Author: Dr Gabrielle Grounds, ST6 Anaesthetics, Kent, Surrey & Sussex School of Anaesthetics

As the representation of women in anaesthesia continues to grow, with women comprising 38% of the consultant workforce and an even higher 47% in resident and non-consultant roles, it is essential to promote gender equality and address systemic barriers within the anaesthetic specialty.

Encouraging open discussions about the common challenges faced by female anaesthetists can foster a more inclusive and supportive work environment.

One significant issue affecting many female anaesthetists, partners and their colleagues is miscarriage. Defined as the spontaneous loss of pregnancy before the 24th week, miscarriage is regrettably prevalent, occurring in 10% to 20% of pregnancies and late miscarriage (between 14 and 24 weeks) occurs in 1 to 2% of cases.

Considering these statistics and the increasing number of female anaesthesia residents, SAS and consultant anaesthetists, clearly, a considerable portion of the workforce is likely to have experienced pregnancy loss.

After miscarriage

The impact of a miscarriage on both the woman and her partner is significant and should not be overlooked. For some, it may be experienced as an immediate loss, while for others the grief may manifest itself weeks later. Common experiences following a miscarriage include fatigue, loss of appetite, and difficulty sleeping. Since everyone grieves differently, some individuals may find comfort in discussing their experiences, while others may prefer to process their feelings privately.

While the emotional and physical effects of miscarriage are well acknowledged, the unique challenges faced by anaesthetists require further consideration. Anaesthetists may find themselves at an emotional crossroads, dealing with their own grief while also feeling a pressure to remain desensitised due to their frequent encounters with baby loss in their professional roles.

Looking ahead, a previous miscarriage may lead to increased anxiety in future pregnancies. Anaesthetists operate in environments that can be both physically and emotionally demanding. Factors such as elevated stress levels, shift work, exposure to inhalational agents, and radiation may all contribute to adverse pregnancy outcomes. While adherence to workplace safety regulations, such as using scavenging systems and minimising exposure to ionising radiation, can help mitigate some of these risks, it is important that each anaesthetist undertakes a full risk assessment with their clinical director or educational supervisor to better understand the risks and mitigations available.

Furthermore, experiencing a miscarriage can have implications for professional identity. Anaesthetists may contend with feelings of guilt, questioning their ability to balance a demanding but rewarding professional career with personal aspirations for family life. This internal struggle can lead to reduced job satisfaction and may even prompt changes in career path.

Meeting anaesthetists’ needs

Addressing the needs of anaesthetists experiencing miscarriage requires a multifaceted approach. It is important to create a supportive environment that encourages open discussions about women’s health and mental wellbeing. Words of support from colleagues, often reflecting their own experiences, can help reduce feelings of isolation and provide comfort and reassurance in the workplace. Anaesthetic departments can further foster this supportive atmosphere by directing affected staff to appropriate resources. With the increasing number of women in leadership roles in anaesthesia, they can help to influence policies that address issues faced by female employees.

If you were unaware, the National pregnancy and baby-loss people policy framework recommends that NHS trusts provide staff with additional paid time off for medical examinations, scans and tests, as well as mental-health related interventions after pregnancy loss. Ultimately, ensuring the wellbeing of anaesthetists is not only beneficial to the NHS workforce, but also enhances patient care, as supported professionals are more capable of providing high-quality anaesthetic care.

Pregnancy and Infant Loss Awareness Month occurs annually in October, with the Wave of Light on 15 October. This gesture serves to raise awareness of the impact of pregnancy and infant loss, fostering a sense of community and helping to break the silence surrounding these losses.