WOMEN IN EMERGENCY MEDICINE SECTION
Championing Flexible Scheduling for Pregnancy and Parenthood in Emergency Medicine Elspeth Pearce, MD FAAEM
I
f you are waiting for the right time, it will never come. This adage is used frequently in all realms of work and personal life to prompt individuals to take a chance before all conditions are perfect. I have heard it time and time again regarding being a woman in medicine and family planning. The best time to plan a pregnancy often physiologically overlaps with some of the most difficult years in training and beginning our careers. If we don’t want to sacrifice progress in our careers, we have tough choices to make. We can try to “have it all” and balance long hours with a growing family, or we wait to have an established stable career and risk infertility and miscarriage. Either choice increases the health risk to the pregnant physician and the unborn child.1-9 Emergency medicine physicians have the added risk of shift work. Rapid cycling between night and day shifts significantly increases the risk of pregnancy complications including miscarriage, preterm labor, and intrauterine growth restriction, among other complications.1-5,8,9 The United States is woefully behind other countries when it comes to supporting pregnancy, breastfeeding, and parental leave.10 The federal government provides some guidance through legal frameworks like the Pregnant Workers Fairness Act, the Family and Medical Leave Act (FMLA), and the PUMP Act, but there are still significant hurdles for pregnant physicians in prioritizing personal health without compromising their professional duties. Emergency physicians work in an environment unlike many other medical careers, and as such, we should go above and beyond the bare minimum standards to support our colleagues. The AAEM Joint Young Physician Section and Women in Emergency Medicine Section Position Statement on Scheduling Recommendations During Pregnancy, the Postpartum Period, and Parental Leave outlines
the need for flexible scheduling initiatives including eliminating night shifts in the first and third trimesters, allowing exemptions for working over contract hours in the third trimester, and providing adequate time and resources for pumping while on shift.11 It also presents scheduling and staffing considerations regarding the increasingly common medical needs for situations of fertility treatments and miscarriages.11 As emergency physicians, we frequently care for others who experience pregnancy complications and loss, and we empathize with this vulnerable time in their lives. I would bet that you know colleagues who have struggled through similar circumstances. As AAEM board member Dr. Kraftin Schreyer states, “As both a medical director and mother, who oversees the schedules for a large ED group and has been through every iteration of pregnancy outlined in this position statement, I can say this is much needed. I’m very proud to stand behind a statement that promotes the health of mother and baby in a way that is the most fair and equitable to the larger ED group.” By embracing flexibility in scheduling, we’re creating a culture of care and compassion that resounds throughout our individual departments and our specialty. Well-supported physicians are happier, more productive, and less likely to experience burnout or turnover, which ultimately benefits the entire healthcare system.12 As part of the working group on this statement, I have spent a lot of time reflecting on what this position statement means to me personally. I am a woman in medicine without children. For now, I am in the demographic of EM physicians who would be creatively scheduled to help others achieve their family goals. From that perspective, I see this position statement as progressive and equitable, and I am delighted that the AAEM board agreed. Lead author of the position statement, Dr. Jennifer Rosenbaum, Continued on page 32 >>
With thoughtful planning, collaboration, and a commitment to shared goals, flexible scheduling can be successfully implemented to the benefit of all. Now is the right time.”
COMMON SENSE MAY/JUNE 2024
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