Nearly half of surveyed female surgeons experienced major pregnancy complications

Their findings are published in JAMA Surgery.

"The way female surgeons are having children today makes them inherently a high-risk pregnancy group," said corresponding author Erika L. Rangel, MD, MS, of the Division of General and Gastrointestinal Surgery. "In addition to long working hours, giving birth after age 35 and multiple gestation -- which is associated with increased use of assisted reproductive technologies -- is a risk factor for having major pregnancy complications, including preterm birth and conditions related to placental dysfunction."

The researchers found that over half (57 percent) of female surgeons worked more than 60 hours per week during pregnancy and over a third (37 percent) took more than six overnight calls. Of the 42 percent of women who experienced a miscarriage -- a rate twice that of the general population -- three-quarters took no days off of work afterwards.

"As a woman reaches her third trimester, she should not be in the operating room for more than 12 hours a week," Rangel said. "That workload should be offset by colleagues in a fair way so that it does not add to the already-existing stigma that people face in asking for help, which is unfortunately not a part of our surgical culture."

The authors developed their survey with the input of surgeons, obstetricians, and gynecologists, distributing it electronically to a variety of surgical societies and practices. Male and female surgeons were asked to respond, with nonchildbearing surgeons answering questions regarding their partners' pregnancies. Overall, female surgeons had 1.7 greater odds than female nonsurgeon partners of experiencing major pregnancy complications, along with greater odds of musculoskeletal disorders, non-elective cesarean delivery, and postpartum depression, which was reported by 11 percent of female surgeons.

"The data we have accumulated is useful because it helps institutions understand the need to invest in a top-down campaign to support pregnant surgeons and change the culture surrounding childbearing," Rangel said. "We need to start with policy changes at the level of residency programs, to make it easier and more acceptable for women to have children when it's healthier, while also changing policies within surgical departments. It is a brief period of time that a woman is pregnant, but supporting them is an investment in a surgeon who will continue to practice for another 25 or 30 years."

Funding for this work was provided by the Brigham and Women's Hospital Department of Surgery Robert T. Osteen Junior Fellowship award.