Pregnant cardiologists are regularly mistreated by their employers both before and after they give birth, according to a new analysis published in the Journal of the American College of Cardiology.[1] In fact, a majority of childbearing cardiologists say their pregnancy had a negative impact on their career.
The study’s authors noted that just 15% of practicing cardiologists identify as women — and this comes after years of efforts to improve diversity within the specialty.
“One factor likely deterring women from choosing cardiology as a specialty is the difficulties faced by women cardiologists pertaining to pregnancy and maternity leave,” wrote lead author Martha Gulati, MD, MS, a cardiologist with the University of Arizona College of Medicine in Phoenix, and colleagues. “Many women cardiologists delay childbearing because of the high acuity of patients, call demand, workday length, and schedule unpredictability. Similar to all childbearing doctors is the interruption in practice and lack of a national paid family leave policy in the United States, leaving institutions to create a patchwork of policies that are inconsistent across types of practices.”
Gulati et al. reached out to members of the American College of Cardiology’s Women in Cardiology Section for their analysis, sending out an anonymous survey to more than 1,300 women cardiologists from the United States. A total of 341 respondents completed the survey in 2011; after a small number of exclusions, the final number of respondents was 323.
Some of the study’s co-authors were attorneys; they evaluated answers closely to determine if any employer actions were potentially in violation of the Family and Medical Leave Act (FMLA) or antidiscrimination laws.
More than half of all respondents were pregnant within five years of taking the survey. Another 10.5%, meanwhile, were pregnant more than 20 years before taking the survey. Also, 48.3% of respondents were working in an academic setting when they were pregnant.
These are some key findings from the team’s analysis:
1. Many women are concerned they will be treated poorly after revealing they are pregnant
Most respondents notified their supervisor of their pregnancy in the late first or early second trimester. A significant number of respondents (37%) said they were concerned about being treated poorly or being perceived in a bad light after sharing the news.
2. Pregnancy can have a negative impact on cardiologist salary, especially if not in an academic setting
More than 55% of respondents said their salary was based on relative value units (RVUs). Twenty-four (7.4%) of those women had their RVUs prorated for the time they were on maternity leave. Also, during the year of pregnancy, 57.9% of the study’s respondents had no change in their salary, but 41.2% saw a decrease. Salary was unchanged for a majority of respondents working in an academic setting.
3. Maternity leave times are inconsistent
Paid maternity leave was six weeks for 22.9% of respondents, three months for 19.2%, six months for 0.9% and one year for 0.6%. Another 23.2% had no paid maternity leave.
Overall, 48.9% of respondents took three months of paid or unpaid maternity leave.
4. Extra service time before maternity leave was common
A considerable number (37.2%) of respondents said they were asked to perform extra services before maternity leave to try and frontload hours. This was associated with a much higher risk of being placed on bedrest before delivery, though no other significant associations with pregnancy complications were observed. It was also associated with a higher likelihood of believing pregnancy had a negative impact on their career.
5. Many cardiologists still worked while on maternity leave
While 39.9% of women posted an “out-of-office” email message and did not do any work, 20.4% still managed some patients and 24.8% still performed “work not related to patients.”
“Salary changes during year of pregnancy were not significantly different in those who had an ‘out-of-office’ e-mail response and did not work, compared with those who had an ‘out-of-office’ e-mail response, but continued to check e-mail and participate in patient care or other work, or those who did not have any e-mail response and continued management of patients from home,” the authors wrote.
6. Some cardiologists were heavily pressured about returning to work
Gulati et al. noted that some respondents included comments about being pressured to return from maternity leave. “Every day while on maternity leave, I was contacted by my employer as to when I would return so they can open my schedule,” one cardiologist said. “I was so harassed.”
7. Most cardiologists said their pregnancy had an adverse impact on their career
A total of 51.1% of respondents said pregnancy had an adverse impact on their career. Specific details mentioned by cardiologists included “outright discrimination” and delayed promotions.
8. Potentially illegal actions were quite common
Overall, 73.4% of patients reported at least one potentially illegal action that occurred while they were pregnant, on maternity leave or returning from maternity leave.
“Nearly three-fourths of women cardiologists who have experienced pregnancy report experiencing troubling practices that are illegal in many circumstances, including requiring extra work before delivery, requiring work during leave, and inadequate accommodation for breastfeeding once returning to work,” the authors concluded. “Because these employer actions were associated with negative outcomes, improving policies and practices related to pregnancy and motherhood will not only improve compliance with the law, but also the professional lives of women cardiologists, their health and well-being and that of their infants, and the ability to recruit and retain women in the cardiology workforce.”
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Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.