Best Practice and Recommendations for Pregnant Orthopedic Surgeons Part I: Navigating Residency.

Family planning and maternity leave concerns contribute to reasons why the percentage of women in orthopedic surgery is disproportionally and consistently low. Without institutional policies, these stressors are often placed on the pregnant resident in training. The establishment of formal department policies allows for clear, universal expectations, which helps decrease negative peer perception and overall dissatisfaction. This practice not only supports current trainees but can also help attract more diverse applicants to create a sustainable workforce. This is the first of a two-part paper that outlines key evidence-based considerations for pregnancy during residency. Importantly, we address the balance of early disclosure with confidentiality, call schedules, medical appointments, and return-to-work considerations, including lactation policies. Creation of these formal guidelines will require an investment in the department but can lay the foundation for a new generation of surgeons who thrive both at home and in the operating room.