Birth Trends and Pregnancy Complications among Women Urologists

BACKGROUND: As the number of women entering urology grows, so should discussions and awareness about pregnancy. To understand if urology training and practice potentially put women and their pregnancies at risk, we set out to assess the childbearing differences between the average American woman and the female urologist. STUDY DESIGN: A 114-item anonymous survey was sent to all 365 American board certified female urologists in 2007. Data concerning birth trends, pregnancy, assisted reproduction, and complications were analyzed. Findings were compared with 2004 CDC data. RESULTS: Two mailings yielded a 69% (n=243) response rate; average age was 43 years; 67.4% had biologic children (average 2.0 children). Women urologists were older by 7 to 8 years for all births. An assisted reproduction technology birth was nearly 10 times more likely. Pregnancy complications were high, with a prevalence greater than that in the lowest income brackets in the United States. The induction rate was above average; the rate of cesarean deliveries was similar, with only 21 elective procedures performed. Ninety-two percent of women urologists would choose to have the same number of children: 66% at the same point in their career; 16%, earlier; 4%, later; 15%, uncertain. CONCLUSIONS: Women urologists have children later in life, a smaller number, a higher induction rate, and a higher incidence of pregnancy complications. These are likely related to the older age at pregnancy, which certainly contributes to the higher number conceived by assisted reproduction technology. Cesarean delivery rates, which were expected to be higher, were similar. To avoid complications, childbearing should not be delayed, and residency programs and practice groups will need to develop programs that support the growing number of women urologists.