Among younger doctors, women earn the same as men if they work the same hours in the same specialties and arrangements. The remaining gap comes from women choosing shorter hours and more regular, lower-paid niches to fit family duties, so the penalty attaches to motherhood rather than to being female.
When paid work moved out of the home, the unpaid work left behind was relabeled a "labor of love," and that sentiment now stands in for real compensation. A society can honor caregiving in speeches while leaving those who do it dependent and exploitable, because their altruism makes them easy to underpay.
Child care done at home is left out of national output, at-home mothers aren't counted as workers, and pension systems credit a paid nanny but not a mother doing the same work. Because the accounting treats this work as nothing, the safety net built on that accounting simply leaves caregivers out.
Time out to raise children costs not just current wages but the earnings, promotions, and pension credits that would have followed, more than a million dollars for an educated woman. These losses pile up over a lifetime, making motherhood the single biggest risk factor for poverty in old age, and they hit hardest after divorce or widowhood.
Calling a mother's sacrifice "her choice" hides that she chose within rules she didn't write, such as jobs built around workers with someone at home full-time. A rule-set like that turns doing the right thing for children into a personal financial risk, which shifts the cost of raising the next generation onto individual parents.