Motherhood Forced My Exit from Emergency Room Leadership

At the age of 33, I assumed the roles of emergency department medical director and chair. Perhaps naively, I believed I could use my new position to enhance our emergency department for everyone, especially for our female staff and patients.

Studies have demonstrated that women physicians are more inclined to adhere to evidence-based clinical guidelines, provide preventive care, engage empathetically with patients, perform equally well (if not better) on outcomes, and deliver superior care to their patients compared to their male counterparts. One study even revealed that patients treated by women physicians experienced lower mortality and readmission rates. I presumed that a woman in a leadership position might offer similar advantages. However, that wasn’t exactly how things unfolded.

Almost immediately, I encountered microaggressions and obstacles to implementing meaningful change. There was an executive administrator who disputed my title, a chair of medicine who refused to let me speak during meetings, and a per-diem physician with a history of sexist behavior reported by nurses and patients. I attempted to remove him from the schedule—a relatively simple process for contractors like him—but my boss continued to support him. A few months later, he failed to diagnose a patient’s ectopic pregnancy, which nearly cost her life. He dismissed the pain caused by her ruptured fallopian tube as mere hysteria. Despite my best efforts, I had been unable to protect this patient from the sexism of one of our physicians.

When I became pregnant myself, the situation only deteriorated. Although I had intentionally postponed pregnancy until after completing my medical training—a decision shared by many of my female colleagues but few of the men—I also didn’t wish to delay starting a family for too long. Research indicates that female physicians face higher rates of infertility and pregnancy complications than the general population, risks that only increase with age.

During my first trimester, I constantly felt a combination of flu-like symptoms and car-sickness. On one occasion, I went directly from working a shift to checking in as a patient. Yet, this wasn’t something I wanted to discuss, as I didn’t wish to be perceived as weak. I felt pressured to fill vacant spots in our schedule, but working extensively during the third trimester can lead to poorer health outcomes for both mother and baby. I did everything I could and worked right up to my due date, as I was not eligible for paid parental leave through my job. Although I was expected to heal others, my job made it impossible to adequately care for myself and my baby.

After my daughter was born, we faced unexpected medical complications that required additional hospital stays and procedures. Subsequently, we struggled to find suitable daycare for our daughter. In our Oakland neighborhood, many daycares have two-year-long waitlists, meaning we would have needed to apply and pay a deposit even before I became pregnant. I felt I had no choice but to bring my baby to hospital meetings, something I worried made me appear unprofessional in the eyes of my older, male colleagues.

As I wanted my baby to receive the health benefits of breast milk, I had to slip away during busy ER shifts every 4 hours to pump. However, even a 15-minute absence often meant I was late to trauma cases or cardiac arrests. To be more efficient, I tried a “discrete” pump that fit into my bra, allowing me to pump while seeing patients, with no break needed. But then I developed painful, clogged ducts that later required hours of care to resolve. It felt impossible to accommodate the needs of my lactating, peripartum body—a struggle I had never experienced as an able-bodied person. Suddenly, I had more empathy for many of my patients.

And although motherhood was shaping me into a more capable doctor, I felt like I was failing both at work and at home, with migraines, anxiety, sleep deprivation, and mom-guilt as my constant companions. I began to question if it was all worth it, especially since I hadn’t been able to make any of the significant changes I had hoped for. My choice seemed formidable: suffer in a misogynistic work environment to try and improve it for other women, or find a job that was more supportive yet less influential.

Ultimately, I resigned and accepted a lower-paying job as an assistant professor. Because there wasn’t a single, dramatic event that forced me out of my role, I felt like a statistic, further proving that women—especially mothers—are unsuitable leaders. But according to researcher Joan Williams, my experience was not unique; this was the exact pattern that preceded the departure of so many women from academics. Jessica Williams, the cofounder and chief executive of Mothers in Science, explained that because the obstacles facing mothers in STEM are largely invisible, women, as well as those around them, assume that all it takes to succeed is hard work and determination. So, when a woman finally chooses to walk away from the fallout of systemic failings, it is framed as a personal decision.

Almost immediately, my life became markedly easier. No longer fighting against the status quo, my job was less of a struggle. I was happier, both at work and at home. My health improved. Yet, a part of me felt like I had abandoned the women I wanted to serve. I tried to alleviate my guilt by telling myself that I could effect more change from a more supported role. And while that has been true, we still need more women in leadership roles.

Although I transitioned from one full-time job to another, many of my female colleagues are leaving medicine altogether. Even though men and women now matriculate into medical schools in equal numbers, a significant percentage of women physicians scale back their practice or completely leave medicine within six years of finishing residency. The main reason? Family.

While gender harassment, salary inequity, and gender bias all limit women’s career opportunities in medicine, work-family conflict during the early years of a physician’s career may have an even greater impact. According to a 2018 study, within six years of completing training, 3.6% of men physicians are not working full-time, compared with 4.6% of childfree women physicians and a whopping 30.6% of women physicians who are also mothers. But healthcare needs them.

It seems absurd to have to argue for the value of women in medicine in this modern age, but the current political landscape threatens to erode our role even further. With federal policies aimed at slashing accommodations that improve work-family balance, we risk losing even more women from medicine. Instead, we need the opposite—more social and institutional support for work-family balance that allows both women and men to be parents and physicians. It’s simply better healthcare.