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Published on: January 17, 2019
Challenges in pregnancy and lactation among surgical residents and attendings: A systematic review
Iris Noldus1, Elise Smisaert2, Stefanie Gijsels3
1Department of Gastro-Intestinal Surgery, Ghent University Hospital, Ghent, Belgium. Electronic address: https://www.twitter.com/IrisNoldus.
Background:
With more women entering surgical training, barriers concerning pregnancy and breastfeeding are pertinent issues that have not been addressed adequately in a specialty with more men. An increasing body of evidence for the consequences of these challenges is emerging but has not been reviewed thoroughly. This study aims to provide a comprehensive review of the physical, emotional, and practical challenges of pregnancy and breastfeeding during surgical training and career and to elucidate the main difficulties and barriers female surgeons experience.
Methods:
A systematic review was conducted (PROSPERO ID CRD42022365022) in PubMed, Embase, Google Scholar, and Cochrane up until October 2022. Literature search, data extraction, and quality and risk of bias assessments were performed by 2 reviewers independently.
Results:
Forty-four studies from 7 countries (United States of America, Australia, Canada, Ireland, Japan, New Zealand, and the United Kingdom) were included. Female surgeons were significantly more likely to have undergone artificial reproductive treatments and reported more pregnancy-associated complications. Negative stigma, harassment, discrimination regarding parenthood, and incompatibility of surgical work with childbearing were seen across different countries. Difficulties during lactation caused by high work demands, too little time to express milk, and feeling unsupported resulted in shorter duration and greater dissatisfaction.
Conclusions:
Female surgeons have a high risk of experiencing a myriad of fertility and childbearing complications during their career. Pregnant female surgeons and trainees face widespread issues of stigma, discrimination, and harassment. This review emphasizes the need to address the lack of support and shortage of facilities to create a more inclusive training and working environment.
