The opportunity cost of operating: Infertility increases among female plastic surgeons

• Published in: The American journal of surgery 2023-01, Vol.225 (1), p.11-12
• Main Authors: Adams, Alexandra M., Weaver, M. Libby
• Format: Article
• Language: English
• Subjects: Breast feeding; Complications; Female; Fertility; Fetuses; Humans; Infertility; Miscarriage; Occupational health; Patient Protection & Affordable Care Act 2010-US; Plastic surgery; Pregnancy; Surgeons; Surgery; Surgery, Plastic; Tobacco; Trends; Work environment; Working conditions
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2022.10.042

In this Association of Women Surgeons special issue of the American Journal of Surgery, Dr. Hemal and colleagues investigate the differences in fertility and childbearing outcomes of plastic surgeons today,1 in comparison to a historical cohort 25 years ago as presented by the landmark paper The Pregnant Plastic Surgery Resident by Eskenazi et al.2 As surgical departments strive to be welcoming environments for surgeon mothers, we commend the authors for addressing such a high visibility topic. Other studies have demonstrated similar findings of increasing rates of infertility, miscarriages, and obstetrical complications among female surgeons of other subspecialties, as well as a trend towards older age at first pregnancy.3–5 Hemal et al. acknowledge some strides made towards improving the work environment for working mothers, such as the Family and Medical Leave Act in 1993 and the Patient Protection and Affordable Care Act in 2010, which attempt to provide reasonable leave time and work environments for breastfeeding mothers, but these seem to be bare minimums. Studies show the impact of long workhours and high job strain during the first trimester impacts pregnancy outcomes to the same degree as smoking tobacco.7 With such high rates of miscarriage and complications, women in surgery are, understandably, hesitant to openly share their pregnancy status until they are well into their term. [...]important opportunities for maternal wellness during the first trimester, a crucial time for fetal development, may be missed.