Balls, Babies and Bullying: Barriers to the career progression of women in the profession Obstetrics and Gynaecology

Abstract

The profession of obstetrics and gynaecology (O&G) in Australia has long been dominated by men, but in recent decades, more women have entered the clinical field. Women now make up the majority of registered obstetricians in Australia, and with the focus on women patients, the stakes of gender inequity within the profession are high. This study explores career trajectories in the field, from training to leadership roles, with a focus on the experiences of women.

Using a qualitative approach, the study design involved in-depth interviews with 35 current and previous O&G clinicians (including both men and women). Interviews focused on training and employment experiences and perspectives on gender in the workplace. Thematic analysis was used to explore experiences of working in the O&G field and to elucidate gendered social relations and inequity.

Participants described workplace relations and training and employment structures that create barriers to full professional participation for women. Women participants described suffering oppression due to gendered norms, motherhood, and mistreatment. Despite the influx of women doctors, the field of O&G remains a man's world, where 'having balls', being the ideal worker, and masculine traits are highly valued. Women felt that motherhood made them vulnerable in the workplace, detracting from their ability to reach "ideal worker" status, and undercutting their feelings of competency. The impossible dichotomy between the ideal worker and mothering ideals creates a significant conflict for women, sometimes resulting in workforce attrition. Previous Australian research shows that women in the medical workforce are also more likely than men to be the victims of mistreatment, especially sexual harassment. This study into the culture of O&G suggests that workplace mistreatment is normalised, including the gendered harassment of women where their sex and/or motherhood status forms the basis of mistreatment.

Women reported that their experiences of navigating a masculine workplace and the double jeopardy of home and work responsibilities, as well as their exposure to mistreatment, led to feelings of shame and guilt. Women's stories also suggest that they tend to endure these negative workplace experiences alone, as the culture of normalisation and dismissal restricts organisational change. Formal policies supporting gender equity are perceived to have had little impact on the informal 'standards' expected in the workplace, reinforcing the gender status quo. Women's disadvantage in the field persists due to powerful societal, institutional and personal factors that reinforce patriarchal structures. Women's experiences of inequity in the workplace links to poor mental health, reduced work performance, and workforce attrition, all of which have a negative effect on career progression.

This study, then, elucidates a triple whammy of disadvantage -gender, workplace mistreatment, and mothering; or balls, babies, and bullying. The negative effects of these factors are mutually compounding. Addressing these systemic inequities requires more than an increase in women occupying leadership positions; in fact, increasing women's representation in leadership without addressing cultural issues can negatively affect gender equity, as the appetite for pursuing cultural change decreases with an increase in gender parity in leadership. Instead, achieving gender equity involves removing the barriers to women's full and equal participation in the field, with the goal of equitable accessibility of career opportunities, regardless of gender or caring responsibilities. Such culture change requires attention to the gap between formal policies and workplace practice and revision of the current organisational structures and power relationships that lead to disadvantage for women. Show more