Stress, childbearing delays: The struggles physicians face when starting a family

Key takeaways:

• Physicians often delay having children because of residency’s demands.
• Childbearing delay, relationship strain and fertility problems are all common issues for physicians starting families.

Infertility, high rates of regret for the delay of childbearing and relationship strain can make family building difficult for many physicians, according to the results of research published in JAMA Internal Medicine.

“For physicians who desire children, the family-building journey is often complicated by infertility, stress, childbearing delays, and professional pressures,” Morgan S. Levy, BS, an MD/MPH student at the University of Miami Miller School of Medicine, and colleagues wrote.

Physicians tend to initiate childbearing at later ages than people in the general population — largely because medical training coincides with one’s “prime reproductive years” — with a median age of first birth at 32 years vs. 27 years, respectively, they wrote. Additionally, female physicians are twice as likely to experience infertility than women in the general population.

Levy and colleagues surveyed medical students and physicians to learn more about the psychosocial burdens connected with building a family.

The survey study included 3,310 participants who were recruited from email listservs and social media. The researchers measured psychosocial burden from family building with relationship strain, infertility diagnosis, assisted-reproductive technology (ART) use, regret from delayed childbearing and well-being outcomes.

Levy and colleagues found worse well-being associated with fertility challenges and high rates of regretting delaying childbearing.

Nearly two-thirds — 60.1% — of participants reported delaying childbearing because of training, saying that residency simply requires too many work hours, which makes parenting more difficult. Among them, 55.8% said they regretted delaying childbearing. The highest regret rates were found among those aged 32 to 36 years and then those aged 37 years or older.

Additionally, among those who used ART, there was a four times greater use of therapy to cope with the stress of family building and six times greater likelihood of reporting relationship strain, but the researchers wrote that “the often-inadequate insurance coverage for ART paired with the high cost may be factors in these difficulties.”

“Notably, almost half of those who delayed childbearing cited medical training or practice as the reason for the delay,” they wrote.

About 21% of participants also reported being diagnosed with infertility — 19.2% used ART — and 28% reported fertility issues affecting their well-being. Also, 14.1% reported that these issues hurt their relationship with their partner.

Levy and colleagues wrote that their data build on other research “by outlining the psychosocial burdens experienced by physicians and trainees building their families.”

“The high rates of regret of delaying family building, subsequent infertility and use of ART, and relationship strain, including therapy needs, make family building arduous for many physicians and medical students, especially ART users,” they concluded. “Our data highlight the need to change how we support family building for the entire physician workforce.”