Motherhood and medicine: systematic review of the experiences of mothers who are doctors

Abstract

ncreasing numbers of women are graduating in medicine in Australia 1 and overseas. 2,3 This has led to a "feminisation of medicine", 4 and concerns have been expressed that women work fewer hours than men, primarily because of family commitments. 5 Such criticism focuses on the competing demands of being mothers and doctors, and the career breaks taken by women to care for children. 4 Balancing the two roles can be challenging. Doctors must prioritise patient care, often to the detriment of their own needs and those of their families. 6,7 Motherhood can be as personally rewarding as medicine, and similarly requires placing another person's needs before one's own. 8 In this systematic review, we identify what is known about women balancing motherhood and medicine by examining the published research into their experiences and perspectives. Methods Search strategy Our systematic review was prospectively registered with PROSPERO on 30 April 2019 (CRD42019116228). We searched the CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, PsycINFO, Web of Science, and Scopus databases in November 2019 for relevant published studies with the same search string: female/women AND doctor*/physician*/clinician* AND family OR child* OR mother* OR parent AND "family work relationships" OR "work life balance" OR "work home culture" (Supporting Information, table 1). Study selection and data extraction The titles and abstracts of articles identified by our search were screened by two authors (RH, MN), and the full text of relevant articles were then assessed according to our inclusion criteria: Articles were excluded if doctors were not explicitly objects of the study, sex was not a variable in the study, or motherhood or parental experiences were not reviewed. Disagreements about inclusion were resolved by consensus between the two authors. Screening identified 101 potentially relevant articles. After excluding nine because no English language versions were available, 43 not specifically related to motherhood or medicine, one undergraduate study not about doctors, and twelve non-research articles, 35 original research studies were included in our systematic review (Box 1). Thematic analysis We undertook an integrative review synthesis of the included research studies. Information was categorised according to emergent themes and synthesised. A quantitative meta-analysis was not attempted because of marked differences between studies in the outcomes and variables assessed. Results Nineteen of the 35 research studies (32 quantitative, three qualitative studies) were from the United States, and three each from Japan and Germany. The quantitative studies were either cross-sectional surveys or longitudinal in design (32 to 10 866 participants each) from specific specialities to large multi-centre studies. The qualitative studies included focus groups and semistructured interviews (eight to twenty participants each) (Box 2; Supporting Information, tables 2-4).

Motherhood and medicine: systematic review of the experiences of mothers who are doctors

“…Specialties that have been previously perceived as family‐friendly, such as general practice, 2 are seeing an increase in community demand for more doctors, coinciding with a decline in trainee numbers 3 . While research demonstrates that, internationally, family‐friendly workplaces are attractive and drive a greater number of trainee applicants and trainee retention, 4 a review of the current workplace policies in general practice is needed to examine a potential sustainable and effective workforce solution. Beyond this, further research is essential, and needs to be targeted and achievable, examining what Australian medical families and doctors who are parents see as barriers and supports into this balance and then what policy changes are needed to support them and their workplace.…”

Motherhood and medicine: systematic review of the experiences of mothers who are doctors

“…To the Editor: Hoffman and colleagues’ 1 excellent review highlights the tightrope women walk when pursuing both a career and children. It is clear that, internationally, inflexible workplace policies as well as more insidious outdated attitudes towards working women cause significant damage to society as a whole.…”

Motherhood and medicine in the time of COVID‐19

“…A recent review of the literature reveals medical mothers are more likely to delay careers or child rearing, choose careers that are more family‐friendly, and take on more domestic duties than male colleagues in equivalent specialties 4 . Motherhood and medicine are an exhausting but rewarding juggling act at baseline.…”

“…Mother guilt: 78% of surgeons in the US took less than 6 months of maternity leave and 72% felt this was inadequate 4 . The balance between nurturing your infant, providing for your family, functioning at prenatal capacity, and pursuing career goals can often seem unattainable.…”