A National Survey of Pregnancy and Parental Leave Policies in Pediatric Emergency Medicine Fellowship Programs.

BACKGROUND: Knowledge of pregnancy and parental leave practices in US pediatric emergency medicine (PEM) fellowship programs is limited. Occupational exposures of emergency medicine (EM) such as night shifts and high cumulative work fatigue are linked to adverse pregnancy outcomes. Breastfeeding and other post-birth outcomes are improved by longer maternity leave and paid parental leave for both birthing and non-birthing parents. Professional organizations recommend offloading pregnant individuals from night shifts in the third trimester and providing up to 12 weeks of paid parental leave. OBJECTIVE: This study aims to describe pregnancy and parental leave policies and practices in U.S. pediatric emergency medicine (PEM) fellowship programs. METHODS: We distributed the survey to the PEM Program Director listserv, which includes 94 members representing 85 fellowship programs including both program directors (PDs) and assistant program directors (APDs). Data on policies and experiences of women and birthing parents were collected and analyzed using descriptive statistics. RESULTS: We received 51 responses to the survey, representing 60% of the 85 PEM fellowship programs in existence at the time of the survey. Of those to respond, most programs (75%) modify schedules for pregnant fellows. Most allow pregnant individuals to adjust shifts as desired. Most have no standardized stop date prior to delivery. Programs vary widely in their approach to parental leave, with FMLA and Short-Term Disability commonly used to plan paid leave. Most report between 4 and 8 weeks of parental leave for both birthing and non-birthing parents. Many fellows are required to make up missed shifts, despite the lack of minimum shift requirements in fellowship and the existence of a Training Waiver. CONCLUSION: Variability exists in policies across institutions regarding policies for pregnancy and parental leave for PEM fellows. The variability highlights a need for standardized guidelines to support new parents in PEM training.

Duke Scholars

Author Corrie Chumpitazi Pediatrics, Emergency Medicine