Alignment of United States Emergency Medicine Programs' Pregnancy, Parental Leave, and Lactation Policies With Recent...

Many emergency physicians start families. Consensus recommendations to support physician pregnancy, parental leave, and lactation for emergency medicine (EM) programs were recently developed. This study aimed to determine how well EM programs' existing parental policies align with these recommendations for resident and attending physicians across US emergency departments.

A 53-item REDCap survey evaluated policies for pregnancy, parental leave, and lactation in university- and community-based EM programs with residencies. The survey was emailed to faculty chairs and residency program directors at the 282 programs listed in the Fellowship and Residency Electronic Interactive Database Access database, with at least 4 contact attempts (one by phone) from September 2024 to February 2025.

A total of 102 (36%) residency program surveys and 83 (29%) attending group surveys were completed. Most respondents limited overnight shifts in the third trimester for resident and attending physicians (69% and 76%), though fewer, did so in the first trimester (39% and 34%). In the postnatal period, nonbirthing parents received compensated leave in 68% and 57% of resident and attending programs, respectively. Access to compensated leave for adoptive parents and parents by surrogate ranged from 43% to 52% for resident programs and 28% to 42% for attending programs, respectively. Most programs had written lactation policies supporting breastfeeding indefinitely, though access to adequate lactation space and the ability to step away from patient care varied. A minority covered assisted reproductive therapies.

EM programs' existing parental policies do not consistently align with recently published consensus-driven parental policy recommendations. More work is needed to increase the adoption of recommendations and understand the impact of adherence on parental and fetal outcomes.