SheMD Journal Club - Pregnancy and Motherhood During Surgical Training

Updated: Feb 26

Here at sheMD, we believe in the importance of practicing Evidence-Based Medicine. We believe the same principles apply to discussing Gender and Medical Education. Therefore, we are bringing you an entire Journal Club series! Our series will focus on foundational and new literature within the gender and medicine space.


Today, we will be discussing the article entitled, Pregnancy and Motherhood During Surgical Training by Erika L. Rangel, MD; Douglas S. Smink, MD, MPH; Manuel Castillo-Angeles, MD, MPH; Gifty Kwakye, MD; Marguerite Changala, BS; Adil H. Haider, MD, MPH; Gerard M. Doherty, MD


Why is this article important?


Do you ever what it's like to be pregnant as a resident? This 2018 study looked at the perception and experience of pregnant general surgery residents.



Article Summary


What they looked at:

  • This study looked at 347 female surgeons with 452 pregnancies.

How they measured things:

  • The authors distributed a 74-question survey. They did this using the Association of Women Surgeons, the Association of Program Directors in Surgery listserv, and through targeted social media platforms.

What were their outcomes:

  • The authors found a total of 297 women (85.6%) worked an unmodified schedule until birth, and 220 (63.6%) were concerned that their work schedule adversely affected their health or the health of their unborn child. Of the 297 respondents, 121 (34.9%) reported program maternity leave policies.

  • The majority of the respondents (251/297, 78.4%) received maternity leave of 6 weeks or less, and 250 (72.0%) perceived the duration of leave to be inadequate. The American Board of Surgery leave policy was cited as a major barrier to the desired length of leave by 268 of 326 respondents (82.2%).

  • Breastfeeding was important to 329 (95.6%), but 200 (58.1%) stopped earlier than they wished because of poor access to lactation facilities and challenges leaving the operating room to express milk. Sixty-four women (18.4%) had institutional support for childcare, and 231 (66.8%) reported a desire for greater mentorship on integrating a surgical career with motherhood and pregnancy.

  • A total of 135 (39.0%) strongly considered leaving surgical residency, and 102 (29.5%) would discourage female medical students from a surgical career, specifically because of the difficulties of balancing pregnancy and motherhood with training.



Why do we care about this article?

What does this mean?

  • The challenges of having children during surgical residency may have significant workforce implications. A deeper understanding is critical to prevent attrition and to continue recruiting talented students. This survey characterizes these issues to help design interventions to support childbearing residents.

How does this apply to us?

  • It is important for us to consider how program and speciality choice can impact the pregnancy experience for women in medical training, especially surgery residency.

  • With what we now know about physician fertility, institutions need to create better support systems for women who choose to become pregnant in medical school and residency.


Take Home Point

  • Pregnancy and childcare support may influence the decision to pursue or maintain a career in surgery (or any other speciality). .

  • It is important for residency leaders and educators to develop strategies for workforce shortages, improvements in the working environment, flexible leave policies, and preservation of the integrity of education for the pregnant resident and her colleagues.


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