gms | German Medical Science

This article contains excerpts of the live debate between Jutta Struck and Dr. Daniel De Ridder from the conference panel discussion 10/14/2010 on the subject of maternity leave.

De Ridder: There are still unresolved problems, particularly in relation to making childcare more flexible and for female doctors regarding maternity leave as well. The important thing is for medical studies to have a family-friendly profile; if necessary, the Medical Licensure Act needs looked at again. I would like to speak with you, Mrs. Struck, about the medical profession with regard to the legal aspects of maternity leave. You are a Deputy Director, a dedicated lawyer who has worked in the Federal Ministry for Youth, Family and Health since 1985, which is now called the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth. What is the key point you take away from this conference? What is the most pressing issue? The possibilities are infinite. But where would you, when you leave this conference and return to work tomorrow, want to start first?

Struck: After such a conference I’m usually very excited when I arrive at work about new ideas and want to start implementing them straight away. Apart from the fact that I usually don’t have sole responsibility, my jam-packed schedule soon catches up with me again, which unfortunately tends to slow any developments down. I very much hope that we, on this important issue, everyone in their own capacity and in their area, such as the Federal State, the provinces, universities and the many other stakeholders, will be able to contribute to improving the framework. Even with lots of good will on all sides sometimes there are communication difficulties between the different disciplines.

De Ridder: A plea for cooperation.

Struck: Yes. I was approached directly about maternity leave. I think it’s really alarming how often the following contrast is constructed: maternity laws as necessarily unpopular regulations which unnecessarily hinder female doctors in exercising their profession. As Professor Fegert has very rightly said: why does maternity leave have to be something bad? The rules provide important protection for (pregnant) mothers and her child in a very important and positive but also a very sensitive life stage for both. Worse, the parties often even work on the basis of wrong assumptions. The Maternity Protection Act does not envisage 14 months of leave but only 14 weeks as a period of protection; and actually, it’s all about the eight (or 12 weeks in cases of premature births and multiple births) which are mandatory after childbirth. Because a pregnant woman does not have to make use of the protection period before birth and may work, although this can be changed at any time within the six-week period. So a female doctor theoretically can work up until the day of delivery from point of view of maternity protection laws. Of course there are, depending on the type of activity, limitations. But the Federal Law, the Maternity Protection Act nowhere stipulates that a pregnant woman should not perform surgery. She may, for example, not be exposed to certain substances and must be safely protected from needlestick injuries, may not sit too long - but these days we have highly developed medical technology, with new and reliable opportunities. And let’s look at anaesthesia. It would seem that for over 20 years now, better organisational conditions exist for pregnant women. Why can’t we try that in different departments? For example, one could arrange multiple job-shares as a precautionary measure in surgery in certain cases. When you’re running a hospital, you must cater for potential sudden illnesses of male surgeons too. In anaesthesia for example, a pregnant female doctor can be sufficiently protected if there is a closed anaesthesia gas circuit. The purpose of maternity protection schemes is to protect mother and child in this short period of time. We do not believe, as called for within the EU, that we should have longer maternity leave. We’re saying that with the parent money and parent period we have a good system that allows us to integrate both parents into caring for the child after maternity leave.

De Ridder: You very clearly refute claims that the Maternity Protection Act equals a working ban. We still see, however, that it has an impact and makes women rather anxious.

Struck: I believe it’s right, to be open to sensible changes. For example, I quite understand if people are debating the sense of rigid hours of a work ban if there is a corresponding time offset. In my view, a prohibition on working in a clinic does not necessarily have to be from 8pm onwards. But even there opinions already differ. All participants must weigh the pros and cons to achieve improvements.

A word about family friendliness. I do understand, as was said during the conference, that children should also be cared for by the parents, that the parents do wish for that. When you consider how many people want children, not only young female doctors but also young male doctors, as we know from surveys, then time for the family should be available for male and female doctors. The hospitals should try to provide optimal conditions under the provisions of the laws. The rules do provide a framework within which you can be flexible. The Maternity Protection Act makes a lot fewer fixed demands than is usually assumed. Of course there are certain basic principles and specific prohibitions, without which the protection of mother and child couldn’t exist. But within this framework a lot can be done. The implementation of the Maternity Protection Act in the Federal States leaves room for manoeuvre. The supervising authorities can grant exceptions; they can judge individual cases on the ground and advise. One shouldn’t see maternity protection as a blocking instrument only. There are a number of ways of improving organisation, which allow male doctors, the fathers, to look after their children, not just female doctors. Surveys indicate that men are also interested in flexible working hours in order to take on family responsibilities.

De Ridder: Question for you - if a student came to you today and said she’d prefer to emigrate to Sweden next semester because the conditions there are much better, what would you tell her?

Struck: I’d ask her, after her time in Sweden, to talk to me and to a larger forum and to tell us what she experienced there. How is it working better? Why is it working better? What can we learn from there? We have looked to Sweden many times, for example in the case of the parent money. Maybe there is something you can transfer. In particular, I would be interested if it is true that in Scandinavia - for example in Denmark or Sweden - fathers are able to pick up their children at four in the afternoon, no one stares because that is something normal, as indeed is the case in France. Only here it’s inconceivable that a male doctor would not be in hospital at that time but instead is caring for his child. We need a change in the way people think. Perhaps those returning from Sweden can give us a little help there.

De Ridder: Thank you very much for having taken the place in the spotlight. The program is big, that much we’ve learned from this conference. There are many measures we need to implement, whether that’s the curriculum, the doctors, the working conditions, the work climate or maternity leave. But I’m sure we’ll all be taking away a lot of things from this conference that we will want to implement as soon as possible

The author declares that she has no competing interests.