Certain aspects of the structure of medicine and medical training are unique, deeply ingrained, and may inadvertently discriminate against women who become mothers. The limitations of this work environment perpetuates a cycle in which women, and mothers in particular, are excluded from leadership positions in which they might otherwise be able to drive incremental change by advocating for more family-friendly policies in their institutions. Identification of specific structural biases that contribute to maternal discrimination—such as institutional policies that exclude part time physicians from leadership roles—is essential to identifying avenues for intervention. In addition, our findings indicate that maternal discrimination varies by institution, suggesting that solutions exist. Further research examining “positive deviants”—that is, institutions where physician mothers report better work-life balance and support—could provide models for combating discrimination elsewhere. Further, we see men as allies who can help make long lasting change by advocating for family-friendly policies.