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The aim of this study was to perform a large-scale, national survey of physician mothers to define the personal, professional, and financial impact of maternity leave and its relationship to career satisfaction for female physicians in procedural and nonprocedural fields.Little is known about the impact of maternity leave on early career female physicians or how childbearing affects career satisfaction.A nationwide sample of physician mothers completed a 45-question anonymous, secure, online questionnaire regarding the impact of pregnancy and childbearing.One thousand five hundred forty-one respondents were attending physicians during their most recent pregnancy and 393 (25.5%) practiced in a procedural field. Overall, 609 (52.9%) reported losing over $10,000 in income during leave with no significant difference between procedural and nonprocedural fields. Maternity leave was included in only 28.9% of female physicians’ most recent contracts. Proceduralists were more likely to report negative impact on referrals by maternity leave [odds ratio (OR) 1.78, 95% confidence interval (95% CI) 1.28–2.47, P = 0.001], a requirement to complete missed shifts (OR 3.04, 95% CI 2.12–4.36, P < 0.001), and owing money to their practice (OR 2.71, 95% CI 1.34–5.50, P = 0.006). Proceduralists were also significantly more likely to report desire to have chosen a less demanding specialty (OR 2.33, 95% CI 1.80–3.02, P < 0.001).Female physicians lose significant income during maternity leave and report high rates of career dissatisfaction, particularly those in procedural specialties. Given these findings, improved family leave policies may help improve career satisfaction for female physicians.