There is a kind of work that keeps coming up among the women MoMo works with, and for a long time none of us had a good word for it. It is the work of holding the threads. Knowing the dentist appointment needs rebooking before anyone has said so. Carrying, in the back of the mind, the running ledger of what is low, what is due, who needs what and by when. It does not appear on any calendar, and it does not end when the working day ends. When you try to describe it to someone who does not carry it, it tends to evaporate in the telling, because the most accurate description sounds like nothing at all.

The research has started, recently, to make it visible. Not all of it, and not perfectly. But enough that I want to write down what it has found, because naming a thing changes what it is possible to do with it.

A measurable instance

The cleanest entry point I have found is a study published this year in the Journal of General Internal Medicine.[1] The researchers looked at primary care physicians and their electronic health record "in-baskets": the running queue of patient messages, lab results, refill requests, and administrative notes every clinician has to clear. They measured a gender gap. Women physicians spent significantly more daily time on this documentation and message management than their male colleagues, and were more likely to report that the patient-messaging load contributed to burnout.

I find this useful precisely because it is so concrete. The in-basket is a real interface, on a real screen, generating real timestamps. And even there (in a setting that logs every click) the extra load the women carried was invisible to the thing that schedules their day. Their calendars looked the same. The work did not.

That is the shape of the whole problem in miniature: work that is real, time-consuming, and consequential, but illegible to the systems built to account for work.

Why it stays invisible

Outside the clinic, the same pattern has a literature of its own, and a name now: cognitive household labour. This is the planning, anticipating, and monitoring layer of domestic and care life, distinct from the physical tasks of doing the laundry or cooking the meal. A 2025 sociological study draws the distinction sharply.[4] Physical tasks respond to the levers you would expect: earn more, work more hours, bring in help, and the hours you personally spend scrubbing and folding go down. The cognitive layer does not move the same way. The remembering, the noticing, the keeping-track: that stays.

Part of why it stays invisible is that it cannot easily be measured. A 2025 paper developing a method for capturing the mental load describes it as boundaryless: it runs concurrently with everything else, in the background, while you are also doing three other things.[5] You cannot put it in a time-use diary, because it has no start and no stop. It is a low hum underneath the activities, and that quality is exactly why the standard instruments for measuring work have missed it for so long.

The same paper found something quietly telling: partners systematically underestimate how much of this load the women beside them carry.[5] Not out of bad faith: the work of anticipating a problem looks, from across the kitchen, like nothing happening.

When the load is finally quantified, the asymmetry is larger than people expect. In a survey of U.S. parents, mothers reported primary responsibility for around 71% of cognitive household tasks, against fathers' 45%, a wider gap than in physical tasks.[7] A study of Italian mothers maps the load into three dimensions (cognitive, managerial, and emotional) and notes the emotional dimension is largely insensitive to how much practical help a partner provides.[6] You can hand off the dishes. The emotional layer does not transfer with them.

The part that resists the fix

Here is the finding I think matters most, because it contradicts the advice the women MoMo works with have usually already tried.

The same sociological study describes the cognitive load as sticky.[4] Once a task gets assigned (usually along old gendered lines, often without anyone deciding anything) it tends to stay assigned, and resists redistribution. This is offered as an observation from survey data, not a law of nature, and it has not, as far as I know, been tested experimentally. But it lines up with something I hear constantly: they have tried to negotiate their way out. Make the list. Split the list. Hand over the column. And somehow the load finds its way back, because the deeper task was never the column on the list, it was the holding of the list, the remembering that the list exists at all.

The mainstream conversation tends to land on couple negotiation: share the tasks more fairly. The research keeps suggesting the cognitive layer does not yield to that the way the physical layer does. The gap between what should work and what actually works is, I think, one of the more important things to sit with. It is not that women negotiate badly. It is that the thing they are negotiating is structurally resistant to negotiation.

Where this lands

I want to be careful here. The household research documents that this load is associated with emotional exhaustion and disturbed sleep (associated with, not shown to cause) and I am not going to pretend otherwise. The physician work shows a measurable gap and a reported link to burnout in one setting. A separate analysis of working women found the most common burnout profile clustered in those longest-tenured, with children and a partner (care load accumulating, over years, into depletion).[3] Different samples, different methods, pointing loosely the same way. Some clinicians argue this gendered burden is itself a threat to women's wellbeing at work; that is a perspective worth knowing, though it is an argument rather than a measured finding.

What I take from all of it is not a prescription. The women MoMo works with do not need to be told to delegate more, or communicate better, or lower their standards. Most have tried. The value here is not in a tip.

The value is in the naming. There is a category of work you have been doing (anticipating, tracking, remembering, holding) that does not appear on the calendar, does not show up in the household division of labour as anyone counts it, and does not respond to the optimisation you have aimed at it. That is not a personal failure of organisation. It is a documented, structural property of labour the systems around you were never built to see.

Part of why I built MoMo was for exactly this: a place to set down some of the threads, so the holding does not have to live in one tired mind across one long week. But that is a footnote. The essay is the in-basket (the real one and the invisible one) and the fact that someone has finally started to measure it.

If this feels like more than a pattern, or if you're in distress or crisis, please reach out: Mind Sweden 90101 | Samaritans UK 116 123 | your local crisis line.

References

Branford, G. L., Bucala, M. D., Hepper, A., Hadeed, N. M., Northway, R. M., & Brenner, M. J. (2025). The Gender Gap in EHR Workload: A Comparative Analysis of Primary Care Physician In Basket Usage. Journal of General Internal Medicine. PMID: 40439865.
Nottberg, V. I., Klingelhöfer, L., Schweitzer, N. I., et al. (2026). Structural barriers to work-family reconciliation in surgery: a gendered analysis of career disruption and care responsibilities. Updates in Surgery, 78(2), 487–497. PMID: 41649725.
Załuski, M., & Makara-Studzińska, M. (2022). Latent Occupational Burnout Profiles of Working Women. International Journal of Environmental Research and Public Health, 19(11), 6525. PMID: 35682109.
Weeks, A. C., Kowalewska, H., & Ruppanner, L. (2025). Take a Load Off? Not for Mothers: Gender, Cognitive Labor, and the Limits of Time and Money. Socius: Sociological Research for a Dynamic World. DOI: 10.1177/23780231251384527.
Barigozzi, F., Biroli, P., Monfardini, C., Montinari, N., Pisanelli, E., & Vitellozzi, S. (2025). Beyond Time: Unveiling the Invisible Burden of Mental Load. arXiv preprint arXiv:2505.11426.
Vettoretto, E., Minello, A., Ortensi, L. E., & Tosi, F. (2026). Understanding the dimensions of mental labor: the invisible load of Italian mothers. Frontiers in Sociology. PMC12893982.
Weeks, A. C. (2026). The Political Consequences of the Mental Load. European Sociological Review, 42(3), 372–386. DOI: 10.1093/esr/jcaf019.