It’s not always easy being a mom. Try being a mother and a physician.
A new study, published in the BMJ, finds “insidious, persistent and sometimes blatant” discrimination experienced by physicians based specifically on their status as mothers.
That conclusion was drawn from an analysis of 947 responses to an online survey of female doctors who are part of the Physicians Moms Facebook group. In their own words, the survey participants provided vivid descriptions of maternal discrimination.
How so? The team of U.S. researchers found several themes. The physicians reported varying expectations of job performance (both higher and lower), financial inequities (including lower pay than equally qualified colleagues and more unpaid work), fewer opportunities for career advancement, lack of support during pregnancy and after giving birth and difficulties achieving life-work balance.
For instance, participants said they were denied salary increases or bonuses because of maternity leave, were passed over for leadership roles or had their contracts modified or terminated after announcing they were pregnant or when returning from maternity leave. One doctor said she had to sneak off to a call room infested with cockroaches to pump breast milk. Others described disparaging comments about their workplace role.
“I have experienced gender discrimination by my administrators: ‘You should just stay home and be a mom,’ as well as ‘Your husband makes enough money; why do you work?’” said one respondent.
While some of the experiences are consistent with those reported by women in other professions, the researchers said there are unique aspects of medical training and the profession that make maternal discrimination worse.
The researchers called for structural changes that address pregnancy, parental leave and childcare to mitigate the impacts of maternal discrimination in medicine. That becomes more crucial since the majority of medical students are now women and it is estimated that around 80% of female physicians are or will become mothers.
In an accompanying editorial, Kate F. Lovett, dean of the Royal College of Psychiatrists in London, said she hopes the study will help start a conversation.” However, as long as parenthood is seen as a women’s issue rather than an issue for us all, maternal discrimination will remain unresolved,” she said.
Hitting the “maternal wall” in medicine: As long as parenthood is seen as a women’s issue rather than an issue for us all, maternal discrimination will remain unresolved, says @DrKateLovett @bmj_latest https://t.co/jEAMTvMzUi— MWF (@medicalwomenuk) December 13, 2018
Inconsistent policies for paid family leave for medical residents
Two recent studies published in JAMA highlighted parental stresses for medical residents, who are in their prime childbearing years. The first study found physicians training at many of the top U.S. medical schools get much less time off for childbearing and family leave than the 12 paid weeks supported by the American Academy of Pediatrics.
Of 15 top teaching hospitals, eight had an institutional policy providing paid childbearing or family leave for residents. The average maternity leave was 6.6 weeks. For same-sex couples, adoptive parents or fathers, paid leave policies averaged 3.9 weeks.
"In my opinion, there is an urgent need for medical schools to create more generous family leave policies for all of their trainees," said co-senior study author Christina Mangurian, M.D., professor of psychiatry and vice chair for diversity and health equity at the University of California, San Francisco, in an announcement.
"Regarding birth-mothers specifically, I believe that expanding childbearing leave will not only benefit the mental and physical health of these mothers and their babies, but will also support our long-term goal to have women thrive in medicine by providing support when they need it most," she said.
The second study described specialty board leave policies for resident physicians requesting parental leave. It compared family and childbearing leave policies among 24 American Board of Medical Specialties member organizations that set training duration requirements for U.S. residency programs.
Half of the specialty boards offered doctors in residency at least six weeks off without permitting them to extend the timeline for their training program.
Our research letter using qualitative methods to shed light on issues related to residents needing parental leave. Summary: substantial variation and ambiguity across specialty board leave policies may be an issue. In @JAMA_current @McKGloverMD— Briony Varda (@BrionyVarda) December 12, 2018