Challenges to Navigating Pregnancy and Parenthood for Physician Parents: a Framework Analysis of Qualitative Data.

BACKGROUND: Some gender-based disparities in medicine may relate to pregnancy and parenthood. An understanding of the challenges faced by pregnant physicians and physician parents is needed to design policies and interventions to reduce these disparities. OBJECTIVE: Our objective was to characterize work-related barriers related to pregnancy and parenthood described by physicians. DESIGN: We performed framework analysis of qualitative data collected through individual, semi-structured interviews between May and October 2018. Data related to pregnancy or parenthood were organized chronologically to understand barriers throughout the process of pregnancy, planning a parental leave, taking a parental leave, returning from parental leave, and parenting as a physician. PARTICIPANTS: Physician faculty members of all genders, including parents and non-parents, from a single department at a large academic medical school in Canada were invited to participate in a department-wide study broadly exploring gender equity. APPROACH: Thematic analysis guided by constructivism. KEY RESULTS: Twenty-eight physicians were interviewed (7.2% of eligible physicians), including 22 women and 6 men, of which 18 were parents (15 mothers and 3 fathers). Common barriers included a lack of systems-level guidelines for pregnancy and parental leave, inconsistent workplace accommodations for pregnant physicians, a lack of guidance and support for planning parental leaves, and difficulties obtaining clinical coverage for parental leave. Without systems-level guidance, participants had to individually navigate challenges and resolve these difficulties, including negotiating with their leadership for benefits. This led to stress, wasted time and effort, and raised questions about fairness within the department. CONCLUSIONS: Physician parents face unique challenges navigating institutional policies as well as planning and taking parental leave. Systems-level interventions such as policies for pregnancy, parental leave, and return to work are needed to address barriers experienced by physician parents.