Female Doctors Have Higher Infertility Rates and Riskier Pregnancies: What Can Be Done?

 (Source: https://www.medscape.com/)

 

In 2021, Eugene Kim, MD, division director of pediatric surgery and vice chair in the department of surgery at Cedars-Sinai Medical Center in Los Angeles, gave his presidential address to the Association for Academic Surgery.

"Presidents tend to give a message of hope or inspiration; I probably took it in a different way," he said.

 

Kim told the story of one of his clinical partners, Eveline Shue, who, after five rounds of in vitro fertilization (IVF), became pregnant with twins. A high-achiever in her field, Shue continued working the grueling hours required by her job throughout pregnancy until she noticed concerning symptoms — musculoskeletal issues, extreme swelling, and more. She and her group decided that she should step back from work in her third trimester. A few days later, Shue suffered a stroke. She was rushed to the hospital where her babies were delivered by emergency C-section. Shue underwent brain surgery but later recovered and is still practicing in Southern California.

 

"I remember being at her bedside thinking, 'How could we have let this happen? How could we have prevented this?' "

Kim's speech kicked off a firestorm of awareness about pregnancy complications among physicians. "I got scores of emails from women around the country, surgeons in particular, who felt like their issues had been seen. The conversation was long overdue," he said.

 

Family planning issues, pregnancy complications, infertility, and pregnancy loss are common, pervasive, and often silent issues in medicine. In July 2021, Kim and a group of other researchers published a study in JAMA Surgery. It revealed staggering truths: When compared to non-surgeons, female surgeons were more likely to delay pregnancy, use assisted reproductive technology such as IVF, have non-elective C-sections, and suffer pregnancy loss. In the study, 42% of surgeons had experienced pregnancy loss — more than double the rate of the general population. Almost half had serious pregnancy complications.

 

Research has found that female physicians in general have a significantly greater incidence of miscarriage, infertility, and pregnancy complications than the general population. According to a 2016 survey in the Journal of Women's Health, the infertility rate for physicians is nearly 1 in 4, about double the rate of the general public.

 

The Barriers to Starting a Family

Physicians face significant professional barriers that impact family planning. Demanding jobs with exhausting and often unpredictable hours contribute to a culture that, traditionally, has been far from family friendly. As a result, many physicians start families later. "For a pediatric surgeon, you finish training at age 35 — minimum," says Kim. "Simply being a surgeon makes you a high-risk pregnancy candidate just because of the career."