Despite increasing representation in surgical training, women surgeons still face many challenges that undermine the long‑term sustainability of their careers. The well‑documented underrepresentation in senior academic and leadership roles is partly due to structural barriers, including exclusion from informal networks, but also to difficulties in managing work–life balance1.

Maternity profoundly impacts the careers of women surgeons, presenting unique challenges that span from early family planning to returning to the operating room. In Europe, pregnant surgeons generally prefer to continue operating, but their surgical activity typically decreases as pregnancy progresses. Different patterns are observed based on seniority and geography: while senior women doctors tend to end their surgical duties later in pregnancy than junior trainees, European surgeons overall cease operative duties earlier than their North American counterparts, who often continue their surgical activity well into pregnancy. Furthermore, fully paid maternity leave across surveyed European nations varies from as little as 4 weeks up to 32 weeks, with data showing women surgeons taking an average of 10 months of total parental leave2,3.

While only a minority of European countries require a change of duties for pregnant clinicians, Italy makes a strong exception regarding specific occupational hazards. Occupational safety and maternity protection are governed by Legislative Decree No. 151/2001 and No. 81/2008, which mandate the removal of pregnant workers from tasks involving potential biological, chemical, or physical risks. In surgical environments, these laws are frequently interpreted as a total incompatibility with operating room activity, and pregnant surgeons are often excluded from operative practice for nine to twelve months or longer2.