Balancing scalpel and stroller: the unique challenges of surgeon mothers navigating maternity leave

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Abstract
Purpose: Ideal family building years inevitably coincide with training and early career for surgeons. Quantitative studies have demonstrated that maternity leave for surgeon mothers can be a significant source of stress and indecision, leading to significantly shorter maternity leaves than both non-surgeon physicians and the general population. This study sought to qualitatively explore the experience of navigating maternity leave as a surgeon mother. Methods: Surgeons and surgical trainees participated in semi-structured interviews that explored their experience of motherhood. Interviews were transcribed and de-identified. Constructivist grounded theory was for analysis. Open coding was conducted by the entire research team to establish familiarity with the data, followed by refined coding by two authors. Themes were discussed with the entire research team until the key themes were finalized. Results: Sixteen surgeons across surgical specialties participated, including three residents and one fellow. An equal number had their first child in residency compared to in early career. Three major themes emerged from the data regarding maternity leave: (1) Productivity, (2) Pressure and (3) Policies. Productivity encapsulated the incredible amount of work that surgeon mothers continued to complete throughout their maternity leaves. This included completing advanced degrees, exam preparation, academic and research work. Pressure was evident both through external sources demanding productivity and early return to work as well as internal pressures and guilt to prove oneself as not lesser than colleagues once embodying the roles of both mother and surgeon. Policies were not in place to protect surgeon mothers during their maternity leaves, and this included policies to protect surgeons financially or temporally. Conclusion: Surgeon mothers face unique challenges to navigating maternity leave due to current organizational and cultural norms. Addressing policies to support surgeon maternity leave is an important step, but policies alone will fail without cultural shifts and surgical leadership that truly support surgeons in their pursuit of motherhood.

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