From postpartum to menopause, ‘brain fog’ affects women at work. Here’s how leaders can help

I was four centimeters dilated and in active labor with my first child when I successfully pitched our startup’s $5 million seed round. Two years later, I closed our $10 million Series A just seven days after giving birth to my second child.

These are the kinds of stories about ambitious women that we love to celebrate. The startup founder who pumps in the airport bathroom on her way to a client meeting (been there). The seasoned executive who barely misses a beat through perimenopausal brain fog and hot flashes. The new mom who’s back to work just a few weeks after giving birth, stitches burning and breasts leaking (been there, too).

I’m proud of what I’ve accomplished, and I’m in awe of the women out there doing it all—and doing it well. But I have begun to wonder what exactly we are celebrating when we tell these stories, and whether there might be a bit of patriarchy hiding in the applause.

Because while I was navigating some of the most consequential moments of my professional life, I was also experiencing a level of mental, physical, and emotional vulnerability that was entirely new to me.

Under pressure

I have always been someone who can handle pressure. Stressful jobs are nothing new to me. And running a startup means confronting high-stakes situations and ambiguity daily. Usually, I address it, solve it, and move on.

When I was pregnant and postpartum, I was still able to do all of those things, but my experience of doing them had changed. Situations I would normally navigate without a hitch felt higher-stakes and took a greater mental toll. Problems I knew perfectly well how to solve felt emotionally consuming.  

For centuries, women’s biology was used as evidence that we were inferior to men and incapable of doing the jobs men do. We’re “too emotional,” “too hormonal,” “too distracted by birthing and raising children.” These traits, the story went, made women unsuitable for positions of consequence and authority requiring sound judgment.  

Women have spent the past decades fighting that narrative and have made progress. 

However, we have fought so hard to prove that our biology doesn’t make us less competent that we’ve ended up feeling like we have to pretend it doesn’t affect us at all.

The menopause factor

This is just as relevant for the 50 million women navigating perimenopause, many at the height of their careers. Two-thirds of women in menopause report reduced work performance associated with menopausal symptoms. And another recent study found that 66% of women felt their coworkers and managers didn’t understand what they were going through.

It’s not hard to understand why women might hesitate to speak openly about our experiences. When we’ve fought so hard to prove that our biology doesn’t hamper our competence, acknowledging that it affects us at all can feel like failure.

And when we celebrate women for performing at a high level through pregnancy, postpartum, and perimenopause as though those biological transitions don’t affect us, we reinforce that narrative.

Assimilation not liberation

That is not liberation. That’s assimilation to a corporate world built for a worker who is unaffected by reproduction, changing biology, and hormonal transitions. We’ve fought so hard for a seat at the table, only to find that seat is contingent on our bodies performing exactly like men’s.

In our current hustle culture, women have two choices. We can be honest about how our biology is affecting us—talk openly about the brain fog, the emotional vulnerability, the sleep deprivation, the anxiety, the physical suffering—and risk being perceived as incompetent, unstable, and unfit to make important decisions or lead teams. Or, we can conceal the realities of pregnancy, postpartum, and perimenopause, perform our way through them, and then receive applause for proving they don’t affect our performance. 

Neither feels much like progress. Either way, we are still treating the reality of being a woman as  something to overcome. 

What leaders can do 

As a CEO, I firmly believe that we won’t solve this with another benefits program or a well-intentioned webinar about “women’s health and wellness.” It requires more open dialogue with employees, including being vulnerable about your own lived experiences. 

Stop celebrating invulnerability. When we celebrate women who do incredible things while pregnant, postpartum, or perimenopausal, it raises the question: Are we applauding their achievements, or their willingness to deprioritize their well-being and recovery?  

As leaders, we shape workplace culture through what we reward and recognize. We must applaud women’s performance without compelling them to make their physical and emotional realities invisible.

Normalize it. One of the most powerful things leaders can do is talk honestly about how pregnancy, postpartum, and perimenopause can affect how we feel and function without diminishing our professional competence. 

When leaders speak openly about their own experiences and vulnerabilities, they enable others to do the same. A CEO who acknowledges that she’s dealing with pregnancy brain or postpartum anxiety while continuing to lead effectively demonstrates that these experiences are not incompatible with doing her job well. 

Build support into your workplace. Create flexible structures that allow women to adjust to and nurture their biological realities, such as returning to work part-time, giving them control over their return-to-work plans, making it normal to ask a colleague to cover a meeting, or structuring the days around when they feel they can work their best. The point isn’t to lower our expectations, but rather to give talented women the conditions they need to meet them, without requiring them to prove how much they can endure.

We have spent generations proving that women can succeed in a world designed without their biology in mind. It’s time to build a world where they no longer have to.