A mixed methods survey evaluating perceptions of pregnant clinicians in the emergency department.

BACKGROUND

Pregnancy among clinicians remains associated with workplace challenges, yet little is known about how visibly pregnant emergency clinicians are perceived by coworkers or patients. We evaluated clinician perceptions of support and examined whether visible pregnancy influenced patient experience.

METHODS

We conducted a mixed-methods study at seven emergency department consisting of (1) an anonymous survey of physicians and advanced practice providers assessing perceptions of workplace support for pregnancy and related accommodations and (Jagsi et al., 2012 (2)) a retrospective analysis of patient experience scores during clinician visible pregnancy (≥20 weeks' gestation). Likert-scale responses were summarized descriptively, free-text comments underwent thematic analysis, and patient likelihood-to-recommend scores were analyzed using clinician fixed-effects linear regression.

RESULTS

Ninety-eight clinicians completed the survey; 47 (48%) had worked while visibly pregnant. Overall, respondents reported high levels of support for pregnant clinicians, particularly from departmental leadership and emergency medicine colleagues. However, clinicians with prior pregnancy consistently perceived lower levels of support than colleagues without pregnancy experience. Support declined when specific accommodations, including limiting overnight shifts or avoiding infectious exposures, were discussed. Consultants were perceived as less supportive than emergency department colleagues. Analysis of 230 patient encounters during visible pregnancy demonstrated no association between visible pregnancy and patient likelihood-to-recommend scores, and only one patient comment referenced pregnancy, doing so positively.

CONCLUSIONS

Pregnant emergency clinicians perceived lower workplace support than colleagues without pregnancy experience despite no measurable differences in patient experience. These findings suggest opportunities to improve clinician pregnancy may lie primarily in organizational culture rather than patient acceptance.