Challenges in Breastfeeding Faced by the Lactating Gynecologic Surgeon.

Objectives: Characterize the experiences of lactating gynecologic surgeons, identify common challenges, and propose solutions to address barriers. Methods: In this mixed-methods, cross-sectional study, a novel survey was electronically distributed to measure lactation experiences among gynecologic surgeons. Descriptive statistics were used to analyze quantitative data, and thematic analysis was used for the qualitative data analysis. Results: Eighty-six survey respondents reported having been pregnant and met the eligibility criteria. The rate of breastfeeding was 95% (n = 82) among women who had given birth, and 91% (n = 75) of surgeons breastfed after returning to work. Of the 66 surgeons who shared lactation experiences, 97% (n = 64) reported challenges faced at work, and 86% (n = 57) faced more than one challenge. Most respondents were fellowship trained (85%, n = 56) and half delivered within the last 2 years (48%, n = 32). Analysis yielded eight themes and nine subthemes. The most common themes were time constraints (n = 48), difficulty balancing clinical responsibilities (n = 53), and pumping logistics (n = 59). Surgeons suffered from emotional distress (n = 14) and physical challenges included decreased supply, engorgement, and leakage (n = 16). Conclusions: Gynecologic surgeons face multiple challenges when lactating at work. This research highlights the lack of protection and support for the lactating surgeon. We propose solutions to address these workplace inequities, including allotted time for milk expression, adequate facilities, institutional and national policy and protections, and creation of a culture of support.