Female surgeons are more prone to miscarriages during pregnancy than the overall U.S. female population, according to research published in the Journal of the American Medical Association Wednesday.
Working long, strenuous hours during pregnancy contributes to female surgeons in their 30s and 40s being 1.7 times more likely to suffer miscarriages than others in that age group, researchers at Brigham and Women's Hospital in Boston conclude in the study.
Among the surgeons surveyed, 41% had a miscarriage, the study found. Eighty-five percent of those miscarriages occurred during the first 10 weeks of pregnancy, and one-third before the end of the second trimester, the study found. About 3% of these pregnancies ended in a stillbirth.
Healthcare companies lack adequate measures to ensure the safety of pregnant workers and don't provide sufficient maternity leave, which puts pregnant surgeons in a risky position, said Dr. Erika Rangel, one of the article's authors. Female physicians also may feel pressure to work harder to fight perceptions that women who become pregnant are less committed to their careers.
"The way female surgeons are having children today makes them inherently a high-risk pregnancy group," Rangel said. There is a stigma about asking for help within surgical culture, she said.
Many female surgeons work long hours during pregnancy or delay plans to have children until they have completed their surgical training, which can take them into their mid-30s—just as the dangers of pregnancy complications increases because of age. As a consequence, female surgeons are at greater risk of problems such as preterm births or placental dysfunction, Rangel said.
The Brigham and Women's researchers discovered that 57% of pregnant surgeons worked more than 60 hours a week. Almost 2 of 5 spent at least 16 hours a week in the operating room during their third trimesters. And one-third reported taking at least a half-dozen overnight calls per month during their pregnancies.
These surgeons aren't taking much of a break after miscarriages, either the study found. Three-quarters of these doctors took no time off following miscarriages, although half of those who had a stillbirth took up to a week off.
The Family and Medical Leave Act does not guarantee paid parental leave for surgeons, but about two-thirds of surgical training programs enacted paid leave policies within the last year, Rangel said.
Addressing the shortcomings in how healthcare employers treat pregnant workers is only growing more critical as women make up a larger share of the medical workforce, Rangel said. Four years ago, only 20% of general surgeons were female, but that's changing. In 2018, women comprised 45% of all medical residents and 41% of general surgery residents.