JAMA: More than 1/3 have had miscarriages, 1/3 have suffered discrimination, how difficult is it for female oncology doctors to give birth?

Female doctors often spend their childbearing years training and building their
careers.
According to the Centers for Disease Control and Prevention, as many as one in four female doctors in the United States suffer from infertility, more than
double the general population.
On average, female doctors may have their first child 7.
4 years later than the general population, by which time they are already considered advanced maternal age (defined as ≥ 35 years of age at the time of delivery).

Currently, physician fertility and family planning are rarely discussed or taught
in medical school or graduate training.

To this end, the purpose of this study was to (1) understand barriers to family planning in a person's career, (2) understand the association of fertility treatment options (such as ART) with career decisions, and (3) evaluate experiences of pregnancy-based discrimination among female oncologists
.

In the study, a new questionnaire containing 39 items was distributed to female oncologists
in the United States via email and social media channels from May 7 to June 30, 2020.
This includes issues
related to family planning, maternity leave and discrimination.
Distribution
of responses to the survey was compared according to tumor subspecialties.
Multivariate logistic regression analysis determined the independent variable
of discrimination during maternity leave.

The study ultimately collected responses
from 1004 female oncologists.
The majority of respondents (847 [84.
4%]) were married and 713 (71.
0%) were currently working
full-time.
A total of 351 oncologists (35.
0%) worked in radiation oncology, 344 (34.
3%) in medical oncology, 186 (18.
4%) in surgical oncology and 91 (9.
1%) in pediatric oncology
.
A total of 768 (76.
5%) had children, of whom 415 (41.
3%) gave birth for the first time during their postgraduate studies and 275 (27.
4%) gave birth
during their 1-5 years as attending physicians.
Almost all respondents (951 [94.
7%]) said their career plans were at least partly related to
when they started a family.
Having a supportive partner was the most common positive factor related to family planning (802 [79.
9%]), while long working hours and heavy workload (669 [66.
6%]) were the most common negative factors
.
One third (318 [31.
7%]) miscarried, and 315 (31.
4%) reported infertility requiring fertility counseling and/or treatment; 660 (65.
7%) believed that fertility preservation should be discussed with women during medical school and/or hospital stay
.
One third (312 [31.
1%]) reported discrimination during pregnancy and 332 (33.
1%) reported discrimination
on the basis of taking maternity leave.
In multivariate logistic regression, having more than one child was associated with an increased likelihood of discrimination during maternity leave (2 children: odds ratio, 1.
62 [95% CI, 1.
10-2.
39]; P = .
02 points; ≥3 children: odds ratio, 1.
84 [95% CI, 1.
14–2.
95; P = .
01)
。

Overall, in this survey study of female oncologists, one-third reported having infertility and one-third said they experienced discrimination
during pregnancy and/or maternity leave.
Systemic reforms were needed to ensure that women were supported and able to develop equitably in
that area.

Original source:

Lee A, Kuczmarska-Haas A, Dalwadi SM, et al.
Family Planning, Fertility, and Career Decisions Among Female Oncologists.
JAMA Netw Open.
2022; 5(10):e2237558.
doi:10.
1001/jamanetworkopen.
2022.
37558