Transcript: The Mental Challenges of Returning to Work After Maternity Leave

This is a text transcript from The First Time Mum’s Chat podcast. The episode is called The Mental Challenges of Returning to Work After Maternity Leave and you can click on the link to view the full episode page, listen to the episode and view the show notes.

Helen Thompson: This is your host, Helen Thompson. Thank you for being here today. If you are already subscribed to the show, thank you so much, mums. You always are amazing and if you’re here for the first time, make sure you subscribe to the show.

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Today, like in every episode, I’m bringing you an amazing woman, Dr. Emily Guarnotta, who is a licensed clinical psychologist, specializing in maternal mental health. Dr. Emily is launching a US based online practice that aims to reduce the barriers that mums often face when looking for support and therapy, in areas including postpartum anxiety or depression.

During our chat, you’ll hear us talk about the challenges of returning to work after maternity leave, which is sadly often a hard time of readjustment for mums. Now, let’s meet Dr Emily and get on to the interview.

Hi, Dr. Emily, and welcome to First Time Mum’s Chat. I’m delighted to have you here, and I can’t wait to chat about the challenges of returning to work after maternity leave, and to hear all about your new venture.

Emily Guarnotta: Thank you so much, Helen. Yes, my name is Dr. Emily Guarnotta, and I’m a psychologist, and I also own Phoenix Health, which is a maternal mental health practice where we support new mothers that are dealing with a lot of the challenges of new motherhood.

So Phoenix Health came out of a need for, I realized when I was working as a psychologist that there just weren’t enough practices that specialized in serving mothers. I truly believe that mothers deal with unique issues that, it’s challenging for them to go to a more general practice, a more general therapist, because everything that they’re going through, especially during the postpartum period is really unique.

They really need someone who can understand what that period brings and what that’s like. So, my business partner and I developed Phoenix Health. So we’re an online practice, so we make it really easy for mothers to get therapy and we’re based in the United States. We’re serving New York and our hope is that down the road, we can also serve mothers in other states as well.

Helen Thompson: It sounds like a fantastic opportunity for mums who need that extra support. I know that it’s quite a trauma to get help when you’re a first time mum, with a baby.

Emily Guarnotta: That’s kind of been the experience that I’ve heard as well that a lot of mothers find it hard to find a provider that specializes in this area and then to make it a priority to take the time and really put their mental health first, is really difficult. So we want to really reduce as many barriers to moms getting help as we can and that’s our mission at Phoenix Health.

Helen Thompson: I think that’s a wonderful idea. You hear a lot about trauma, everybody talks about the birth trauma, but what I really wanted to focus on with you is the trauma of when you go back to work as a mum. How did you feel when that happened to you when you had to go back to work when your baby was so young?

Emily Guarnotta: Well, it’s definitely something that I personally didn’t feel really prepared to do so early on and I know when you and I had originally spoken we had talked a little bit about how it’s a bit different in Australia compared to the United States. In the United States, there’s a lot of pressure to go back to work really soon and a lot of mothers here feel like they don’t really have a choice. So their employer might give them, if they’re lucky three months off but sometimes it’s far less than that, or they’re having to take unpaid leave, and it’s a big burden financially for their families.

So the consensus that I hear among mothers is that they feel like they’re being kind of pushed back to work much sooner than they feel ready, and this is actually even been referred to as the fifth trimester. So, you know how we kind of talk about the fourth trimester as being that first three months of the baby’s life, and then you get to that point, and then we call the fifth trimester that transition back to work, and it’s its own unique trimester with its own stresses, it’s just a very, It’s a very different experience.

I personally did feel that when I had both my children and I had to return back to work that I felt like it was a new transition. I kind of felt like I was back on my first day of the job again. It felt like almost starting a new job after, taking some time off and becoming a mother. That’s another thing that I hear a lot of mothers share is that they feel like they’re going back to work and they think that they’re just going to pick up where they left off, but it really does feel like they’re starting over again.

Helen Thompson: And how were you supported? Were you supported by your colleagues when you went back to work after having your baby, if you needed to breastfeed or leave to go at lunchtime to feed your baby or whatever you needed to do?

Emily Guarnotta: I personally did have a really good experience because I did have colleagues that were mothers or fathers themselves and I think part of the benefit also of being a mental health professional and working around other mental health professionals is that they’re really in tune to that. I know a lot of the clients that I’ve worked with or even family or friends who have gone back to work after having a baby share that they’re not so fortunate and that they feel like sometimes their colleagues don’t understand or are pressuring them to do things that maybe they’re not comfortable with.

If they want to schedule in breaks to breastfeed or pump that legally their companies can tell them not to do that, but there might be kind of this company culture or pressure to just jump right back into work and be really productive. So a lot of people have different experiences, and it’s really hard for mothers that are going back to a company that isn’t so supportive.

Helen Thompson: What sort of advice would you give to a mum who was going through that trauma and doesn’t have the support from their colleagues?

Emily Guarnotta: The number one thing that I always tell moms when they’re preparing to go back to work is to understand that it is going to be a transition. So to have really realistic expectations for themselves. I tell them, don’t expect to go back the first day and feel like yourself and don’t push yourself too hard, too fast. Give yourself time to acclimate back and even if you’re feeling that pressure from your boss or your colleagues, you need to take a step back and tell yourself, I’m going to take this time because I know I’ve been through a lot and to put that into place for themselves, even if they’re getting that pressure from other people.

I also think it’s very important to know your legal rights wherever you live. So here in the US, we have state laws around requiring mothers who are breastfeeding to have time to pump at work and just really educate yourself on what your rights are. So, if your company is giving you a hard time about that, you know, legally what you’re entitled to.

Helen Thompson: You’ve got a much vaster state system than we do. Are you saying that each state has a different law?

Emily Guarnotta: Each state does have slightly different laws around pumping, around being entitled to breaks to pump breast milk during work hours. It can vary from state to state. Generally, most states do allow some sort of break system. For example, when I was going back to work, I was living in New York and we were entitled to have breaks scheduled throughout our day. I was very fortunate, like I mentioned, that I had a really very supportive workplace environment, so I didn’t have to really stress too much about it because whatever I needed my colleagues were wonderful about providing for me. For moms who don’t have such great support at work, it is important just to know legally what your rights are in your state in case your employer is giving you a hard time about taking those pumping breaks or whatever it may be.

Helen Thompson: Yeah, as you mentioned in the beginning, Phoenix Health actually supports mums and helps them to go back to work. So how does Phoenix Health help mums?

Emily Guarnotta: Yeah, that’s a great question. So we’re a therapy practice, so we have therapists who are licensed and specialized in helping moms who are trained in how to treat moms that are dealing with different mental health concerns and we do online telehealth sessions. So the beauty of Phoenix health is that you can go on to our website, you can get matched with a therapist and then you can actually attend your therapy sessions online. So it is actually really convenient for moms who are planning on going back to work or who are already back at work because you can, it makes it a little bit easier to schedule your therapy session, since you could do them during your lunch break or in the evening after your baby goes to bed, you don’t have to worry about driving to a therapist’s office and sitting there for an appointment. So that’s something that I’ve gotten a lot of feedback from clients on that it’s really important that therapy can fit into their busy lifestyle as a mom, or else it just doesn’t become a priority.

So that’s why we really aim to reduce as many barriers for moms as possible so that. Those moms who want the support, who need therapy, who want therapy, can get it as easily as possible.

Helen Thompson: And what kind of therapy is that? Do you have different kinds of therapy that mums can get?

Emily Guarnotta: That’s actually another great question. So the types of therapy that we offer, we tailor to the specific client,so there are certain things that some clients might be dealing with that might respond better to certain types of therapy. For example, if a mom is coming in with really bad anxiety, we’re probably going to do a type of therapy called cognitive behavioral therapy, because the research has showed that that’s really effective at helping moms manage anxiety and that really focuses on a person’s thoughts and changing negative thoughts that are causing the anxiety but for example, if a mom is dealing with something like obsessive compulsive disorder (OCD), which can arise during the postpartum period, moms are actually quite vulnerable to developing OCD, we would do a type of therapy called exposure and response prevention. That’s simply because that type of therapy has been shown in the research to be most effective for treating OCD. So we really tailor the type of therapy that we use to what each of our clients needs.

Helen Thompson: And that relates to postpartum depression, as you mentioned anxiety, a lot of mums go through postpartum depression and it also could be anxiety as we’ve mentioned, about going back to work, or anxiety about not being able to touch their baby, or anxiety about not being able to sleep, or not being able to rest, and running around, excuse, this Australian expression, but running around like a headless chook, not being able to do anything, because you’re so focused on your baby, that you’re not taking that time for yourself and so that can produce anxiety.

Emily Guarnotta: Absolutely. Yeah, absolutely. And I find that a lot of people use the term postpartum depression. They’ll come into therapy and they’ll say, you know, I think I have postpartum depression, but what a lot of people don’t realize is there are actually a lot of different conditions that are kind of subtypes under postpartum depression.

So like you mentioned, there’s postpartum anxiety, there’s OCD, which some women can develop after having a baby. There’s the birth trauma that can lead to PTSD (post-traumatic stress disorder). So there’s all these specific conditions that it’s hard for a person who hasn’t gone to school for this or isn’t knowledgeable in this to identify.

So when you come to us and you get assessed by a psychologist or by a therapist, we’ll be able to tell what specific condition you have, and then that’ll tell us what type of treatment we can offer you or what type of therapy is going to work best for that specific condition. So that’s why I always tell people, if you’re suspecting that something’s not quite right, if you’re really not feeling like yourself after about a month or so postpartum, don’t hesitate to reach out for help because there’s really no reason to kind of wait and see if it gets worse, when the help is out there, even if you just need a couple of sessions to get your bearings again and feel a little bit better. It’s just so much easier to come in for a couple of sessions and work on things versus letting things fester and then having them get worse and everything kind of piles on top of each other. There’s really no reason to do that or put yourself through that.

Helen Thompson: Do you support the dad as well? Can it be a group session with dad as well as mom? Or is it solely just for moms?

Emily Guarnotta: We really tailor it to what each of our clients needs. So there’s a lot of cases where we find it helpful to bring the father or the partners into sessions to o, especially if the couple is having trouble communicating with each other, or the father is concerned about what his spouse is going through and doesn’t quite understand it. We can help him understand what’s going on and teach him some ways to communicate better with her and support her. So we definitely do encourage fathers or partners to be involved in the therapy as well.

Helen Thompson: I think that’s a good thing because, it takes two to have a baby, so I think the fathers sometimes feel stressed as well and they feel, if mom’s breastfeeding, they don’t have the connection with the baby.

Emily Guarnotta: Absolutely. I’ve heard a lot of fathers and partners have expressed that as well, that they feel like they don’t know how to be a support to the family or they don’t know what to do. So giving them a task that can help facilitate bonding, I think, is a great way to have fathers feel more involved and to start developing their confidence as a dad as well. Studies do show that fathers or non birthing partners or even adopted parents can also experience postpartum depression. Often it can look a little bit different. For example, fathers are actually more likely to experience more anger in their depression or more irritability. The researchers estimate that about one in ten dads do show signs of postpartum depression. So it definitely doesn’t only affect mothers.

Helen Thompson: Yeah, it’s interesting how you said just then, even if you’re an adoptive parent, that you haven’t actually gone through the birth yourself and you’ve adopted. I’d never thought of postpartum depression with an adoptive parent before, because I sort of figured that if you’ve adopted a child, you haven’t gone through all that trauma, so it’s more of an excitement, but then I guess it changes your life as well. That’s a very interesting point you just brought up.

Emily Guarnotta: It really shows that we think of postpartum depression as being hormonal, or hormones play a big role, and they definitely do play a very large role, but the fact that we do see postpartum depression among dads, non birthing partners, adopted parents, it shows us that it’s more than just the hormones, it’s the whole stress of the transition, it’s taking care of a newborn, which is very demanding. It’s the lack of sleep, it’s so many things that all comes together and any parent is really vulnerable to, to possibly experiencing postpartum depression.

Helen Thompson: So, is there any thing that we haven’t mentioned that you’d like to add?

Emily Guarnotta: I think just the thing that I want to emphasize again with mothers going back to work is really for moms to remember that it is a transition. I think so often we just want to jump back into things, we want quick fixes, we want to go back to work and just on day one, feel like ourselves again, and we really have to understand that it is going to take time to acclimate back, that when you go back to work after having a baby, you’re in some ways, you feel like you’re a new person, you’re going back as this person who is changed and just to have grace for yourself and manage your expectations and do what’s best for you. You might feel pressure from colleagues or from your employer to jump right back in and be as productive or better than you were before, but we really have to be our own advocates and we have to know our own limits and go at the speed and the pace that feels right for us.

So I just want to reemphasize that to listeners that it is the journey.

Helen Thompson: Yeah, especially when you’ve just given birth and you have to go back after six weeks, that can be a trauma in itself, leaving your little baby behind and having to go through who’s looking after the baby, I can’t get into childcare, I don’t have a grandmother or anybody to help look after the baby, as you said it’s a stress in itself. So that makes it even harder and not having a supportive workplace would make it harder again.

Emily Guarnotta: Yeah,

Helen Thompson: So if anybody wants to get in touch with Phoenix Health how would they go about doing that? I found what you’ve said really interesting. Although I come from Australia, most of the p eople listening are in America.

Emily Guarnotta: They could reach us at our website, which is and we’re also on Facebook, Instagram, and LinkedIn. So if you search for us, you should be able to find us in any of those places.

Because of licensing laws in the United States, we can only serve clients that live in the states that our business is able to serve right now. But our hope is really to be able to serve more states in the near future. So we’re working very hard on that to to branch out to other states so we can support more moms.

But if you do live in another state and you’re in need of mental health services and you’re having trouble finding a provider, I would highly recommend you go to Postpartum Support International which is an international organization that offers a directory of providers you can actually search for therapists in your area, and all the therapists specialize in working with new moms, and you can find them at That’s their website.

Helen Thompson: Well, thank you Dr. Emily for being here. Just before you go, what’s the tip you would give to a mom who’s struggling with having a baby?

Emily Guarnotta: Don’t be afraid to reach out for help. So often moms will say, I’ll just give it a little bit more time. I’ll wait and see. I’m sure it’ll get better. And they kick the can down the road, but there’s really no reason to put it off. If you feel like something’s not quite right, you’re not feeling good, please reach out for help, cause there are people out there that want to help you and you deserve it.

Helen Thompson: If you’re looking for further support and guidance in your return to work after maternity leave, then I highly recommend checking out an interview I did with Millie Che, author of ‘Merging Parenthood and Work’. I’ve included a link to the episode in the show notes.

Thanks mums, you’re amazing and I hope you enjoyed this episode. I would love to hear from you and let me know what topics are of interest to you. If you haven’t done so already, make sure you hit the subscribe button, because in the next episode, I’m chatting with birth healing specialist and pelvic health physical therapist, Lynn Schulte about her approach to helping women with issues they experience after birth.