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Sacrifices female physicians make to have children

When researchers asked women about regrets, about half said they wished they had started a family earlier.

August 2023

A NEW STUDY that looks at how female physicians juggle having and raising children while maintaining their careers found that two-thirds delayed starting a family by about five years—and that about half wish they hadn’t waited so long.

The research in JAMA Network Open looked at a group of just over 1,000 women across various stages of training. The group included physicians practicing in a variety of specialties and working in both academic and nonacademic practices.

About 86% of respondents were married; 65% had children. About 80% who didn’t have children planned to do so, and 32% with children planned to have more.

Just over three-quarters of the female physicians (75.6%) said they had put off having a family. About one-quarter (22.8%) of those physicians waited for more than five years.

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When asked why they put off having a family, respondents cited factors like a lack of schedule flexibility or time, stress, financial strain and concern about burdening colleagues.

Balancing career and children
When it came to balancing career and family, women in the survey identified several strategies they used during childbearing and parenthood:

  • Just under one-third (29%) had taken an extended leave of 12 weeks or longer.
  • One-quarter (25%) switched specialties.
  • Nearly half (47%) reduced their work hours.
  • One quarter (25%) changed practice settings.
  • Nearly half (47%) passed up opportunities for career advancement.
  • Just under 5% left medicine altogether.

When researchers asked female physicians what they wished they had done differently, nearly half (45.7%) said they wished that they had conceived earlier. Looking back, 45% said they wished that they had cut their work hours, 39% said they wished that they had taken an extended leave, and 29% said they wished that they had pursued oocyte cryopreservation.

The most represented specialties in the study were ob/gyn (30%), internal medicine (18%) and pediatrics (13%). Researchers noted that their study is one of the largest to evaluate family-building strategies and fertility among female physicians in the United States.

Researchers also noted, however, that some of their findings backed up previous data. For example, a 2016 study of delayed childbearing in medicine found that female physicians on average gave birth the first time at age 32. Nonphysicians, by comparison, had their first child at age 27.

The study pointed out that the strategies used by women “suggest that fertility and family-building concerns among women in medicine may contribute to ongoing gender disparities and attrition and represent a potentially critical area for policy reform and future change.”

The decision for women to put off childbearing by five years may help explain another major finding of the study: Just over one-third (36.8%) of respondents said they had experienced infertility.

Researchers said that the infertility rate of female physicians was alarming, particularly when compared to infertility rates of nonphysicians, which range from 6% to 19%. While the study found that delayed childbearing is likely associated with lower fertility rates among female physicians, researchers also acknowledged that lifestyle factors such as shift work and poor sleep quality may have some impact on fertility.

The study also found that 11.5% of respondents underwent oocyte or embryo cryopreservation. Less than 10% said insurance covered the procedure.

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August 2023 5:36 pm

As a clinical administrator and a husband I see this everyday. We are losing female physicians in our work force everyday because of the inflexibility of our schedules and unfortunately the lack of empathy from the other members of the team. My wife and I waited and also didn’t have a third child for those reasons. She is an accomplished internist/hospitalist that placed her career on hold for the kids, while I pursued professional success. I encouraged her to go forward and take more roles but she felt guilty about time spent away from the kids. As a man, husband,… Read more »