Despite the fact that only one fifth of the U.S. surgeons is female, more women are entering the field. Although women accounted for 38 percent of surgical residents in 2018, they still face many challenges. National surveys have documented pregnancy-related stigmas, unmodified work schedules and short maternity leave options. There is also little support for breastfeeding and childcare after childbirth. Researchers from Brigham and Women's Hospital and other institutions surveyed 1,175 female surgeons and surgical trainees across the U.S. in order to learn about their and their partners' experiences with pregnancy. The survey found that 48% of female surgeons had experienced major complications during pregnancy. Those who worked 12-or more hours per week in the last trimester were at greater risk than those who didn't.The results of their research were published in JAMA surgery.Erika L. Rangel MD, MS of the Division of General and Gastrointestinal Surgery said that "the way female surgeons have children today makes them inherently high-risk pregnancy groups." "In addition to the long work hours, multiple gestation and giving birth after 35 is a risk factor for major pregnancy complications including preterm births and placental dysfunction.Researchers found that more than half (57%) of female surgeons worked over 60 hours per week while pregnant and more than a third (37%) made more than six overnight phone calls. Three-quarters of miscarriage victims, which is twice the rate in the general population, did not take a day off work.Rangel stated that a woman should not spend more than 12 hours in the operating area once she reaches her third-trimester. Rangel said that colleagues should share that workload in a fair manner so that there is no stigma associated with asking for help.With the help of surgeons, obstetricians and gynecologists they developed their survey and distributed it electronically to various surgical societies and practices. Both male and female surgeons were asked for their opinions, while non-childbearing surgeons answered questions about the pregnancies of their partners. Overall, female surgeons had 1.7 times more chance of having major pregnancy complications than their nonsurgeon female partners. They also had higher odds of developing musculoskeletal disorders and non-elective Cesarean delivery. Postpartum depression was also reported by 11% of female surgeons.Rangel stated that the data they have gathered is valuable because it helps institutions understand why top-down campaigns are needed to support pregnant surgeons, and to change the culture around childbearing. Rangel stated that policy changes must be made at the level of residency programs to make it easier for women to have children when they are healthier. They also need to change policies within surgical departments. Although it is only a short time when a woman becomes pregnant, supporting them is an investment in the future of a surgeon who will continue practicing for 25 to 30 more years.The Robert T. Osteen Junior Fellowship at Brigham and Women's Hospital provided funding for this project.
