Gender Inequities in the Obstetrics and Gynecology Workforce: A Narrative Review

Abstract

Aim

Obstetricians and gynecologists (OBGYNs) are high-risk, surgically intensive, and emergency-driven specialists. Women are the majority of OBGYNs, but their representation in decision-making roles remains disproportionately low. This narrative review explores the empirical evidence and aims to narrow gender gaps among OBGYNs.

Methods

We included 154 publications from 2000 to 2025 on gender inequity, career progression, women physicians, OBGYNs, academic promotion, leadership, workforce, and regional variation from Asia, Europe, North America, Africa, South America, and the Caribbean. Eligible studies either (1) focused on OBGYNs or female surgeons, (2) reported gender disparities in academic, administrative, or service domains, or (3) provided regional data. Qualitative and quantitative studies, policy reports, and professional society publications were included.

Results

There were insufficient data from South America and the Caribbean. For the other regions, we identified cultures, societal norms, and the structures of health systems as contributors to gender barriers in OBGYNs. These barriers are not at the entry levels, but rather in career ascension. In high-income countries, implicit biases persist despite established work-life policies and legislative protections. In low and middle-income countries, disparities are shaped by sociocultural expectations, fewer institutional supports, and rigid hierarchical structures. Men also face distinct barriers, such as limited patient acceptance and unequal distribution of out-of-hours duties.

Conclusions

There is an urgent need to acquire high-quality data on stereotypic biases, structural, and cultural barriers to gender inequities among OBGYNs. Without timely intervention, gender gaps within the OBGYN workforce will likely be widened over time.