As we embark upon women’s history month, it appears 2024 is on track to be another stressful year for women in America. This isn’t a post about the recent women’s health news, but instead, about what this recent ruling continues to signify about the stressors of women’s health care and health outcomes in the US, and how we might make our current state better. 

In the US, we have a long history of underinvesting in women’s health, which leads to worse health outcomes for women. While underinvestment, poor health, and the resulting stress are issues for women broadly, they also affect mothers acutely. We have a society that continues to add stressor after stressor onto its mothers, as if these stressors have no consequence.

But we know that isn’t the case.

Reams of medical literature highlight that stress is bad for mental and physical health, both for the affected individual and for those for whom they care. Yes, maternal stress is bad for moms. But it’s also bad for their children, their employers, and thus, society as a whole.

This isn’t the prosperity for which America stands. We can and must do better, both for today’s population and for the nation’s future ability to thrive. Herein, I’ll highlight the drivers of stress, what isn’t working to fix them, and what just might. 

Drivers of stress

Lack of access to prenatal and postpartum care. Lack of affordable and accessible child care. Lack of access to mental health care. Unaffordability of healthy food. Loneliness and lack of a “village.” No paid leave. Unequal pay, and lower pay after childbirth. The list of maternal stressors is lengthy, and for a great recap of those specifically surrounding the earliest days of parenting, Molly Dickens’ Maternal Stress Project is a great resource. However, it’s only the tip of the iceberg. Stress continues and amplifies throughout the life of the parent.

So, what can we do about it? Our society currently puts the onus of solving the stress problem on the individual by promoting self-care, yoga, meditation, etc., as “solutions.” These may be great practices, but they are in no way a solution to the deeply-ingrained problem of maternal stress in the US. 

Individual-level interventions can’t solve societal-level problems. Modularity Theory explains why—and what to do instead.

Modularity Theory

The Modularity Theory explains how different parts of a solution’s architecture relate to one another and, consequently, affect solution creation and adoption. In brief, once a solution reliably delivers for people, individual parts and their interactions become standardized. This creates a state of modularity where many suppliers can compete to deliver one or more modules of a solution more cheaply and quickly. However, before this standardization exists, one entity must wrap its arms around the entirety of the problem in order to create a solution. In effect, one entity must “hug” the entirety of the situation. 

Therefore, one can’t leverage a modular architecture effectively until the interfaces between component parts are standardized and predictable. For the interfaces between maternal stressors, such as those listed above, there is great unpredictability and a complete lack of standardization. Different pockets of the population will encounter these stressors to varying degrees, at various points, and in different ways. Therefore, a modular approach—such as suggesting that individuals do yoga or meditate—to address these stressors is ineffective. As noted above, we can’t take an individual approach and expect to solve a societal problem. 

Who is going to hug the problem of maternal stress (i.e., wrap their arms around the entire situation)?

If individuals can’t solve a systems-level problem, who can? Additional theories have a lot to say about this. As I outline in our latest maternal health report, If health is wealth, America’s working mothers are living in extreme poverty, the Tools of Cooperation suggest that national policy change won’t be an effective first step in our society today. Instead, based on where we are as a nation, we need employers to lead the way by role modeling effective solutions. 

This isn’t to say that there isn’t a role for policy change. There absolutely is, and that’s why we need an employers-first, not an employers-only, approach. By setting the example in developing consensus on how to reduce stress and improve health, employer insights can set the stage for effective policy changes at the national level. 

What does success look like? 

A recent Harvard Business Review article highlights how asking one key question can help create alignment around goals. It applies well in this situation, and I’d like to ask how you’d answer it: “If we were drinking champagne on New Year’s Eve because we’d completed an outstanding year, what progress would we be celebrating?” Asking this question helps identify where there is alignment around a future vision and where greater consensus needs to be established, which is critical for identifying the best pathway to achieve the desired outcomes. 

When it comes to maternal stressors and the resulting impact on health, there are a number of goals one could propose. Only by uncovering those goals can we identify points of alignment, discuss areas of misalignment, and determine the path forward to achieve a common vision. I’d love to hear your thoughts around goals in the comments below, or via email. I would propose the following list for consideration. In 2024, I hope we will see… 

  • More national attention placed on the drivers of maternal stress and the pathways to reduce them, via publication outlets, advocacy organizations, new employer policies, and national dialogue. 
  • At least three large employers make investments in paid parental leave for up to six months. (Bobbie is setting a great example for this.)
  • A bill pass both chambers of Congress to pave the way for affordable child care for all within three to five years. 

America’s mothers need a hug, both literally and figuratively. To deliver one that achieves these goals and others, we need society’s largest institutions—both employers and ultimately, government—to wrap their arms around this problem and provide it.

Who’s going to lead the way? 


  • Ann Somers Hogg
    Ann Somers Hogg

    Ann Somers Hogg is the director of health care at the Christensen Institute. She focuses on business model innovation and disruption in health care, including how to transform a sick care system to one that values and incentivizes total health.