1. 1 in 3 female oncologists report they experience infertility and 1 in 3 faced discrimination during pregnancy and/or for taking maternity leave

2. Almost all female oncologists in the study stated career plans were at least somewhat associated with the timing of starting a family

3. Female physicians in the US face infertility at a rate two times of the general population

Evidence Rating Level: 2 (Good)

1 in 4 female physicians in the US experience infertility, at a rate more than twice that of the general population. Studies have found that many women delay childbearing for professional advancement, with female physicians having their first child 7.4 years later than the general population, at a point where they are already considered advanced maternal age. This study surveyed over 1000 female oncologists to understand the barriers to family planning in the context of career, the association of fertility treatment with career decisions and to assess experiences of pregnancy-based discrimination among female oncologists. The age of survey participants ranged from 25 to 60 years, of which most were married and working full time, and most of which also had children. 24.2% of the participants said family planning was associated with their career decisions of academic vs private practice and 94.7% stated their career plans were at least somewhat associated with the timing of when to start a family. Positive factors associated with fertility planning were found to be a supportive partner, income as an attending physician, nearby family support, having a female mentor/role model and a supportive program during training. Negative factors associated with fertility planning were long work hours and heavy workload, concern for fertility, income as a trainee, lacking nearby family support and a bad or non-existent maternity leave policy. Additionally, of all respondents who had been pregnant, 2/3 had some sort of pregnancy complication. 1/3 of respondents reported having a miscarriage and 1/3 reported difficulty with infertility requiring counseling and/or treatment. In addition to difficulties with pregnancy, 1/3 of respondents did not feel well supported during training surrounding issues around fertility/pregnancy, including issues such as the absence of maternity leave during training and as an attending physician. Selection bias may have been a concern in this study as social media users chose to participate and some may have been subject to recall bias. Despite these limitations, it is clear that further changes are needed in medical education and training to support women in family planning.

Click to read the study in JAMA Network Open

Image: PD

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