Issues

Why are female surgeons having miscarriages at such a high rate?

surgeon

A troubling new study has found that an overly demanding workplace can have a deleterious effect on pregnant women. Published in JAMA Surgery, researchers discovered that female surgeons are suffering miscarriages at significantly higher rates than other women, along with infertility and other pregnancy complications.

In the study, researchers at Brigham and Women’s Hospital surveyed 692 female surgeons, and found that nearly half — 48% — experienced pregnancy complications, while 42% experienced pregnancy loss, meaning miscarriage or stillbirth. The miscarriage and stillbirth rate is more than twice as high as that of women who aren’t surgeons.

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, told USA Today that the pressures of the job play a significant role. “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.”

Over half of the female surgeons said they worked more than 60 hours a week during pregnancy, and many took overnight calls. Sadly, 42% of the female surgeons who experienced miscarriage took no time off of work afterwards to grieve their loss. And surgeons typically spend hours and hours on their feet at a time in an operating room, which Rangel says also puts them at risk.

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

READ: Former Amazon employee blames denial of pregnancy accommodations for miscarriage

On top of the strenuous expectations of their job, many female surgeons are not having children until after age 35, which also increases their risks of various complications. Dr. Mary Jane Minkin, OB-GYN and clinical professor of obstetrics and gynecology at the Yale School of Medicine, told USA Today that pregnancy after 35 means an increased risk of complications like preeclampsia, diabetes, preterm labor and miscarriage.

Instead of expecting pregnant surgeons to keep up with their colleagues, Minkin said accommodations need to be made so they can safely treat their patients — even accommodations as simple as extra break time to use the restroom, drink water, and eat. “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?”

Yet the workplace culture may make women feel that they can’t ask for extra help or accommodations, fearing resentment or retaliation. “There’s always a surgical bravado, we’re very independent and pride ourselves in problem solving on our own,” Rankel said.

It’s not uncommon for women to feel forced to choose between their children and their career, as pressure is put on them not to take any extra time off after birth, or receive accommodations for pregnancy and parenting. Yet surgery is even worse, with Rangel’s previous research finding that 40% of women who had children during surgical training considered quitting because of the demands of the job. Supporting these women, she explained, will have a positive impact for a long time.

“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.”

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