Menopause support – A U.S. care workforce built on doulas, midwives, and other birthworkers is aging into perimenopause and menopause with limited guidance and little structural protection—raising risks for caregiver well-being and the stability of the care economy.
At 3 a.m., in the quiet stretch between contractions, a doula named Renee stepped into the hallway to steady herself. She’d been supporting a laboring client for nearly 12 hours—warm room, low lights, a body and mind narrowed to one job. Outside that space, her body pushed back.
A sudden wave of heat rose through her chest. Her heart began to race. Her shirt was damp and sticky with sweat. Weeks of poor sleep had left her with brain fog that kept hijacking her daily functions. She wiped her face. took a breath. and walked back in—continuing to hold space for a birth that couldn’t wait.
“I know how to guide someone through birth,” she later shared. “No one ever taught me how to move through whatever this is.”
Renee isn’t alone. Across the United States. women are sustaining the care economy while entering perimenopause and menopause with very little guidance. limited clinical support. and almost zero structural protection. The gap doesn’t just matter for individual health. It threatens workforce stability at a moment when the care economy is already strained.
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 vast and layered, 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. 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 pressure mounts on the people doing the caring, the lack of reproductive health resources becomes more than a personal problem. Without critical investment in midlife care, experienced birthworkers and caregivers risk leaving fields that families and communities rely on.
The issue isn’t abstract. It surfaced with clarity 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 restoration—and recognition that many participants had been 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 participants said they visited 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.
Menopause is often framed as a private experience. In reality, it 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, even as the market opportunity is widely recognized. The infrastructure required to support real people—especially working caregivers—still lags behind.
So what would change look like if menopause were treated as a workforce priority instead of a side issue?
It would mean expanding access to clinicians trained in menopause care. particularly for communities that have historically been marginalized within the healthcare system. where menopause symptoms can hit hardest. It would mean workplace policies designed for real transitions: flexible scheduling. menopause leave. and resources for midlife health. so workers can navigate changes without jeopardizing their careers. It would also 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, the shift required isn’t only relief—it’s reframing. Midlife is not something to endure quietly. It is a stage of life that deserves attention, resources, and ultimately, care.
If menopause continues to be ignored, the caregiving workforce risks destabilizing further. But if midlife care receives real investment, the systems that support families, communities, and future generations can become more resilient.
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—a blueprint for the future of work that values health, equity, and sustainability.
Latham Thomas is founder and CEO of Mama Glow. Leona Hariharan is a medical student at UCSF.
care economy menopause perimenopause birthworkers doulas midwives workforce retention women’s health gap workplace policies community-based care