This article examines evidence of the need for maternity leave policies in residency programs and reviews studies of such policies. The author concludes that communication to residents of an established maternity leave policy facilitates equitable treatment of residents and minimizes disruptions for their colleagues and patients. The development of maternity leave policies is discussed in the context of existing and proposed federal legislation and the current pressures on program director and hospital administrators to improve other aspects residency training. Strategies for building flexibility in residency programs are presented.