Purpose

To characterize how female residents make decisions about childbearing, factors associated with the decision to delay childbearing, and satisfaction with these decisions.

Method

In 2017, the authors sent a voluntary, anonymous survey to 1,537 female residents enrolled across 78 graduate medical education programs, consisting of 25 unique specialties, at 6 US academic medical centers. Survey items included personal, partner, and institutional characteristics, whether the respondent was delaying childbearing during residency, and the respondent’s satisfaction with this decision.

Results

The survey response rate was 52%(n= 804). Among the 447 (56%) respondents who were married or partnered, 274 (61%) were delaying childbearing. Residents delaying childbearing were significantly more likely to be younger (P<. 001), not currently a parent (P<. 001), in a specialty with an uncontrollable lifestyle (P=. 001), or in a large program (P=. 004). Among self-reported reasons for delaying childbearing, which were not mutually exclusive, the majority cited a busy work schedule (n= 255; 93%) and desire not to extend residency training (n= 145; 53%). Many cited lack of access to childcare (n= 126; 46%), financial concerns (n= 116; 42%), fear of burdening colleagues (n= 96; 35%), and concern for pregnancy complications (n= 74; 27%). Only 38%(n= 103) of respondents delaying childbearing were satisfied with this decision, with satisfaction decreasing with increasing age.

Conclusions

Decisions to delay childbearing are more common in certain specialties, and many residents who delay childbearing are not satisfied with that decision. These findings suggest that greater attention is needed overall, and particularly in certain specialties, to promote policies and cultures that both anticipate and normalize parenthood in residency, thus minimizing the conflict between biological and professional choices for female residents.