Maternal discrimination against women in medicine

Time and again, female doctors are told that their professional ambitions should take a backseat to their roles as mothers and homemakers. The issues of breastfeeding and maternity leave are dismissed as mere inconveniences rather than valid parenting obligations, resulting in contracts that are changed far too frequently during and after pregnancy. 

An article in the Canadian Medical Association Journal defined maternal discrimination as “gender-based discrimination specifically based on motherhood status; it may be experienced as lack of support during pregnancy and postpartum, lack of accommodations for childcare challenges, disparaging remarks related to pregnancy and motherhood, and exclusion from career opportunities.”^[]

It's an all-too-common story that deserves more attention and action. 

The evidence is overwhelming

A 2017 study by the Physician Moms Group reported the following:^[]

• A significant proportion (35.8%) of female physicians experience maternal discrimination.

• 90% of discrimination cases stem from pregnancy or maternity leave status, with 48.4% related specifically to breastfeeding.

• Maternal discrimination takes various forms, including disrespectful treatment by nursing or support staff (52.9%), exclusion from administrative decision-making (39.2%), and unequal compensation and benefits compared to male colleagues (31.5%); a separate 2019 nationwide survey added “inappropriate comments” (30.5%) to the list.^[]

Overworked, underpaid, and underestimated

Physician mothers are caught in a paradox at work: They are expected to meet high-performance standards while being underestimated by their superiors. In an online survey published in BMJ, some of their difficulties were revealed.^[] 

Even when meeting their RVU (relative value units) goals and holding more clinical experience than others, physician mothers often received lower pay and fewer benefits, and they were denied raises and bonuses that they had earned. 

They sometimes lost pay during childbirth recovery or pumping breaks, and continued to pay full-time overhead costs while working part-time. Some were given more work without additional pay, while male partners kept receiving their regular paychecks. 

According to the 2019 survey, just under half of female physicians receive paid maternity or family leave. 

Job discrimination

According to the authors of the BMJ article, there is a perception that mothers aren't committed to their careers. Women are often asked about their child-rearing plans during medical school interviews. No points for guessing why! 

Shockingly, physician mothers have also been handed contract changes or terminations after taking maternity leave. Often, they lose their privileges, get overlooked for leadership roles, or receive ultimatums to return to work under different contracts or face job loss. 

Physician moms have even been excluded from important projects and decisions—without any intimation—after announcing their pregnancy or returning from leave. Sadly, some have even lost out on promotions because of their pregnancy. 

Maternity leave or vacation?

Maternity leave policies are often limited, giving women little time to bond with their newborns. The results from the survey found that most female physicians (89%) would prefer a longer leave period, ranging from 11 weeks to 6 months, instead of the commonly offered (and often unpaid) 5 to 12 weeks.

The 2019 survey found that almost 15% of female physicians were verbally reprimanded because their absence caused an increased workload for other physicians who had to cover for them. 

But in reality, the BMJ researchers found, these women have to make up for missed calls during maternity leave and attend to more patients to compensate for pumping breaks—all while being criticized for their personal life interfering with work responsibilities. 

Working mothers and work-life balance

Balancing work and childcare can be tricky when you have an inflexible schedule, demanding long working hours, and night shifts. 

Unfortunately, administrators and program directors are of little help. As one participant in the BMJ analysis recalls, “Chief of service once told me that he did not want to hire more women because of people being out for maternity leave and calling in sick with kids.” 

One of the most frequently reported negative experiences of physician mothers returning to work, as evidenced in the survey, is the lack of breastfeeding and pumping facilities at work, which affects 30% of new doctor moms. Nearly 50% of new moms struggle to find time for breast pumping due to clinical obligations. Some women are forced to use bathrooms or pest-infested rooms to pump.

Implications

Undoubtedly, write the BMJ authors, all of these experiences are a recipe for a toxic work environment. This environment makes women feel guilty for prioritizing their children over work, or vice versa. It breeds feelings of guilt, alienation, and overwhelming stress.

The career impact can be considerable. Despite their education, expertise, and experience, many physician mothers have chosen part-time work to balance their personal and professional lives. Others leave the profession entirely due to burnout or constant disrespect. 

Women in medicine are powerful assets to the medical field, and their struggles must be recognized and addressed. Training programs to help the administration identify and address maternal discrimination would be a great first step.