Pregnancy and parenthood among Italian residents in anesthesia and intensive care - a national survey.

Abstract

Background: Parenthood during medical residency is challenging, especially in Anesthesia and Intensive Care Medicine, given the irregular schedules, long working hours, and high levels of stress. Prior studies among surgeons and intensivists reported increased miscarriage and pregnancy complications, while cultural stigma and limited support further increase difficulties. This national survey among Italian Anesthesia and Intensive Care Medicine residents aimed to elucidate the experience of (i) parenthood and pregnancy outcomes, (ii) maternity leave and work arrangements, (iii) breastfeeding support, and (iv) workplace well-being.

Methods: A national anonymous online survey (ethical approval no. 0017063), endorsed by the National Board of Anesthesia and Intensive Care Professors (Collegio dei Professori di Anestesia e Rianimazione-CPAR), was systematically distributed via institutional emails to members of the Italian Society of Anaesthesia, Analgesia and Intensive Care Medicine (SAARTI). The questionnaire, designed with the BRUSO model and pretested, targeted Italian residents in Anesthesia and Intensive Care Medicine.

Results: A total of 1387 residents completed the survey (national response rate: 33%, 62% female). Most responses (61%, 748/1387) and pregnancies (52%, 151/289) were from Northern Italy. Parenthood was reported by 24% (208/862) female residents and 18% (92/525) males (p = 0.004). Complications during full-term pregnancies were more frequent among female residents than among partners of male colleagues (47% vs 22%, p < 0.001). When healthy residents were pregnant, 34% were reassigned to alternative tasks, 11% lost their tasks with no new assignments, and 44% were declared at high risk regardless of being healthy and remained at home. Breastfeeding was reported in 61% (144/235), and only 33% (48/144) requested leave. Workplace support was inadequate, particularly during work arrangements, breastfeeding, and fertility attempts. Finally, residents from Northern Italy declared to work more than 38 h/week (p < 0.001). Pregnancy-related complications were similar between regions.

Conclusions: This first Italian national survey, among anesthesia residents, highlights organizational and cultural barriers to parenthood, as well as significant regional disparities, stressing the need for institutional strategies ensuring equity, safety, and workplace well-being.