Abstract
BACKGROUND: Medical training occurs during optimal childbearing years. While unique family planning challenges for surgeons are becoming more widely reported, a gap in knowledge remains regarding fertility and pregnancy risks for each subspecialty. This study assessed reported experiences and opinions of orthopaedic surgeons compared with other physicians and the general population regarding pregnancy complications, infertility, and maternal support. METHODS: An anonymous, voluntary survey was distributed to female physicians through private physician social media groups from June 2021-August 2021. The survey queried pregnancy demographics and complications, infertility diagnosis and treatment, workplace environment, and prior education on these topics. Results were compared between orthopaedic surgeons and the general population and other physicians. RESULTS: Four thousand six hundred thirty-eight female physicians completed the survey, including 141 orthopaedic surgeons (3%). Compared with the general population, orthopaedic surgeons had children later in life (34.1 vs. 23.6 years; p < 0.0001), were more likely to have had a miscarriage (40% vs. 19.1%; p < 0.0001), undergone infertility evaluation (40.1% vs. 8.8%; p < 0.0001) or infertility treatment (31.9% vs. 12.7%; p < 0.0001), and had a preterm birth (19.9% vs. 10.2%; p < 0.0001). Forty-six percent of orthopaedic surgeons reported a pregnancy complication, and 6% received education on risks of delaying pregnancy. Compared with other physicians, orthopaedic surgeons were older at their first pregnancy (34.1 vs. 31.7, p < 0.0001), had fewer children (1.8 vs. 2.0, p = 0.0094), were more often discouraged from starting a family during training and practice (56% vs. 42%, p = 0.0007), and worked more hours per week while pregnant (59.1 vs. 54.1, p = 0.0002). CONCLUSIONS: Female orthopaedic surgeons may have increased risks of miscarriage, infertility, and preterm birth compared with the general population. In addition, orthopaedic surgeons report experiencing more negative workplace attitudes and longer working hours while pregnant compared with physician peers. The culture of orthopaedic surgery must continue to evolve to better support women physicians with pregnancy and family planning. LEVEL OF EVIDENCE: Level III. See Instructions for Authors for a complete description of levels of evidence.