Addressing the high rates of pregnancy complications and infertility among female surgeons: What should we do about it?

Abstract

Although nearly half of current surgical trainees identify as women, significant reproductive health disparities persist in our field. Female surgeons experience infertility rates nearly three times that of the general U.S. population, alongside substantially higher rates of pregnancy complications-even when compared to other demanding professions. These disparities are compounded by modifiable occupational hazards and the absence of standardized accommodations during pregnancy. In this article, we synthesize current evidence, identify the specific occupational factors contributing to these disparities, and propose practical, evidence-based workplace modification and policy recommendations. We also present a reproducible institutional model for pregnancy accommodations that can be adapted across institutions. The surgical profession is at an inflection point; just as duty-hour limits reshaped the culture of surgical training in the name of safety, so too must we advance comprehensive, enforceable accommodations that protect reproductive health.