Parenting in Surgery

19 December 2023

CBS recently conducted a survey to ascertain how supported employees, from trainees to consultants, felt when seeking information or guidance around parental leave. Sadly, over half of those responded felt that the Trust they work for failed to give them appropriate and clear guidance, and almost 70% felt let down by their line manager or lead clinician.

While these findings are shocking, they are not unexpected. There are many studies which point to precisely the same discrimination within the NHS workforce. It is therefore sadly not a surprise that surgeons feel that navigating pregnancy and parental leave within a surgical team is a minefield, and are left feeling unguided and largely unsupported.

A recent study by Jessica Whitburn, Saiful Miah, and Sarah Howles reveals more shocking statistics. The study delves into the experiences of 222 childbearing surgical trainees, unearthing statistics that underscore the severity of the challenges faced. The full study results from the article Pregnancy and Parenthood in BJS are available here.

A staggering 36% of these trainees experienced pregnancy loss, higher than those within the general population, and particularly prevalent among those under 35 years of age. The study amplifies the struggles of trainees who postpone parenthood due to rigorous training, leading to increased rates of infertility investigations among both male and female surgeons.

Financial repercussions are also highlighted, with trainees reporting significant losses, some up to £50,000, when work restrictions are put in place during pregnancy. Pregnant surgical trainees working without restrictions reported working night shifts and extended working hours, some surpassing 60 hours a week. These practices are associated with higher risks of miscarriage and adverse pregnancy outcomes, further highlighting the inadequacies of current safeguards.

“A shift is needed in how we view and support childbearing individuals within the surgical profession," advocates author, Consultant Urologist Sarah Howles, “We need to recognise pregnant surgical trainees as a high-risk obstetric group and adapt their working schedules to protect their obstetric health. Our data demonstrates that a reevaluation of attitudes toward childbearing people within the surgical community needs to start now. We must begin working towards mitigating these risks”.

It’s clear that changes are imperative. Surgeons are a high-risk pregnancy group and must be recognised as such. The intersection of surgical training and family life demands more than the existing system provides, and change must be inevitable.

At CBS, we are committed to forging a more supportive and inclusive future for those navigating the delicate balance between career and family, and to do so need to hear your stories. Contact us in confidence via Instagram or email (admin@cbsgb.co.uk) to tell us how pregnancy and parenthood has been managed within your workplace, and any shortfalls or inadequacies you have experienced that you feel need to be addressed. Additionally, please do not hesitate to contact the Surgical Advisory Service advice@cbsgb.co.uk or 07498 322935 if you require any support. CBS members also have access to a free and confidential counselling service.

Mark Henley, consultant plastic surgeon and President of The Confederation of British Surgery says:

“It is shocking to hear of the negative experiences and hurdles encountered by hardworking NHS employees when seeking guidance about their parental leave rights. We urge Trusts, Educational Supervisors and Lead Clinicians to view this feedback as an opportunity to evolve, and to implement the support structure required to make decisions to protect the health of pregnant surgical trainees. The onus is not on the individual to seek guidance, but for the guidance to be provided to the individual as soon as is practicable. Furthermore, we call for clarity when signposting the law and protocols, as well as training to empower line managers and lead clinicians to further support team members.”

CBS Survey highlights

58.57% felt they did not have clear guidance on maternity leave from the trust.
81.25% stated that information given to them by their trade union was unclear.
79.31% said they let down by their trainer.
74.19% did not receive sufficient support from their deanery.
68.75% were not given adequate support by lead clinician or line manager.

Pregnancy and Parenting Study highlights

36% had experienced a pregnancy loss
Pregnancy loss rate was 31%
Rates of pregnancy loss in under-35s were three times that expected in the age group
One in three childbearing surgical trainees did not take any time off work after pregnancy loss
Only 47% disclosed their loss to a colleague
Financial losses ranged from £3000 to £50,000
Over 70% of childbearing surgical trainees worked for 40 hours or more each week during pregnancy
4% worked more than 60 hours per week
Most trainees continued to work at night throughout their pregnancy
Half continued to operate for more than 9 hours each week, up until maternity leave
70% of childbearing surgical trainees altered their work schedule during pregnancy
77% felt guilty for burdening their colleagues by reducing their workload
Of those trainees who did not alter their work schedule in pregnancy, 40% made this decision to avoid being ‘considered weak’
The most common reason for surgical trainees stopping breastfeeding early was inadequate work provision

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