At 3 a.m., in the midst of labor, a doula we’ll call Renee stepped into the hallway to steady herself.
She had been supporting a laboring client for nearly 12 hours. The room was warm, the lights low, the energy focused. But outside, her body told a different story. A sudden wave of heat rose through her chest, her heart began to race, her shirt damp and sticky with sweat. She hadn’t slept well in weeks. The brain fog had been hijacking her daily functions. Still, she took a breath, wiped her face, and walked back in to continue holding space for her client’s imminent birth.
“I know how to guide someone through birth,” she later shared. “No one ever taught me how to move through whatever this is.”
Renee is not alone. Across the United States, women are sustaining the care economy; doulas, midwives, and other birthworkers are entering perimenopause and menopause with very little guidance, limited clinical support, and almost zero structural protection. This gap undermines not only caregiver well-being but the stability of the workforce.
CLOSE THE GAP
Women spend an average of nine years of their lives in poor health, much of it during their working years. More than half of the women’s health gap occurs during this period, shaping productivity, workforce retention, and economic participation. Closing that gap could add at least $1 trillion to the global economy annually by 2040, according to the McKinsey Health Institute.
The care economy is a vast and layered system spanning both paid and uncompensated work. In the U.S., formal sectors like healthcare, childcare, and long-term care account for several trillion dollars in annual economic activity. Meanwhile, unpaid caregiving—largely performed by women—adds trillions more in hidden value that isn’t captured in GDP. These systems underpin the broader economy, supporting workforce participation, productivity, and population health, yet remain structurally undervalued and underinvested relative to their impact.
As the individuals buttressing the care economy face increasing strain, the lack of reproductive health resources threatens the stability of a workforce already stretched to capacity. Without critical investment in midlife care, we risk losing experienced birthworkers and caregivers who are vital to supporting families and sustaining communities.
THE MENOPAUSE CONNECTION
We saw this firsthand at Flourish, a wellness retreat hosted by Mama Glow during Minority Health Month for women in midlife, centering Black women and birthworkers. What unfolded over the weekend was not only restoration but recognition. Many participants arrived carrying questions they previously didn’t have space to ask.
“I thought something was wrong with me,” one attendee shared. A longtime birthworker described the tension of continuing to show up for clients while feeling increasingly disconnected from her own body. “I didn’t realize this was perimenopause. I’ve been pushing through exhaustion for years and navigating this transition in silence.”
Several described visiting clinicians with symptoms like fatigue, sleep disruption, and mood changes, yet never connected them to perimenopause. Without the language to name what was happening, they kept pushing through.
These stories point to a gap that business leaders and health innovators can no longer afford to ignore.
Menopause is often framed as a private experience. In reality, it is an experience that is quietly shaping the stability of entire workforce sectors. In the corporate setting, menopause has been linked to decreased productivity and increased attrition. In the care economy, the stakes are even higher.
Investment in menopause remains disproportionately focused on consumer solutions rather than comprehensive care. While the market opportunity is widely recognized, the infrastructure required to support real people still lags behind.
A WORKFORCE PRIORITY
What would it look like to take menopause seriously as a workforce priority?
It would mean expanding access to clinicians trained in menopause care, particularly for communities that have historically been marginalized within the healthcare system as these individuals are most impacted by menopause symptoms. It would mean designing workplace policies that include flexible scheduling, menopause leave, and resources for midlife health, ensuring workers can navigate transitions without jeopardizing their careers. It would mean investing in community-based care models, where trust and cultural alignment are essential for optimal wellbeing. Listening to the lived experiences of birthworkers and caregivers navigating menopause can inform policies and practices that truly meet their needs.
Culturally, we don’t simply need relief, but a reframing. Midlife is not something to endure quietly but a stage of life that deserves attention, resources, and ultimately, care. If we continue to ignore menopause, we risk further destabilizing the caregiving workforce. But if we invest in this major life event, we can strengthen the systems that support families, communities, and future generations. Supporting caregivers through menopause is more than an investment in their well-being. It is an investment in the resilience of the care economy itself. That truth is a blueprint for the future of work, one that values health, equity, and sustainability.
Latham Thomas is founder and CEO of Mama Glow. Leona Hariharan is a medical student at UCSF.