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Mixed-Methods Evaluation of Surgeon Workplace Support and Obstetric Complications
Sarah J Halix1, Manuel Castillo-Angeles2, Atziri Rubio-Chavez1
1Department of Surgery, Massachusetts General Hospital, Mass General Brigham, Boston.
JAMA Surgery
|March 11, 2026
Summary
Lack of workplace support (LOWS) significantly increases obstetric risks for female surgeons. Addressing this stigma and improving institutional support are crucial for gender equity in surgery.
Area of Science:
- Obstetrics and Gynecology
- Surgical Workforce Studies
- Occupational Health
Background:
- Obstetric complications impact surgeons and their partners, with workplace dynamics during pregnancy being under-researched.
- Understanding these challenges is vital for surgeon well-being and retention.
Purpose of the Study:
- To determine the prevalence of obstetric complications among surgeons and their partners.
- To identify occupational risk factors for these complications.
- To explore surgeons' lived experiences with obstetric complications and workplace support.
Main Methods:
- A 2024 survey of US surgeons from the American College of Surgeons was conducted.
- Convergent mixed-methods analysis included quantitative survey data and qualitative free-text responses.
- Logistic regression and thematic network analysis were employed.
Main Results:
- Obstetric complications were more frequent in female surgeons (31.1%) than male surgeons (22.9%), even after adjusting for demographics and work factors.
- Lack of workplace support (LOWS) was significantly more common in female surgeons (64.4%) than male surgeons (31.9%).
- Adjusting for LOWS eliminated the sex-based disparity in obstetric complications, and qualitative data highlighted physical demands, cultural norms, and inadequate parental leave as key issues.
Conclusions:
- Pregnancy-related lack of workplace support (LOWS) is a key factor mediating increased obstetric risk for female surgeons.
- Addressing flexibility stigma, enhancing institutional support, and implementing supportive policies are essential for gender equity in surgical family building.
