Narrative Data

Stories are just data with a soul - Brené Brown

380 reports of maternal discrimination → 199 narratives shared → 645 individual codes applied

Predicted codes:

Abusive work environment / scheduling

Anxiety concerning fertility

Blatant discrimination (verbal or otherwise)

Barriers to making/attending child appointments

Different behavioral expectations

Discrimination regarding desire to get pregnant/grow a family

Gaslighting

Inability to pump adequately during work

Lack of interpersonal support for lactation/pumping

Lack of support during pregnancy or postpartum

Inadequate maternity leave

Passive discrimination

Positive experiences

Barriers to accessing & attending prenatal care

Lack of adequate pumping spaces

Unsafe working conditions (ex: deliberate exposures, frequent call)

Emerging codes:

Overt acts of discrmination from program director

Pressure from program director (ex: harassing postpartum trainee to come back early)

Psychological costs

Health consequences (ex: preeclampsia, preterm delivery)

Shortened breastfeeding journey

Violations of privacy (ex: PD/peers opening trainee's chart)

Peer resentment

Inadequacy / non-existence of parental/paternal leave

Maternity leave not respected

Withholding benefits

Inaccurate interpretation of benefits & rights (ex: programs withholding information or disregarding ACGME/board rules)

Assumption that femaleness equates to desire to have children

By codifying new and emerging patterns, the expansive experience of maternal discrimination was further characterized. The voices of the participants are forever held together by this common thread.

Desired changes to the culture and structure of medical training were shared. Unifying themes emerged:


Standard, 12-week leave across all specialties for parents.

  • Proper execution of policies and labor rights.

  • Transparent leave policies


Standard, inclusive lactation policies and protection.

  • Require clean, accessible lactation spaces & time to pump.


NP/PA support during leave to decrease the burden on other residents and thus mitigate resentment and perpetuation of a toxic environment.


Have faculty/admin demonstrate competence in basic understanding of lactation physiology and needs of a pumping person in the workplace.