Around 90% of registered nurses and midwives in England are women. Many will become mothers during their careers. How women combine work in the NHS with motherhood brings with it important implications for recruitment, retention and hours of work. Kelly and Stockton (2022) noted that, despite the implications of maternity and how the NHS responds to it as part of workforce planning, efficiency and women's careers, little systematic, quantitative evidence on the labour supply of mothers with young children in the NHS is available.
Making the most of the actual and potential power and promise of the nursing profession depends on addressing a number of complex issues, including how women are treated. Although the nursing profession is a heavily female-dominated occupation, Punshon et al (2019) noted that men are over-represented at the most senior levels.
Employment rates and hours of work of mothers in the UK fall after they have had their first child and average wages stagnate. The NHS performs reasonably well at keeping female staff after maternity leave (Kelly and Stockton, 2022).
Kelly and Stockton's (2023) report, published by the Institute for Fiscal Studies, examined how, in the NHS in England, the length of parental leave and rates of progression after having children differ by specialty, gender and other characteristics among nurses, midwives, doctors and dentists.
The length of maternity leave taken by female nurses is usually shorter in fields of nursing with a higher proportion of men (such as psychiatry) and longer in those that are most female dominated (such as obstetrics and gynaecology). The average amount of maternity leave is 41 weeks in mental health nursing, compared with 48 weeks in obstetrics and gynaecology. This finding is similar in medicine, where the length of maternity leave female doctors take is shortest in those specialties that are dominated by males (such as cardiology and surgery) and longest in the more female-dominated specialties (geriatric medicine and paediatrics). Women in male-dominated specialties have fewer children and work more contracted hours when they return from maternity leave (Kelly and Stockton, 2023: 5).
With the vast majority of fathers, regardless of specialty and occupation, it is noted that there is little variation in the length of paternity leave. Most fathers take 2 weeks' paternity leave, corresponding to the period of occupational paternity pay.
Female nurses are less likely to progress than their childless male colleagues for several years after they have returned from maternity leave. This is true at every transition that Kelly and Stockton (2023: 5) analysed, from band 5 to band 6 for nurses. Among men, the differences in progression between fathers and childless men are much smaller.
Central to the delivery of high-quality and cost-effective care for patients is the career development of NHS staff. Employment practices that are truly inclusive and flexible have an important role to play in this, as recognised in the NHS People Promise (NHS England, 2021). Although these practices can benefit all employees, they can be of increased benefit to parents with young children.
As the challenges of recruitment and retention continue, understanding and reacting to how motherhood can impact the careers of women across the NHS have implications for workforce planning and NHS efficiency. It is in all our best interests to delve deeper, pose important questions concerning the retention of female nurses and generate more insight into factors that can enhance the retention of highly skilled female nurses and to understand the drivers and challenges that are at play across trusts and within specialties.