Motherhood and medicine

On Mother’s Day this year I will lift my glass three times. 

My first toast will celebrate Dr Emily Howard Jennings Stowe (1831–1903). Graduate of a US medical school in 1867, she was the first Canadian woman physician, and with three children, the first physician-mother in Canada. 

My second toast will be to Emily’s daughter, Augasta (1857–1943), who was the first woman graduate of a Canadian medical school in 1883, and the second physician-mother in this country. 

I will raise my glass a third time to honor all physician-mothers of today.

In preparation for my last toast, I searched the literature for information about motherhood and medicine, and I found a recent (2020), relevant review by four Australian physicians from the Graduate School of Medicine, University of Wollongong, NSW. The objective of their review was to synthetize what is known about women combining motherhood and a career in medicine. In their wide search, the authors identified 35 articles that best met their inclusion criteria and they summarized their findings under three headings. 

The impact of being a doctor on raising children

The various studies indicated that many women delayed having children to complete their training. Women who had children early in their career felt less secure financially and more anxious, reporting greater family strains than women who did not have children. Family size was also negatively influenced by career progression. Working hours caused family strain, many of the mothers reported concerns over missing their children’s milestones, and in general they thought that their careers negatively affected their children.  

The impact of being a mother on a medical career

On the negative side, in several studies, pregnant colleagues were rated as less productive. Hiring decisions were influenced by disclosures about pregnancy or pregnancy plans. Female doctors reported perceptions of gender bias. One study indicated that female doctors were often presumed to be disinterested, unavailable to work extra hours, or did not want to be promoted if they had children. On the positive side, most studies indicated that motherhood did not reduce motivation or ability to return to work after pregnancy, and female doctors with children remained motivated to work, some preferring work in family-friendly environments such as primary care settings. The time required for parenting did influence working hours. In general, women bore greater responsibility for parenting and domestic roles than men in the same specialties. 

Policies relating to combining motherhood and medical practice

On the negative side, inadequate maternity leaves influenced women’s ability to balance motherhood and medicine. Some facilities discouraged women from working in surgery while pregnant. Many residency policies did not have a formal maternity leave arrangement. On the more positive side, expanded child care and breastfeeding facilities were established in some facilities and offered flexibility in the workplace. Support for hiring and retaining female doctors has increased in the last decade.

This complex review of mothers and medicine illustrates how balancing motherhood and a career in medicine can be challenging. The review does have serious limitations: only English-language articles were included and most of the articles focused on hospital-based specialties, targeting single hospitals or certain specialty training programs. More in-depth studies are needed to understand and defuse gender and motherhood bias and to formulate realistic policies and strategies in and out of medicine to enable women to excel in their dual roles as mothers and physicians.

Happy Mother’s Day to all physician-mothers!
—George Szasz, CM,MD

Suggested reading
Hoffman R, Mullan J, Nguyen M, Bonney AD. Motherhood and medicine: Systemic review of the experiences of mothers who are doctors. Med J Aust 2020;213:329-334.

This post has not been peer reviewed by the BCMJ Editorial Board.

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