Reproductive patterns, pregnancy outcomes and parental leave practices of women physicians in Ontario, Canada: the Dr Mom Cohort Study protocol

Abstract

IntroductionSurveys and qualitative studies suggest that women physicians may delay childbearing, be at increased risk of adverse peripartum complications when they do become pregnant, and face discrimination and lower earnings as a result of parenthood. Observational studies enrolling large, representative samples of women physicians are needed to accurately evaluate their reproductive patterns, pregnancy outcomes, parental leave practices and earnings. This protocol provides a detailed research plan for such studies.Methods and analysisThe Dr Mom Cohort Study encompasses a series of retrospective observational studies of women physicians in Ontario, Canada. All practising physicians in Ontario are registered with the College of Physicians and Surgeons of Ontario (CPSO). By linking a dataset of physicians from the CPSO to existing provincial administrative databases, which hold health data and physician billing records, we will be able to retrospectively assess the healthcare utilisation, work practices and pregnancy outcomes of women physicians at the population level. Specific outcomes of interest include: (1) rates and timing of pregnancy; (2) pregnancy-related care and complications; and (3) duration of parental leave and subsequent earnings, each of which will be evaluated with regression methods appropriate to the form of the outcome. We estimate that, at minimum, 5000 women physicians will be eligible for inclusion.Ethics and disseminationThis protocol has been approved by the Research Ethics Board at St. Michael’s Hospital in Toronto, Ontario, Canada (#18–248). We will disseminate findings through several peer-reviewed publications, presentations at national and international meetings, and engagement of physicians, residency programmes, department heads and medical societies.

The inconvenience of motherhood during a medical career

“…The referenced studies by the authors 8,9 were conducted with grant funding from Physicians' Services Incorporated Foundation.…”

“…Women physicians face difficult decisions as to whether they will have children, when, and how many, while still pursuing their career goals. We recently mapped the trajectory of childbirth in women physicians in a populationbased study using data from Ontario, Canada 8,9 and found that the culture of delay starts early and persists throughout postgraduate training. We found a significantly reduced rate of childbirth among women physicians compared with nonphysicians overall, and an accelerated rate of childbirth only at later reproductive ages, suggesting that women physicians appeared to defer pregnancy until after training, with specialists delaying pregnancy longer than family physicians.…”

Evaluation of Adverse Pregnancy Outcomes in Physicians Compared With Nonphysicians

“…We therefore examined the odds of maternal and neonatal morbidity in physicians compared with nonphysicians using a unique linkage of physician registration data with population-based administrative data in Ontario, Canada. 19 …”

Les inconvénients de la maternité au cours d’une carrière médicale

“…le choix d'avoir ou non des enfants, à quel moment, com bien, tout en essayant d'atteindre leurs objectifs profession nels. Nous avons récemment cartographié la trajectoire de l'accouchement chez les femmes médecins dans le cadre d'une étude populationnelle faisant appel à des données onta riennes, au Canada8,9 . Nous avons découvert que cette culture de report se manifeste de façon précoce et persiste tout au long…”

“…Soutien financier : Parmi les études citées, celles réalisées par les auteures 8,9 ont obtenu le soutien financier de la fondation Physicians' Services Incorporated.…”