systems. are shown
to reduce burnout in the same way that preventative
care does. They protect long -term health. These
aren't luxuries. They are protective factors.
And that's why I started this agency was because
what I realized is, as someone who's been married
and divorced, I'm on my second marriage, was
that I really believe that if more families had
support, there would be fewer families that are
broken and divided as a result. So that's actually
something your kind of mindset that you had at
the beginning of that is still things that I
say to myself is I want to raise my children
myself. I'm not a mother yet. And so it's very
interesting to hear you say that. What what pulls
you out of that funk and thinking that and what
made you say, OK, actually, it's OK to have some
help. You know, my pediatrician had a little
part in that. She asked me one day we were in
my son's pediatrician appointment and Our pediatrician
could overhear us arguing in the room and she
comes in and she says, hey, you too. And she
goes from pediatrician to marriage counselor.
And my husband's like, I've been telling her
let's hire a mother's helper. And she refuses.
And my pediatrician said, are you crazy? Your
husband's offering to hire a nanny and you're
telling him no. And I said, well, yeah, because
I don't want someone else raising my son. And
she goes, someone's not. someone else isn't raising
your son. It's just accepting support and help.
And hearing it from a pediatrician, I think,
for me, rather than my husband, we become immune
to our husband's advice. But when it's someone
who's a professional, it's more logical. And
so it just resonated with me. And so hearing
it from my pediatrician was like, OK. she's a
professional. I hold her in high regard in her
professional opinion. And so she's telling me
that there is nothing wrong with me hiring support.
And so she allowed me to do that soul searching
that I needed to come to that revelation. That's
great. I'm glad that she was there to support
you. That's incredible. How would you say we
move this conversation from just the household,
you and your husband just talking about it, into
more public policy, more workplace structures,
what kind of systemic changes would you say would
help? I would say it would be things like paid
leave, affordable child care, flexibility without
penalty, or not just maternity leave, but also
paternity leave and normalizing paternity leave.
I actually had a colleague of mine who I worked
with many years ago. I noticed he posted something
on LinkedIn a few weeks ago. And he said he had
taken a sabbatical or he had not a sabbatical.
He quit his job for a year while he was there
for his family during a really hard and difficult
time for his family. after the loss of his mother
and, you know, finalizing her estate and then
being there for his wife and his family through
that, he said he felt like he was letting down
his organization. And so for him, he felt like
the solution was just to resign from his position
because he didn't want to let his company down.
And I thought, you know, that right there, I
think is it sends a it's a huge message, right,
that. The men in our society also have a ton
of pressure on them culturally as well that if
they are supposed to work as though they don't
have families as though they don't have responsibilities
because the assumption is they have a spouse
at home who's taking care of all of those things.
And so I think if we normalize paternity leave,
we normalize dads being a large part of their
family systems and a large part of rearing and
raising and developing their children, that the
imbalance will shift that way as well. I love
that. That sounds incredible. So for anybody
listening, whether it's mothers, partners, employers,
policymakers, what's one of the biggest kind
of mind shift or action you believe would most
immediately help reduce this mental load and
better support caregiving equity? I would say
allowing families, because families are expected,
when they hire support, they're expected to pay
legally. Above board, they're an employer, they're
W -2 -ing the person that they hire in the home,
and yet they are not allowed to write that expense
off as an operational expense as a business would.
So I would say the first thing is policy reform
as it relates to how we treat families as an
employer and the tax liabilities that they have
by being an employer and that if they are operating
as a business that they are also able to be seen
in a tax perspective as a business and that the
operational expense of hiring support in their
home, whether that be a nanny or a family assistant.
And I'm not saying a full staff. I'm saying one
person in the home that that is an operational
expense that can offset tax liability. Do you
know if people who like have personal LSEs or
something do this? Is this something that people
who run their own business can do for themselves?
No, you cannot write. You cannot employ your
nanny or your family assistant under your LLC
or under your business. It's not legal. Gotcha.
Right. So that's the issue. Right. Exactly. And
so I think that if there was policy reform that
says, look, every family, if you hire someone
in the home, whether it's a family assistant,
a nanny, one employee, not multiple, not a team,
but just want that because in order for me to
go to work, I need that support at home. And
it is a necessity. I cannot go to work if I don't
have this infrastructure at home. It is an operational
expense that is contingent on my ability to contribute
to the workforce. So it's an operational expense,
but it's not treated as that. So I think that
would be the biggest impact right away if we
had policy reform in that regard. I love that.
Thank you. That's such a perspective I've never
even heard anything about before. And that's
so incredible. Thank you for sharing that. Yes,
I'm happy to share it. And I'm hoping that more
people can hear about it. And it's just an out
of the box way that as I've been doing this,
I've been doing it for almost five years now.
And I eat, sleep, and breathe this industry,
which I never imagined I would. hiring support
became such a revelation for me and my life that
I was like more people need to know about this
and how can I fix it and make it better so that
families are functioning and by starting this
work, I realized there is a systematic issue
that we have and I'm determined to resolve it.
So thanks for including me on this conversation.
Yeah, it's kind of so cool to hear how you came
from being postpartum from your second child
and like not believing in the help at all to
now being like the pro advocate for it. Yeah,
I went from one extreme to the other and I actually,
one part of my story that I've shared publicly
as well is that my biological mom left when I
was five years old. And I spent my entire life
really not understanding how a mom could just
leave her children. And it wasn't until I had
my son that when I went through my postpartum
depression period, I was like, it makes sense
now. Now I understand because leaving felt easier
in that moment. And the difference in what I
realized was the difference between my biological
mom and myself was that I had a supportive partner
and access to resources that she didn't have
access to. And that if more moms had access to
this type of support, that there would be fewer
There would be less trauma in this world. There'd
be more families that stay together. There would
be more children that have parents that are grounded
and healthy. And so I think this is a systematic
issue that if we can find a solution for culturally,
there will be a shift and a much healthier shift
in our society. That's incredible. Thank you
so much for sharing that. This has been a great
conversation. Thanks for having me. Yeah. So
that's a wrap on this episode of Our Voice is
Our Future. We hope today's conversation inspired
you, challenged you, and reminded you of the
power of raising your voice. The fight for equity
doesn't stop here. Join us in the movement, subscribe
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is Our Voice is Our Future.