The number of women entering the field of plastic and reconstructive surgery (PRS) has increased substantially. In 1980, only 12.5% of plastic surgery residents were women. In contrast, women accounted for 47% of integrated plastic surgery residents in 2023.1 With this shift in demographics changing the landscape of the medical profession, it is important to understand the reproductive and childbearing challenges faced by plastic surgeons. Specifically, it is well-established that female surgeons have fewer children than male surgeons.2 Female surgeons also face higher rates of infertility, endure more pregnancy complications, and have higher use of assistive reproductive technologies with worse neonatal outcomes than both women in general and women doctors in nonsurgical fields.3,4 Factors such as irregular work hours, longer duration of training, and a culture that perpetuates work-life imbalances have been cited as contributing to these disparities.3 These factors may play a role in more female surgeons opting for nontenure tracks for work-life balance, leaving academic positions, and reporting higher rates of burnout.5, 6, 7

As our profession has become more diverse, there has been an increased awareness of the need for new policies to support female surgeons interested in having children within training institutions. For example, in July 2019, the Accreditation Council for Graduate Medical Education (ACGME) included clean and private lactation facilities as a universal program requirement for Graduate Medical Education in PRS.8 In 2020, the American Board of Plastic Surgery (ABPS) introduced the Personal Leave Policy, allowing residents to take up to 12 weeks of personal leave that can be used for specific purposes, including maternity or paternity leave, without delay in graduation.9 Before this policy, the amount of time a resident could take for parental leave without extending training was 4 weeks.10 This limited support left many residents without adequate time to bond with a new child or recover from childbirth.10,11 These guidelines are meaningful steps toward supporting family planning goals during training.

Despite these progressive policy shifts, the understanding of fertility and childbearing patterns among female plastic surgeons remains limited and primarily grounded in small-scale, survey-based studies. Therefore, this scoping review aims to provide a more comprehensive understanding of the family planning and childbearing experience of plastic surgeons and plastic surgery trainees, addressing gaps in the current literature and informing a more supportive approach for women in this field.