Pregnancy and Parenthood in Surgical Training

ObjectivesTo describe pregnancy outcomes, rates of infertility, patterns of parental leave, and working schedules in surgical trainees in the United Kingdom. DesignCross sectional survey. SettingSurgical training programs in the United Kingdom ParticipantsFour hundred and sixteen individuals who were enrolled on a surgical training program between June 2022 and March 2023. Main Outcome MeasuresSelf-reported age, gender, infertility investigations, pregnancy loss, pregnancy-associated complications, live births, parental leave, and working patterns. ResultsApproximately half of all surgical trainees delayed attempting to have children due to training, over 80% regretted this decision and 23% of trainees had undergone fertility testing. Overall, childbearing surgical trainees experienced a pregnancy loss rate of 31%, and those aged less than 35 years had a pregnancy loss rate of 35%. A third of trainees did not take any time off work following pregnancy loss and over half of trainees did not disclose their loss to colleagues. Major pregnancy-associated complications occurred in 31% of pregnancies in surgical trainees, a significantly higher rate than pregnancies in a socio-demographically similar control group (9%, p=0.0001). Most trainees continued to work at night throughout their pregnancy and half continued to operate for more than 9 hours each week up until parental leave; trainees felt guilty for burdening their colleagues by reducing their workload. Childbearing surgical trainees on average took 10.2 months of parental leave whilst most non-childbearing surgical trainees took 2 weeks; two thirds of non-childbearing surgical trainees felt this was insufficient. After parental leave, 61% of childbearing and 15% of non-childbearing surgical trainees reduced their working hours to accommodate family life. ConclusionSurgical trainees often delay parenthood due to training and are at risk of high rates of infertility, pregnancy loss, and major pregnancy-associated complications. This study highlights the need for changes in surgical culture and training structures to improve obstetric health and facilitate family life for surgeons in training.