Physicians pay the price for taking parental leave, increasing their workload in early pregnancy and returning soon after childbirth 

Toronto, ON, April 22, 2026 — Physicians experiencing pregnancy often maintained or increased their workload in the first and second trimesters, then reduced it in the third, according to a new research study from ICES and Unity Health Toronto. The study also found that surgeons returned to work sooner than other specialties after childbirth—typically within about 19 weeks.  

Physicians experiencing pregnancy, particularly earlier in their careers, may face significant pressures, including income loss during leave and maternal discrimination, which can affect well-being and the experience of taking and returning from parental leave. While the study did not assess the underlying causes of these pressures, many of them can be influenced by workplace and policy supports. Authors of the study recommend strengthening parental leave and return-to-work supports, which could help improve physician well-being and retention. 

The study aimed to examine changes in work patterns for physicians before, during, and after pregnancy. Using physician billing claims, they identified the work activity of 3,932 doctors who experienced 5,948 pregnancies.  

During early pregnancy, physician workload remained stable or increased. Among all physicians, overall workload increased in pregnancy. Compared to an average of 43.5-67 days worked over 14 weeks pre-pregnancy, their workload increased by about 12 per cent in the first two trimesters—equivalent to approximately 46-70.5 days per trimester—and then decreased in the third trimester to 27-43 days (each trimester is 98 days or 14 weeks in length). Overnight work followed a similar pattern, with physician workload increasing during early pregnancy and decreasing in the third trimester.  

“Our findings suggest physicians may increase their workload in early pregnancy in anticipation of working less later on,” says Dr. Andrea Simpson, an obstetrician and gynaecologic surgeon at St. Michael’s Hospital, a site of Unity Health Toronto, and an ICES scientist. “In group practices, physicians may need to take an equal share of call or overnight work, and some may schedule more of those shifts to the first and second trimesters. Overall, the pattern suggests some physicians may be ‘paying the price’ early—taking on more work up front—to make it possible to step back later in pregnancy.” 

On average, physicians returned between 133 and 270 days postpartum. Surgeons returned the earliest, at a median of 133 days (19 weeks) after childbirth, and psychiatrists returned the latest at a median of 270 days (39 weeks). This is quicker than most Canadians taking parental leave—the majority take at least nine to 12 months (39 to 52 weeks). 

“We also found differences in return-to-work patterns among family physicians by practice model,” says Dr. Simpson. “A higher proportion of those practising in major primary care models, such as family health teams, returned sooner than peers in other models.” 

Resident physicians were not included because they do not submit billing claims. Male physicians and adoptive physician parents were also excluded, although other studies suggest that these groups adjust their workload to accommodate parenting. All physicians included in the study were active between April 1, 2002, and November 18, 2018, and had practised for a minimum of two years prior to their pregnancy in Ontario.  

The study, “Physician work patterns in pregnancy, parental leave, and return to the workforce,” is in the April issue of JAMA Network Open. 

ICES is an independent, not-for-profit research and analytics institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. ICES leads cutting-edge studies and analyses evaluating healthcare policy, delivery, and population outcomes. Our knowledge is highly regarded in Canada and abroad and is widely used by government, hospitals, planners, and practitioners to make decisions about healthcare delivery and to develop policy. For the latest ICES news, follow us on BlueSky and LinkedIn: @ICESOntario    

Unity Health Toronto is a leading Canadian health research institution with a wingspan across Toronto’s core. Unity Health Toronto’s strength lies in the combined expertise of its three hospital sites: St. Joseph’s Health Centre, a community academic and acute care hospital supporting Toronto’s west end; St. Michael’s Hospital, a research-intensive academic health sciences centre affiliated with the University of Toronto with world-class specialty programs for complex cases; and Providence Healthcare, a campus of care for seniors, rehabilitation and long-term care. Our satellite clinics offer team-based primary care and community-based services. We aim to provide compassionate, high-quality care at every stage of our patients’ health journey, from pediatric to primary care, urgent and acute care, world-class specialty care programs, seniors care, rehabilitation, long-term care, palliative care and advanced care for the most complex patients.
 

FOR FURTHER INFORMATION PLEASE CONTACT:    

Charlotte Lam   
Communications Associate  
ICES    
[email protected]    
437-317-8804    

Unity Health Toronto
[email protected]