Next Steps

Understand that trainees are protected by federal and state labor laws. They may access powerful resources:

  • Equal Employment Opportunity Commission

  • Title IX

  • ACLU legal counsel


Using these avenues, residents and fellows may seek counsel and protection. An investigation may be launched even if legal action is not taken. This opens institutions, hospitals, and programs up to significant liability. It also confers much needed protection and inquiry to the issues faced by trainees. Special attention should be drawn to protections under Title IX. Signed into law in 1972, Title IX states that "[n]o person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance…." Previously thought to only pertain to schools and universities, a 2013 precedent in the US Court of Appeals Third circuit this provision now applies to all residency programs. Maternal discrimination is included in the harassment and retaliation clauses.


It is important for training faculty, supervisors, program directors and trainees to ensure they understand the laws, and their responsibilities or rights under those laws. This understanding is not only beneficial for the work environment; it can also play a significant role in defending against discrimination and harassment claims, while empowering victims of discrimination.


To trainees: an EEOC claim and Title IX claims have to be filed within 180 days of the alleged violation. Even if you want to wait to file, documentation is your strongest tool. Document as much as you can while your memory is fresh. Institutions know about these deadlines, so should you.


Initial action steps include:

Standard, 12-week leave across all specialties for parents

  • Proper execution of policies and labor rights

  • Transparent and widely-understood leave policies


Standard, inclusive lactation policies and protections

  • Trainees require clean, accessible lactation spaces & time to pump.

  • Lactation policies will vary by specialty

  • Committees assembled to create and employ these policies must include trainees and exclude figures disconnected from day-to-day life of trainees


Mid-level support during leave

  • This model is being used in some programs across the country. Particularly helpful in surgical subspecialties where floor work can be delegated easily. This requires buy-in from administration but may ultimately mitigate legal and financial risk.


Faculty and residency administration must demonstrate competence in basic understanding of lactation physiology and needs of a pumping person in the workplace.

  • This also applies to basic pregnancy physiology education

  • Contracts signed by faculty and other staff in positions of power over residents may attest to their understanding and commitment to fighting maternal discrimination in their own role. This will increase accountability but also decrease institutional liability.


A sweeping acceptance of the issue of maternal discrimination in residency and fellowships is imperative.

When marginalized groups thrive, we all do.