Pregnancy and parental leave among neurosurgeons and neurosurgical trainees

View More View Less
  • 1 Department of Neurosurgery and
  • 2 School of Medicine, University of California, San Diego, La Jolla, California;
  • 3 Department of Neurosurgery, Mercer University School of Medicine, Savannah, Georgia;
  • 4 Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York;
  • 5 Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan;
  • 6 Department of Neurosurgery, IU Health Neuroscience Center, Indiana University, Indianapolis, Indiana;
  • 7 Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York;
  • 8 Department of Neurosurgery, University of Nebraska Medical Center, Omaha, Nebraska;
  • 9 Department of Neurosurgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio;
  • 10 Department of Neurosurgery, Case Western Reserve University, Cleveland, Ohio;
  • 11 Department of Neurological Surgery, Weill Medical College of Cornell University, New York, New York; and
  • 12 Department of Neurosurgery, The Cleveland Clinic Foundation, Cleveland, Ohio
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

OBJECTIVE

Despite recently heightened advocacy efforts relating to pregnancy and family leave policies in multiple surgical specialties, no studies to date have described female neurosurgeons’ experiences with childbearing. The AANS/CNS Section of Women in Neurosurgery created the Women and Pregnancy Task Force to ascertain female neurosurgeons’ experiences with and attitudes toward pregnancy and the role of family leave policies.

METHODS

A voluntary online 28-question survey examined the pregnancy experiences of female neurosurgeons and perceived barriers to childbearing. The survey was developed and electronically distributed to all members of the American Association of Neurological Surgeons and Congress of Neurological Surgeons who self-identified as female in February 2016. Responses from female resident physicians, fellows, and current or retired practicing neurosurgeons were analyzed.

RESULTS

A total of 126 women (20.3%) responded to the survey; 57 participants (49%) already had children, and 39 (33%) planned to do so. Participants overwhelmingly had or planned to have children during the early practice and senior residency years. The most frequent obstacles experienced or anticipated included insufficient time to care for newborns (47% of women with children, 92% of women planning to have children), discrimination by coworkers (31% and 77%, respectively), and inadequate time for completion of board requirements (18% and 51%, respectively). There was substantial variability in family leave policies, and a minority of participants (35%) endorsed the presence of any formal policy at their institution. Respondents described myriad unique challenges associated with pregnancy and family leave.

CONCLUSIONS

Pregnancy and family leave pose significant challenges to the recruitment, retention, and advancement of women in neurosurgery. It is thus imperative to promote clear family leave policies for trainees and practitioners, address discrimination surrounding these topics, and encourage forethought and flexibility to tackle obstacles inherent in pregnancy and the early stages of child rearing.

ABBREVIATIONS AANS = American Association of Neurological Surgeons; ABNS = American Board of Neurological Surgery; CNS = Congress of Neurological Surgeons; WINS = Women in Neurosurgery.

Supplementary Materials

    • Supplemental Data (PDF 982 KB)

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Correspondence Sharona Ben-Haim: University of California, San Diego, CA. sbenhaim@health.ucsd.edu.

INCLUDE WHEN CITING Published online May 29, 2020; DOI: 10.3171/2020.2.JNS193345.

M.G. and A.R. contributed equally to this work.

Disclosures Dr. Germano: consultant for Brainlab and Integra and direct stock ownership in Elminda and Surgical Theater. Dr. Sweet: consultant for Koh Young Inc.

  • 1

    ACGME. Data Resource Book Academic Year 2007-2008. Accreditation Council for Graduate Medical Education; 2008.

  • 2

    ACGME. Data Resource Book Academic Year 2017-2018. Accreditation Council for Graduate Medical Education; 2018.

  • 3

    AAMC. Residency Applicants to ACGME-Accredited Programs by Specialty and Sex, 2018-2019. Association of American Medical Colleges; 2018.

    • Search Google Scholar
    • Export Citation
  • 4

    Abosch A, Rutka JT. Women in neurosurgery: inequality redux. J Neurosurg. 2018;129(2):277281.

  • 5

    Agarwal N, White MD, Pannullo SC, Chambless LB. Analysis of national trends in neurosurgical resident attrition. J Neurosurg. 2019;131(5):16681673.

    • Search Google Scholar
    • Export Citation
  • 6

    Rangel EL, Smink DS, Castillo-Angeles M, Pregnancy and motherhood during surgical training. JAMA Surg. 2018;153(7):644652.

  • 7

    Cochran A, Hauschild T, Elder WB, Perceived gender-based barriers to careers in academic surgery. Am J Surg. 2013;206(2):263268.

  • 8

    Dixit A, Feldman-Winter L, Szucs KA. Parental leave policies and pediatric trainees in the United States. J Hum Lact. 2015;31(3):434439.

    • Search Google Scholar
    • Export Citation
  • 9

    Eskenazi L, Weston J. The pregnant plastic surgical resident: results of a survey of women plastic surgeons and plastic surgery residency directors. Plast Reconstr Surg. 1995;95(2):330335.

    • Search Google Scholar
    • Export Citation
  • 10

    Gabbe SG, Morgan MA, Power ML, Duty hours and pregnancy outcome among residents in obstetrics and gynecology. Obstet Gynecol. 2003;102(5 Pt 1):948951.

    • Search Google Scholar
    • Export Citation
  • 11

    Holliday EB, Ahmed AA, Jagsi R, Pregnancy and Parenthood in Radiation Oncology, Views and Experiences Survey (PROVES): results of a blinded prospective trainee parenting and career development assessment. Int J Radiat Oncol Biol Phys. 2015;92(3):516524.

    • Search Google Scholar
    • Export Citation
  • 12

    Merchant S, Hameed M, Melck A. Pregnancy Among Residents Enrolled in General Surgery (PREGS): a survey of residents in a single Canadian training program. Can J Surg. 2011;54(6):375380.

    • Search Google Scholar
    • Export Citation
  • 13

    Park J, Minor S, Taylor RA, Why are women deterred from general surgery training? Am J Surg. 2005;190(1):141146.

  • 14

    Pham DT, Stephens EH, Antonoff MB, Birth trends and factors affecting childbearing among thoracic surgeons. Ann Thorac Surg. 2014;98(3):890895.

    • Search Google Scholar
    • Export Citation
  • 15

    Bellini MI, Graham Y, Hayes C, A woman’s place is in theatre: women’s perceptions and experiences of working in surgery from the Association of Surgeons of Great Britain and Ireland women in surgery working group. BMJ Open. 2019;9(1):e024349.

    • Search Google Scholar
    • Export Citation
  • 16

    Mulcahey MK, Nemeth C, Trojan JD, O’Connor MI. The perception of pregnancy and parenthood among female orthopaedic surgery residents. J Am Acad Orthop Surg. 2019;27(14):527532.

    • Search Google Scholar
    • Export Citation
  • 17

    Fujimaki T, Shibui S, Kato Y, Working conditions and lifestyle of female surgeons affiliated to the Japan Neurosurgical Society: findings of individual and institutional surveys. Neurol Med Chir (Tokyo). 2016;56(11):704708.

    • Search Google Scholar
    • Export Citation
  • 18

    Steklacova A, Bradac O, de Lacy P, Benes V. E-WIN Project 2016: Evaluating the current gender situation in neurosurgery across Europe—an interactive, multiple-level survey. World Neurosurg. 2017;104:4860.

    • Search Google Scholar
    • Export Citation
  • 19

    Dixon A, Silva NA, Sotayo A, Mazzola CA. Female medical student retention in neurosurgery: a multi-faceted approach. World Neurosurg. 2019;122:245251.

    • Search Google Scholar
    • Export Citation
  • 20

    Salles A, Milam L, Cohen G, Mueller C. The relationship between perceived gender judgment and well-being among surgical residents. Am J Surg. 2018;215(2):233237.

    • Search Google Scholar
    • Export Citation
  • 21

    Zhuge Y, Kaufman J, Simeone DM, Is there still a glass ceiling for women in academic surgery? Ann Surg. 2011;253(4):637643.

  • 22

    Acai A, Steyn C, Reid SE, Sonnadara RR. A solution to gender inequity in surgery? Better caregiving policies. Can J Surg. 2018;61(1):67.

    • Search Google Scholar
    • Export Citation
  • 23

    Sandler BJ, Tackett JJ, Longo WE, Yoo PS. Pregnancy and parenthood among surgery residents: results of the first nationwide survey of general surgery residency program directors. J Am Coll Surg. 2016;222(6):10901096.

    • Search Google Scholar
    • Export Citation
  • 24

    Davis JL, Baillie S, Hodgson CS, Maternity leave: existing policies in obstetrics and gynecology residency programs. Obstet Gynecol. 2001;98(6):10931098.

    • Search Google Scholar
    • Export Citation
  • 25

    Hariton E, Matthews B, Burns A, Pregnancy and parental leave among obstetrics and gynecology residents: results of a nationwide survey of program directors. Am J Obstet Gynecol. 2018;219(2):199.e1199.e8.

    • Search Google Scholar
    • Export Citation
  • 26

    Burtle A, Bezruchka S. Population health and paid parental leave: what the United States can learn from two decades of research. Healthcare (Basel). 2016;4(2):4.

    • Search Google Scholar
    • Export Citation
  • 27

    Greenfield JC, Klawetter S. Parental leave policy as a strategy to improve outcomes among premature infants. Health Soc Work. 2016;41(1):1723.

    • Search Google Scholar
    • Export Citation
  • 28

    Dagher RK, McGovern PM, Dowd BE. Maternity leave duration and postpartum mental and physical health: implications for leave policies. J Health Polit Policy Law. 2014;39(2):369416.

    • Search Google Scholar
    • Export Citation
  • 29

    Mayer KL, Ho HS, Goodnight JE Jr. Childbearing and child care in surgery. Arch Surg. 2001;136(6):649655.

  • 30

    Kahn JR, García-Manglano J, Bianchi SM. The motherhood penalty at midlife: long-term effects of children on women’s careers. J Marriage Fam. 2014;76(1):5672.

    • Search Google Scholar
    • Export Citation
  • 31

    Mueller C, Wright R, Girod S. The publication gender gap in US academic surgery. BMC Surg. 2017;17(1):16.

  • 32

    Shaikh AT, Farhan SA, Siddiqi R, Disparity in leadership in neurosurgical societies: a global breakdown. World Neurosurg. 2019;123:95102.

    • Search Google Scholar
    • Export Citation
  • 33

    Cohen KL. Racial and ethnic disparities in health care. Ann Intern Med. 2005;142(2):154.

  • 34

    Roter DL, Hall JA, Aoki Y. Physician gender effects in medical communication: a meta-analytic review. JAMA. 2002;288(6):756764.

  • 35

    Wallis CJ, Ravi B, Coburn N, Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study. BMJ. 2017;359:j4366.

    • Search Google Scholar
    • Export Citation
  • 36

    Lerner LB, Stolzmann KL, Gulla VD. Birth trends and pregnancy complications among women urologists. J Am Coll Surg. 2009;208(2):293297.

    • Search Google Scholar
    • Export Citation
  • 37

    Greenberg CC. Association for Academic Surgery presidential address: sticky floors and glass ceilings. J Surg Res. 2017;219:ixxviii.

  • 38

    Kin C, Yang R, Desai P, Female trainees believe that having children will negatively impact their careers: results of a quantitative survey of trainees at an academic medical center. BMC Med Educ. 2018;18(1):260.

    • Search Google Scholar
    • Export Citation
  • 39

    Statement on Family and Medical Leave. American Board of Neurological Surgery. Accessed March 23, 2020. https://abns.org/family-and-medical-leave/

    • Export Citation
  • 40

    Weiss J, Teuscher D. What provisions do orthopaedic programs make for maternity, paternity, and adoption leave? Clin Orthop Relat Res. 2016;474(9):19451949.

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 590 590 205
Full Text Views 82 82 20
PDF Downloads 37 37 13
EPUB Downloads 0 0 0