BACKGROUND AND PURPOSE:

• Longer maternity leaves are associated with better maternal and infant health outcomes
• In a 1993 survey of American Medical Women’s Association resident members
  • 36% of medical residents took 4 to 8 weeks of leave
  • 30% took less than 4 weeks
• Stack et al. (Academic Medicine, 2019) sought to characterize maternity leave, and effects of length of leave, on infant and maternal well-being

METHODS:

• Observational study
  • Survey tool based on physician focus groups
• Participants
  • Female residents | 78 US programs | 25 unique specialties | 6 institutions
• Survey items included
  • Personal, partner, and child demographics
  • Logistics: e.g., paid leave vs vacation and/or sick days
• Primary outcomes
  • Maternity leave length
  • Duration of breastfeeding
  • Burnout and postpartum depression screens
  • Perceptions of support
  • Satisfaction with length of leave, breastfeeding, and childbearing during residency

RESULTS:

• 1,537 residents
• 52% of residents responded (804 respondents)
  • Medical 56% | Surgical 22% | Hospitalist 21%
• Maternity leaves
  • Length of leave: Ranged from 2–40 weeks
  • Most leaves were 6 weeks (32% of leaves)
  • Most leaves included vacation (81%) or sick time (64%)
• Length of leave was associated with institution, use of sick leave or vacation, and amount of paid leave
• The most frequently reported factor in determining length of leave was a desire not to extend residency training (27%)
  • Training was not extended for 53% of mothers | Additional 9% were unsure
  • For those who took >6 weeks, training was extended a median of 4 weeks vs 0 weeks for those who took ≤6 weeks
  • 86% had no adjustment to schedule upon return following delivery
• Longer breastfeeding duration and perceptions of logistical support from program administration were associated with longer maternity leaves
• Regardless of leave length, burnout affected approximately 50%

CONCLUSION:

• There is a great deal of variability in administration of maternity leaves across institutions
• Possible areas of improvement include
  • Clarifying policies
  • Improving residency program support for new mothers
  • Emphasizing maternal wellness when mothers return following delivery
• The authors conclude

The GME community has widely embraced the mandate to attend more closely to the physical and psychological wellbeing of trainees. Our findings underscore the need for clear, consistent, transparent, and easily accessible policies that support the many women already attempting to integrate GME and motherhood, as well as the many others who may be considering it.

Learn More – Primary Sources:

Maternity Leave in Residency A Multicenter Study of Determinants and Wellness Outcomes

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