Careers in medicine increase childbearing delays, infertility for many women
Key takeaways:
- Three-fourths of women physicians delayed childbearing and more than one-third experienced infertility.
- Nearly half of women with children surveyed reported passing up opportunities for career advancement to accommodate family building.
Career-associated pressures appeared to influence the timing of childbearing and led to diversions in career trajectories to accommodate family building among women physicians, according to survey results published in JAMA Network Open.
Fertility and family building concerns among women in medicine may contribute to ongoing gender disparities and attrition, and represent a potentially critical area for policy reform and future change, researchers concluded.
‘No narrowing of gap’
It is well-established that gender disparities exist within medicine in terms of time to promotion, achievement of academic rank and appointment to leadership positions, Jennifer B. Bakkensen, MD, obstetrician/gynecologist in the division of reproductive endocrinology and infertility in the department of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, told Healio.
“Despite this knowledge, there has been no narrowing of this gap over time,” Bakkensen said. “Our team wondered if career-specific fertility and family building challenges among women physicians may be playing a role given the unique set of challenges faced in the duration and intensity of medical training.”
Researchers surveyed 1,056 cisgender women physicians (mean age, 38.3 years; 98.1% U.S. residents; 86.2% married or partnered; 65.3% had children) across all levels of training (67.6% attending physicians), specialties (60.4% nonsurgical) and practice settings (45.2% academic).
They distributed surveys through medical society electronic mailing lists and social media between March and August 2022 that evaluated delayed childbearing and infertility among women in medicine and investigated the extent to which women physicians altered career trajectories to accommodate family building and parenthood.
Researchers assessed baseline demographic information and fertility knowledge, and collected descriptive data on delayed childbearing, infertility, use of assisted reproductive technology and career alterations to accommodate parenthood.
They additionally used Likert-type scales to examine factors associated with timing of pregnancy and family building regret, and chi-squared analyses to assess group differences in fertility knowledge, delayed childbearing, infertility and family building regret.
‘Echoed data’
Results showed that 78% of respondents accurately identified the age of precipitous fertility decline. However, 75.6% reported delaying family building and 36.8% experienced infertility.
Researchers found the most common measures taken to accommodate childbearing or parenthood included passing up opportunities for career advancement among women with children (47.2%), reducing work hours (47.1%), taking extended leave (28.8%), choosing a different specialty (24.8%) and changing practice (24.8%).
Of note, 4.3% of women reported leaving medicine entirely.
“These data echo those from previous studies, suggesting that a career in medicine is associated with delayed childbearing and may lead to an increased risk for infertility,” Bakkensen said. “What we found most striking was the way in which women in medicine reported family building and parenthood had influenced their careers. In fact, nearly half of women with children reported passing up opportunities for career advancement to accommodate family building and parenthood. These findings point to a huge — yet previously understudied — factor in gender disparities in medicine.”
Highlighted needs
This study is one of the largest to evaluate fertility and family building among women physicians across specialties, levels of training and practice patterns, and the first survey to evaluate the impact of family building and parenthood on career, Bakkensen told Healio.
“Women reported making significant alterations to their careers in order to accommodate family building and parenthood, highlighting a critical area for evaluating gender disparities,” she said. “Collectively, these data indicate a need to support women physicians in balancing family and career. This includes paid parental leave for all physicians, including birth and nonbirth parents to combat norms of women shouldering a disproportionate burden of childcare responsibilities.”
In addition to offering insurance benefits and clinical flexibility to the nearly 20% of female physicians who use in vitro fertilization to conceive, Bakkensen said awareness of and access to fertility preservation services should be offered to those desiring greater flexibility in family planning.
“While there is clearly more work to be done, these data shed light on potentially critical areas for policy reform and future change,” she said.
For more information:
Jennifer B. Bakkensen, MD, can be reached at jennifer.bakkensen@northwestern.edu.
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