Many women physicians regret delaying reproduction

Excerpted from “Many women physicians regret delaying reproduction,”OB.Gyn.News. October 21, 2013 – Many female physicians say that if they had to do it over again, they might have tried to have children sooner, chosen a different specialty or elected to have embryos frozen "just in case" they had later fertility problems, an investigator said at the conjoint meeting of the International Federation of Fertility Societies and the American Society for Reproductive Medicine.

Dr. Natalie A. Clark and her colleagues surveyed a random sample of female physicians in the United States to ask about their choices for timing of conception, their basic knowledge of reproductive limitations, and how reproductive choices factor into their professional and personal decision making. The investigators randomly selected 600 women who graduated from medical school from 1995 through 2000, and a total of 333 (55.5%) responded.

Asked whether they would in retrospect have changed anything about their reproductive choices, 27.9% said they would have attempted to conceive earlier, 17.7% would have opted for a different specialty, 7.2% would have used cryopreservation of embryos or oocytes, 5.3% would have started medical training earlier, and 4.3% would have taken a leave from training. The survey highlights the unique challenges women of childbearing age face when trying to balance the demands of education, training and career advancement, said Dr. Clark, a third year resident at the University of Michigan department of obstetrics and gynecology in Ann Arbor. "We have a number of highly educated patients who come into our clinic who have finished their MDs or PhDs, and have done a great amount of postgraduate work, and they present at very late reproductive ages. They say, ‘I’m ready to start reproducing, and I don’t want to be too aggressive, but what can I do?’ – not fully realizing that they’ve missed their ideal reproductive window," Dr. Clark said in an interview.

One-fourth (25%) of all respondents had been diagnosed with infertility. "Despite having a medical background, 44% of infertile respondents were surprised about their diagnosis of infertility," Dr. Clark said.

Commentary

CMDA Member and Care Net Pregnancy Center Medical Director Sandy Christiansen, MD, FACOG: “Dr. Clark’s survey of 333 U.S. female physicians highlights an important pitfall to the pursuit of a career in medicine for women: the impact of delayed childbearing. As the reproductive clock ticks, female medical students and residents are spending their fertile prime time pouring over textbooks, taking night call and honing their skills as physicians. A significant portion of women physicians surveyed wished they’d tried having children sooner, but that choice brings an entire new set of challenges. One thing seems clear: women in medicine are rethinking their priorities and more are seeking ways to balance the needs of family and career during training years.

“Changing mores within medical education are reflective of increasing numbers of women in the profession. Shared training slots, extended family leave, shortened work days and reduced night call have all helped make room for living life, instead of putting it on hold during training years. The rate of childbearing among surgical residents at one program increased from 7 percent to 35 percent from 1976 to 2009, leading the authors to conclude programs should make accommodations or lose out on well qualified applicants.¹ Sometimes, it isn’t the institution that needs to adjust, but one’s own expectations and goals.

“As a Christian physician, when I married and began having babies, my priorities completely shifted. It was scary making changes, at first, but I’ve never regretted subordinating career for my family. Romans 12:2 provides a great counterpoint to society’s ‘you can have it all’ message: ‘Do not conform any longer to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is—his good, pleasing and perfect will’ (NIV 1984). In God’s economy, sometimes less is more.”

¹Caitlin Smith, Joseph M. Galante, Jonathan L. Pierce, and Lynette A. Scherer (2013) “The Surgical Residency Baby Boom: Changing Patterns of Childbearing During Residency Over a 30-Year Span.” Journal of Graduate Medical Education In-Press. doi: http://dx.doi.org/10.4300/JGME-D-12-00334.1

Dr. Sandy Christiansen is a Fellow of the American College of OB/GYN, is the medical director of the Care Net Pregnancy Center of Frederick and national medical consultant for corporate Care Net, whose mission is to promote a culture of life within our society in order to serve people facing unplanned pregnancies and related sexual issues and whose vision is a culture where lives are transformed by the Gospel of Jesus Christ and every woman chooses life for herself and her unborn child.

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