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A Scoping Review Characterizing Reproductive and Childbearing Challenges in Plastic and Reconstructive Surgery.

Micaela J Tobin1, Audrey K Mustoe1, Tricia Mae Raquepo1

  • 1Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Journal of Surgical Education
|September 24, 2025
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Summary

Female plastic surgeons face significant reproductive challenges, including infertility and obstetric complications. Protected parental leave improves workplace culture, yet pregnancy stigma persists in the field.

Keywords:
childbearingfertilitylactationparental leavepregnancyreproduction

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Area of Science:

  • Medical specialties
  • Surgical education
  • Gender studies in medicine

Background:

  • Increasing female representation in plastic and reconstructive surgery (PRS) necessitates supportive policies.
  • Existing policies often inadequately address the reproductive and childbearing needs of PRS professionals.

Purpose of the Study:

  • To examine the reproductive and childbearing challenges faced by plastic and reconstructive surgeons.
  • To identify specific issues related to obstetric complications, parental leave, breastfeeding, childcare, and infertility within PRS.

Main Methods:

  • A comprehensive scoping review was performed in September 2024.
  • Searches included CINAHL, Google Scholar, MEDLINE, PubMed, and Scopus, adhering to PRISMA-ScR guidelines.
  • Included studies focused on pregnancy, parental leave, or family planning in PRS trainees and attendings.

Main Results:

  • Seventeen studies, mostly surgeon surveys, revealed high rates of infertility (19.6%-50.7%) and assisted reproductive technology use (9.8%-19.6%).
  • Female surgeons experienced delayed childbearing, obstetric complications (39%-56%), and faced pregnancy-related stigma.
  • Inadequate lactation spaces and significant childcare burdens were reported.

Conclusions:

  • Protected parental leave policies positively impact workplace culture in plastic and reconstructive surgery.
  • Persistent gender-related challenges, including stigma surrounding pregnancy and parental leave, require continued attention.