Pregnancy and Residency – Laboring for Equity

April 24, 2023

Written by Rebecca White

Spoon Feed
Though incremental progress has occurred over the last several decades, inequities loom for people that wish to become pregnant during medical training.

Why does this matter?
Sustaining a pregnancy, recovering from childbirth, breastfeeding and caring for a newborn are difficult for anyone – let alone for postpartum residents working overnights, 28-hour shifts, and 80-hour work weeks. At a time when more than half of new physicians may become pregnant during their careers, how can we change the status quo?

Due for a change
The residency system wasn’t designed to support trainees considering pregnancy or parenthood. Duty-hour restrictions, night-float coverage, increased hospital ancillary support, lactation rooms, the Family Medical Leave Act (FMLA) and the Accreditation Council for Graduate Medical Education (ACGME) requirements for parental leave have moved the needle in the right direction. However, these policies are often implemented in unhelpful ways. Trainees who wish to become pregnant during residency still face a choice between juggling the demands of pregnancy and postpartum with those of training or deferring childbearing until afterwards, when risk of infertility and complications are higher.

Policies such as the American Board of Internal Medicine’s “interrupted full-time training” or “deficiencies in required training time” clauses are underutilized and may allow residents flexibility in making up time away from training. Responsibility for enacting these policies should be part of the system itself and should not fall on the shoulders of trainees already balancing personal and professional obligations. This article calls for a new status quo rather than considering these changes “favors” for those who become pregnant during medical training.

Source
Pregnancy and Residency – Overdue for Equity. N Engl J Med. 2023 Mar 16;388(11):966-967. doi: 10.1056/NEJMp2215288. Epub 2023 Mar 11.