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

An increasing number of women are choosing careers in the field of plastic and reconstructive surgery (PRS). These evolving surgeon demographics have highlighted the need for parental leave policies, lactation accommodations, and childcare services. Therefore, this study examines the reproductive and childbearing challenges that plastic and reconstructive surgeons encounter. Specific areas of focus include obstetric complications, parental leave, breastfeeding, childcare, and infertility.

In September 2024, a scoping review was conducted across CINAHL, Google Scholar, MEDLINE, PubMed, and Scopus, following PRISMA-ScR guidelines. Randomized control trials, observational studies, surveys, and interviews that examined pregnancy, parental leave, or family planning in PRS trainees or attendings were included. Abstracts, commentaries, editorials, systematic reviews, and non-English studies were excluded.

Seventeen studies, consisting primarily of surgeon experience surveys (82.35%, n = 3,145), were examined. Infertility affected 19.6%-50.7% of surgeons, with 9.8%-19.6% utilizing assisted reproductive technology. Female surgeons were older at their first live births than the general population and faced stigma related to pregnancy. Between 39% and 56% experienced obstetric complications. Many reported a lack of lactation spaces and greater childcare burdens. Following the institution of a policy protecting parental leave by the American Board of Plastic Surgery (ABPS), trainees reported a positive affirmation in their selection of the surgical specialty.

The implementation of protected parental leave has positively influenced workplace culture in PRS. However, significant gender-related challenges remain, particularly stigmas surrounding pregnancy and parental leave.