Characterization of Female Urologists’ Pregnancy, Perinatal, and Breastfeeding Outcomes

Objective: To evaluate pregnancy outcomes and breastfeeding (BF) practices for female surgeons and identify modifiable factors improve outcomes. Methods: A survey was distributed to practicing surgeons, including general surgery, urology, otolaryngology, orthopedics, general surgery, plastic surgery, vascular surgery, and other surgical specialties. Survey questions regarding demographics, career stage, maternity leave, pregnancy/delivery, perinatal complications, BF goals, and barriers to meeting those goals were asked. Responses were analyzed and then stratified based on meeting a personal BF goal or not and by those who felt they missed out on career opportunities due to pregnancy. Results: Information on 1227 births by female surgeons with 13.3% urologists were reported. The median maternal age at delivery was 34 years (IQR: 32-37 years). Only 59.5% of respondents reported meeting their personal BF goal and this was significantly different based on specialty (P = .021). Lactation spaces at work were only available for 56.6% of respondents, and access to one was significantly associated with meeting a BF goal and feeling as if BF did not negatively impact their career (P <.001). A quarter of female surgeons (24.9%) felt BF contributed to missed career opportunities and this was significantly associated with levels of support from colleagues and administration (P <.001). Conclusion: Female surgeons still have external (ie, lack of lactation spaces, etc) and internal (ie, perception of lack of support from colleagues, etc) barriers to achieving their BF goals. Further research to identify specific modifiable factors to improve outcomes for all child-bearing surgeons, and targeted interventions regarding maternity leave and flexible scheduling to allow direct BF to infants should be encouraged to support surgeon mothers.