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Corbisiero MF, Acker SN, Bothwell S, Christian N. Transforming Perceptions: The Impact of a Formal Parental Leave Policy on Surgical Trainees. JOURNAL OF SURGICAL EDUCATION 2024; 81:816-822. [PMID: 38677898 PMCID: PMC11088490 DOI: 10.1016/j.jsurg.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/13/2024] [Accepted: 03/03/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE Surgical trainees who welcome a new child during residency often face challenges related to appropriate parental leave. To address this, we instituted a comprehensive family medical leave policy within our training program and assessed resident perceptions before and after the policy's introduction. We hypothesized that this new formal policy would enhance feelings of support amongst all (not just childbearing) trainees. DESIGN A web-based survey to gauge resident perceptions on parental leave was distributed to all residents at a single academic general surgery residency at 2 intervals: prior to policy implementation and 1 year after policy implementation. SETTING The study was conducted at a single institution, academic general surgery residency program. PARTICIPANTS All general surgery residents at the institution were included (n = 95). RESULTS About 40 out of 95 (42%) residents participated in the initial survey and 25 of 95 (26%) completed the subsequent survey. There was a significant improvement in resident reported satisfaction with the policy from pre to post: 15% pre to 68% post, p < 0.001, report the policy frequently supported trainees' needs, 20% pre to 88% post, p < 0.001, perceived the policy as fair. Most residents (90.0% pre and 80.0% post) perceived pregnancy as a risk during surgical training. There were no differences in perception of the new policy between residents who were parents and residents who were not parents. CONCLUSIONS The introduction of a comprehensive family medical leave policy improved all surgical trainees' (including nonparents) perception of policy effectiveness and policy fairness. This is counter to the published perception that parental leave creates a burden on fellow trainees. However, pregnancy remains a stressor for the individual new parent. Surgical programs can develop supportive formal family medical leave policies; it is important to address the inherent systemic and cultural barriers surrounding childrearing during surgical training.
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Affiliation(s)
| | - Shannon N Acker
- Division of Pediatric Surgery, Department of Surgery, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado
| | - Samantha Bothwell
- Center for Children's Surgery, Research Outcomes in Children's Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Nicole Christian
- Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado.
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Beltrán Ponce S, Jagsi R, Florez N, Thomas CR, Banerjee A, Jasti S, Bailey MM, Lawton CAF, Johnstone C, Clarke CN, Bedi M, Jovanovic M, Saeed H. Can I Leave? Perspectives on Parental Leave and Parenthood in Medical Training Among Program Directors and Trainees in Oncologic Specialties. J Womens Health (Larchmt) 2024; 33:218-227. [PMID: 38011014 DOI: 10.1089/jwh.2023.0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Purpose: Peak fertility commonly occurs during medical training, and delaying parenthood can complicate pregnancies. Trainee parental leave policies are varied and lack transparency. Research on the impacts of parenthood on trainee education is limited. Methods: A Qualtrics-based survey was distributed via e-mail/social media to program directors (PDs) within oncologic specialties with a request to forward a parallel survey to trainees. Questions assessed awareness of parental leave policies, supportiveness of parenthood, and impacts on trainee education. Statistical analyses included descriptive frequencies and bivariable comparisons by key groups. Results: A total of 195 PDs and 286 trainees responded. Twelve percent and 29% of PDs were unsure of maternity/paternity leave options, respectively. PDs felt they were more supportive of trainee parenthood than trainees perceived they were. Thirty-nine percent of nonparent trainees (NPTs) would have children already if not in medicine, and >80% of women trainees were concerned about declining fertility. Perceived impacts of parenthood on trainee overall education and academic productivity were more negative for women trainees when rated by PDs and NPTs; however, men/women parents self-reported equal impacts. Leave burden was perceived as higher for women trainees. Conclusions: A significant portion of PDs lack awareness of parental leave policies, highlighting needs for increased transparency. Trainees' perception of PD support for parenthood is less than PD self-reported support. Alongside significant rates of delayed parenthood and fertility concerns, this poses a problem for trainees seeking to start a family, particularly women who are perceived more negatively. Further work is needed to create a supportive culture for trainee parenthood.
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Affiliation(s)
- Sara Beltrán Ponce
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Reshma Jagsi
- Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Narjust Florez
- Lowe Center for Thoracic Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
- The Cancer Care Equity Program, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Charles R Thomas
- Department of Radiation Oncology, Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Anjishnu Banerjee
- Department of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Shravya Jasti
- Department of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Morgan M Bailey
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
| | - Colleen A F Lawton
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Candice Johnstone
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Callisia N Clarke
- Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Meena Bedi
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Hina Saeed
- Baptist Health Medical Group, Boca Raton, Florida, USA
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Hoang Roberts LN, Zwaans BMM, Vollstedt A, Sharrak A, Han E, Fischer M, Sirls L, Padmanabhan P. Maternity Leave Satisfaction Among Physicians Compared with Nonphysician Professionals. J Womens Health (Larchmt) 2024; 33:33-38. [PMID: 37639698 DOI: 10.1089/jwh.2023.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
Objective: The objective of this study was to compare maternity leave satisfaction between physicians and nonphysicians. Currently, paid maternal leave is not guaranteed in the United States, resulting in palpable dissatisfaction among parents. Previous studies have shown associations between length of paid leave and career satisfaction and maternal happiness. Materials and Methods: A Qualtrics® electronic survey was distributed to female professionals through email and social media from April 2019 to March 2020. Inclusion criterion was ≥1 child by birth or adoption, or active pregnancy. Continuous and categorical data were analyzed using two-sample t-test and chi-square, respectively. Results: Of 808 respondents, 77% were physicians. Mean age at birth/adoption of first child was higher in physicians versus nonphysicians (32.1 years vs. 29.7 years; p < 0.001). Physicians took shorter maternity leave than nonphysicians (10.9 weeks vs. 12.0 weeks, p = 0.017) with half of that time paid by employers (5.4 weeks vs. 5.9 weeks, p = 0.2). Dissatisfaction was high among physicians (85.1%) and nonphysicians (92.4%) that correlates with maternity leave compensation dissatisfaction (49% vs. 71.3%, p < 0.001). Thirty-four percent of physicians versus 41% of nonphysicians stated that their health was negatively impacted by maternity leave length. Physicians and nonphysicians reported similar incidences of depression, and breastfeeding, delivery, and other postpartum complications. When queried, 38.8% of physicians and 57% of nonphysicians said they would desire >16 weeks of paid maternity leave (p < 0.001). Conclusions: In conclusion, dissatisfaction among professional women on maternity leave duration and compensation is high in the United States. Given health implications for both mother and child, this should invite further discussion and changes.
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Affiliation(s)
| | - Bernadette M M Zwaans
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Annah Vollstedt
- Department of Urology, University of Iowa, Iowa City, Iowa, USA
| | | | - Esther Han
- Orlando Health Medical Group, Orlando, Florida, USA
| | - Melissa Fischer
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Larry Sirls
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
| | - Priya Padmanabhan
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
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Machen JL, Raaum SE, Patel R, Cioletti A. What to Expect When They're Expecting: Addressing Policy Nuances of Resident Parental Leave. Am J Med 2023; 136:1124-1129. [PMID: 37567377 DOI: 10.1016/j.amjmed.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/06/2023] [Indexed: 08/13/2023]
Affiliation(s)
- Julie L Machen
- Department of Internal Medicine, Cone Health Teaching Service, University of North Carolina School of Medicine, Greensboro.
| | - Sonja E Raaum
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City
| | - Rajvi Patel
- Department of Internal Medicine, Dell Medical School at the University of Texas at Austin
| | - Anne Cioletti
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City
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Feld LD, Sarkar M, Au JS, Flemming JA, Gripshover J, Kardashian A, Muir AJ, Nephew L, Orloff SL, Terrault N, Rabinowitz L, Volerman A, Arora V, Farnan J, Villa E. Parental leave, childcare policies, and workplace bias for hepatology professionals: A national survey. Hepatol Commun 2023; 7:e0214. [PMID: 37639705 PMCID: PMC10461944 DOI: 10.1097/hc9.0000000000000214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The presence of workplace bias around child-rearing and inadequate parental leave may negatively impact childbearing decisions and sex equity in hepatology. This study aimed to understand the influence of parental leave and child-rearing on career advancement in hepatology. METHODS A cross-sectional survey of physician members of the American Association for the Study of Liver Diseases (AASLD) was distributed through email listserv in January 2021. The 33-item survey included demographic questions, questions about bias, altering training, career plans, family planning, parental leave, and work accommodations. RESULTS Among 199 US physician respondents, 65.3% were women, and 83.4% (n = 166) were attendings. Sex and racial differences were reported in several domains, including paid leave, perceptions of bias, and child-rearing. Most women (79.3%) took fewer than the recommended 12 paid weeks of parental leave for their first child (average paid leave 7.5 wk for women and 1.7 for men). A majority (75.2%) of women reported workplace discrimination, including 83.3% of Black and 62.5% of Hispanic women. Twenty percent of women were asked about their/their partners' pregnancy intentions or child-rearing plans during interviews for training. Women were more likely to alter career plans due to child-rearing (30.0% vs. 15.9%, p = 0.030). Women were also more likely to delay having children than men (69.5% vs.35.9%). CONCLUSIONS Women reported sex and maternity bias in the workplace and during training interviews, which was more frequently experienced by Black and Hispanic women. As two-thirds of women had children during training, it is a particularly influential time to reevaluate programmatic support to address long-term gender disparities in career advancement.
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Affiliation(s)
- Lauren D. Feld
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Massachusetts, Worcester, Massachusetts, USA
| | - Monika Sarkar
- Department of Medicine, Division of Gastroenterology & Hepatology, University of California San Francisco, San Francisco, California, USA
| | - Jennifer S. Au
- Department of Organ Transplant, Division of Gastroenterology and Hepatology, Scripps Clinic, La Jolla, California, USA
| | - Jennifer A. Flemming
- Department of Medicine and Public Health Sciences, Queen’s University, Ontario, Canada
| | - Janet Gripshover
- Department of Transplant Surgery, Ronald Regan UCLA Medical Center, Los Angeles, California, USA
| | - Ani Kardashian
- Department of Medicine, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Andrew J. Muir
- Department of Medicine, Division of Gastroenterology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Lauren Nephew
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Susan L. Orloff
- Department of Surgery, Division of Abdominal Organ Transplantation, Oregon Health & Science University School of Medicine, Portland, Oregon, USA
| | - Norah Terrault
- Department of Medicine, Division of Gastroenterology and Liver, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Loren Rabinowitz
- Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Anna Volerman
- Departments of Medicine and Pediatrics, University of Chicago, Chicago, Illinois, USA
| | - Vineet Arora
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Jeanne Farnan
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Erica Villa
- Dipartimento di Specialità Mediche, Struttura Complessa di Gastroenterologia, Universita Degli Studi Di Modena E Reggio Emilia, Modena, Italy
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Ben-Zion S, Lehmann A, Price L, Burnett HQ, Michelson CD. The Use of Parenting Electives in Pediatric Residency. Acad Pediatr 2022; 22:513-517. [PMID: 34864134 DOI: 10.1016/j.acap.2021.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Financial considerations and the desire to not prolong training often influence residents' parental leave length. Some residencies offer parenting electives. These primarily self-directed electives can extend parental time at home, support transition back to work, and allow residents to remain in training and be paid during these transitions. OBJECTIVE Describe the prevalence and structure of parenting electives within pediatric residency programs from 3 geographic regions of the Association of Pediatric Program Directors (APPD). METHODS All 66 pediatric residency program directors in the Western, Mid-America, and Northeastern regions of APPD were invited to participate in a phone interview regarding existence of and structure of their programs' parenting elective. RESULTS Thirty-six programs responded (55%). Of those, 24 (67% of responding programs) offer a specific parenting elective and an additional 5 (14%) offer a generic elective that can be tailored to new parents. Curricular elements shared by almost all programs offering specific parenting electives include self-reflective exercises, exploration of a community resource, and parenting articles/book review. Most programs incorporate clinic but not call into these electives. CONCLUSION Parenting electives are increasingly available in pediatric residency programs to support new resident parents. Sharing common curricular elements may help other programs implement and/or enhance this elective offering.
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Affiliation(s)
| | - Amalia Lehmann
- Indiana University School of Medicine (A Lehmann and L Price), Indianapolis, Ind
| | - Lori Price
- Indiana University School of Medicine (A Lehmann and L Price), Indianapolis, Ind
| | - Honora Quinn Burnett
- Department of Pediatrics, University of California (HQ Burnett), San Francisco, Calif
| | - Catherine D Michelson
- Department of Pediatrics, Boston University School of Medicine/Boston Medical Center (CD Michelson), Boston, Mass
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Ortega SR, Barnes JM, Waller JD. Parental leave in medical school: supporting students as parents. J Osteopath Med 2022; 122:229-233. [PMID: 35179008 DOI: 10.1515/jom-2021-0208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/02/2021] [Indexed: 11/15/2022]
Abstract
CONTEXT The overlap between medical school, residency, and childbearing potential increases the likelihood a woman will pursue parenthood within her, or her partner's, medical training. Parental leave benefits mothers, fathers, and infants. Adequate parental leave promotes physical recovery, mental health, infant bonding, improved breastfeeding, appropriate childhood immunization, and familial engagement. Despite the risks and benefits, the United States does not have national paid maternity, paternity, or parental leave requirements. Complicating matters for medical trainees, parental leave policies are not well-defined within the undergraduate (UME) and graduate medical education (GME) realms. Significant policy advancements are on the horizon for GME; however, medical schools are left without evidence to support policy formation. OBJECTIVES This study aims to identify the presence and nature of maternal/paternal leave policies and procedures within UME. Given the authors' close association with osteopathic medical education, only osteopathic medical schools were considered to lay the framework for future study in UME. METHODS Investigators searched university websites for student handbooks outlining rules and policies surrounding parental leave. The following terms were utilized to investigate these documents: "parental," "maternity," "paternity," "pregnant," "pregnancy," and "leave of absence" (LOA). Administrative personnel were contacted, and subjective data were documented. A parental leave policy was defined as explicitly dedicated to expectant parents or those parents planning on adoption. Medical leave or other short- and long-term LOA policies were not considered a parental leave policy. RESULTS A total of 42 osteopathic medical schools were identified. Investigators established email communication with 17 schools (40.5%). Neither a student handbook nor email contact could be made with one institution. Two (4.9%) osteopathic medical schools overtly described parental leave in their policies. The majority of schools recommended students seeking parental leave follow short- or long-term LOA policies. CONCLUSIONS Without protected leave time, students must decide whether to begin a family or delay medical education. As GME begins prioritizing policy change, the authors call on UME to follow suit. Parenthood and medicine must be intertwined.
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Affiliation(s)
- Sheila R Ortega
- St. Anthony North Family Medicine Residency, Westminster, CO, USA
| | - Jacob M Barnes
- The University of Florida College of Medicine - Jacksonville, Jacksonville, FL, USA
| | - Jacquelyn D Waller
- Department of Biomedical Sciences, Rocky Vista University, Parker, CO, USA
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Jamorabo DS, Khander A, Koulouris V, Feith JE, Briggs WM, Renelus BD. Fellowship program directors and trainees across the United States find parental leave policies to be inconsistent, inaccessible, and inadequate. PLoS One 2021; 16:e0260057. [PMID: 34788326 PMCID: PMC8598025 DOI: 10.1371/journal.pone.0260057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/31/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Determine the consistency, accessibility, and adequacy of parental leave policies for adult and pediatric medicine fellowship programs. Methods We administered a 40-question survey to fellowship program directors (PDs) and trainees in adult and pediatric cardiology, hematology/oncology, gastroenterology, and pulmonology/critical care fellowship programs in the United States. We used Chi-square tests to compare proportions for categorical variables and t-tests to compare means for continuous variables. Results A total of 190 PDs from 500 programs (38.0%) and 236 trainees from 142 programs (28.4%) responded. Most respondents did not believe that parental leave policies were accessible publicly (322/426; 75.6%), on password-protected intranet (343/426; 80.5%), or upon request (240/426; 56.3%). The PDs and trainees broadly felt that parental leave for fellows should be 5–10 weeks (156/426; 36.6%) or 11–15 weeks (165/426; 38.7%). A majority of PDs felt that there was no increased burden upon other fellows (122/190; 64.2%) or change in overall well-being (110/190; 57.9%). When asked about the biggest barrier to parental leave support, most PDs noted time constrains of fellowship (101/190; 53.1%) and the limited number of fellows (43/190; 22.6%). Trainees similarly selected the time constraints of training (88/236; 37.3%), but nearly one-fifth chose the culture in medicine (44/236; 18.6%). There were no statistically significant differences in answers based on the respondents’ sex, specialty, or subspecialty. Discussion Parental leave policies are broadly in place, but did not feel these were readily accessible, standardized, or of optimum length. PDs and trainees noted several barriers that undermine support for better parental leave policies, including time constraints of fellowship, the limited number of fellows for coverage, and workplace culture. Standardization of parental leave policies is advisable to allow trainees to pursue fellowship training and care for their newborns without undermining their educational experiences.
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Affiliation(s)
- Daniel Sabido Jamorabo
- Department of Medicine, Stony Brook Medicine, Stony Brook, New York, United States of America
- * E-mail: ,
| | - Amrin Khander
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, New York, United States of America
| | - Vasilios Koulouris
- Department of Medicine, Montefiore Medical Center, Bronx, New York, United States of America
| | - Jeremy Eli Feith
- Department of Neurosciences, State University of New York-Binghamton, Binghamton, New York, United States of America
| | - William Matthew Briggs
- Department of Biostatistics, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York, United States of America
| | - Benjamin Dwight Renelus
- Department of Medicine, Johns Hopkins Medicine, Baltimore, Maryland, United States of America
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Couples' paid work, state-level unemployment, and first births in the United States. DEMOGRAPHIC RESEARCH 2021. [DOI: 10.4054/demres.2021.45.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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10
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Advanced Gastroenterology Trainees Should Be Included in National Trainee Parental Leave Policies. Am J Gastroenterol 2021; 116:2302. [PMID: 34131084 DOI: 10.14309/ajg.0000000000001338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Rangel EL, Castillo-Angeles M, Easter SR, Atkinson RB, Gosain A, Hu YY, Cooper Z, Dey T, Kim E. Incidence of Infertility and Pregnancy Complications in US Female Surgeons. JAMA Surg 2021; 156:905-915. [PMID: 34319353 DOI: 10.1001/jamasurg.2021.3301] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance While surgeons often delay pregnancy and childbearing because of training and establishing early careers, little is known about risks of infertility and pregnancy complications among female surgeons. Objective To describe the incidence of infertility and pregnancy complications among female surgeons in the US and to identify workplace factors associated with increased risk compared with a sociodemographically similar nonsurgeon population. Design, Setting, and Participants This self-administered survey questionnaire was electronically distributed and collected from November 2020 to January 2021 through multiple surgical societies in the US and social media among male and female attending and resident surgeons with children. Nonchildbearing surgeons were asked to answer questions regarding the pregnancies of their nonsurgeon partners as applicable. Exposures Surgical profession; work, operative, and overnight call schedules. Main Outcomes and Measures Descriptive data on pregnancy loss were collected for female surgeons. Use of assisted reproductive technology was compared between male and female surgeons. Pregnancy and neonatal complications were compared between female surgeons and female nonsurgeon partners of surgeons. Results A total of 850 surgeons (692 women and 158 men) were included in this survey study. Female surgeons with female partners were excluded because of lack of clarity about who carried the pregnancy. Because the included nonchildbearing population was therefore made up of male individuals with female partners, this group is referred to throughout the study as male surgeons. The median (IQR) age was 40 (36-45) years. Of 692 female surgeons surveyed, 290 (42.0%) had a pregnancy loss, more than twice the rate of the general population. Compared with male surgeons, female surgeons had fewer children (mean [SD], 1.8 [0.8] vs 2.3 [1.1]; P < .001), were more likely to delay having children because of surgical training (450 of 692 [65.0%] vs 69 of 158 [43.7%]; P < .001), and were more likely to use assisted reproductive technology (172 of 692 [24.9%] vs 27 of 158 [17.1%]; P = .04). Compared with female nonsurgeon partners, female surgeons were more likely to have major pregnancy complications (311 of 692 [48.3%] vs 43 of 158 [27.2%]; P < .001), which was significant after controlling for age, work hours, in vitro fertilization use, and multiple gestation (odds ratio [OR], 1.72; 95% CI, 1.11-2.66). Female surgeons operating 12 or more hours per week during the last trimester of pregnancy were at higher risk of major pregnancy complications compared with those operating less than 12 hours per week (OR, 1.57; 95% CI, 1.08-2.26). Compared with female nonsurgeon partners, female surgeons were more likely to have musculoskeletal disorders (255 of 692 [36.9%] vs 29 of 158 [18.4%]; P < .001), nonelective cesarean delivery (170 of 692 [25.5%] vs 24 of 158 [15.3%]; P = .01), and postpartum depression (77 of 692 [11.1%] vs 9 of 158 [5.7%]; P = .04). Conclusions and Relevance This national survey study highlighted increased medical risks of infertility and pregnancy complications among female surgeons. With an increasing percentage of women representing the surgical workforce, changing surgical culture to support pregnancy is paramount to reducing the risk of major pregnancy complications, use of fertility interventions, or involuntary childlessness because of delayed attempts at childbearing.
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Affiliation(s)
- Erika L Rangel
- Division of General and Gastrointestinal Surgery, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.,Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Manuel Castillo-Angeles
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.,Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Sarah Rae Easter
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Rachel B Atkinson
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Ankush Gosain
- Department of Surgery, University of Tennessee Health Science Center, Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis
| | - Yue-Yung Hu
- Division of Pediatric Surgery, Ann & Robert Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Zara Cooper
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.,Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Tanujit Dey
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Eugene Kim
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles
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Sherin M, Gildner TE, Thayer ZM. COVID-19-Related Changes to Pregnant People's Work-Plans Increase Prenatal Depression. Front Glob Womens Health 2021; 2:639429. [PMID: 34816196 PMCID: PMC8594024 DOI: 10.3389/fgwh.2021.639429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/22/2021] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic has caused unprecedented rates of unemployment in the United States. Pregnant workers may be especially affected as they are over-represented in low-wage service and hospitality industries impacted by the pandemic. We surveyed an online convenience sample of currently working pregnant people living in the U.S. (n = 1,417) to determine whether COVID-19-related changes to how long individuals planned to work during their pregnancy, and uncertainty about these changes, were associated with prenatal depression. As hypothesized, both COVID-19-related work-plan changes (OR = 1.81, 95% CI 1.36-2.42, p < 0.001) and uncertainty about the precise nature of these changes (OR = 2.62, 95% CI 1.14-6.0, p = 0.022) were associated with significantly higher odds of a clinically-significant depression score. These effects appeared to be even greater among individuals who continued working outside the home during the pandemic. Since the U.S. is one of the few countries in the world that does not guarantee paid parental leave, pregnant people may be forced to choose between keeping their jobs and risking infection during the COVID-19 pandemic. Our results demonstrate a need for immediate suspension of the eligibility requirements for the Family and Medical Leave Act and/or universal access to both paid family leave and prenatal depression screening. This would help to alleviate these concerns and provide pregnant people with more options while preserving their employment status and financial security.
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Affiliation(s)
- Margaret Sherin
- Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Theresa E. Gildner
- Department of Anthropology, Dartmouth College, Hanover, NH, United States
- Department of Anthropology, Washington University in St. Louis, St. Louis, MO, United States
| | - Zaneta M. Thayer
- Department of Anthropology, Dartmouth College, Hanover, NH, United States
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Baby Steps in the Right Direction: Toward a Parental Leave Policy for Gastroenterology Fellows. Am J Gastroenterol 2021; 116:505-508. [PMID: 33481380 DOI: 10.14309/ajg.0000000000001145] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/22/2020] [Indexed: 12/11/2022]
Abstract
The American Board of Medical Specialties announced in July 2020 the adoption of a parental leave policy for residents and fellows allows for a minimum of 6 weeks of leave. This policy includes caveats: vacation and/or sick leave can be applied toward these 6 weeks, this leave can only be utilized once during training (whether for parental, caregiver, or medical leave), and this policy only applies to training programs of 2 or more years' duration. Although the new existence of a parental leave policy is a step in the right direction, trainees are in need of a more robust and evidence-based policy. There are particular challenges to be addressed in the male-dominated and procedural field of gastroenterology, in which women are underrepresented and female gastroenterology trainees are more likely to have career decisions limited around the availability of parental leave. This article reviews the evidence supporting the creation of a parental leave policy for gastroenterology fellows, with potential benefits to individual trainees as well as the field, in order to promote equity, recruitment, retention, and advancement of women in gastroenterology.
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14
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Lee BC, Modrek S, White JS, Batra A, Collin DF, Hamad R. The effect of California's paid family leave policy on parent health: A quasi-experimental study. Soc Sci Med 2020; 251:112915. [PMID: 32179364 DOI: 10.1016/j.socscimed.2020.112915] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/06/2020] [Accepted: 03/08/2020] [Indexed: 11/27/2022]
Abstract
The U.S. is the only high-income country without a national paid family leave (PFL) policy. While a handful of U.S. states have implemented PFL policies in recent years, there are few studies that examine the effects of these policies on health. In this study, we tested the hypothesis that California's PFL policy-implemented in 2004-improved parent health outcomes. Data were drawn from the 1993-2017 waves of the Panel Study of Income Dynamics, a large diverse national cohort study of U.S. families (N = 6,690). We used detailed longitudinal sociodemographic information about study participants and a quasi-experimental difference-in-differences analytic technique to examine the effects of California's PFL policy on families who were likely eligible for the paid leave, while accounting for underlying trends in these outcomes among states that did not implement PFL policies in this period. Outcomes included self-rated health, psychological distress, overweight and obesity, and alcohol use. We found improvements in self-rated health and psychological distress, as well as decreased likelihood of being overweight and reduced alcohol consumption. Improvements in health status and psychological distress were greater for mothers, and reductions in alcohol use were greater for fathers. Results were robust to alternative specifications. These findings suggest that California's PFL policy had positive impacts on several health outcomes, providing timely evidence to inform ongoing policy discussions at the federal and state levels. Future studies should examine the effects of more recently implemented state and local PFL policies to determine whether variation in policy implementation and generosity affects outcomes.
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Affiliation(s)
- Bethany C Lee
- University of Pennsylvania Law School, Philadelphia, PA, USA
| | - Sepideh Modrek
- Health Equity Institute, San Francisco State University, San Francisco, CA, USA
| | - Justin S White
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA; Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Akansha Batra
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Daniel F Collin
- Department of Family & Community Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Rita Hamad
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA; Department of Family & Community Medicine, University of California San Francisco, San Francisco, CA, USA.
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Ortiz Worthington R, Feld LD, Volerman A. Supporting New Physicians and New Parents: A Call to Create a Standard Parental Leave Policy for Residents. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1654-1657. [PMID: 31299674 DOI: 10.1097/acm.0000000000002862] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Parents taking leave after the birth of a child is associated with significant benefits for infants, mothers, and fathers. Although nearly 40% of residents have or plan to have children during residency, there is no standard parental leave policy for these trainees. In this Perspective, the authors discuss the benefits of parental leave, synthesize findings about maternity bias and other negative effects of the current variable approaches to parental leave during residency, and explore underlying causes of the lack of a standard parental leave policy for residents. They also call on the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties to work together to address this issue, recommending a standard parental leave policy that ensures a minimum of 8 weeks of paid leave for all residents without requiring them to extend training or making them ineligible to sit for board certification exams. Creating evidence-based and family-friendly guidelines for parental leave is important to the progress of academic medicine in the modern era, as it supports parental and child health, promotes resident wellness, and reduces gender disparities in medicine to the benefit of all.
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Affiliation(s)
- Rebeca Ortiz Worthington
- R. Ortiz Worthington is a resident, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois. L.D. Feld was chief resident, Department of Internal Medicine, University of Chicago Medicine, Chicago, Illinois, at the time this article was written. She is currently a fellow in gastroenterology and hepatology, University of Washington School of Medicine, Seattle, Washington. A. Volerman is assistant professor, Departments of Medicine and Pediatrics, University of Chicago Medicine, Chicago, Illinois
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16
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Altieri MS, Salles A, Bevilacqua LA, Brunt LM, Mellinger JD, Gooch JC, Pryor AD. Perceptions of Surgery Residents About Parental Leave During Training. JAMA Surg 2019; 154:952-958. [PMID: 31389989 PMCID: PMC6686777 DOI: 10.1001/jamasurg.2019.2985] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 05/17/2019] [Indexed: 11/14/2022]
Abstract
Importance To our knowledge, there has been little research conducted on the attitudes of residents toward their pregnant peers and parental leave. Objective To examine the perceptions of current surgery residents regarding parental leave. Design, Setting, and Participants A 36-item survey was distributed to current US general surgery residents and residents in surgical subspecialties through the Association of Program Directors in Surgery listserv and social media platforms. Questions were associated with general information/demographics, parental leave, having children, and respondents' knowledge regarding the current parental leave policy as set by the American Board of Surgery. The study was conducted from August to September 2018 and the data were analyzed in October 2018. Main Outcomes and Measures Main outcomes included the attitudes of residents toward pregnancy and parental leave, parental leave policy, and the association of parental leave with residency programs. Results A total of 2188 completed responses were obtained; of these, 1049 (50.2%) were women, 1572 (75.8%) were white, 164 (7.9%) were Hispanic/Latinx, 75 (3.6%) were African American, 2 (0.1%) were American Indian or Alaskan Native, 263 (12.7%) were Asian, and 5 (0.2%) were Native Hawaiian or Pacific Islander. From the number of residents who had/were expecting children (581 [28.6%]), 474 (81.6%) had or were going to have a child during the clinical years of residency. Many residents (247 [42.5%]) took fewer than 2 weeks of parental leave. Many residents did not feel supported in taking parental leave (177 [30.4%] did not feel supported by other residents and 190 [32.71%] did not feel supported by the faculty). Only 83 respondents (3.8%%) correctly identified the current American Board of Surgery parental leave policy. Residents who took parental leave identified a lack of a universal leave policy, strain on the residency program, a loss of education/training time, a lack of flexibility of programs, and a perceived or actual lack of support from faculty/peers as the top 5 biggest obstacles to taking leave during the clinical years of residency. Conclusions and Relevance Most of the modifiable factors that inhibit residents from having children during residency are associated with policies (eg, a lack of universal leave policy and lack of flexibility) and personnel (eg, a strain on the residency program and lack of support from peers/faculty). These data suggest that policies at the level of the Accreditation Council for Graduate Medical Education or Resident Review Committee (RRC), as well as education and the normalization of pregnancy during training, may be effective interventions.
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Affiliation(s)
- Maria S. Altieri
- Section of Minimally Invasive Surgery, Washington University School of Medicine at St Louis, St Louis, Missouri
| | - Arghavan Salles
- Section of Minimally Invasive Surgery, Washington University School of Medicine at St Louis, St Louis, Missouri
| | - Lisa A. Bevilacqua
- Department of General Surgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - L. Michael Brunt
- Section of Minimally Invasive Surgery, Washington University School of Medicine at St Louis, St Louis, Missouri
| | - John D. Mellinger
- Department of Surgery, Southern Illinois University School of Medicine, Springfield
| | - Jessica C. Gooch
- Department of Surgery, University of Rochester Medical Center, Rochester, New York
| | - Aurora D. Pryor
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York
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17
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Gracey LE, Cronin M, Shinkai K, Mathes EF. Program Director and Resident Perspectives on New Parent Leave in Dermatology Residency. JAMA Dermatol 2019; 154:1222-1225. [PMID: 30167642 DOI: 10.1001/jamadermatol.2018.2878] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Lia E Gracey
- Department of Dermatology, Baylor Scott & White Health, Austin, Texas
| | - Morgan Cronin
- Department of Dermatology, University of California, San Francisco
| | - Kanade Shinkai
- Department of Dermatology, University of California, San Francisco.,Editor
| | - Erin F Mathes
- Department of Dermatology, University of California, San Francisco
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18
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Morain S, Schoen L, Marty M, Schwarz EB. Parental Leave, Lactation, and Childcare Policies at Top US Schools of Public Health. Am J Public Health 2019; 109:722-728. [PMID: 30896996 PMCID: PMC6459636 DOI: 10.2105/ajph.2019.304970] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To describe policies related to parental leave, breastfeeding, and childcare for faculty and staff at top schools of public health in the United States. METHODS We identified the top 25 schools of public health from the US News and World Report rankings. We reviewed each institutional Web site to identify publicly available policies as of July 2018. RESULTS For birth mothers, 80% (20/25) of the schools provided paid childbearing leave to faculty (mean = 8.2 weeks), and 48% (12/25) provided paid childbearing leave for staff (mean = 5.0 weeks). For nonbirth parents, 68% (17/25) provided paid parental leave for faculty and 52% (13/25) for staff (range = 1-15 weeks). We found that 64% (16/25) of the schools had publicly available lactation policies, and 72% (18/25) of the schools had at least 1 university-run on-campus childcare center. CONCLUSIONS The majority of top US schools of public health provide paid leave to faculty birth mothers. However, most schools fall short of the 14 weeks recommended by the American Public Health Association.
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Affiliation(s)
- Stephanie Morain
- Stephanie Morain is with the Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX. At the time of the study, Lauren Schoen was a research assistant at the Center for Medical Ethics & Health Policy, Baylor College of Medicine. Makenna Marty is a medical student at California Northstate University, Elk Grove. Eleanor Bimla Schwarz is with the Department of General Internal Medicine at University of California Davis, Sacramento
| | - Lauren Schoen
- Stephanie Morain is with the Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX. At the time of the study, Lauren Schoen was a research assistant at the Center for Medical Ethics & Health Policy, Baylor College of Medicine. Makenna Marty is a medical student at California Northstate University, Elk Grove. Eleanor Bimla Schwarz is with the Department of General Internal Medicine at University of California Davis, Sacramento
| | - Makenna Marty
- Stephanie Morain is with the Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX. At the time of the study, Lauren Schoen was a research assistant at the Center for Medical Ethics & Health Policy, Baylor College of Medicine. Makenna Marty is a medical student at California Northstate University, Elk Grove. Eleanor Bimla Schwarz is with the Department of General Internal Medicine at University of California Davis, Sacramento
| | - Eleanor Bimla Schwarz
- Stephanie Morain is with the Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, TX. At the time of the study, Lauren Schoen was a research assistant at the Center for Medical Ethics & Health Policy, Baylor College of Medicine. Makenna Marty is a medical student at California Northstate University, Elk Grove. Eleanor Bimla Schwarz is with the Department of General Internal Medicine at University of California Davis, Sacramento
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19
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Kaar JL, Sauder KA, Shapiro AL, Starling AP, Ringham BM, Johnson SL, Dabelea D. Infant Feeding Practices In a Diverse Group of Women: The Healthy Start Study. CLINICAL MEDICINE INSIGHTS-PEDIATRICS 2019; 13:1179556518824362. [PMID: 30718970 PMCID: PMC6348534 DOI: 10.1177/1179556518824362] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/09/2018] [Indexed: 11/17/2022]
Abstract
Background To describe infant feeding practices among a diverse group of mother-offspring pairs and identify factors associated with adherence to the American Academy of Pediatrics (AAP) recommendations. Methods Data were analyzed from 835 mother-offspring dyads in The Healthy Start Study, an ongoing longitudinal prebirth cohort in Denver, Colorado. Maternal report of infant feeding practices was obtained at 4 to 6 months and 18 to 24 months postnatally. Practices were classified according to the following AAP recommendations: exclusive breastfeeding for first 6 months, continued breastfeeding through 12 months, and introduction of solid foods around 6 months of age. Participants who met all 3 recommendations were categorized as "adherent." All others were categorized as "not adherent." Results About 77% of dyads did not adhere fully to the AAP recommendations. Women who worked ⩾35 hours/week or had a higher prepregnancy body mass index were more likely to be nonadherent. Women who were older, college educated, or had offspring with greater weight for gestational age at birth were less likely to be nonadherent. Conclusions Most of the women in a large contemporary cohort are not adhering to AAP infant feeding recommendations. Our results highlight the specific subgroups of women who may need additional support to optimize infant feeding practices.
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Affiliation(s)
- Jill Landsbaugh Kaar
- Department of Pediatrics, School of Medicine, University of Colorado, Anschutz Medical Campus
| | - Katherine A Sauder
- Department of Pediatrics, School of Medicine, University of Colorado, Anschutz Medical Campus
| | - Allison Lb Shapiro
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus
| | - Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus
| | - Brandy M Ringham
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus
| | - Susan L Johnson
- Department of Pediatrics, School of Medicine, University of Colorado, Anschutz Medical Campus
| | - Dana Dabelea
- Department of Pediatrics, School of Medicine, University of Colorado, Anschutz Medical Campus.,Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus
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20
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Hamad R, Modrek S, White JS. Paid Family Leave Effects on Breastfeeding: A Quasi-Experimental Study of US Policies. Am J Public Health 2018; 109:164-166. [PMID: 30359107 DOI: 10.2105/ajph.2018.304693] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To test whether paid family leave policies in California and New Jersey improved breastfeeding practices, overall and among key subgroups.Methods. We conducted difference-in-differences analyses, comparing pre-post policy changes in California and New Jersey with changes in states where no paid family leave policies were implemented. We examined a large, diverse sample of children born during 2001 to 2013 (n = 306 266), drawn from the 2003 to 2015 National Immunization Survey waves. Outcomes included ever breastfed, breastfed exclusively at 3 and 6 months, and still breastfed at 6 and 12 months, as well as duration of any breastfeeding and exclusive breastfeeding. We examined heterogeneity in policy response by maternal characteristics.Results. Paid family leave policies resulted in a modestly greater likelihood of exclusively breastfeeding at 6 months. Subgroup analyses were mixed, although several breastfeeding outcomes were consistently improved among married, White, higher-income, and older mothers.Conclusions. Exclusive breastfeeding improved after implementation of paid family leave policies in the overall sample, and additional benefits were noted for more advantaged mothers. This contributes critical evidence to an ongoing policy discussion, suggesting that subsequent paid family leave policies should be designed to target more vulnerable mothers.
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Affiliation(s)
- Rita Hamad
- Rita Hamad is with the Philip R. Lee Institute for Health Policy Studies and the Department of Family & Community Medicine, University of California, San Francisco. Sepideh Modrek is with the Health Equity Institute, San Francisco State University, San Francisco. Justin S. White is with the Philip R. Lee Institute for Health Policy Studies and the Department of Epidemiology & Biostatistics, University of California, San Francisco
| | - Sepideh Modrek
- Rita Hamad is with the Philip R. Lee Institute for Health Policy Studies and the Department of Family & Community Medicine, University of California, San Francisco. Sepideh Modrek is with the Health Equity Institute, San Francisco State University, San Francisco. Justin S. White is with the Philip R. Lee Institute for Health Policy Studies and the Department of Epidemiology & Biostatistics, University of California, San Francisco
| | - Justin S White
- Rita Hamad is with the Philip R. Lee Institute for Health Policy Studies and the Department of Family & Community Medicine, University of California, San Francisco. Sepideh Modrek is with the Health Equity Institute, San Francisco State University, San Francisco. Justin S. White is with the Philip R. Lee Institute for Health Policy Studies and the Department of Epidemiology & Biostatistics, University of California, San Francisco
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21
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Access to Paid Parental Leave for Academic Surgeons. J Surg Res 2018; 233:144-148. [PMID: 29397145 DOI: 10.1016/j.jss.2018.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 11/15/2017] [Accepted: 01/03/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Parental leave is linked to health benefits for both child and parent. It is unclear whether surgeons at academic centers have access to paid parental leave. The aim of this study was to determine parental leave policies at the top academic medical centers in the United States to identify trends among institutions. METHODS The top academic medical centers were identified (US News & World Report 2016). Institutional websites were reviewed, or human resource departments were contacted to determine parental leave policies. "Paid leave" was defined as leave without the mandated use of personal time off. Institutions were categorized based on geographical region, funding, and ranking to determine trends regarding availability and duration of paid parental leave. RESULTS Among the top 91 ranked medical schools, 48 (53%) offer paid parental leave. Availability of a paid leave policy differed based on private versus public institutions (70% versus 38%, P < 0.01) and on medical center ranking (top third = 77%; middle third = 53%; and bottom third = 29%; P < 0.01) but not based on region (P = 0.06). Private institutions were more likely to offer longer paid leaves (>6 wk) than public institutions (67% versus 33%; P = 0.02). No difference in paid leave duration was noted based on region (P = 0.60) or rank (P = 0.81). CONCLUSIONS Approximately, 50% of top academic medical centers offer paid parental leave. Private institutions are more likely to offer paid leave and leave of longer duration. There is considerable variability in access to paid parenteral leave for academic surgeons.
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22
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Hewitt B, Strazdins L, Martin B. The benefits of paid maternity leave for mothers' post-partum health and wellbeing: Evidence from an Australian evaluation. Soc Sci Med 2017; 182:97-105. [PMID: 28437694 DOI: 10.1016/j.socscimed.2017.04.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/01/2017] [Accepted: 04/09/2017] [Indexed: 11/28/2022]
Abstract
This paper investigates the health effects of the introduction of a near universal paid parental leave (PPL) scheme in Australia, representing a natural social policy experiment. Along with gender equity and workforce engagement, a goal of the scheme (18 weeks leave at the minimum wage rate) was to enhance the health and wellbeing of mothers and babies. Although there is evidence that leave, especially paid leave, can benefit mothers' health post-partum, the potential health benefits of implementing a nationwide scheme have rarely been investigated. The data come from two cross-sectional surveys of mothers (matched on their eligibility for paid parental leave), 2347 mother's surveyed pre-PPL and 3268 post-PPL. We investigated the scheme's health benefits for mothers, and the extent this varied by pre-birth employment conditions and job characteristics. Overall, we observed better mental and physical health among mothers after the introduction of PPL, although the effects were small. Post-PPL mothers on casual (insecure) contracts before birth had significantly better mental health than their pre-PPL counterparts, suggesting that the scheme delivered health benefits to mothers who were relatively disadvantaged. However, mothers on permanent contracts and in managerial or professional occupations also had significantly better mental and physical health in the post-PPL group. These mothers were more likely to combine the Government sponsored leave with additional, paid, employer benefits, enabling a longer paid leave package post-partum. Overall, the study provides evidence that introducing paid maternity leave universally delivers health benefits to mothers. However the modest 18 week PPL provision did little to redress health inequalities.
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Affiliation(s)
- Belinda Hewitt
- School of Social and Political Sciences, The University of Melbourne, Parkville, VIC 3010, Australia.
| | - Lyndall Strazdins
- National Centre for Epidemiology and Population Health, Australian National University, Australia
| | - Bill Martin
- Institute for Social Science Research, The University of Queensland, Australia
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Burtle A, Bezruchka S. Population Health and Paid Parental Leave: What the United States Can Learn from Two Decades of Research. Healthcare (Basel) 2016; 4:E30. [PMID: 27417618 PMCID: PMC4934583 DOI: 10.3390/healthcare4020030] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 05/18/2016] [Accepted: 05/24/2016] [Indexed: 11/17/2022] Open
Abstract
Over the last two decades, numerous studies have suggested that dedicated time for parents to be with their children in the earliest months of life offers significant benefits to child health. The United States (US) is the only wealthy nation without a formalized policy guaranteeing workers paid time off when they become new parents. As individual US states consider enacting parental leave policies, there is a significant opportunity to decrease health inequities and build a healthier American population. This document is intended as a critical review of the present evidence for the association between paid parental leave and population health.
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Affiliation(s)
- Adam Burtle
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA.
| | - Stephen Bezruchka
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA.
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