In order to understand and contextualize these stark disparities between women and men’s experiences, Kin turned to women surgeons to hear what they had to say. She discovered that women felt an overwhelming pressure to hold off on having children until they had completed their training. Or, if they decided not to wait, felt they needed to hide and suppress their pregnancies or any existing children as much as possible.
The women in Kin’s interviews consistently expressed a deep sense of responsibility to not let their colleagues down, meaning they felt they could not show any differences or “weaknesses” compared to men. This is why so many women worked up until the very moment they are in labor, only to return as little as two to six weeks later. One woman surgeon explained how normative this practice had become, claiming, “Everyone plans on working right up to the minute they deliver. You work until your water breaks.”
Kin discerned that this intense desire to uphold women surgeon’s collective reputation comes from all quarters. On the one hand, women surgeons are told at an institutional level, “Couldn’t you have waited?” and “You girls go through all this training and then you go off and have kids and just be moms. It’s a shame. It’s a waste of training.” While many women Kin interviewed emphasized how horrified their colleagues were upon discovering they were trying to start a family, others also pointed out that women surgeons often self-generated “a little bit of machismo” and a lot of stubbornness when trying to prove that being pregnant or having a family would not hamper the quality of their work or extend the length of their training.
Kin also investigated women surgeons’ experiences once they had children. She found that most women felt tremendously guilt-ridden, believing they were failing at both their career and motherhood. During her talk, Kin described how women surgeons possess higher rates of work-home conflicts than men, including conflicts associated with depression, emotional exhaustion, lower quality of life, and dissatisfaction with both their spouse and career. One woman summed up the general sentiment about the “superwoman” transformation that surgery demands when she explained, “Academically, I’ve found it impossible. I can’t be a full time clinical surgeon, vaguely [a] full time mom, and full time researcher. I am not one of those women who rise at 3:45 am to write a paper while exercising on a treadmill. I’m never going to be able to do that. When I realized that, I got depressed.”
What made women surgeons’ experiences especially frustrating, Kin discovered, was how men were seemingly not subject to many of the same pressures, despite being more likely to have families. One reason was that 83 percent of women’s partners also worked outside of the home while only 48 percent of men’s partners did. This meant women surgeons were more likely to be tasked with organizing elaborate child care schemes, often involving multiple nannies or the help of extended family members and little-to-no face-time with their partner.
Some women attributed the extra pressure to how women are still seen as primarily responsible for child rearing, regardless of whether they work outside the home or not. Many women surgeons felt like they could not make their families visible in the workplace, because any hint of being a mom was seen as interfering with their work in a way that being a dad would not. Or, conversely, one woman shared, “When my section chief sees me here beyond 6:00 pm, he says, ‘Go home and be with your kids, I don’t want you to be here and burn out.’ He probably wouldn’t say that to any of the guys with kids.” She further explained how her male partners assumed that she would go part time “because I’m the mom” without applying that same expectation to the men with families.
New models, new possibilities
Kin concluded her talk by sharing the hope women surgeons had for building a new model of being both a mom and surgeon, including an environment in which not “having it all” doesn’t result in so much guilt and conflict. Some women voiced that they would simply dial down their high career aspirations. Others said they would stop striving to be the type of full-time moms their mothers were, and that this was okay.
In fact, some women expressed that combining motherhood and the practice of surgery could even hold certain advantages. Some have found that they built better relationships with their patients when they disregarded convention and actually acknowledged their status as both mother and surgeon in the workplace. Other women emphasized the importance of breaking new ground and becoming role models for their children as well as future generations of women surgeons.
Kin also proposed several concrete solutions that would help ease the double standard women surgeons face. These solutions include creating a workplace environment that allows for greater autonomy in scheduling, more room for job sharing and other innovative practice structures, and on-site back-up childcare for non-school days. They hope to accommodate the surgeon’s life choices using innovative problem-solving and without compromising their work. If empowering and practical changes like these are instituted, Kin believes it will be possible for women surgeons to maintain a work-life balance and live life according to priorities that embrace both their professional and personal goals.