Change needed on ‘multiple structural levels’ to improve family planning in medicine
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Key takeaways:
- Results showed three overarching themes, including institutional, departmental and personal barriers.
- Common themes highlighted areas where policies and culture in medicine could improve.
Women oncologists reported a multitude of barriers to family building, including dysfunctional maternity leave and poor education on infertility risk, according to results of a qualitative study published in Cancer.
Improvements in institutional support, expansion of parental leave and a general shift in work culture in the medical field are needed, researchers concluded.
Voiced experiences
Researchers conducted a secondary analysis and qualitative study of a survey to assess family planning among women physicians, which Healio reported about previously.
They used a modified version of an accelerated data reduction technique to perform a thematic analysis of comments that they categorized and combined into illustrative themes using qualitative techniques.
“By virtue of being a qualitative study, it offers the opportunity for participants to voice experiences not captured in our primary survey questions,” Sarah Marion, MD, an internal medicine resident at Penn Medicine, told Healio. “This research in family planning is especially relevant and critical, as the future of reproductive rights is uncertain. From the overturning of Roe v. Wade in June 2022 to more recent debates over in vitro fertilization access, women’s decisions in regards to family planning, including when and how they choose to start a family, are not promised support.”
Overarching themes
Overall, 162 physicians completed the survey and open-ended prompt.
Researchers identified three overarching themes:
- institutional barriers: increased need for parental leave, part-time options and concern for academic/professional consequences for having children;
- departmental barriers: discrimination, poor access for breastfeeding, childcare experience; and
- personal barriers: timing of having children, struggles with reproductive health and reproductive assistance, and personal decisions against family planning.
“Responses were unique but also shared common themes, most of which highlighted areas where policies and culture could improve,” Marion said. “Change can and should happen on multiple structural levels. Departments and institutions can work toward streamlining benefits to better support faculty/trainees and their families, as well as improve culture to better support these individuals interpersonally. Meanwhile, national and state legislators should protect reproductive freedoms to allow all people the opportunity to safely, effectively and privately start families in ways that best suit each family.”
‘Seek supportive work environments’
“I have not yet started a family, so the following advice is from the perspective of a researcher on the topic of family planning: For young women in oncology who want to have a family, I recommend that you seek supportive work environments in your career alongside other priorities,” Marion said. “Just as one may consider mentorship opportunities in fellowship, you may also consider flexible schedules, parental leave policies, childcare benefits, reproductive-assistance insurance coverage and perhaps even geographical preferences based on state reproductive rights.”
Marion further recommended advanced family planning given that certain time periods within training may be better suited for family rearing, she said.
“For any person, including physicians, older age is associated with infertility and other obstetric complications,” she continued. “The female oncologists who participated in this secondary analysis were vulnerable, brave and gracious in sharing their personal experiences. Their participation not only allowed for a robust research study but offers the general public a unique lens into the experiences of female physicians in family planning spanning specialty, region and generations. From our research team to you — thank you.”
For more information:
Sarah Marion, MD, can be reached at sarah_marion1@alumni.brown.edu.
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