Project title

Medicine and Motherhood- The MAM Study

Country

Ireland

Background

Physician burnout has been framed as a public health crisis, with negative consequences for doctors, their patients, and healthcare organisations. Female sex has been identified as a predictor of burnout. Two important factors implicated are maternal bias (colleagues perceive pregnant women and/or mothers as less competent or less committed within their job) and the lack of support for female physicians around family planning, pregnancy, and motherhood. Pregnancy among physicians may be associated with a variety of challenges including delayed childbearing, increased use of assisted reproductive technology, higher rates of complications, discrimination against, and stigmatisation of, pregnancy, and slowed career progression. There is a need to understand the experiences of female physicians around fertility and family planning, pregnancy and motherhood, and to enact supports required to ensure females can realise both family and career aspirations. Ensuring the appropriate support of female physicians around pregnancy and motherhood is likely a crucial part of a solution to the international medical recruitment and retention crisis.

Summary

This research will be conducted as four work packages:

  • A scoping review of research on pregnancy and motherhood among European and UK physicians.
  • A survey of Irish female physicians that will consider fertility and family planning, experiences of pregnancy and childbearing, perceived impacts of pregnancy and childbearing on work and careers, and the relationship of these variables with wellbeing.
  • Interviews with Irish female physicians on perceived barriers and facilitators to pregnancy and motherhood.
  • A national, multispecialty panel of female physicians that will consider the data collected and offer recommendations on changes required to support an optimal working environment.

Outcome

This research will provide a better understanding of the supports required to enable female physicians to enjoy pregnancy and motherhood alongside career success. It has the potential to deliver important benefits for physicians, patients, and the healthcare system.

The first outcome of this project was a scoping review in BMJ Open: Fertility, family planning, pregnancy and motherhood among women doctors working in the EU and UK: a scoping review

Abstract:

Objectives Women doctors face considerable challenges navigating family planning, pregnancy and motherhood. Their experiences can have relevance for health system functioning, including doctor retention. This scoping review synthesises research on family planning, fertility, pregnancy and motherhood among women doctors in the EU and the UK.

Design Scoping review conducted according to JBI best practice guidance.

Data sources MEDLINE, CINAHL, Academic Search Complete, PsycInfo and Web of Science were searched, and supplemented with backwards and forwards citation chasing.

Eligibility criteria Peer-reviewed, original research, in English, focusing on either fertility and family planning, pregnancy and/or motherhood among women doctors in an EU country(s) and/or the UK.

Data extraction and synthesis Data were extracted independently by two authors. Data were synthesised using deductive content analysis and collated using narrative synthesis.

Results In total, 34 studies were identified. Family planning appears complicated by medical careers. Medical specialty choice is particularly impacted, with certain specialties (eg, General Practice) considered particularly family friendly and others markedly less so. Pregnancy complications among women doctors, especially surgeons, were documented. However, women doctors’ and non-doctors’ pregnancy outcomes were overall not significantly different. Notably, doctor-mothers had fewer children and were more likely to report making compromises or facing negative consequences when balancing family and career than doctor-fathers.

Conclusions Women doctors in the EU and UK report challenges in balancing work and motherhood. With the potential for their experiences to impact on health system functioning and patient outcomes, training bodies and health organisations should take proactive action to better support women doctors and ensure they can remain in the profession and practice in their desired specialty. Future research examining working practices/schedules during pregnancy, breastfeeding experiences, parenting and childcare and maternal mental health will support a better understanding of women doctors’ experiences and facilitate implementation of effective supports.