Parenthood and Family Planning Challenges Amongst Cardiothoracic Surgery Trainees

E. Lopez¹, D. Shehata¹, T. Varghese², A. Doty³, C. Erkmen⁴, D. T.. Cooke⁵, D. D. Odell⁶, K. Freeman⁷, E. Servais⁸, Y. Hu⁹, K. Bilimoria¹⁰, D. Ceppa¹¹, A. Watkins^1
1Lahey Hospital and Medical Center, Burlington, Massachusetts ²University of Utah School of Medicine, Salt Lake City, Utah ³The Society of Thoracic Surgeons, Chicago, Illinois ⁴Temple University Health System, Fox Chase Cancer Center, Philadelphia, Pennsylvania ⁵University of California, Davis Medical Center, Sacramento, California ⁶University of Michigan, Ann Arbor, Michigan ⁷University of Florida, Gainesville, Florida ⁸Lahey Hospital & Medical Center, Wellesley, Massachusetts ⁹Division of Pediatric Surgery, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois ¹⁰Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana ¹¹Indiana University School of Medicine, Indianapolis, Indiana

Purpose: The demands of cardiothoracic surgery (CTS) training may impact family planning for trainees. This study examines cardiothoracic trainee experiences with family planning, including parenthood, maternal care, and breastfeeding.

Methods: A cross-sectional national survey was conducted after the completion of the 2024 Thoracic Surgery Directors Association ()In-Training Exam (TSDA-ITE). The 17-item questionnaire consisted of multiple choice and Likert-scale questions regarding family planning, parenthood, parental leave, maternal care, pregnancy complications, and breastfeeding. Data were described using frequencies and percentages, and comparisons were made using the chi-square test.

Results: Among 546 trainees, 454 responded(83.2% response rate) and 99(21.8%) were pregnant or had a partner pregnant during CTS training. Most trainees were male (62.3%). Trainees identified as White (54.2%), Asian (22.7%), Black/African American (5.5%), and Hispanic/Latino (7%). Forty-three percent (n=39) of trainees changed their family plan (i.e. delayed childbearing, adoption, surrogacy, or had less children). Only 18%(57/309) indicated they received resources on family planning (i.e. egg freezing, assisted reproduction technology, adoption). Among CTS trainees who gave birth, 78.6% (11/14) breastfed. Four (36.3%) trainees reported backlash for breastfeeding. Six (54.5%) felt they had convenient pumping spaces at their institution. Nine (66.7%) reported lack of financial assistance for breastfeeding equipment. Trainees were more likely to have < 4weeks of parental leave, especially if male (62.5% versus 5.8%, p< 0.001). Conversely, 94.1% of females reported receiving >5 weeks (n=16, p< 0.001). Pregnancy and maternal care complications are listed in Table 1. Seventy-five percent (n=6/8) of trainees that experienced, or had a partner experience miscarriage, received no time off (p=0.006). Within the past academic year, women trainees had a higher likelihood of being encouraged to consider an “easier” specialty/subspecialty due to the role/obligations of being a parent compared to men (n=11;63.6% versus 5%, p=0.03).

Conclusion: Approximately 20% of CTS trainees are pregnant or have a pregnant partner. Several barriers in family planning, parental leave, maternal care, and breastfeeding exist. Policies to support parenthood and family planning amongst CTS trainees either need to be adhered to by local graduate medical education leadership or are needed.

Identify the source of the funding for this research project: n/a