Intensive care medicine places sustained pressure on staff through unpredictable shifts, heavy workloads and high cognitive and emotional demands. Survey responses from 420 intensive care professionals in 32 countries show that these pressures extend into family life and influence decisions about parenthood, pregnancy and work-family balance. Most responses came from Europe, with Italy, the Netherlands and the United Kingdom most represented. Respondents were predominantly women, with a mean age of 40 years and a mean of 11 years of ICU experience. Consultants and senior residents formed the largest professional groups. Sixty-seven percent were parents, with a median of two children.
Parenthood was associated with older age, greater ICU experience, more stable contracts and senior roles. Parents also reported fewer working hours per week, fewer nights and weekends, and a greater share of part-time work. Across the survey, intensive care work emerged as a major influence on family development choices and on how professionals experienced support for pregnancy and parenthood.
Parenthood Decisions Under ICU Pressure
The survey found that ICU work had a strong effect on decisions about whether and when to have children. Among respondents without children, 60% said that working in intensive care had a strong or very strong impact on their decision to become parents. Among respondents with children, 46% said ICU work had a strong or very strong impact on their decision to have more children. The effect was more marked in some groups. Women with children reported a stronger impact than men, with rates of 50% and 40% respectively. Junior residents showed the highest rate at 70%.
These responses indicate that parenthood decisions were shaped not only by personal preference but also by the structure of work in intensive care. The survey population already reflected differences between parents and non-parents in age, seniority and working patterns. Parents were older, had more ICU experience and more often held stable contracts and senior positions. They also reported fewer hours, nights and weekends, alongside a greater proportion of part-time work.
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Career impact formed part of that picture. Nearly half of respondents agreed or strongly agreed that parenthood limited career opportunities. Mothers gave higher ratings than fathers when asked about that limitation. Parenthood therefore emerged as both a personal and professional issue in intensive care, with effects on family planning, work patterns and perceptions of career progression.
Childcare Support Remains Limited
Employer support for childcare and parenthood was rated low. On a 10-point scale, the median perceived level of childcare support was 3. Where support was available, it most often took the form of flexibility, facilitated rotations or reduced working hours. Even with these measures, 43% of respondents reported receiving no support at all, and 60% disagreed that their employer adequately supported parenthood.
Parental leave data also pointed to differences between mothers and fathers. Among parents, 88% of mothers reported taking parental leave compared with 48% of fathers. The survey did not go beyond these figures, but the contrast adds to a broader pattern of unequal experiences around parenthood. The responses show that practical support was inconsistent and that many professionals did not see their workplace as responsive to family needs.
Expectant parents who were not themselves pregnant also reported limited support. Among partners of pregnant ICU workers, 53% were able to take time off work to attend antenatal appointments. Forty-five percent felt their workplace was supportive of their role as expectant parents. At the same time, 72% reported that working hours interfered with their ability to support their partner during pregnancy, and only 20% received clear information on maternity or paternity leave options.
Pregnancy Support and Work-Family Conflict
Among 192 respondents who completed the pregnancy section, 61% continued working in the ICU during pregnancy. Most were aware of national guidelines on work during pregnancy, but only 19% received guidance specific to intensive care. Forty-three percent underwent institutional health and safety assessments. Perceived employer support during pregnancy was low, with a median score of 4 on a 10-point scale. After birth, measures such as adjusted shifts, breastfeeding facilities and structured return-to-work programmes were inconsistently provided.
The survey also examined conflict between work and family among parents. ICU professionals reported higher work-to-family conflict than family-to-work conflict, with median scores of 23 and 15 respectively. Women reported higher levels of work-to-family conflict. These results indicate that professional demands more often disrupted family life than family responsibilities disrupted work.
The survey also identified important limitations. The data were self-reported, the design allowed voluntary self-selection, and the survey link was openly accessible, so a precise denominator of eligible ICU professionals could not be defined and a response rate could not be reliably calculated. Geographic distribution, diversity of childcare policies and gender imbalance further limited representativeness.
The survey presents intensive care medicine as a setting where pregnancy, parenthood and professional demands often come into conflict. ICU work influenced decisions about becoming a parent and having more children, while many respondents reported limited childcare support, unclear leave information and inconsistent pregnancy protections. Work-to-family conflict exceeded family-to-work conflict, reinforcing the central role of job demands in shaping family life. The responses also show that these pressures affected both maternal and paternal perspectives, though some burdens were reported more strongly by women. While the findings are descriptive perceptions rather than population estimates, they point to persistent gaps in institutional support around pregnancy and parenthood in intensive care.
Source: Intensive Care Medicine
Image Credit: iStock
References:
Scaramuzzo G, Jagodzinska-Peškova J, Grasselli G et al. (2026) Parenting, pregnancy and work–family balance in intensive care medicine: an ESICM survey and a call for action. Intensive Care Med: In Press.
