Canadian women in otolaryngology: head and neck surgery part 2-challenges in family planning, fertility, and lactation

Abstract

Background: Previous literature demonstrates that female surgeons face difficulties in family planning, meeting breastfeeding goals, leadership and advancement opportunities. These issues have received limited attention in Canadian surgeons despite different maternity leave patterns compared to the general Canadian population. We sought to describe the experience of otolaryngologist-head and neck surgeons in family planning, fertility, and lactation and to identify the role of gender and career stage in these experiences.

Methods: A RedCAP^® survey was disseminated to Canadian otolaryngology-head and neck surgeons and residents from March to May of 2021 through social media and the national listserv. This survey examined fertility, pregnancy losses, and infant feeding. Major independent variables include gender and career stage (faculty and resident). Dependent variables include respondent experiences with fertility, number of children, and length of parental leave. Responses were tabulated and presented descriptively to communicate the experience of Canadian otolaryngologists. Further, statistical comparisons such as chi-square and t-tests were employed to identify relationships between these variables. Thematic analysis was conducted for narrative comments.

Results: We received 183 completed surveys (22% response rate). 54% of females versus 13% of males agreed that career influenced their ability to have children (p = 0.002). 74% of female respondents without children have concerns about future fertility compared to 4% of men (p < 0.001). Furthermore, 80% of women versus 20% of men have concerns about future family planning (p < 0.001). The average maternity leave was 11.5 weeks for residents, and 22.2 weeks for staff. Additionally, significantly more women than men stated that maternity leave impacted advancement opportunities (32% vs. 7%) and salary/remuneration (71% vs. 24%) (p < 0.001). Over 60% of those choosing to pump breastmilk at work reported having inadequate time, space, and breastmilk storage. In total, 62% of breastfed infants were receiving breastmilk at 1 year.

Conclusion: Canadian female otolaryngologists-head and neck surgeons face challenges in family planning, ability to conceive, and breastfeeding. Focused effort is required to provide an inclusive environment that helps all otolaryngologists-head and neck surgeons achieve both their career and family goals, regardless of gender or career stage.

Keywords: Canadian otolaryngologists; Family planning; Fertility; Gender; Lactation.

Fig. 1

Female versus male response among respondents without children. A Likert response to the statement “I have concerns about future family planning” (p < 0.001). B Likert response to the statement “I have concerns about future fertility” (p < 0.001). C Likert response to the statement “I have concerns about future maternity/paternity leave” (p < 0.001). Likert responses “agree” and “somewhat agree” have been pooled to provide clarity as have the responses “somewhat disagree” and “disagree”

Fig. 2

Female versus male response among respondents with children. A Likert response to the statement “Training/practice influenced the number of children I CHOSE to have” (p < 0.001). B Likert response to the statement “Training/practice influenced my ABILITY to conceive as many children as I wished to have” (p = 0.010). Likert responses “agree” and “somewhat agree” have been pooled to provide clarity as have the responses “somewhat disagree” and “disagree”

Fig. 3

Female versus male responses regarding leadership and advancement. A Likert response to the statement “Having a child influenced my decision to pursue department or practice leadership roles” (p = 0.019). B Likert response to the statement “Maternity/paternity leave impacted my number of opportunities for career advancement” (p < 0.001). C Likert response to the statement “Maternity/paternity leave impacted my salary/remuneration” (p < 0.001). Likert responses “agree” and “somewhat agree” have been pooled to provide clarity as have the responses “somewhat disagree” and “disagree”

Fig. 4

Likert response to pumping breastmilk at work. Likert responses of women who pumped breastmilk at work to the statements “I had adequate time to pump at work”, “I had adequate space to pump at work (clean, private, accessible)” and “I had adequate space for pumped breastmilk storage at work”. Likert responses “agree” and “somewhat agree” have been pooled to provide clarity as have the responses “somewhat disagree” and “disagree”