Impact of Pregnancy on Work-Related Musculoskeletal Disorders Among Female Gynecologic Surgeons: A Cross-Sectional Survey

INTRODUCTION: The impact of pregnancy on surgeon ergonomics is largely unknown. There is an increase in surgeon pregnancy rates, with more women pursuing careers in surgical specialties. Women surgeons face unique ergonomic challenges with smaller hand size and shorter stature, putting them at higher risk for work-related musculoskeletal disorders (WMSDs). However, the impact of pregnancy on surgeon ergonomics and WMSDs needs further investigation. OBJECTIVE: Evaluate the rate of WMSDs in pregnant surgeons compared to non-pregnant surgeons. Determine if WMSDs affect surgical practice, including changing clinic or surgical volume, route of surgery, and change in surgical stance. METHODS: We conducted a cross-sectional survey of women gynecologic surgeons via electronic distribution to the members of the Society of Gynecologic Surgeons (SGS). Participants completed a survey of up to 24 questions, including personal demographics, practice information, pregnancy history, ergonomics in the operating room (OR), and WMSDs. Participant demographics were descriptively summarized by pregnancy history and presence of WMSD and compared between groups using Wilcoxon rank-sum tests for continuous variables and chi-square tests or Fisher's exact test for categorical variables. Hypothesis tests are two-sided, and p-values less than 5% were considered statistically significant. RESULTS: There were 115 survey responses. 92 respondents had been or currently were pregnant and 23 had never been pregnant. Besides age, no difference in demographics was seen between the two groups. There was no statistical difference in rates of physical strain in the OR (89.1% of previously pregnant participants vs 91.3% of never pregnant participants experiencing strain). Location of strain was statistically different, with higher incidence of pelvic girdle pain in the OR in the pregnant or previously pregnant group (45.1% vs 4.8%, p<0.001). Never-pregnant participants were more likely to report upper back pain (54.9% vs 95.2%, p<0.001) and hand or wrist pain (31.7% vs 71.4%, p=0.002, respectively). There was no difference between these groups with seeking out treatment (Table 1). Of all those experiencing WMSDs in the OR, 32% reported changing their practice due to physical strain. Of these participants, 75.6% changed surgical stance, 33.3% reduced their surgical volume, and 24.2% changed the route of surgery. We found no correlation between rates of WMSDs and high volume (>10 cases per month) vs low volume (1–10 cases per month) surgeons (Table 2). 20.3% of all respondents had received any ergonomics-specific training. CONCLUSIONS: Female surgeons experience a high rate of work-related musculoskeletal injuries, independent of pregnancy status. Despite the high rate, only 23% of those injured sought treatment and 32% changed their practice. Supporting more formal education on surgeon ergonomics is necessary to avoid injuries in the operating room.