Plastic Surgery Research Council

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Fertility and Family for Plastic Surgery Residents and Fellows
Debra A. Bourne, MD1, Wendy Chen, MD1, Benjamin Schilling, MS2, Eliza Beth Littleton, PhD2, Kia Washington, MD3, Carolyn De La Cruz, MD1.
1University of Pittsburgh Medical Center, Pittsburgh, PA, USA, 2University of Pittsburgh, Pittsburgh, PA, USA, 3University of Colorado, Aurora, CO, USA.

PURPOSE:
Plastic surgery training occurs during childbearing years. Women now constitute over one-third of plastic surgery residents. Limited data has been published assessing childbearing in plastic surgery trainees. This is the first study to collect data directly from residents and fellows to understand issues surrounding childbearing and to propose solutions.
METHODS:
This IRB-approved study was performed through distribution of a survey to all current plastic surgery residents and fellows in ACGME accredited programs. Data collected included demographic information, number of pregnancies, assisted reproductive technologies (ART) employed, complications, attitudes regarding pregnancy and breastfeeding, parental leave, and impact of training on decisions to have children.
RESULTS:
The survey was completed by 307 trainees, for a resident response rate of 27.0%. Mean age was 31.7 3.8 years, 58.6% of respondents were married, and 35.3% reported at least one pregnancy for themselves or partner.
Both male (67.4%) and female (76.5%) respondents intentionally postponed having children due to career. Females were significantly more likely to report negative stigma attached to pregnancy (70.4% vs. 51.1%, p=0.003) and plan to delay childbearing until after training. 55.6% of female trainees reported an obstetrical complication. ART was utilized by 19.6% of trainees.
Mean maternity leave was 5.5 weeks with 44.4% taking less than six weeks. Mean paternity leave was 1.2 weeks. 62.2% of females and 51.4% males reported dissatisfaction with leave.
61% of female trainees breastfed for 6 months and 19.5% continued for 12 months. Lactation facilities were available near operating rooms for 29.4% of respondents.
CONCLUSIONS:
Plastic surgery residents and fellows postpone childbearing due to the demands of their career and have their first child 5 years later than the general US population. This could be a contributing factor to increased rates of obstetrical complications (55.6% compared to 14.5% in the general population) and use of ART (19.6% compared to 5.6%) in this cohort.
The American College of Obstetricians and Gynecologists recommends a minimum of 6 weeks paid parental leave, however 44.4% of plastic surgery trainees are not able to take leave of this length. The American Academy of Pediatrics recommends 6 months of exclusive breast feeding and continued supplemental breast feeding until 1 year. Only 19.5% of plastic surgery trainees were able to follow these recommendations.
Policies to allow for greater flexibility in rotation schedules to permit a lighter workload during pregnancy, and formal parental leave and breastfeeding policies are needed. Assisted reproductive technology should be included in health benefits for plastic surgery trainees.


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