As in, in real life, day-to-day, down and dirty?
Genmedmom here.
I'm working on a writing project about being a mother in medicine in practice. This is going to be the everyday stuff: the logistics, the scheduling, the practical aspects, the balancing, the conflict. Funny stories, lessons learned, suggestions, and mistakes.
As I was thinking about this project, I realized that my experience in clinical practice is drastically different from women in other specialties. There's no way I can write this without input from moms in every area of medicine!
Things I was wondering about:
When I was pregnant, it never occurred to me not to tell people. I can't keep a secret to save my life. But I have colleagues who kept their bumps hidden for as long as humanly possible, for many different reasons: worries about discrimination; fears of being passed over for promotion; superstition. What did folks out there do? If you felt like you had to hide your pregnancy, how did you, and for how long? Looking back, what do you think, was it necessary?
What about those specialities where there is risky occupational exposure, I'm thinking radiology, surgical subspecialties… How did you manage that in pregnancy? If you needed to step out of the room, how did your colleagues react?
A lot of doctor-moms don't take a full three months of maternity leave. Some take more. Does this vary a lot by specialty? Did folks feel pressured to take less than three months? Did anyone have to fight for three months?
I never pumped at work. (Long story.) For the moms that did, can you share some of the good and the bad? Were offices and hospitals supportive or not? Were facilities acceptable or not? What were your worst pumping experiences? Would you do it again?
As a general internist with no inpatient duties, my call weekends involve, well, phone calls. What is it like for doctor-moms who have to go in? For the surgeons and anesthesiologists out there, is it better to be on call from the hospital or from home?
My office clinic is low-key enough that if I need to, I can step out and answer a phone call from my kids' teachers or the school nurse. But what about for moms working in the operating room or the ICU or on a busy inpatient floor? If you need to step away to take care of your family, are you supported?
My husband travels, and occasionally, I've had to cancel a clinic day to stay home with the kids: blizzard closed the schools, kids throwing up… Have others needed to cancel their workdays for childcare? Did colleagues make you feel bad, or did they step up? For those who haven't or can't, how do you manage those unforeseen events, the school cancellations and nasty illnesses?
I am eternally grateful that I can work part-time. I know that not all physicians approve of that. For those working full-time, how do you make that work? What supports and systems need to be in place for you?
And of course there are more questions, more scenarios… We can all learn from each other!
All specialties should have representation. I would love to hear what you have to say.
Don't feel comfortable commenting here? Email me: mauroratello2@gmail.com
Adoptive mom. Had to fight for FMLA for maternity leave and it was, of course, unpaid. Had to fight to come back part-time after 8 weeks rather than full-time and had to pay for my benefits (because I wasn't working enough to be "part-time" and was per diem) which ended up costing more than I made. The second time (and yes, I have one kid, it's a a long story) I took three weeks and went back to work with a newborn. It was awful. Can't imagine doing it if I'd actually given birth, but I know women who did.
ReplyDeleteI have cancelled work once or twice or rescheduled things for a sick kid. It was challenging, and the office manager wasn't happy, and officially it's not allowed - I just ignored "officially" and gambled that they wouldn't think it was worth firing me over. I was more concerned about our office staff, who would have been fired.
I go in and round when I'm on call, every third Saturday (for four years it was both Sat and Sun every third weekend.) It sucks. It means I can't commit to anything and my kid HATES it. This is the biggest reason I'm leaving clinical practice.
Oh wow. I would leave too. I'm sorry it's been so tough!
DeleteI wrote a post on pumping back in 2010 - How to (And not) Breast Pump At Work (you can search it comes up). It has lots of answers to your pumping questions and great comments/advice. It also has a link in comments to a published article KC wrote about pumping. I was awarded a Golden Pump award that had a picture of Margaret Thatcher on it at our end of residency award ceremony that's how much I pumped during that time lol. I love that image - Iron Lady pumping iron out for her kiddos.
ReplyDeleteGreat! Question- is it material that you'd like to see republished (with proper credit of course) and if so, under pseudonym or identified?
DeleteI think you will find a lot of answers to those questions in blog history!
ReplyDeleteI bet! Just would want to make sure folks are ok w being quoted/ republished
DeleteYou can use anything I have written under my blog name absolutely.
ReplyDeleteWow. This is a big topic which I have become acutely aware of in the recent months. I am a general internist, outpatient only, full time, and the mom of an almost 4 month old. (Going back for fellowship in Clinical Obesity and Metabolism, a new specialty, soon, yay!)
ReplyDeleteI told my bosses right away that I was pregnant, mostly because I was puking my brains out 24 hours a day and had to. I took 3 months of unpaid maternity leave, which I didn't have to fight for, but some colleagues weren't exactly supportive. It was called "extended maternity leave" in emails, and they tried to make me do extra holiday call compared to every one else even though my maternity leave wasn't during any holidays (turns out this is illegal). I learned a lot about the Pregnancy Discrimination Act, FMLA, and other rights of pregnant women... when my bosses tried to extend my clinic hours when I was 7 months pregnant. I fought that.
Pumping at work...ugh. It sucks, literally and figuratively. I have to pump every 2-3 hours to maintain my milk supply and guzzle water constantly. I pump before I leave home, pump at 10AM, noon, and 2PM. Sometimes I pump after dinner too. It's a big pain having to wash pump parts after every session even if you buy an extra set of parts. My general surgeon friend pumps while driving to work or in between hospitals. She usually has to pump in a locker room shower and has been walked in on multiple times.
I think life would be a lot easier if I quit breast feeding. I've been struggling with this decision recently. Most of the benefit is in the first 4 months...almost there. My baby has multiple food allergies, not even sure what they all are, which means I can essentially only eat fruits, veggies and meat, but not chicken, and even then she is still reacting (blood in her poop). I have to prepare all my food myself, can't eat out from anywhere, which makes life harder. Formula would be a lot easier, but I still can't imagine not breast feeding her...Hmm.
I'm not sure how we will deal with sick kid issues, hasn't really come up yet, but I'm guessing I'll be cancelling clinic. Husband is an ophthalmologist, easier for me to cancel than him.
My call is easy, just phone calls, but with a baby in our bedroom at night sleeping, I'm always worried she's going to wake up if/when I get called.
That's all I can think of for now...next patient is here!
Medela makes pump wipes that are super handy so you don't have to wash parts every time. I actually would cut them in half because they were bigger than they need to be. I've also heard of people putting parts in the fridge and not washing in between.
DeleteI learned a few months into pumping with my first that you can just put pumping parts in the fridge and wash every 24 hours. Huge time saver!
DeleteOh wow, that is a brutal schedule! I never once pumped at work so I do not have that perspective. Respect to you!! Love these suggestions from other moms on making it a little easier.
DeleteYa, I've heard those tips. I know this probably sounds a little crazy but I kinda worried about what was in the wipes and what my little one would be drinking, felt better using soap and water. I also tried refrigerating the parts...cold parts in a cold office isn't super fun, and I worried about all the dried residue on the parts affecting suction. Do you know a lot of the stores won't let you return a breast pump? Once I learned that I started taking really good care of mine...
DeleteNot crazy at all- you're obviously very smart, and very invested in baby's well-being. you're weighing everything exactly as you need to, the pros and cons, and whatever you decide to do (or not do) is exactly what is right for you and your baby. Good luck, as you're in the thick of it!! (FYI, lots of posts on BF and pumping on MiM, check out the labels if you haven't already... there's comfort in company!!)
DeletePumping again... thought of something else. After maternity leave, I returned to work to find two disturbing things...One, that many of my patient's results had not been reviewed by my partners while I was on leave, and second, that the company had changed the medication refill policy while I was gone and that essentially medical assistants were prescribing medications under my name while I was gone without my knowledge or consent. I would recommend clarifying these points to any physician taking a leave.
ReplyDeleteReally good points- that must have made going back to work a bit of a headache!
Delete3 kids- 6 weeks maternity leave for 1st 2 (active duty Army during that time) which was in addition to 30ish paid annual vacation days. 3rd child used 4 weeks total annual vacation days (back to work 2 1/2 weeks after birth) no paid maternity leave- group practice as sole breadwinner of family no choice. Husband has not worked since kids born to support my career & raise kids, I only take sick days if I am sick or husband is sick. Felt like had to hide all 3 pregnancies no support at all. Stole joy from my motherhood experience I will never get to have. Hoping for do over with grand babies when I can retire in 20 years- sigh
ReplyDeleteOh my. That is tough. But really great that your husband is able to be home. Thanks so much for sharing your story!
DeleteGeneral outpatient pediatrician with great support- 3 months paid leave, my own office with a mini fridge and pump 3x/day. I also put the parts in the fridge and wash and steam at the end of every day, and then boil once/week on weekends. The pumping time gets me caught up on charting and I see newborns/minimal impatiens over lunch so I can go straight home after work. Baby is 4 months old now and Mondays are the hardest- hasn't been one yet that I don't cry leaving her, after a weekend of snuggling/nursing and no bottles. Luckily, my husband works from home and will be on for sick days. Overall I feel very lucky with our situation. :)
ReplyDeleteWonderful! I am so glad that there are women out there who do feel supported and are happy with their work/home life balance, as you seem to be- there's hope for us all, ladies!
ReplyDeleteI was pregnant as a 3rd year resident in a neurosurgery program. I didn't feel as if I had to hide it and informed everyone very early on. My fellow residents were not at all supportive, but I expected that. We are around a lot of Xray exposure, but this never bothered me because lead blocks Xrays. I wore lead religiously in the OR and in the resusc room, so it was never an issue. I took 6 wks of maternity leave, but 4 wks of that was part of a neurology rotation that I only needed 3 months of anyway. That was lucky timing! I would have gotten a lot more pushback if I had done this during the regular rotations.
ReplyDeleteI breastfed for 6 wks and then transitioned to formula. I didn't like breastfeeding and refused to feel guilty about bottle feeding- it was the right choice for me and my son. No regrets! Pumping would have been impossible anyway with the surgery schedule.
As a surgeon, I would always prefer to take call from home. At least that way you get to be with your family during down time. During surgery, if I get a call about a family situation, the circulating nurse communicates it to me and I either address it over the phone or turf it to my husband. I am always accessible by phone or text.
I am fortunate to have a husband with much better hours that has always handled sick days, etc. I know not all mom surgeons have this luxury. Not sure what I would have done if it had been just me.
Overall, things worked out well with it all. My son is 18, healthy, graduating from high school, and I would not have done anything differently. I have been fortunate! Good luck with the project...
gcs15
Thanks so much! You sound very confident in the decisions you've made, very positive attitude, that's great. I agree, no guilt about formula. When it's right for you and your baby, it's right for you and your baby. I'm impressed that you're available by phone or text for school issues etc. I wonder if other surgeon-moms are able to be as available?
ReplyDeleteMaybe bad timing to ask, but currently finishing up residency in family medicine and have a three month old, and if I knew what I know now.. I would have waited until residency was over to have a baby. Or I would have been a nurse practitioner rather than an MD to shorten training time (and avoid facing advanced maternal age versus having a baby in training). I had 8 weeks unpaid off, was miserable to return when we was/is so young. I have some support of my coresidents/faculty, though I mostly think that they have no idea what I am experiencing right now. I pump every 3 hrs and often am scrambling to find a place to do it. Honestly, I think the hardest part is that I waited so long to have kids to finish my training, and feel that I am more emotionally geared toward staying home with my baby but can't because a) I must finish residency, and b) I can't train for 7 years to be a stay at home mom! I hope that my preference changes as he gets older. The good news is that I'm taking a few months off after residency and then only working part time.
ReplyDelete