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Maternity Leave in Residency

A Multicenter Study of Determinants and Wellness Outcomes

Stack, Shobha W. PhD, MD; Jagsi, Reshma MD, DPhil; Biermann, J. Sybil MD; Lundberg, Gina P. MD; Law, Karen L. MD; Milne, Caroline K. MD; Williams, Sigrid G. MD, MPH; Burton, Tracy C. MD; Larison, Cindy L. MA; Best, Jennifer A. MD

doi: 10.1097/ACM.0000000000002780
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Purpose: To characterize determinants of resident maternity leave and the effect of length of leave on maternal well-being.

Method: In 2017, the authors sent a voluntary, anonymous survey to female residents at 78 programs, in 25 unique specialties, at 6 institutions. Survey items included personal, partner, and child demographics, and logistics of leave including whether leave was paid, or vacation or sick leave were used. Outcomes were maternity leave length, duration of breastfeeding, burnout and postpartum depression screens, perceptions of support, and satisfaction with length of leave, breastfeeding, and childbearing during residency.

Results: Fifty-two percent (804/1,537) of residents responded. Among 16% (126) of respondents who were mothers, 50% (63) had their first child during residency. Seventy-seven maternity leaves were reported (range, 2–40 weeks), with most taking 6 weeks (32% of leaves; 25) and including vacation (81%; 62) or sick leave (64%; 49). Length of leave was associated with institution, use of sick leave or vacation, and amount of paid leave. The most frequently self-reported determinant of leave was the desire not to extend residency training (27%; 59). Training was not extended for 53% (41) of mothers; 9% (7) were unsure. Longer breastfeeding duration and perceptions of logistical support from program administration were associated with longer maternity leaves. Burnout affected approximately 50% (38) of mothers regardless of leave length.

Conclusions: This study illustrates variability in administration of resident maternity leaves. Targets for intervention include policy clarification, improving program support, and consideration of parent wellness upon return to work.

S.W. Stack is assistant professor of medicine, associate director, Medicine Student Programs, and director, Medical Student Scholarship, University of Washington School of Medicine, Seattle, Washington; ORCID: https://orcid.org/0000-0001-6586-9266.

R. Jagsi is professor of radiation oncology, program director, Radiation Oncology Residency Program, and director, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, ORCID: https://orcid.org/0000-0001-6562-1228.

J.S. Biermann is professor of orthopedic surgery and associate dean of graduate medical education at the University of Michigan Medical School, Ann Arbor, Michigan.

G.P. Lundberg is associate professor of medicine, Division of Cardiology, Emory University School of Medicine, and clinical director, Emory Women’s Heart Center, Atlanta, Georgia.

K.L. Law is associate professor of medicine, program director, Internal Medicine Residency Program, and associate vice chair of education, Department of Medicine at Emory University School of Medicine, Atlanta, Georgia.

C.K. Milne is professor of medicine, program director, Internal Medicine Residency Program, and vice chair for education, University of Utah, Salt Lake City, Utah. ORCID: https://orcid.org/0000-0002-4782-1901.

S.G. Williams is assistant professor of reproductive medicine, at the University of California, San Diego School of Medicine, San Diego, California.

T.C. Burton is assistant professor of pediatrics, University of South Florida College of Medicine, Tampa, Florida.

C.L. Larison is research consultant, Department of Health Services, University of Washington School of Public Health, Seattle, Washington. ORCID: https://orcid.org/0000-0002-1412-5993.

J.A. Best is associate professor of medicine, associate program director, Internal Medicine Residency Program, and associate dean of graduate medical education, University of Washington School of Medicine, Seattle, Washington.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A682.

Acknowledgments: The authors gratefully acknowledge the project development support of Christy McKinney, PhD, MPH, associate professor of pediatrics and associate director of the Institute of Translational Sciences KL2 Career Development program at the University of Washington School of Medicine.

Funding/Support: The 2016 American Medical Association Foundation Joan F. Giambalvo Fund for the Advancement of Women.

Other disclosures: Dr. Stack was also supported by a Mapping the Landscape, Journeying Together grant from the Arnold P. Gold Foundation Research Institute. Dr. Jagsi was supported by unrelated research grants from the National Cancer Institute, the Greenwall Foundation, the Susan Komen Foundation, Blue Cross Blue Shield of Michigan, and the Doris Duke Charitable Foundation; she received consulting fees from Amgen and Vizient and stock options in Equity Quotient for service on its advisory board.

Ethical approval: The Emory University institutional review board (IRB) approved this study (IRB no. 00093572). The University of California San Diego IRB deemed this study exempt (IRB no. 170565XX). The University of Michigan IRB deemed this study “not regulated” status (IRB no. HUM00124493). The University of South Florida IRB deemed this study exempt (IRB no. Pro00030131). The University of Utah IRB deemed this study exempt (IRB no. 00104311). The University of Washington IRB deemed this study exempt (IRB no. 51134).

Previous presentations: This work was presented at the American Medical Association – Women Physicians Section Interim Meeting, November 11, 2017, Honolulu, HI.

Correspondence should be addressed to Shobha W. Stack, Department of Medicine, University of Washington, 1959 NE Pacific Street, Box 356429, Seattle, WA; email: shobhaws@uw.edu; Twitter: @shobhastack.

© 2019 by the Association of American Medical Colleges