Career-related pressures influence childbearing decisions among women physicians

Key takeaways:

• Overall, 75.6% of respondents said they delayed family building and 36.8% reported infertility.
• Respondents took leave, changed specialties, reduced work hours, changed practices or passed on career advancement.

Women physicians reported that career-related pressures influence pregnancy timing, affect infertility rates and result in career trajectory changes to accommodate family building and parenthood, according to survey results.

“Although reasons for attrition are unclear and likely complex, fertility and family building may be contributing given the duration and intensity of medical training, which coincides with women’s peak reproductive years,” Jennifer B. Bakkensen, MD, from the division of reproductive endocrinology and infertility at Northwestern University Feinberg School of Medicine, and colleagues wrote. “Prior research found that women physicians were more likely to delay childbearing and experience infertility compared with nonphysicians. While the decision to delay may be underinformed without full understanding how age is associated with fertility, physicians may postpone childbearing in spite of this knowledge due to insurmountable career-related pressures.”

Bakkensen and colleagues conducted a cross-sectional survey study, published in JAMA Network Open, including 1,056 cisgender women (mean age, 38.3 years) physicians. Surveys were distributed through medical society electronic mailing lists and social media from March to August 2022.

The surveys assessed baseline demographic information and knowledge on fertility and collected information on delayed childbearing, infertility assisted reproductive technology use and career alterations made to accommodate parenthood.

A total of 98.1% of respondents said they lived in the U.S., 67.6% were attending physicians, 26.8% were residents or fellows, 38.6% were in surgical specialties and 45.2% practiced in an academic setting.

Overall, 86.2% of respondents reported being married or partnered, and 65.3% had children. Overall, 78% of respondents correctly identified 35 years or older as the age of fertility decline, and 75.6% reported delaying family building. Of the 36.8% of respondents who reported experiencing infertility, 51.4% said they used IVF.

When responding to what they would do differently regarding family planning, 45.7% said they wanted to conceive earlier, 44.8% said they wanted to reduce work hours, 38.8% said they wanted to take extended leave and 28.4% reported they wanted to pursue oocyte cryopreservation.

When making accommodations because of parenthood, 28.8% reported taking extended leave, 24.8% reported choosing a different specialty to work in, 47.1% reported reducing their work hours, 24.8% reported changing their practice setting and 47.2% reported passing on opportunities for career advancement after having children.

Researchers noted that 4.3% of respondents had left their medical career entirely.

“These findings highlight a need for ongoing research into the reasons underlying delayed family building and infertility within this population and a need for targeted support to address the disparate and discriminatory experiences of women physicians,” the researchers wrote. “While there is clearly more work to be done, these data shed light on potentially critical areas for policy reform and future change.”