Merging motherhood and medicine: A qualitative study exploring barriers and enablers to motherhood among female doctors in Australia

Abstract

Objectives: To identify barriers and enablers to motherhood experienced by female doctors in Australia. Methods: Semi-structured telephone interviews were conducted with 18 female physician-mothers in Australia, during March and May 2020. Interview data were examined using thematic analysis to extract key themes. Results: Six key barriers and seven key enablers were identified. Barriers (B1–6) largely reflected structural and cultural issues operating within health services and the wider medical profession. Barriers were the experience of working in medicine (B1); demands of postgraduate specialty training (B2); attitudes towards mothers in medicine (B3); gender inequality (B4); insufficient entitlements and support (B5); and competing priorities, conflicting roles (B6). Enablers were supportive partnerships (E1); break from traditional gender roles (E2); capacity to delegate/outsource (E3); doctors supporting doctors (E4); flexible work arrangements (E5); increasing acceptance and support (E6); and capacity to combine career and family (E7). Conclusion: This was the first qualitative study to explore motherhood experiences among female doctors in Australia. Participants reported structural and cultural barriers during all stages of motherhood. The mismatch between identified barriers and available supports reveals opportunities for improving the experience of physician-mothers.

Growing the emergency department family: Navigating pregnancy, parenting and ACEM training

“…However, we also acknowledge that gendered inequities intersect with the parenting experience. The biological responsibilities of pregnancy, childbirth and breastfeeding can impose substantial barriers for physicians' career progression 3 . This may be further exacerbated by persisting gender disparities in division of household labour – women in heterosexual partnerships continue to undertake more unpaid domestic work and childcare 4,5 .…”

“…There are important safeguards in place through the Australian Federal Sex Discrimination Act 1984 and New Zealand Human Rights Act 1993 to prevent workplace discrimination based on gender, sex and current or possible future pregnancy 6,7 . Despite these protections, there are ongoing reports of stigma and discrimination, such as parental perception of being overlooked for leadership, research and key rotation opportunities, and job interview questions and hiring decisions that relate to child‐bearing intentions 1,3 …”

“…The relative flexibility of FACEM training may contribute to perceptions that emergency medicine is a family friendly specialty 3 . Certainly, ACEM has established policies supporting trainee access to parental leave and their Advancing Women in Emergency Network is developing comprehensive guidelines to better support doctors during pregnancy, lactation and return to work.…”

“…In practice, the availability and inaccessibility of paid parental leave remain a cause of financial stress for physicians, exacerbated by annual contracts 3 . There are well‐established health benefits to support paid parental leave, including reduction of neonatal morbidity and mortality, improved mental and physical health, and lengthening breastfeeding 18,19 .…”

“…In advocating for increasing flexibility and workplace support for pregnant and parent trainees, these benefits should be extended universally. Conflict between parental and work responsibilities contributes to feelings of guilt and regret for parent physicians, 3 and we should actively counter the implicit expectation that non‐parents should cover for parent trainees. Antagonism between trainees should be avoided by ensuring equity and transparency on issues like rotation and roster allocations.…”