{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T18:02:36Z","timestamp":1775066556335,"version":"3.50.1"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Resident Doctors of BC","award":["2020 Innovation Fund \u2013 Resident Projects category"],"award-info":[{"award-number":["2020 Innovation Fund \u2013 Resident Projects category"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Only 34% of Canadian surgeons in 2022 were female. The protracted length of surgical residency training, concerns regarding infertility, and increased rates of obstetrical complications have been shown to contribute to the disproportionate lack of females in surgical specialties.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A novel online survey was sent to all surgical residents in Canada. Respondents were asked about perceptions of pregnancy and parenthood during surgical training, and parents were asked about parental leave, accommodations they received, and pregnancy complications. Chi squared tests were used to compare opinions of male and female residents.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 272\/2,419 (11.2%) responses were obtained, with a high response from females (61.8%) and orthopaedic residents (29.0%). There were 56 women reporting 76 pregnancy events during training, 62.5% of which had complications. Notably, 27.3% of men and 86.7% of women \u2018agreed\u2019 or \u2018strongly agreed\u2019 that surgeons have higher pregnancy complication rates than the general population (p&lt;0.001). Men were much less likely to believe that pregnant residents should be offered modified duties (74.2% of men, 90.0% of women, p = 0.003). Women were much more likely to experience significant stigma or bias due to their status as a parent (43% of women, 0% of men, p&lt;0.001). Women reported negative comments from others at a higher rate (58.5% of women, 40.7% of men, p = 0.013). Women believe there is negative stigma attached to being pregnant during training (62.7% of women, 42.7% of men, p = 0.01). The limitations of our study include a small sample size and response bias.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Challenges and negative perceptions exist around pregnancy and parenthood in surgical residency, which disproportionately affect women trainees.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0301190","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T17:41:55Z","timestamp":1711561315000},"page":"e0301190","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["The double-edged scalpel: Experiences and perceptions of pregnancy and parenthood during Canadian surgical residency training"],"prefix":"10.1371","volume":"19","author":[{"given":"Mikaela J.","family":"Peters","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alissa W.","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6570-3290","authenticated-orcid":true,"given":"Darren M.","family":"Roffey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8435-8066","authenticated-orcid":true,"given":"Kelly A.","family":"Lefaivre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"pone.0301190.ref001","unstructured":"Canadian Institute for Health Information. A profile of physicians in Canada. 2022. [Cited 2024 January 31]. https:\/\/www.cihi.ca\/en\/a-profile-of-physicians-in-canada."},{"key":"pone.0301190.ref002","unstructured":"Barnum G. CAPER-RCEP: 2020\u20132021 Annual Census of Post-MD Trainees. 2022\u201323. [Cited 2024 January 31]. https:\/\/caper.ca\/sites\/default\/files\/pdf\/annual-census\/2022-23_CAPER_Census_EN.pdf"},{"issue":"1128","key":"pone.0301190.ref003","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1136\/postgradmedj-2018-135952","article-title":"Surgical trainees\u2019 experience of pregnancy, maternity and paternity leave: a cross-sectional study","volume":"95","author":"H Mohan","year":"2019","journal-title":"Postgrad Med J"},{"issue":"10","key":"pone.0301190.ref004","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1097\/ACM.0000000000003351","article-title":"Pregnancy and parenthood remain challenging during surgical residency: A systematic review","volume":"95","author":"AR Todd","year":"2020","journal-title":"Acad Med"},{"issue":"2","key":"pone.0301190.ref005","doi-asserted-by":"crossref","first-page":"e109","DOI":"10.3928\/01477447-20191212-02","article-title":"Program directors\u2019 perception of pregnancy and parenthood in orthopedic surgery residency","volume":"43","author":"C Nemeth","year":"2020","journal-title":"Orthopedics"},{"issue":"14","key":"pone.0301190.ref006","doi-asserted-by":"crossref","first-page":"527","DOI":"10.5435\/JAAOS-D-18-00216","article-title":"The perception of pregnancy and parenthood among female orthopaedic surgery residents","volume":"27","author":"MK Mulcahey","year":"2019","journal-title":"J Am Acad Orthop Surg"},{"issue":"19","key":"pone.0301190.ref007","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.2106\/JBJS.L.00666","article-title":"Residents\u2019 perceptions of sex diversity in orthopaedic surgery","volume":"95","author":"JF Hill","year":"2013","journal-title":"J Bone Joint Surg Am"},{"issue":"5","key":"pone.0301190.ref008","doi-asserted-by":"crossref","first-page":"e243","DOI":"10.5435\/JAAOS-D-20-00198","article-title":"Does a career in orthopaedic surgery affect a woman\u02bcs fertility?","volume":"29","author":"S Poon","year":"2021","journal-title":"J Am Acad Orthop Surg"},{"issue":"5","key":"pone.0301190.ref009","doi-asserted-by":"crossref","first-page":"326","DOI":"10.5435\/JAAOS-22-05-326","article-title":"Occupational hazards for pregnant or lactating women in the orthopaedic operating room","volume":"22","author":"J Downes","year":"2014","journal-title":"J Am Acad Orthop Surg"},{"issue":"6","key":"pone.0301190.ref010","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.ajog.2019.06.051","article-title":"The impact of occupational shift work and working hours during pregnancy on health outcomes: a systematic review and meta-analysis","volume":"221","author":"C Cai","year":"2019","journal-title":"Am J Obstet Gynecol"},{"issue":"8","key":"pone.0301190.ref011","doi-asserted-by":"crossref","first-page":"e0256742","DOI":"10.1371\/journal.pone.0256742","article-title":"Gender imbalance amongst promotion and leadership in academic surgical programs in Canada: A cross-sectional Investigation","volume":"16","author":"J Hunter","year":"2021","journal-title":"PloS one"},{"issue":"2","key":"pone.0301190.ref012","doi-asserted-by":"crossref","first-page":"E159","DOI":"10.1503\/cjs.008920","article-title":"Gender disparity in academic orthopedic programs in Canada: a cross-sectional study","volume":"65","author":"J Hunter","year":"2022","journal-title":"Can J Surg"},{"issue":"6","key":"pone.0301190.ref013","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s40137-022-00314-z","article-title":"Gender diversity in surgery: A review","volume":"10","author":"RL Green","year":"2022","journal-title":"Curr Surg Rep"},{"issue":"7","key":"pone.0301190.ref014","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1097\/CORR.0000000000002564","article-title":"What are the challenges related to family planning, pregnancy, and parenthood faced by women in orthopaedic surgery? A systematic review","volume":"481","author":"LJ Morrison","year":"2023","journal-title":"Clin Orthop Relat Res"},{"issue":"5","key":"pone.0301190.ref015","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1016\/j.spinee.2021.12.003","article-title":"The role of gender in academic productivity, impact, and leadership among academic spine surgeons","volume":"22","author":"N Agaronnik","year":"2022","journal-title":"J Spine"},{"issue":"1","key":"pone.0301190.ref016","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s40463-023-00630-z","article-title":"Canadian women in otolaryngology: head and neck surgery part 2-challenges in family planning, fertility, and lactation","volume":"52","author":"K Naismith","year":"2023","journal-title":"J Otolaryngol Head Neck Surg"},{"issue":"0","key":"pone.0301190.ref017","article-title":"Family planning among Canadian plastic surgeons and trainees","volume":"0","author":"A Kemp","year":"2023","journal-title":"Plastic Surgery"},{"issue":"2","key":"pone.0301190.ref018","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1097\/SLA.0000000000005730","article-title":"The experiences of motherhood in female surgeons: a scoping review","volume":"277","author":"D Mavedatnia","year":"2023","journal-title":"Ann Surg"},{"key":"pone.0301190.ref019","unstructured":"Qualtrics. Qualtrics XM Platform\u2122. 2005 [cited 14 September 2023]. In: Qualtrics [Internet]. Provo, USA. https:\/\/www.qualtrics.com."},{"key":"pone.0301190.ref020","unstructured":"R Core Team. R: A language and environment for statistical computing. 2016 [cited 14 September 2023]. In: R [Internet]. Vienna, Austria. https:\/\/www.R-project.org\/."},{"key":"pone.0301190.ref021","unstructured":"Statistics Canada. Table 13-10-0417-01: Mean age of mother at time of delivery (live births). 2023 [cited 14 September 2023]. In: Statistics Canada. Ottawa, Canada. https:\/\/www150.statcan.gc.ca\/t1\/tbl1\/en\/tv.action?pid=1310041701."},{"issue":"11","key":"pone.0301190.ref022","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1056\/NEJMp2215288","article-title":"Pregnancy and residency\u2014Overdue for equity","volume":"388","author":"S Koven","year":"2023","journal-title":"N Engl J Med"},{"issue":"1","key":"pone.0301190.ref023","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1097\/PRS.0000000000005097","article-title":"An analysis of differences in the number of children for female and male plastic surgeons","volume":"143","author":"HJ Furnas","year":"2019","journal-title":"Plast Reconstr Surg"},{"key":"pone.0301190.ref024","unstructured":"Statistics Canada. 11-627-M: Family matters: Parental leaves in Canada. 2021 [cited 2024 January 31]. In: Statistics Canada. Ottawa, Canada. https:\/\/www150.statcan.gc.ca\/n1\/pub\/11-627-m\/11-627-m2020048-eng.pdf"},{"issue":"1","key":"pone.0301190.ref025","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1186\/s12909-018-1373-1","article-title":"Female trainees believe that having children will negatively impact their careers: results of a quantitative survey of trainees at an academic medical center","volume":"18","author":"C Kin","year":"2018","journal-title":"BMC Med Educ"},{"issue":"10","key":"pone.0301190.ref026","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1001\/jamasurg.2019.2985","article-title":"Perceptions of surgery residents about parental leave during training","volume":"154","author":"MS Altieri","year":"2019","journal-title":"JAMA surg"},{"issue":"11","key":"pone.0301190.ref027","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.2106\/JBJS.K.00707","article-title":"Childbearing and pregnancy characteristics of female orthopaedic surgeons","volume":"94","author":"AR Hamilton","year":"2012","journal-title":"J Bone Joint Surg Am"},{"issue":"7","key":"pone.0301190.ref028","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1001\/jamasurg.2018.0153","article-title":"Pregnancy and motherhood during surgical training","volume":"153","author":"EL Rangel","year":"2018","journal-title":"JAMA Surg"},{"issue":"5","key":"pone.0301190.ref029","doi-asserted-by":"crossref","first-page":"E454","DOI":"10.1503\/cjs.004919","article-title":"Pregnancy and parental leave among plastic surgery residents in Canada: a nationwide survey of attitudes and experiences","volume":"63","author":"H Augustine","year":"2020","journal-title":"Can J Surg"},{"issue":"4","key":"pone.0301190.ref030","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1016\/j.amjsurg.2016.06.018","article-title":"Resident perceptions on pregnancy during training: 2008 to 2015","volume":"212","author":"M-BMD Mundschenk","year":"2016","journal-title":"Am J Surg"},{"issue":"2","key":"pone.0301190.ref031","doi-asserted-by":"crossref","first-page":"E132","DOI":"10.1503\/cjs.009321","article-title":"Parental-leave policies and perceptions of pregnancy during surgical residency training in North America: a scoping review","volume":"66","author":"JS Jakubowski","year":"2023","journal-title":"Can J Surg"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0301190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T17:42:17Z","timestamp":1711561337000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0301190"}},"subtitle":[],"editor":[{"given":"Pracheth","family":"Raghuveer","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,3,27]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0301190","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,27]]}}}