Pregnancy and Parenthood in Surgical Training

Abstract

Objectives To describe pregnancy outcomes, rates of infertility, patterns of parental leave, and working schedules in surgical trainees in the United Kingdom.

Design Cross sectional survey.

Setting Surgical training programs in the United Kingdom

Participants Four hundred and sixteen individuals who were enrolled on a surgical training program between June 2022 and March 2023.

Main Outcome Measures Self-reported age, gender, infertility investigations, pregnancy loss, pregnancy-associated complications, live births, parental leave, and working patterns.

Results Approximately 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.

Conclusion Surgical 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.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

S.A.H. is a Wellcome Trust Clinical Career Development Fellow.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was gained via the Central University Research Ethics Committee, University of Oxford (Ref: R80778/RE001).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Footnotes

jessica.whitburnnhs.net Jessica Whitburn

Saiful.miahnhs.net Saiful Miah

sarah.howlesnds.ox.ac.uk Sarah A. Howles

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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