I opened my email this morning to find a list of curated articles on Women in Medicine. The second article listed, “Should women in medicine be freezing their eggs?” quickly got my attention. Admittedly, it was not a topic I had considered previously, but one that after reading was not easily shaken from my thoughts that day.
The idea, promoted by top corporate institutions and now being adopted at prestigious academic medical centers, is that women are postponing their prime childbearing years to focus on their education and careers. Naturally, this comes at the risk of infertility down the road. As such, the offer of preserving your fertility now by freezing your eggs only to be able to use at a more opportune time, is an attractive option for some. Four years ago, when the idea was first publicized, it was under the heading “Freeze your eggs, Free your career” in Bloomberg Businessweek.
I believe that proponents of this idea are well intentioned. The perpetual quest for balance of career and family is difficult for many professional women, and one arguably renewed each day. Compound that with the struggles with miscarriage and infertility of those who do postpone having children for sake of career, it is truly heartbreaking and worthy of finding solutions. Step outside the house of medicine, and the culture wars on motherhood alone comes with standards set impossibly high that perpetually whisper to women they cannot and should not do it all.
The systemic encouragement of the long-term postponement of female fertility, however, is actually one that I find counter-intuitively destructive to the advance of women in the workplace. It perpetuates the myth that women must sacrifice at any given time either personal and professional success and promotes an environment that women must deny a part of themselves to achieve the same level of respect and success as their male counterparts. Women, like men, should be given the equal opportunity to be able to pursue both at any given time as they see fit. Women are capable of achievement and success when they are more fully themselves and allowed to flourish in an environment that promote their unique contributions to their work and family.
To be clear, I am in no way intending to be critical of women who choose to postpone childbearing years to pursue their professional career or the methods that they choose to do so. Rather, I intend to bring awareness to the fact that by offering and promoting these options, it allows corporations, and more specifically the field of medicine, to avoid much more difficult systemic changes which would maximize all women’s ability to successfully integrate their personal and professional lives.
Some of these corporations, Google for example, have also been public about their support of paid maternity leave and flexible scheduling to offer their employees the true benefit of choice. The house of medicine, however, has not yet embraced this idea, especially during the formative years of medical school and residency. It’s time that the field of medicine takes a page from the cultural competency lectures we receive during training and turn inward to solve the structural barriers that leave women in medicine thinking that oocyte cryopreservation may be their best option for “having it all”. The fact this solution exists is a symptom of a damaged system that allows men to continue on the speeding train of medical training without interruption, but leaves women forced to choose to stay on course or face prolonged and costly interruptions sometimes at the ultimate cost of leaving medicine entirely.
The number of women entering the profession has matched the number of men for quite some time. However, at every phase of training and beyond in the pursuit of academic and administrative careers, there are fewer women than the level prior. There are significantly fewer women who are subspecialists, full professors, department chairs, or involved in hospital leadership.
The pace required is dictated so that completion of the curriculum will allow trainees to be on cycle for interview season and then the all-important Match. The cycle further continues so that physicians can maintain the schedule for completion of board certification and fellowship positions and new employment opportunities. Disruptions not only contribute to being forced off-cycle for up to a full year until eligible for the next cycle, this system places female physicians in a financially vulnerable position as well as any delays that exceed the grace period for student loans puts them into repayment. Additionally, while illegal to ask about one’s plans for family or children in an interview setting, women who have taken any time off cycle are forced to account for that time during interviews, divulging sensitive information that male counterparts would not have had to divulge. By failing to recognize this, we continue to set women up for failure and injustice. At a minimum, women may struggle with inadequacy compared to their male counterparts. At worst, women may leave the profession of medicine altogether.
If our patients came to us and requested a costly and invasive procedure as a potential solution to systemic sexism, racism or other cultural biases in their own lives, would we be complicit in agreeing to their requests, or would we want better for them and seek justice for them by calling attention to the underlying broken system? The empowerment of women in medicine does not lie here. Instead of promoting costly, invasive, risky and unproven technologies to help women postpone their fertility, we should be innovating and promoting changes to the culture of medicine that allow women to enter medicine and succeed at every phase of training and practice.
Dr. Kathryn Redinger, MD, FACEP, practices emergency medicine full time. As a mom of 5, she has had a child at every level of medical training. A Clinical Assistant Professor at Western Michigan University Homer Stryker M.D. School of Medicine, she promotes leadership, wellness and career formation of physicians-in-training.