Childbearing Among Women Cardiologists: The Interface of Experience, Impact, and the Law.

BACKGROUND: Maternity leave is highly variable in the United States given the lack of a federal workforce mandate. OBJECTIVES: The purpose of this study was to describe the experiences and impact of childbearing on women cardiologists and their careers, within a legal framework. METHODS: A survey was sent to women cardiologists, asking about their experiences while pregnant and on maternity leave. The incidence of complications and career impacts on the cardiologists was assessed. RESULTS: Of 323 respondents who had been pregnant as a practicing cardiologist, extra service or call before maternity leave was required in 37.2%. Of those who performed extra service or call, 17.5% were placed on bedrest before delivery, compared with 7.4% who did not perform extra service or call (P = 0.005). During the year of pregnancy, 41.2% experienced a salary decrease; only 7.4% had their relative value units prorated for time on maternity leave; 23.2% had no paid maternity leave. Self-reported pregnancy complications occurred in 36.5%, those with complications had a 60% greater chance of reporting that pregnancy adversely affected their career, compared with those without complications. Nearly three-fourths (237 respondents) reported experiencing at least one of several troubling practices that are illegal in many circumstances. CONCLUSIONS: Women cardiologists report wide variances in maternity leave in the United States, with many experiencing likely violations of the Family and Medical Leave Act or other statues. Childbearing issues in cardiologists should be addressed to improve the professional and personal lives of women cardiologists and the attractiveness of cardiology to potential trainees.

The Health Care Provider's Role in Securing Work Accommodations for Pregnant and Postpartum Patients.

Most women today are the primary, sole, or cobreadwinners for their families; their continued ability to work during and after pregnancy is crucial for their families' well-being. Midwives and other health care providers are regularly asked to provide work notes for patients who need adjustments to how, when, or where their job is done to continue working while maintaining a healthy pregnancy or breastfeeding. Whereas an improperly written work note can result in the patient being forced out on leave or losing their job, an effectively written work note from a health care provider can ensure the patient will receive the adjustments they need to stay safe and healthy on the job. Health care providers can also play an important role by incorporating discussions about workplace issues into care conversations. This article provides an overview of pregnancy-related employment rights, guidelines for writing effective work notes, and a discussion of common workplace issues patients face and how health care providers can respond.

Beyond Work-Life "Integration".

Research on the work-family interface began in the 1960s and has grown exponentially ever since. This vast amount of research, however, has had relatively little impact on workplace practice, and work-family conflict is at an all-time high. We review the work-family research to date and propose that a shift of attention is required, away from the individual experience of work and family and toward understanding how identity and status are defined at work. Several factors enshrine cherished identities around current workplace norms. The work devotion schema demands that those who are truly committed to their work will make it the central or sole focus of their lives, without family demands to distract them. Importantly, the work devotion schema underwrites valued class and gender identities: Work devotion is a key way of enacting elite class status and functions as the measure of a man--the longer the work hours and higher the demand for his attention, the better. Advocating change in the way work is done and life is lived meets resistance because it places these cherished identities at risk. Resistance to these identity threats keeps current workplace norms in place. This is why even the business case-which shows that current practices are not economically efficient-fails to persuade organizations to enact change. What is needed now is sustained attention to the implicit psychological infrastructure that cements the mismatch between today's workplace and today's workforce.

My Obstetrician Got Me Fired: How Work Notes Can Harm Pregnant Patients and What to Do About It.

Prenatal care providers are frequently asked to provide employment notes for their patients requesting medical leave or changes to work duties. Writing employment notes correctly can help patients negotiate for and obtain medically indicated workplace accommodations, allowing them to continue to work and earn an income. However, a poorly written or poorly timed note can jeopardize a patient's employment and salary. This commentary provides an overview of pregnancy-related employment laws and guidance in writing work accommodations letters that allow pregnant women to keep their jobs while maintaining a healthy pregnancy.