By Atlal Abusanad, MD, MSc, FRCPC, CIP

In the months leading up to my maternity leave, I informed my patients that I would be away for a particular length of time and that a colleague will be available to cover my duties. The delight of preparing for my newborn was tempered by my sense of responsibility for those who relied on me to save their lives and offer a feeling of security.

In oncology, we are often deeply involved with our patients. I wondered how my patients would fare, especially those who are on a strict deadline with life. Although they all wished me well and none made me feel guilty for taking this occasional leave, I was frequently asked when I would return and whether I would be available by email or social media. Their desire to connect made me feel cherished and satisfied the self-sense of being indispensable. I gently reminded them that I would be busily nurturing and taking care of a little human being. However, I continued to receive messages and queries that I couldn't ignore. The sense of responsibility could not be defied. Being away from duties created an unfamiliar situation: it was supposed to be a relief, but it was tinged with feelings of guilt and an urge to return to work to catch up on delayed tasks.

As an academic who seeks to inspire and support trainees and students, my absence from this role, although temporary, reinforced the guilty feeling and the need to meet expectations and minimize interruptions. However, taking leave may set a good example by showing the younger generation that they can take time off and be supported. It's essential that they see women and mothers supported and represented in the workforce.

I had hoped to use my parental leave to work on various research projects, write papers, and submit others for publication, even though I knew I would be busy with the baby. That wishful thinking, of course, did not become a reality. Caring for your little one is a full-time job which is satisfyingly demanding. Needless to say, sleep deprivation, newborn reliance, and post-partum blues have not made things any easier.

I was fortunate that I did not have to leave my baby girl and travel away for extended periods, as Dr. Mounika Boppana described of her tough experience being a mother during medical oncology training.¹ My experience caring for a newborn as a consultant medical oncologist is different from residency training, when I had my firstborn—both are challenging, but the challenges are different in each phase. During residency, passing exams and certifications to avoid any delay or absence in my career trajectory were the insistent ideas; the uncomfortable feeling of leaving sick patients and missing critical phases of their treatment journey for an extended period was not as intense as I am experiencing now.

Although I had to decline several scientific meetings and societal events, people were understanding and supportive. Sadly, many other mother physicians do not enjoy this support.² They have been discriminated against and even directed in a concealed manner to delay having children to avoid career/training interruption.³ Working mothers desire to strike a balance that is rewarded with a sense of accomplishment and satisfaction, and to be able to do so, several parties have to coordinate and collaborate. For instance, in my case, my workplace gives several options for maternity leave, ranging from fully paid leave for 10 weeks to a more extended leave with a dedicated payment. 

Supporting and retaining women and mothers in the field of oncology is not a niche issue. In a recent survey assessing burnout among women oncologists from the Middle East and North Africa region (MENA), half of the participating professionals were mothers, and women comprise 54% of the oncology workforce in MENA.^4,5 Women and mothers make up a significant proportion of the workforce, and we have inadequate knowledge of how they are treated and supported.

Peer support is an advantage that I was pleased to have. Likewise, I had household support that helped me to manage my mother-physician status satisfactorily. I had the chance to enjoy more quality time with my baby girl than I had with her older brother during my residency training. However, the urge to cut my leave short to attend my patients and continue academic duties was annoyingly recurring. This state of mind had to be controlled, otherwise, it would have compromised the pleasure of this precious time. 

Motherhood and medical oncology share an interesting link in that both offer the pleasure of helping and supporting the vulnerable. The primary motivation behind the former is maternal love, whereas it is compassion in the latter. When the two M’s, motherhood and medical oncology,  intersect, be sure to consider the following:

• Control the distressing feeling of being responsible while you are on leave.
• Acknowledge and let go of guilt. Motherhood is a natural instinct that should be nurtured and celebrated.
• Cherish the time with your little one, strengthen your bond, and make memories.
• Regulate your online accessibility while on leave. Unfortunately, the boundaries between personal time and work time have been blurred by being easily reachable online.
• Delegate and allow other members of your professional team and household to help.
• Accept and accommodate deviation from your pre-set timeline for publication, promotion, and academic activities.
• Allow time to adjust upon returning to work. Do not stress if you have a feeling of unfamiliarity or disengagement.
• Use the opportunity to inspire by example and show that it is acceptable for female professionals to take time off and be supported during this precious time.

Dr. Abusanad is an associate professor of internal medicine and medical oncology at King Abdulaziz University and Hospital, in Jeddah, Saudi Arabia. Follow her on Twitter @atlal_abusanad. Disclosure.

References

1. Boppana M. Motherhood during medical oncology training: A tough, beautiful, and memorable journey. Cancer Research, Statistics, and Treatment. 2020;3:270-2.
2. Polan RM, Mattei LH, Barber EL. The Motherhood Penalty in Obstetrics and Gynecology Training. Obstet Gynecol. 2022;139:9-13.
3. Collie E, Lew R, Peate M. Merging motherhood and medicine: A qualitative study exploring barriers and enablers to motherhood among female doctors in Australia. Womens Health (Lond). 2022;18:17455057221114268.
4. Abusanad A, Bensalem A, Shash E, et al. Prevalence and Risk Factors of Burnout Among Female Oncologists From the Middle East and North Africa. Front Psychol. 2022;13:845024.
5. Abusanad A, Bensalem A, Shash E. Burnout in oncology: Magnitude, risk factors and screening among professionals from Middle East and North Africa (BOMENA study). Psychooncology. 2021;30:736-46.