7. The Impact of Plastic Surgery Career on Family Planning and Prenatal Health

Abstract

Body: Background: Women now represent 30% of plastic surgery residents. Plastic surgeons purposely delay childbearing due to the length and demanding nature of training and practice. The aim of this study is to report the current status of childbearing, infertility, obstetrical complications, maternity leave, and breastfeeding in practicing female plastic surgeons. Methods: Following IRB approval, an anonymous online survey was sent to all female active members of the American Society of Plastic Surgeons. Data collected included demographics, number of pregnancies, obstetrical complications, infertility, maternity leave, and breastfeeding. Results: Response rate was 19.7% and 189 responses were recorded. Eighty-two percent of respondents reported at least one pregnancy. Women reported they had their first child at a mean age of 34 years, which is older compared to 23 years for the general US population. Being a plastic surgeon increased the odds of having difficulty conceiving or carrying a pregnancy by a factor of 7.0 (95% CI [4.4, 11.0]) as compared to the US population. The odds of having a miscarriage among plastic surgeons was 4.8 (95% CI [2.8, 8.0]) times that of the US population. Furthermore, the rate of obstetrical complications was higher than the US population (61.0% versus 14.5%). Women took a mean of 6.6 ± 3.8 weeks for maternity leave and there was no significant difference based on stage of career. The mean length of breastfeeding was 7.6 ± 5.3 months. Approximately half (52.8%) of women reported they were satisfied with the amount of time they breastfed. Sixty-eight percent of women report stigma against pregnancy, this was significantly different by practice type, with hospital or solo practice having higher proportion of stigma reported as compared to academic or group practice (p=0.050) (Figure 1). Conclusions: Female plastic surgeons delay childbearing. Older maternal age combined with long hours and stressful work environment may contribute to the high rate of infertility, miscarriage and obstetrical complications. The American Board of Plastic Surgeons recently announced a policy to allow residents 12 weeks of parental leave. Additional changes in policy and culture are needed to improve the health of surgeons and future generations.