Maternal Matters: Neurosurgery During Pregnancy—A German Nationwide Survey
Bibliographic record
Abstract
Abstract In Germany, pregnancy often results in a ban from the operating theater for surgeons, reflecting legislation prioritizing maternal and fetal protection over individual autonomy. Due to limited data for German neurosurgeons, we aimed to assess the attitudes of German women neurosurgeons toward continuing surgical work during pregnancy and lactation to provide appropriate recommendations. We conducted an online SurveyMonkey survey among all female members of the German Society for Neurosurgery (Deutsche Gesellschaft für Neurochirurgie) and the Professional Association of German Neurosurgeons (Berufsverband Deutsche Neurochirurgie). Of 286 invited women neurosurgeons, 122 responded (42.6%), with 65 (53.3%) having children or being currently pregnant with their first child. The majority (98.5%) desired to continue surgery during pregnancy, yet 80% expressed concerns about announcing their pregnancy due to potential job-related disadvantages. However, 35.4% (23 out of 65) ceased surgery due to an immediate ban imposed by the company physician and only a minority due to health-related issues (n = 2). Of the remaining 42 women who initially continued operating, 73.2% reported good departmental support during pregnancy. However, 18.5% (12/65) faced a subsequent surgery ban after announcing their pregnancy. Overall, there were no successful appeals (n = 13). Nearly a third eventually resumed surgery, implementing additional protective measures such as extended disease testing. However, self-estimation revealed a reduced surgical performance of approximately 35% compared with the year before pregnancy. Five women (7.7%) informed the company physician only at the end of pregnancy to circumvent the ban. Approximately a quarter (27%) experienced surgery-free periods of 1 to 1.5 years, whereas 21% reported 1.5 to 2 years per pregnancy. Forty-four percent reported discrimination in surgery allocation upon return, whereas 48% reported none. Most women neurosurgeons aspire to continue surgery during pregnancy, yet face involuntary bans. Despite permission to operate, procedural volumes decrease significantly, compounded by surgery-free periods during lactation and parental leave, and reported discrimination upon return. We hypothesize that pregnancy-related bans exacerbate a glass ceiling effect, impeding women neurosurgeons' career progression, and propose removing bureaucratic obstacles to enable continued surgical practice.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".