O2151: Balancing Work and Family: Parental Leave Policies in Pediatric Orthopaedic Surgery

Background: Parental leave is essential to familial bonding and general well-being for pediatric orthopaedic surgeons with newborns. This survey investigation of the Pediatric Orthopaedic Society of North America (POSNA) sought to explore surgeons’ experiences and perspectives regarding parental leave and demonstrate the need for improved policies.

Methods: An anonymous survey was electronically distributed to POSNA members in 2023-2024. Currently practicing pediatric orthopaedic surgeons in the United States and its territories were included. Eligible participants were queried on demographics, occupational data, and experiences and attitudes regarding parental leave. Descriptive statistics were tabulated. Differences between gender were analyzed utilizing Fisher’s Exact, Chi-square, and Mann-Whitney tests. Based on open-ended responses, an inductive thematic analysis was conducted to identify themes regarding surgeons’ perspectives on parental leave.

Results: In total, 131 participants were included for analysis. Most respondents were male (59.5%), White/Caucasian (88.4%), aged 46.6±10.2 years, non-Hispanic (97.7%), and married (91.6%). Fifty (38.2%) surgeons reported taking parental leave during their career. Female surgeons were more likely to take parental leave than their male colleagues (62.3% versus 21.8%, p< 0.001). Female surgeons also took significantly longer parental leaves (9.9±3.7 versus 2.4±1.8 weeks, p< 0.001). On average, female surgeons reported losing $52,450  $76,597 per parental leave. Most respondents (66, 81.5%) were knowledgeable of their practice’s parental leave policies, and five (7.6%) reported having no parental leave policy at their institutions. Fifty-four (49.1%) respondents were completely or moderately satisfied with their current parental leave policies. Women tended to be more dissatisfied with their current parental leave policies (p=0.021). Most respondents (114, 90.5%) believed parental leave should be fully compensated in the first six weeks following birth, with no difference in opinion between genders; however, men tended to believe less compensation should be provided for parental leave at weeks 7-12 (p=0.014). Results are further detailed in Table 1.

Upon thematic analysis, the most common theme focused on the impact of parental leave policies, particularly on finances and career opportunities. Many surgeons also described workplace culture regarding maternal and paternal leave, as well as experiences with parental leave under different compensation models and practice types. Results of the qualitative analysis are further detailed in Table 2.

Conclusion: Women in pediatric orthopaedic surgery more often take parental leave, which are typically longer, than their male colleagues. Women also more strongly support compensation for longer periods of parental leave. Many of these differences likely stem from social norms that vary by gender. Further, taking parental leave can be expensive, with the average child costing $52,450 in lost income, creating another barrier to forming a family. In addition to combating significant income losses, a redesign of current parental leave policies in pediatric orthopaedic surgery is necessary to improve parents’ well-being and work-life balance.