Pregnancy Curriculum: Advocating for a Healthier Pregnancy in General Surgery Residency

With an increasing number of women entering surgical careers, pregnancy amongst surgical residents is anecdotally rising. There is no single resource to inform expectant surgical residents of potential occupational risks, or to help them optimize workplace safety during and after pregnancy. The aim of this initiative is to provide surgical residents with an overview of residency occupational risks applicable to maternal-fetal health, propose systemic and situational modifications, and to empower pregnant residents to better plan and advocate for a healthy pregnancy.

Surgery department staff were invited to contribute to the pregnancy curriculum at the authors' institution. Feedback was received from attending physicians and surgical residents (N = 12), as well as all female residents having experienced in-training pregnancy or early child-rearing from 2017 to 2022 (N = 6). After identifying workplace hazard and compiling staff feedback, the authors developed a set of recommendations for the protection of pregnant and early-parenting female trainees.

Five areas of process improvements were identified for the protection of pregnant residents: culture, ergonomics, exposure, maternal & fetal care, and fourth trimester support. Specific recommendations ranged from widespread institutional support emphasizing psychological safety and zero-retaliation policies, to healthcare-related hazard exposure protections, as well as tangible postpartum and lactation support. Out of this initiative came the pregnancy curriculum.

Widespread and decisive institutional support is paramount to cultural shifts surrounding in-training pregnancy. The guidelines proposed in this project are intended to be enforced by surgical residency leadership with the precise goal of removing the cultural burden from the expectant resident. Only the resident herself can thereafter chose to adopt or decline the protective measures. Through our recommendations, we hope to offer a foundation upon which individual residents and program leaders can build tailored, pregnancy-specific interventions, with the ultimate goal of improving the antenatal outcomes of our trainees and their growing families without compromising surgical training.