Why women physicians are putting off having children

By Jules Murtha | Fact-checked by Barbara Bekiesz

Published January 3, 2023

Key Takeaways

Research suggests that the majority of women physicians delay having children to accommodate their career. They are also likely to make “substantial accommodations” in the workplace to support their efforts to build a family.
Residents are significantly more likely to delay childbearing when they are younger or without any current children; those pursuing a specialty that allows for little flexibility, or enrolled in a bigger program, also tend to postpone having children.
To strike a healthier work-life balance, women physicians can start their days early, prepare their work outfits in advance, optimize time and work, prioritize sleep, and practice boundary setting, among other strategies.

Female physicians are faced with the challenge of navigating a largely male-dominated field. Even in 2022, gender disparities pertaining to promotions, academic rankings, and leadership positions pervade medical spaces.

Emerging research reveals the interplay between career pursuits and family planning, shining a light on the reality that women often sacrifice one to achieve the other.

To combat this dynamic, women physicians can ditch the guilt, set boundaries, optimize their time, and ask for help when needed.

Postponing child-rearing for careers

Fertility and family building have the potential to shape a woman’s trajectory in medicine.

A survey published by JAMA interviewed 24 female physicians about their concerns regarding child-rearing and their careers.^[]

Conducted between April 2020 and September 2020, the survey revealed that some of the women lacked formal education on fertility, learning instead from the experiences of peers and family members. These women wanted to “improve medical education through early introduction and transparent discussions about infertility.”

Regarding childbearing concerns, researchers noted a few recurring themes: high rates of delayed childbearing (71%), insufficient perceived peer and administrative support, and the fear that family building will negatively impact one’s career trajectory.

Another notable finding: 67% of the women interviewed had altered the course of their career due to family planning.

One participant spoke about her willingness to put her family first, saying that being a physician "is something I really love and enjoy doing, but it’s not the only thing and having kids is something very important to me … if I felt like my current position was taking away from that, I’d be happy to make accommodations or even leave medicine.”

Decisions made during residency

Residents are also more likely to delay having children, according to a study published by Academic Medicine.^[]

It found that 61% of participants had delayed childbearing, and those who did were more likely to be young or within a specialty that provides little lifestyle flexibility.

Participants said that concerns about overburdening their colleagues, fertility issues, access to childcare, and their finances influenced their decisions to put off having a family.

Physicians who long to start a family, therefore, have both personal and professional factors to consider.

Promote a healthy work-life balance

Combining a career in medicine and raising children is, without a doubt, a challenge. But it can be done, and women doctors who are also mothers have developed strategies that help them make the most of their careers and family lives.

Women physicians who plan on building a family can take heart by reading the tips offered by doctor and mother Mehvish Kahn, MD, writing in a 2021 Op-Med piece, for ways to achieve a better work-life balance.^[]

Start your days early. Early risers have more time to cook, clean, and read to their kids before heading to work. Before your shift even begins, try to cross some major to-dos off your list.
Prioritize well-being and nutrition (including sleep). Schedule well-visits, vaccinations, and other appointments ahead of time. Don’t skip meals, and be sure to practice good sleep hygiene with meditation, reading, or tea time.
Optimize your work tasks. Find ways to feed several birds with one scone: review labs, answer questions in the in-basket, and make follow-up plans concurrently.
Let go of guilt. As Kahn wrote, “You cannot physically be at two different places at once.” The guilt you feel about choosing between your career and your family isn’t helping you.

Do your best to be present with whatever task you’re faced with at the moment.

Ask for help. Instead of shying away from your support system, lean into it. Ask your spouse, family, friends, and colleagues for assistance when you need it. You’re not only allowed but encouraged to do so.

Setting boundaries

The authors of an article published by Family Practice Management echoed some of these points and emphasized the importance of setting boundaries as a doctor-mom.^[] This may mean committing to answering all of your messages at work so that you don’t wind up taking work home.

It may also look like you’re saying “no” more often.

As a doctor, you may want to give your all and then some.

In order to avoid burnout, however, you will need to start prioritizing your peace—and enjoying the benefits of a healthy work-life balance.

What this means for you

Women in medicine still deal with notable gender disparities in the workplace. Research shows that fertility and family planning may contribute to these existing gender gaps. To make the most of a career in medicine and enjoy a rich family life, women physicians can set boundaries, let go of guilt, and implement strategies to maximize their time on and off the clock.