Female surgeons have miscarriages at more than twice the rate of the general population, study finds

Only one in five practicing surgeons in the U.S. are women.

And while women are entering the surgical field in increasing numbers, health experts worry they may face a higher risk of pregnancy complications because of their profession.

In a survey of 692 female surgeons, researchers at Brigham and Women’s Hospital found 48% experienced pregnancy complications, according to a study published Wednesday in JAMA Surgery.

The report also showed 42% had a pregnancy loss, which is more than twice the rate of the general population in women aged 30 to 40.

Unrelenting work hours, unmodified schedules, brief maternity leave options and little support for childcare may contribute to these outcomes, said corresponding author Dr. Erika Rangel, assistant professor in surgery at Harvard Medical School and director of the surgical intensive care unit at Brigham and Women’s Faulkner Hospital.

“There’s a lot of morbidity associated with women surgeons having children,” she said. “They work at full steam right up until delivery and it’s a very physical job.”

Fifty-seven percent of female surgeons surveyed said they worked more than 60 hours per week during pregnancy and 37% took more than six overnight calls, researchers found. Of the 42% of women who experienced a miscarriage, three-quarters took no days off work afterwards.

“The way female surgeons are having children today makes them inherently a high-risk pregnancy group,” Rangel said. “As a woman reaches her third trimester, she should not be in the operating room for more than 12 hours a week.”

In addition to demanding work hours, many female trainees are choosing to delay pregnancy until after age 35 – when they finish training – which is a risk factor for having major pregnancy complications.

Pregnancy after 35 increases a woman’s risk of preeclampsia, diabetes, preterm labor and miscarrying, said Dr. Mary Jane Minkin, OB-GYN and clinical professor of obstetrics and gynecology at the Yale School of Medicine.

There isn’t much data to support that women working in physically demanding environments have higher rates of pregnancy complications, she said, but surgeons can be on their feet for hours at a time. There must be accommodations to go to the bathroom, grab a snack, drink water, and take a break, she said.

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“The major concern one has is, is she basically taking care of herself or not? Is she eating properly, drinking properly and spending time off her feet?” Minkin said.

To change the course of these health outcomes, experts said institutions need to invest in top-down campaigns to support pregnant surgeons, and change the culture and stigma surrounding childbearing.

Women are pressured by surgical culture to not ask for help, Rangel said. They may not want to be a burden to their colleagues and choose to work without recognizing their health needs.

“There’s always a surgical bravado, we’re very independent and pride ourselves in problem solving on our own,” she said.

To reduce stigma and resentment, Rangel said department leaders must offload work in a fair way and generously compensate colleagues for the extra work they take on. Residency programs must also facilitate and support childbearing earlier in a surgeon’s career to reduce pregnancy-related health risks.

Rangel worries the field may lose hardworking and talented surgeons. In previous research, she found nearly 40% of people who had children during training had seriously considered leaving because of the challenges they faced.

“It is a brief period of time that a woman is pregnant but supporting them is an investment in a surgeon who will continue to practice for another 25 to 30 years,” she said. “This cannot be a woman’s problem. It can’t be a female surgeon problem. This is a problem that our entire next generation faces.”

Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.

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This article originally appeared on USA TODAY: Pregnancy: Female surgeons at higher risk of complications, study says