This module is intended to assist with the personal decision about whether to start a family. If a family is desired, there are complex decisions about when and how to do so along the medical education and career continuum. We hope the module inspires more people to be advocates for women that are navigating the decision to have children and confronting various challenges around starting or growing a family.

Goals

  • Increase awareness for physicians and for leaders of health systems or medical education of prevalence of infertility among female physicians.
  • Explore a wide range of perspectives among female professionals regarding the decision to have children.
  • Increase awareness to the variety of options available for family planning.

Objectives

  1. Consider the increased risk of infertility faced by female physicians and mitigation strategies as you create your own family plan.
  2. Explore the timing of having children along the medical education continuum, and how these decisions impact personal and professional fulfillment.
  3. Develop a basic understanding of various fertility strategies that match your individual situation.
  4. Analyze various policies that pertain to family planning along the medical education continuum and how progressive policies can positively impact individuals and organizations.
  5. Explore the societal expectation to have children and the personal implications of not having children, whether arrived at by choice or after a long struggle with infertility and/or inability to adopt.

Module Content

Title
Author
Time

Egg Freezing Facts for Female Physicians

Objective: 1
Dr. Anu Kathiresan
7 minutes

Informative piece about the basics of egg freezing and how to decide if this is the right decision for the reader, regardless of timing during the medical education and career continuum.

The Silent Struggle of Female Physicians

Objective: 1
Melissa Parsons, MD
7 minutes

FemInEM Idea Exchange lecturer shares her personal journey with infertility including an experience with an ectopic pregnancy. She explores the feelings of inadequacy and loss that accompany infertility.

Infertility and the Female Surgeon

Objective: 1
Britney Corey, MD
8 minutes

A surgeon shares her story of infertility struggle. She provides specific tips for family planning for women in surgery and those considering a surgical field. The article is relevant to women outside of surgery as well.

Women in Medicine and the Ticking Clock

Objective: 2
Lisa N. Miura, MD & Rebecca S. Boxer, MD, MS
5 minutes

This 2013 article from Annals of Family Medicine that offers multiple brief anecdotal accounts from female physicians. It's a refreshing, honest, and compelling article for those pursuing motherhood later than most.

Marriage, children cause more burnout for female physicians

Objective: 2
Dr. Rebekah Bernard
8 minutes

Many women historically have considered having a family a must, rather than choice due to societal or family pressures. This article is helpful for those on the fence about starting a family. It also lays the groundwork of what a good spouse should be, leading to good topics of discussion for a significant other prior to committing to marriage and children.

I Spent My Fertile Years Training to Be a Surgeon. Now, It Might Be Too Late for Me to Have a Baby

Objective: 2
Dr. Arghavan Salles
10 minutes

Dr. Arghavan Salles, FeminEM supporter and surgeon extraordinaire, gives a personal and compelling argument for trainees and early career physicians to take change of their fertility; or at least consider it.

Best Time to Have a Baby as a Physician? It Depends

Objective: 2
Valerie Anne Jones, MD
10 minutes

This brief article debates the pros and cons of having children during various career points along the medical education continuum.

Being An Older Mom Comes With Some Major Advantages

Objective: 2
Carolyn Gregoire
10 minutes

Despite the well-known medical risks to mothers and infants, studies on older mothers (40's) from Denmark are encouraging about the effects of parental emotional maturity (from age) on the emotional health of their offspring. Encouraging article for those who have not yet started a family or are unsure of taking this next step.

Reporter's Notebook: Stories of Infertility

Objective: 3
Chris Bodenner
5 minutes

The Atlantic has compiled a series of personal struggles with infertility, and a diverse array of individuals (various ages, backgrounds, sexual orientations) are included among the stories.

One in Four — The Importance of Comprehensive Fertility Benefits for the Medical Workforce

Objective: 4
Erica Kaye, MD, MPH
5 minutes

Article discusses the high rate of infertility among physicians and makes a case for comprehensive fertility benefits. It outlines several companies that have comprehensive fertility benefits as a way to attract and retain top talent. The article dispels many myths associated with expanding fertility coverage.

Physician Fertility: A Call to Action

Objective: 4
Ariela L. Marshall, MD, Vineet M.Arora, MD, MAPP, Arghavan Salles, MD, PhD
15 minutes

Published in Journal of AAMC. The authors discuss the challenges around both physician infertility and preservation of fertility. They propose three strategies to address physician infertility: increasing fertility education and awareness, providing insurance coverage for and access to fertility assessment and management; and offering support for those undergoing fertility treatments.

Childfree but still a FeminEM

Objective: 5
Elizabeth Pontius, MD
5 minutes

Do you have children? The author explores how this question can be so painful for so many women. Perhaps it triggers the issues with infertility. For women without children, we're often left trying to justify our decision, which is often met with a lukewarm reception. Additonally, women in medicine groups are not alway welcoming to women without children. The article reminds us that a woman's choice requires no justification.

On Being Childfree – Danielle’s Story

Objective: 5
Dr. Danielle Wilhelm
5 minutes

“Du hast Wert ohne Kinder” – You have worth without children. The author is an emergency physician that resides in Germany with her German husband. She shares her personal struggle with the decision to have children, the challenges of infertility and later with adoption. Despite years of trying to have a family, the path appears much more narrow and she explores the implications of a life without children.

Footloose and Childfree

Objective: 5
Justine Kelly, Executive Producer
30 minutes

In this podcast, this Aussie journalist explores the long-adopted plan of "grow up, find a partner, have kids". More and more women are choosing to ignore that path, and the latest research says they’re actually happier for it. So why do we judge women without kids?

Talking Points and Discussion Questions

  1. It is often an assumption that women will have children. When did you first consider having children? Do you feel more of an intrinsic or extrinsic desire for children?
  2. If you’ve had children, what drove the timing of when you decided to have children? Would you have changed it if you could have?
  3. Infertility can feel like a failure. What strategies have you or your colleagues utilized to accept and navigate this life challenge? How have your various institutions helped (or hindered) this issue?
  4. How do your colleagues (fellow students, residents, attendings, staff) talk about women and their pregnancies or family planning decisions?