Childbearing, Adoption, Motherhood, and Eldercare by Women in Pediatrics

This chapter explores the chronology of challenges faced by women in pediatrics from childbearing and adoption through motherhood and eldercare. At the outset of their careers, women in medicine commonly face reproductive barriers with one in four reporting a diagnosis of infertility. During the childbearing process, the AAP recommended 12-week duration of paid maternity leave is unfortunately not a typical option for women physicians, with most resident physicians taking only 6.6 weeks of leave and academic faculty taking an average of 8.6 weeks. Challenges continue for women pediatricians when they return after family leave, facing barriers related to inadequate support for breast pumping and childcare. As careers progress, women pediatricians are more likely to report having increased household responsibilities and the provision of eldercare. About 17% of women pediatricians report having additional caretaking responsibility in addition to childcare for their own children. These additional caretaking roles negatively impact productivity and the ability to take leadership roles. This impact has been further exacerbated in the COVID-19 pandemic. To address these gender disparities, policies are needed that promote fair leave, access to childcare, and flexible scheduling and support for eldercare as well as providing adequate mentorship and support from physician colleagues. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Women Authorship Trends in the Highest-Impact Anesthesiology Journals from 2005 to 2021.

Background: Although women and men have matriculated into medical schools in similar proportions since the 1980s, recent data indicate that anesthesiology is lagging in gender equity, especially in academic leadership roles.1,2 As promotion in academic medicine is strongly influenced by publications, understanding whether a lack of women authorship is contributing to this gender gap is crucial.3,4 This article aims to assess how woman authorship trends have changed in the last 16 years, including during the COVID-19 pandemic. Materials and Methods: The five highest impact journals in anesthesia were identified as Journal of Clinical Anesthesia, British Journal of Anaesthesia, Anesthesiology, PAIN, and Regional Anesthesia & Pain Medicine. Number of total authors, including women, men, and unknown gender authors as well as incidence of woman first and/or last author, was documented from articles published in 2005, 2010, 2015, 2020, and 2021. Results: This analysis shows that women are gaining representation in anesthesia publications. Overall, there was a statistically significant increase in the total number of women authors and women first and last authorship. However, as of 2021, women still only represented ∼40% of total and first authors and ∼24% of last authors. In addition, increase in first/last woman authorship was not present in all journals when stratified. Conclusion: These journal differences may suggest the editorial evaluation process as a potential source of gender bias. There was a statistically significant relationship between women senior authors and articles with 50% or more women authors, indicating that woman mentorship is contributing to closing equity gap. These data present a starting point for further investigations into gender disparities within anesthesia to continue the forward progression for women in academic medicine.

Disproportionate Negative Career Impact of the COVID-19 Pandemic on Female Pediatric Cardiologists in the Northeast United States.

The COVID-19 pandemic has had a dramatic impact on practicing physicians, with effects in clinical practice, academic pursuits, research endeavors, and personal lives. Women in medicine have been uniquely impacted. We examined the impact of the pandemic on the careers of pediatric cardiologists in the Northeast with an anonymous online survey. Participants reported demographic data, information on work hours, administrative burden, career satisfaction, academic productivity, and burnout. We approached 490 cardiologists and received 127 completed surveys (response rate 26%; 49% female). Among all respondents, 72% reported increased burnout, 43% reported decreased career satisfaction, and 57% reported decreased academic productivity. In multivariable ordinal regression analysis, when compared to male physicians, females were 2.4 times more likely to report decreased overall career satisfaction (p = 0.027), 2.6 times more likely to report decreased academic productivity (p = 0.028), and 2.6 times more likely to report increased feelings of burnout "to a large degree" (p = 0.022). Among all respondents, decreased career satisfaction was independently associated with increased household responsibility (OR = 4.4, p = 0.001). Increased administrative burden was independently associated with decreased academic productivity (OR = 2.6, p = 0.038). Open-ended responses highlighted loss of community due to remote work and blurring of the boundaries between work and home. Conversely, respondents appreciated flexibility to work remotely. In conclusion, the majority of pediatric cardiologists in the Northeast experienced negative career impacts due to the COVID-19 pandemic. Important gender differences emerged, with female physicians disproportionately reporting increased burnout, decreased career satisfaction, and decreased academic productivity.

Sexual medicine programs for women across the life span: Lessons learned from a new initiative in a US-based academic medical center

In a self-report study of women presenting to a gynecological clinic, 9 out of 10 women reported a sexual health concern (Nusbaum 2003). These concerns are best addressed using a biopsychosocial approach to assessment, treatment and prevention drawing on medical, behavioral and psychological science. At an academic health center in the United States, The Women's Sexual Health Consultation Service was launched in 2019 to provide evaluation, education, treatment and prevention interventions using an integrated practice model. The interdepartmental program currently includes an Advanced Practice Nurse from the Department of Obstetrics and Gynecology as well as two clinical health psychologists from the Department of Psychiatry all with expertise in women's health and women's sexual medicine. Our interprofessional team collaborates closely with providers in women's primary care, medical, gynecologic and radiation oncology, urogynecology, colorectal surgery, among others. Review lessons learned from interdepartmental program design, funding, implementation, and evaluation of the Women's Sexual Health Consultation Service in an academic health center, summarize the types of sexual health concerns among women who presented to the integrated service, and highlight recommendations to generalize and/or adjust the program model to other types of health settings. Review the program implementation and evaluation process for the Women's Sexual Health Consultation Service, summarize the data on the women seen for care from April 23 2019 through June, 2021 (e.g., the number of unduplicated patients evaluated, their age, sexual health concerns, and treatment offered, etc), and outline program challenges and strategies to sustain and expand the initiative during and following the COVID-19 pandemic through virtual and in-person care. The Women's Sexual Health Consultation Service saw 198 women from April 23 2019 through June, 2021. Patients ranged in age from 21 to 72 (mean: 45 years). While most patients (33%) referred themselves to this program, other women were referred by obgyns, medical oncologists, women's primary care providers and gynecologic oncologists. Primary sexual health concerns included one or more of the following issues: pain (100), low desire (76), difficulty with orgasm (19), difficulty with arousal (12) and other (55). Additional findings will be presented on the types of treatment offered as well as patient and referring provider satisfaction with the new integrated sexual health consult service. Our interdepartmental Women's Sexual Health Consultation Service implemented a highly successful program that integrates sexual medicine, behavioral health, health psychology and sexual therapy to ensure access to state-of-the-art interprofessional education and care for women across the life span in all their diversities. We were able to sustain and expand this program through telehealth and in-person visits during the COVID-19 pandemic, and anticipate further growth in patient referrals and treatment modalities moving forward. Providers across disciplines also routinely refer to and collaborate with the program. Several components of the model are generalizable or adjustable to other women's health settings. Work supported by industry: no. [ FROM AUTHOR] Copyright of Journal of Sexual Medicine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)