Statement on the importance of parental leave

The following statement was developed by the American College of Surgeons (ACS) Women in Surgery Committee to support surgeons who choose to have children. The ACS Board of Regents approved the statement at its February 2016 meeting in Chicago, IL.

The College recognizes that a successful surgical career should not preclude a surgeon’s choice to be a parent. Surgeons who choose to have children (whether through the pregnancy of the surgeon or the surgeon’s partner, a surrogate, or adoption) have made an equivalent commitment and investment in their surgical careers as those individuals who choose not to have children. Choosing to become a parent does not detract from one’s full professional commitment as a surgeon. As a profession, surgery should be supportive of healthy pregnancy outcomes and should not impose punitive repercussions on those surgeons who choose to have children.

Parental leave terms should be explicitly included in all employment contracts. The following guidelines provide a framework for a parental leave policy:

  • The surgeon will inform appropriate team members of the pregnancy or anticipated adoption in a timely fashion to allow for accommodation of anticipated absence from professional duties. The team has a responsibility to support the medical needs of the surgeon and to keep health care information confidential. The surgeon will work together with the team to create a schedule that is flexible and equitable for the surgeon taking leave and all others who will be affected by the absence. Surgeons should not be expected to make up for call missed during leave.
  • The Family Medical Leave Act (FMLA) of 1993 allows employees to take up to 12 weeks of unpaid leave for certain reasons, such as the birth of the child, to care for a newly adopted child, or placement of the child with the individual for adoption, presuming the surgeon is employed by an organization meeting the criteria of the law and the surgeon meets the eligibility criteria for FMLA and has FMLA time available. The ACS supports maternity leave of no less than six weeks (vaginal delivery)/eight weeks (cesarean section) and paternity leave of not less than six weeks.

    Payment for parental leave should be negotiated between the surgeon and the employer. If a surgical practice or employing organization is unable to provide paid parental leave, the surgeon should not be responsible for costs to the practice during the period of leave.

    The ACS encourages institutions and practices that are exempt from the FMLA law to voluntarily allow new parents to take unpaid leave consistent with what is provided by the FMLA, if requested. In addition, the ACS encourages an individualized assessment of requests for reasonable accommodations of pregnancy-related conditions during pregnancy in accordance with applicable federal and state laws.

  • To encourage a positive return to practice, surgeons should not be required to make up call coverage for the period of absence. Upon return from leave, surgeons who intend to breastfeed should be allowed flexibility to support expressing breast milk. Nursing mother break time provisions in the Patient Protection and Affordable Care Act of 2010, which amended Section 7 of the Fair Labor Standards Act, require covered employers to provide eligible employees with reasonable break time in a private place other than a bathroom to express breast milk for one year following the birth of a child. Parental leave should not be a factor when making decisions regarding benefits, promotion, or continued employment.

Bibliography

California Department of Fair Employment and Housing. Fair Employment and Housing Act. Available at: www.dfeh.ca.gov/Publications_FEHADescr.htm. Accessed February 18, 2016.

Eskenazi L, Weston J. The pregnant plastic surgical resident: Results of a survey of women plastic surgeons and plastic surgery residency directors. Plast Reconstr Surg. 1995;95(2):330-335.

Grunebaum A, Minkoff H, Blake D. Pregnancy among obstetricians: A comparison of births before, during, and after residency. Am J Obstet Gynecol. 1987;157(1):79-83.

Hamilton AR, Tyson MD, Braga JA, Lerner LB. Childbearing and pregnancy characteristics of female orthopaedic surgeons. J Bone Joint Surg Am. 2012;94(11):e77.

Lerner LB, Stallman KL, Gulla VD. Birth trends and pregnancy complications among women urologists. J Am Coll Surg. 2009;208(2):293-297.

U.S. Department of Labor. Wage and Hour Division. Family and Medical Leave Act. Available at: www.dol.gov/whd/fmla/. Accessed February 18, 2016.

U.S. Department of Labor. Wage and Hour Division. Section 7(r) of the Fair Labor Standards Act—Break Time for Nursing Mothers Provision, Patient Protection and Affordable Care Act amendment. Available at: www.dol.gov/whd/nursingmothers/sec7rflsa_btnm.htm. Accessed February 18, 2016.

U.S. Equal Employment Opportunity Commission. Enforcement guidance: Pregnancy discrimination and related issues. Available at: www.eeoc.gov/laws/guidance/pregnancy_guidance.cfm. Accessed February 18, 2016.

U.S. Equal Employment Opportunity Commission. Pregnancy Discrimination Act of 1978. Available at: www.eeoc.gov/laws/statutes/pregnancy.cfm. Accessed February 18, 2016.

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