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UID:HFESHCS_2025 International Symposium on Human Factors and Ergonomics i
 n Health Care_sess147_POST121@linklings.com
SUMMARY:PS6 - Gaps in Research with Pregnant Bodied Surgeons: Four Recomme
 ndations From the Literature
DESCRIPTION:Poster Presentation\n\nSabina M. Patel (Embry-Riddle Aeronauti
 cal University); Liam D. Brennan (Embry-Riddle Aeronautical University, Li
 mb & Branch Businesses LLC); Monica Jain (Wavemaker Three-Sixty Health); T
 ara Cohen (Cedars-Sinai Medical Center); Deborah DiazGranados (Virginia Co
 mmonwealth University); Shawn M. Doherty and Joseph R. Keebler (Embry-Ridd
 le Aeronautical University); Falisha Kanji and Aleeque Marselian (Cedars-S
 inai Medical Center); and Elizabeth H. Lazzara (Embry-Riddle Aeronautical 
 University)\n\nBackground: \nAs of 2022, 18.5% of the surgeons in the Unit
 ed States are women, with the number expected to rise over the next five y
 ears (datausa.io). Much of the surgical training that individuals who can 
 conceive are required to perform happens in the most fertile years of a pr
 egnant-bodied individual’s life. Unfortunately, this population has also s
 hown a higher risk of facing pregnancy complications and miscarriages than
  the general population, partly due to the increased stress that they are 
 under in the workplace (Rangel et al., 2021; Phillips et al., 2014). Despi
 te the introduction of tools and protocols to support this population duri
 ng pregnancy and in lactation, there remain critical research gaps to furt
 her understand the entire experience and needs of a surgeon who can concei
 ve before, during, and after pregnancy. The purpose of this poster is to i
 dentify four gaps in the literature regarding surgeons who can conceive al
 ong with four recommendations for mitigation. \n	\nGap 1: Psychological Sa
 fety\nIn May of 2024, the American Board of Surgery put out a new announce
 ment in collaboration with the Association of Women Surgeons outlining rec
 ommendations for supporting pregnant surgeons throughout their pregnancy. 
 Though this is an excellent step in the right direction, some research has
  found that there is a fear of backlash from colleagues and leaders if ind
 ividuals utilize these support systems, thus creating a need for research 
 regarding the psychological safety of surgeons who can conceive and pregna
 nt surgeons (Rangel et al., 2022; Young et al., 2021). Psychological safet
 y is the belief that an individual will not be reprimanded for speaking up
  and advocating for themselves (Edmonson et al., 1999). To illustrate, sur
 geons who do not feel safe advocating for adjusted shifts to accommodate f
 ertility or prenatal appointments are exhibiting poor psychological safety
 . Additionally, not all institutions have implemented policies that align 
 with the recommendations outlined for pregnant surgeons (Rangel et al., 20
 22). To best support this population at an institutional level, it is crit
 ical that further research be conducted to understand if and when people a
 re utilizing the support available to them and the factors that influence 
 the degree that they experience psychological safety.\n\nGap 2: Fertility 
 Journey and Pregnancy Complications and Loss\n	There is a robust amount of
  literature stating the decrease in fertility and increase in pregnancy co
 mplications and loss among surgeons who can conceive (Delva et al., 2023).
  However, there is a gap in the literature surrounding ways to support thi
 s population throughout their fertility journeys, pregnancy complications,
  and/or pregnancy loss. The type of support required when these events occ
 ur can also vary greatly depending on the nature of the events themselves.
  For example, if a surgeon decides to utilize assisted reproductive techno
 logies or has pregnancy complications, they could require additional docto
 r’s appointments, medications, and/or procedures that may require a surgeo
 n to have a more flexible schedule or time off. Conversely, a miscarriage 
 near the end of pregnancy or stillbirth could require time off for bereave
 ment. The intricacies of support required at each stage are underrepresent
 ed in the literature. Future research should include insights into the psy
 chological toll taken and the identification of opportunities for organiza
 tional or institutional support. \n\nGap 3: Postpartum Assistance \n	Many 
 institutions have attempted to implement protocols to offer support to pre
 gnant surgeons. However, the resources available to these same individuals
  deteriorate rapidly in the postpartum stage. Some researchers have called
  for hospitals to provide lactation rooms and refrigerators to store milk 
 and allow surgeons to leave the OR to pump (Sterbling et al., 2023; Knell 
 et al., 2023). However, not all institutions are providing support in alig
 nment with recommendations by the American Board of Surgery or research (R
 angel et al., 2022). Research is also needed to better understand a surgeo
 n's experience with postpartum complications, such as childbirth-associate
 d complications, breastfeeding-associated complications, and postpartum de
 pression. \n\nGap 4: Cultural Nuance \n	There continues to be a lack of re
 search surrounding surgeons of a variety of backgrounds and the influence 
 of culture, both positive and negative, on their experience of pregnancy. 
 The intersectionality of an individual's identity is necessary to fully un
 derstand what type of toll is taken. For example, living in a multi-genera
 tional household may mean that some surgeons have more support for childca
 re; however, this could also mean that there are more individuals reliant 
 upon the surgeon for their daily needs. Including this level of detail abo
 ut the provider pregnancy experience is necessary to meaningfully explore 
 this multifaceted experience. \n\nRecommendations: \n	Unquestionably, the 
 literature demonstrates that there is a paucity of research related to fer
 tile and pregnant surgeons and their needs. To bridge these gaps, we have 
 provided four recommendations and their rationale for future research. \n\
 nRecommendation 1: Emphasize Diverse Populations and Perspectives \nFirst,
  the inclusion of a diverse population is critical to ensure that the cult
 ural nuances are gathered both within and outside of the workplace. Using 
 inclusive language within these research efforts is also necessary to ensu
 re that all individuals with the ability to conceive can have their voices
  heard based on their individualized experiences. To gather these voices, 
 utilizing online surveys with compensation can be useful in ensuring that 
 people can complete it without fear of a breach of confidentiality or anon
 ymity while also not having to infringe upon their clinical care duties as
  it can be completed in a safe space on their own time. \n\nRecommendation
  2: Leverage Personal and Professional Community Voices \nSecond, all indi
 viduals with the ability to conceive should be identified as potential sou
 rces of information, along with critical members of their personal and pro
 fessional communities. Examples of professional community members could in
 clude peer surgeons and administrators; whereas, personal members would th
 en incorporate partners, family, and other caregivers. Further, probing la
 ctation and fertility specialists, physical and occupational therapists, a
 nd obstetricians can be valuable ways to gather expert perspectives. Recei
 ving insights from these groups could further illustrate gaps between poli
 cy and the lived experience of surgeons. \n\nRecommendation 3: Investigate
  All Hospital Types \n	Third, research at a variety of hospital types (e.g
 ., academic, rural, community) is critical to understanding the full scope
  of how pregnancy is impacting surgeons across the healthcare system. For 
 instance, providing a pregnant surgeon time off to attend doctor’s visits 
 may be more difficult at a rural hospital as opposed to an academic medica
 l center due to the varying numbers of people available for coverage. Insi
 ghts into these challenges are necessary to understand what policy adjustm
 ents are needed to best support surgeons across the board. \n\nRecommendat
 ion 4: Provide Peer Education \n	Fourth, providing practitioners, their co
 mmunities, and leaders with further education and training about the inter
 section of surgery and fertility, pregnancy, and postpartum issues may sti
 mulate action to implement or adapt existing policies to support them. Thi
 s type of training has already been recommended for residents and toolkits
  have been developed to support this effort (Sterbling et al., 2023). Like
 wise, individual practitioners have made efforts to promote knowledge rega
 rding these issues through articles and other pathways (Hamilton, 2018). V
 ersions of these resources could be made accessible to leaders, practition
 ers, and their communities. This has the potential to both effect positive
  change as well as generate further willingness to invest resources and pa
 rticipate in research endeavors exploring these issues.\n\nTrack: Digital 
 Health (DH), Simulation and Education (SE), Hospital Environments (HE), Me
 dical and Drug Delivery Devices (MDD), Patient Safety and Research Initiat
 ives (PS)
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