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The Evolving Focus on Surgeon Pregnancy by the Medical Community
Marianne Casilla-Lennon, MD, Stephanie Hanchuk, MD, Alyssa Grimshaw, M.S., Justin Nguyen, MD, Benjamin Press, MD, Sisi Zheng, BA, David Kim, BA, Jaime Cavallo, MD, MPHS.
Yale School of Medicine, New Haven, CT, USA.

BACKGROUND: Women surgeons have co-managed pregnancy and surgical practice for as long as they have been surgeons. We sought to chronicle the evolution of the medical community's focus on surgeon pregnancy by investigating thematic trends in the medical literature.
METHODS: A systematic literature search using keywords was performed in Web of Science, Embase, and Medline for publications regarding physician pregnancy. Data regarding surgeon pregnancy in training and in practice were abstracted from the literature search results.
RESULTS: Studies and narrative reviews regarding physician pregnancy began to populate the medical literature in the 1970s, paralleling a surge in medical school matriculation by women. Approximately fifteen years elapsed before the first studies of surgeon pregnancy emerged. The earliest studies focused on the effects of pregnancy on the field of specialty, practice type, and careers of women physicians. Multiple studies reported that female physicians who bore children were significantly less likely to hold academic positions commensurate with their experience level or ability, to have full-time employment status, and to achieve the work productivity of male physicians or female physicians who did not bear children. Early studies also consistently reported that male medical faculty and trainees were significantly more likely to hold negative views of female trainee pregnancy, the medical work environment toward pregnant trainees, and family-medical career balance. The medical community began to shift its focus toward medical workforce planning in the 1990s by evaluating the existence and comparative features of maternity leave policies for physicians in practice and in training. Beginning around the turn of the millennium, multiple studies report an increase in the birthrate among women surgeons in training, coined the “surgical residency baby boom”. Studies in the new millennium began to report on the occupational hazards of procedural careers on pregnancy, including radiation exposure, hazardous substance exposures, and long work hours. Higher frequencies of infertility, assisted reproductive technology utilization, spontaneous abortion, preeclampsia, fetal growth restriction, preterm labor, and labor induction have been reported in female surgeons compared to age-matched female peers.
CONCLUSIONS: The medical community's focus on surgeon pregnancy has evolved substantially from a prioritization of the effects of surgeon pregnancy on colleagues and the pregnant surgeon's work productivity, to maternity leave policy advocacy, and ultimately to the occupational hazards of surgical practice on pregnancy.


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