Gendered Workload and Emotional Labour

Three Stories Out of the Unheard Millions, by Eman Jawed (Advocacy Council Member)

In surgical corridors around the world, there is a kind of work that never appears on an operative note or a training logbook. It does not get counted in publications, nor does it fit into the tidy boxes of “service” or “education.”

It is invisible, emotional, physical, moral, and overwhelmingly carried by women. It is the labour that keeps global surgery running, even when it breaks the women who provide it.

These are three stories from the countless unheard millions. They come from women in surgery who stitched wounds, inserted tubes, delivered babies, saved lives, and then returned quietly to the work that nearly destroyed them.

Saving a Child While Losing Her Own

As a junior doctor in a pediatric surgical unit, I worked with a senior female resident who was

one of only two trainees holding the entire department together. She was a new mother, so her infant often came with her on calls because there was no breastfeeding support, no childcare, no accommodation for her reality as both a surgeon and a woman.

One night, during a particularly heavy call, she shared privately that she had just discovered she was pregnant again. Her test was positive, but her ultrasound showed an empty sac. She was heartbroken. Yet the night continued as if nothing had happened. There were emergencies, admissions, and a whole department depending on her.

Four days later, again on call with me, she began to miscarry. She was bleeding heavily. She

could barely stand. She asked for help. Not one male colleague stepped in. Not the senior

registrar living inside the hospital. Not a single doctor offered to cover her shift. That same night, a critically ill nine-month-old baby arrived with a bilateral pneumothorax. Anesthesia struggled to intubate. I did everything I could as a junior, but the child needed a surgeon.

So this woman, in the middle of an active miscarriage and in excruciating pain, walked into the emergency, scrubbed in trembling, and inserted two chest tubes. She saved the baby’s life. She went back to bleeding in silence. This was not resilience. This was unsupported suffering, framed as dedication.

A Pregnancy Hidden to Keep a Job

Another woman in surgery experienced a different but equally piercing reality. She worked

throughout her pregnancy under a supervisor who refused her maternity leave. His offer

sounded generous on the surface: if she stayed home, he would still pay her, but she could not resign. That meant she could not ethically stop working, and she could not formally step away.

So she worked through exhaustion, swelling, and late-pregnancy discomfort, because she was

trapped by a signature withheld from her resignation form. Eventually she managed to leave, but soon financial need pushed her into an online surgical telehealth job with an international clinic. She applied without mentioning her pregnancy because she knew what it would cost her. She was hired. But without disclosing her pregnancy, she had no maternity protections.

She delivered her baby late at night. Only a few hours later, bleeding, exhausted, barely able to stand, she logged into her 3 a.m. shift and completed her seven-hour duty. She mothered a newborn and held calls at the same time because she had no other choice.

Motherhood was not supported. It was penalized.

A Surgeon’s Pregnancy That Became a Surgical Emergency

A chief resident in plastic surgery entered her final year while pregnant. She was visibly expecting, her abdomen swollen against her scrubs, yet nothing in her workload changed. She stood for hours during long reconstructive cases. She was denied sitting breaks. She was denied call swaps. She was denied the bare minimum she needed to stay physically safe.

Day after day, she operated while swollen, breathless, and fatigued. Long hours of standing are a known risk for premature delivery, and her body eventually gave way. She developed complications that led to an emergency C-section. Her baby was born two months early. The newborn developed necrotizing enterocolitis, needed two surgeries, and endured repeated intubations. He spent weeks in the NICU, fighting for his life. Even now she had to return to the same department that had pushed her into this crisis. She walked back into the building carrying her trauma, her guilt, and the memory of the pain she endured.

No woman should have to choose between her training and her life, or her child’s.

Why These Stories Matter?

These are not rare tragedies. They are the lived experiences of women in surgery everywhere.

The system benefits from our silence. It counts on our ability to absorb harm. It assumes we will stand through miscarriage, hide pregnancies to keep our jobs, and return to work before our babies breathe independently.

Women in surgery do not lack resilience. We lack support. We lack policies. We lack leadership that sees us as whole human beings.

As Dr. Ines Peric, a respected leader in global surgery and gender equity, said: “We don’t need to change women. We need to change the system so it can be more inclusive for women.”

This is exactly what gender equity in global surgery demands: not applause for women’s strength, but accountability for the structures that exploit it.

These stories are only three. The unheard millions remain. It is time for the system to finally hear them without indifference!