Attitudes Toward and Experiences of Pregnant Medical Students

by J. Caroline Carwie, Biology

Abstract: Pregnancy during medical school is becoming a more relevant topic as the average age of medical students increases and more women pursue medicine. Mothers can sometimes be viewed as less capable in the general workforce, raising the question of how pregnant students and mothers are viewed in the medical field. Many pregnant students did not report receiving judgment from their classmates but were often concerned about peer judgment and maintaining adequate performance nonetheless. Policies such as maternity leave and protected breastfeeding locations can be very helpful for pregnant medical students. However, these policies are very limited at some institutions—new mothers may have to take an entire year off of medical school due to lack of flexibility. Challenges facing pregnant women and mothers are also present during the matching processes for residency. Some women report being asked inappropriate or pointed questions during interviews. Additionally, even many established women doctors report having experienced discrimination due to maternity. It is also important to assess how the environment of medical school can affect pregnancy, as physicians have higher rates of infertility than the average population. This may be due to stress or the increased age at which physicians tend to have children, but the exact cause is largely unknown. Finally, the physical and emotional experiences of pregnancy can impact a student’s performance and experience in medical school. While many of these complexities are unavoidable if a woman wishes to have a child during medical school, institutions can help new mothers by acknowledging risks and implementing appropriate policies.

pregnancy, medical school, pregnant student, policies, stress, maternity

Throughout class, we have discussed various sociological phenomena that occur in the medical field. Medical schools foster a competitive and fast paced environment, which is particularly interesting to study. In particular, I have investigated the experiences of pregnant medical students. Currently, more women are entering medical school than ever before. According to the Association of American Medical Colleges (AAMC), women made up 54.6% of medical students in 2023. Additionally, the average age of medical students is increasing. According to John Hopkins University, the average age to begin medical school is 24. Thus, students are likely to finish medical school at 28 and complete residency between 31 and 35 years old. With the rising number of and age of women entering the medical field, pregnancy is likely to become increasingly common during medical school. This paper aims to investigate the effects of fellow students, medical school policies, and the attitudes of medical institutions concerning pregnant medical students.

Women certainly face challenges in the general workforce. In an experiment by Bernard and Correll, participants believed they were hosting job interviews for high paying, professional jobs (625). When given somewhat ambiguous interviewees, participants were more likely to favor nonmothers over mothers. Mothers were viewed as significantly less committed and competent than nonmothers (629). Based on this information, I predicted that with such a competitive environment, pregnant women may be looked down on by other medical students.

However, in many of the articles discussing pregnancies and motherhood during medical school, few women mentioned feeling looked down upon by others. Alternatively, many of the women doctors, such as Dr. Shruthi Mahalingaiah from Boston University, mentioned self-imposed pressure to keep up with colleagues. Dr. Habiba Tunau mentioned worrying about peers looking down on her, but never mentioned actually experiencing it (Tunau). Thus, their self- imposed pressure was not due to external judgment from peers, but a preconceived notion that they might experience it. Even in 1984, when fewer women students attended medical school, pregnancy did not seem to incur criticism from peers according to Dr. Perri Klass. Dr. Klass, who attended Harvard Medical School, said she felt as though many classmates viewed her as slightly young to have a baby (Klass). However, she also mentioned the kindness with which classmates treated her, even implying that sometimes they worried about her pregnancy too much. The stories of these women, along with many others, bring to light a common concern of pregnant students—being viewed as less than by their peers. This pressure to seem committed is not limited to pregnant students. As discussed in the book Why Surgeons Struggle with Work-Hour Reforms, residents often work over their designated number of hours (74-91). This is often due to their desire to seem competent and fully committed to the job. However, the difficulties that come with pregnancy and motherhood could exacerbate this concern and cause pregnant students to be viewed as incompetent. It is certainly beneficial to pregnant women that they do not generally seem to receive direct criticism from peers. However, the threat of that criticism is still an important stressor. As in any competitive workplace, it is important to foster a sense of healthy and uplifting motivation without looking down on those who do not display stereotypical pictures of commitment.

Another factor that hugely affects pregnant women are the policies, or lack thereof, in many medical schools concerning pregnancy. It is often difficult for new mothers to stay on track. At many medical schools, pregnant students must take a whole year off and then may continue with the medical class a year below them. This is troublesome to many students and puts pregnant women at a disadvantage. However, some schools, such as Harvard, now allow the opportunity to work on an academic project or research project during a set time off (“Pregnancy, Childbirth and Adoption during Medical School”). This opportunity allows mothers more flexible hours, while also preventing students from falling a whole year behind. Some institutions allow maternity leave to be taken from vacation time. These policies depend on both the institution and what year the student is in medical school. Other helpful policies, like protected pumping times and breastfeeding rooms, are being developed at various institutions. In addition to breastfeeding policies, childcare programs are also beneficial (Taylor et al). These provisions are promising and extremely helpful and need to be implemented into more medical programs to best support pregnant students.

As students transition from medical school to residency, they exchange one competitive environment for another. Many pregnant students continue to face challenges from medical staff and medical institutions. For example, medical students from one school reported significant rates of illegal and inappropriate questions in residency interviews. Of the around 70 students who responded, 31% had been asked about children and 10% had been asked about plans for pregnancy (Santan et al.). As described by author Ashley Altus, a woman named Dr. DeHoff did not want her potential residency programs to know she was newly pregnant due to fear of being discriminated against (Altus). Also, Dr. Langhals-Totino, another pregnant interviewee, mentioned that while interviewers did not directly mention her pregnancy, they asked pointed questions that were clearly aimed to understand her plan moving forward (Altus). The interviewers may be considering pregnancy as a factor in their hiring decisions, which, even when conducted in a covert manner, can clearly harm a woman’s chances of being hired. The idea that being pregnant makes a potential resident less desirable can be very damaging for women in medicine. Obviously, a new baby is an enormous commitment and requires a large investment of time. However, whether a woman must take some time off, rally a support system, or create an alternative plan, mothers can be perfectly capable residents. Nonetheless, this attitude of the interviewers and residency programs is a challenge pregnant women must overcome.

These concerns are not limited to medical students or residents. Women physicians also reported discrimination based on maternity. According to one survey for physician mothers, 36% faced discrimination due to maternity (Adesoye et al.). In this experiment, “maternal discrimination was … based on pregnancy, maternity leave, or breastfeeding” (Adesoye et al.). The fact that maternity specifically was mentioned as a discrimination factor displays the intersectionality between gender and parenthood. Women who have given birth to children face challenges that are distinct from both childless women and men with children.

Additionally, the environment in which medical students work, and the course content they study, can greatly impact a woman’s pregnancy. Dr. Klass, the Harvard student, discussed how learning about fetal abnormalities in depth during her pregnancy made her fears more specific and intense (Klass). While this coursework must be taught to medical students, the stress it may place on a pregnant mother should certainly be acknowledged. Also, as previously mentioned, the competitive environment of medical school fosters stress relating to one’s own competence. In fact, there is some concern that the stress of medical school and practicing medicine may be damaging to a woman’s fertility. It is estimated that women physicians have a higher rate of infertility (around 25%) than the average population (8-16%), although this topic is rarely discussed in medical school (Marshall et al.). This may be due to stress or the increased age at which physicians may tend to have children. Both of these risk factors could be decreased by implementing specific policies, as previously mentioned, to assist new mothers throughout their medical education and career.

Finally, the physical and emotional effects of being pregnant can clearly have an impact on a student’s ability to perform throughout medical school. Many mothers are nauseous, weak, and exhausted during pregnancy (Bai, et al.), and some can even be confined to bed rest (“Bed Rest during Pregnancy”). New mothers need time to physically recover after birth, and must navigate fluctuating hormone levels throughout pregnancy and birth. Medical school is already intense and challenging. These pregnancy symptoms, along with perceived judgment from others, school or hospital policies, and the intense environment of medical institutions makes having a baby in medical school a challenge. However, none of the women doctors I read about seemed to regret their decision. It is certainly possible to be a successful and committed medical student while also starting a family.

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Citation Style: MLA