Pregnancy complications in orthopaedic surgeons: Does subspecialty choice matter?

Introduction: Female orthopaedic surgeons report delaying pregnancy secondary to their career and also have higher risks for infertility and pregnancy complications. The purpose of this study was to determine if a relationship exists between orthopaedic subspecialty and fertility, pregnancy complications, and paid parental leave. Methods: An anonymous, 168-item online survey was distributed to the Ruth Jackson Orthopaedic Society and the Women in Orthopaedics Facebook group. Respondents were queried regarding subspecialty, family planning, fertility, age and training stage at each pregnancy, pregnancy complications and paid parental leave. One way ANOVA and multiple regression were used for statistical analysis. Results: Subspecialty was reported by 586 (of 801) respondents. Respondents with children (n=324) were surveyed about their first three pregnancies. Subspecialty was not associated with age at first delivery, number of miscarriages, method of conception, assistance with conception, secondary infertility, or complications. There was a significant relationship between subspecialty and weeks of paid leave. Adult reconstruction surgeons were offered the shortest paid leave time (average 2.5 wk), while oncology offered the longest (average 9.9 wk). Surgeons who were offered less paid leave took less leave overall ( P =0.023). The cost of leave was significantly associated with weeks offered and weeks taken ( P <0.001). Discussion: Subspecialty choice was not found to have a relationship with fertility and pregnancy outcomes. However, subspecialty was related to the amount of paid leave offered, which influenced the amount of leave taken and associated costs. These findings demonstrate the need for the development of parental leave policies that provide equal opportunities across subspecialties.