Experiences of Australian anaesthetists and anaesthetic trainees of working whilst pregnant: Results of a national survey.

Abstract

Changing medical workforce demographics emphasise the need to understand and effectively manage pregnancy in the workplace. An Australian survey exploring pregnancy experiences of specialists and trainees working in anaesthesia received 242 responses describing 549 pregnancies. One hundred and sixty-two (67%) of these respondents were aged 31-40 years, 185 (76%) were specialists and 159 (66%) reported one or two pregnancies. Reported pregnancy complication rates were similar to national averages. Potentially harmful exposures included working >40 h per week (n = 298, 55%), ionising radiation and unscavenged gases. Other than ergonomic hazards and stress, exposures were not associated with an increase in self-reported complications. Moving heavy patients on a daily to weekly basis (n = 278, 53%) was associated with an increased risk for any maternal complication; odds ratio (OR) 2.13, 95% confidence interval (CI) 1.37 to 3.33, P < 0.001. High or debilitating stress levels were associated with any maternal complication, OR 2.93, 95% CI 2.06 to 4.17, P < 0.001, and any adverse neonatal/fetal outcome, OR 1.72, 95% CI 1.10 to 2.69, P = 0.018. The most common stress contributors were 'work-related', 'exams' and 'pregnancy anxiety'. Ninety-one (38%) respondents reported experiencing stigma or negative attitudes toward their pregnancy from anaesthetic colleagues. Overall, 171 (71%) of respondents were satisfied with their experience of working in anaesthesia whilst pregnant. Thematic analysis of free text comments identified three major themes: workplace culture, maternal and fetal wellbeing, and career impacts on both pregnancy and family planning. Development of multilevel mechanisms to guide and support pregnant trainees and specialists in anaesthesia is recommended to address these findings.