Wednesday, March 21, 2012

Why you absolutely need to have a baby in residency

Last week, Red Humor mentioned Dr. Sibert's blog post about how you shouldn't have a baby during residency. Is anyone else getting the feeling that Dr. Sibert is just trying to make people angry at this point?

Anyway, I was going to write a post going through several domains (pumping, maternity leave, pregnancy, etc.) and decide which was easier: doing it as an attending or doing it as a residency.

But I'll save some time for both of us. Attending wins all around. To the point where I got mad at myself for not having waited the first time around. Of course, everything is easier the second time around because you know what to expect. And I happened to have an easier second child than first child and a flexible job.

That said, I think having a baby during residency was a good experience in many ways and I obviously do not regret it. So in the interest of being positive, I present to you.....

Reasons to have a kid during residency instead of waiting:

1) Because apparently, it isn't so great to have kids after age 40. And yes, you may finish residency before you're 40, so maybe that argument doesn't hold water. Except say you're 25, which was the average age of matriculating students at my med school. You go through med school and four years of residency. Now you're 33. And because you're already in your 30s, it takes you a little longer to get pregnant, so you get pregnant at 34, first baby born age 35 (now advanced maternal age). And you want three kids. I won't do the math, but you can see how you're creeping into the 40s territory, when there's a higher risk of complications, birth defects, and infertility. (I could go on about this. I won't. But I could.)

2) It's unlikely when you get out in the real world that you will have like 20 people to share coverage for your leave. Coverage is much harder to come by in the real world.

3) If you're gonna have preggo brain or "milk brain" (it's real!), is it better to have it when you've got an attending looking over your shoulder or when it's your first year in real practice?

4) Everyone talks about "getting the career stuff out of the way" before having kids. Because you want to enjoy your kids. But how about enjoying your career? The second you get out in the real world and start building your career, do you want it broken up by maternity leaves and sleepless nights?

5) Gives you a great excuse to hightail it when attending comes up with a really stupid reason why they want you to stay.

6) Helps you to grow up and gain maturity and perspective, which, let's face it, a lot of residents really need.

7) It makes residency (which can be horrible) more tolerable.

8) Being a parent gives you a way to relate to attendings. And while some of them might give you smack for taking a maternity leave, I felt like I got a lot more respect for being a mom.

9) Because what else are you going to put a picture of at the end of your powerpoint lecture? Your cat??

10) Dr. Sibert herself had a baby prior to residency and thinks that was A-OK. So what's the hard part then? Being pregnant? Arranging maternity leave? Dr. Sibert says yes, but I say no! The hard part is having a freaking child to take care of. Is having a baby as a med student better than doing it as a PGY2 like I did? I'd again say NO. I got through my whole internship without having to worry about my kid missing me. Isn't that the hardest part??

11) In many fields, being an attending can be harder than being a resident. Especially if you do as Dr. Sibert suggests and don't work parttime.

12) Similar to one reason why women have kids close together in age: you're already sleeping badly, so why not?

13) I'm in my early thirties and I think I'm done! I never have to go through pregnancy and childbirth again! It's so liberating. (Sometimes depressing. But also liberating!)

So there you go. 13 great reasons to have a baby in residency. But ultimately, as we know, it's a very personal decision and you shouldn't let some idiot on a blog tell you what to do with your life.

23 comments:

  1. Great post - but as a childless (and likely to remain so) woman with two cats, what's wrong with a picture of a cat at the end of a slide show?

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  2. OMDG: Thanks! :)

    Solitary: I can tell you that I genuinely don't think putting up a picture of your cat is any worse than putting up a picture of your kid.

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  3. YES!!!!

    I had one of my kids before med school and one in med school. One of my attendings during medical school told me that her biggest regret was waiting until after her training to have her children. She said many of the things you did: she had trouble conceiving, and she was much older when her children were growing, and getting coverage as an attending was even more difficult.

    We need to come to the consensus that there is never the perfect time to have a baby. People will choose the time that works best in their life, and we all need to be supportive of that.

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  4. Thank you! I am 24 and starting med school so in my best attempts to avoid IVF, I will have to have kids in residency.

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  5. Someone once said, "having a baby is like breaking a leg--there is just no good time to do it." That being said, people should do what makes sense for them and their families and other people, including idiots with blogs, should mind their own business.

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  6. momofthree and docMarch 21, 2012 at 9:56 PM

    great post. especially like the ending. to each her own!

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  7. To each her own - I agree! I had my first a week after finishing MFM fellowship, and my second 2.5 years later. I was glad to be done with training, and have great partners to cover my leave/call for the second ( my first was actually between fellowship and starting my job!). I was lucky to get pregnant easily, and I have a stay at home partner which makes unscheduled kid illness not such a worry. Having kids is never easy, but in the end we love them no matter what - it doesn't really mean when in our timeline they are born!

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  8. In my very busy residency prior to work restriction hours, there was a pregnancy virus. I talked to all pregnant residents when I was an intern, and all of them said residency is the best time. Ton of coverage. You can arrange all your elective non-call month to be at the end of pregnancy and arrange your leave as scheduled vacation block plus whatever you can get. That's how I did it. Not one person had to ever cover for me during pregnacy, maternity leave or post-pregnancy. You do not have guilt (only miss them terribly) when you leave a newborn, who only needs food, good care. But you will have guilt leaving toddler, older child behind when you work long hours because they are already talkative human beings who want their mommy at home. They will tell you how they hate your absence. I am glad I did all boards when babies were rocked by a nanny and did not know the difference. Now I am re-certifying and kids have to adjust their expectations. And when you are younger your productivity is incredible. I took and passed my board 3 weeks after baby#2 having to breasfeed 3 times all night prior to exam and pump twice during the exam. Having 5 hours of interrupted sleep would kill me now.

    Dr Sibert needs to get a life. Throwing a stone in your own. I never understood that.

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  9. A-men ... Or a-women! You all inspire me. I am entering medical school in August with a baby. Love hearing from you all and am grateful that there are now two generations of trailblazers ahead of me. I owe you a debt of gratitude. Keep being leaders in your (our) field - and I don't need to tell you to keep being the amazing, warm, dedicated mothers that you already are. Medicine, as any field, is more humane for being peopled with actual PEOPLE in all our glory (male, female, black, white, mothers, fathers, etc., etc., etc.) Anyone who thinks otherwise is missing out on the fellowship and mutual support that comes from empathizing with colleagues, neighbors, etc.

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  10. Awesome. Our peeps are obviously eager for much diaglogue on this point given the controversy Dr Siberts post has generated. But there is no one answer to fit all. There is no bad time to have kids in this short life (i say the more the merrier i have a 2yo and a 6mo and in residency). There is no "good time" in medicine. What a great job is medicine, which will take its pound of flesh and a bit more if you let it. But how great if we can make medicine work for us instead of us slaving to it. Medicine fulfils intellectual and alturistic puzzle pieces that lead to a purposeful full life, and so does balancing that with having cheeky monkeys and having a small hand in shaping another little person(how important). I say breed as often and as much and whenever you like! We are trying to change an industry job which still operates under archahic paternal tones like no other. If kids are in your life vision, go for it and make the medicine fit around you! Oops that post was not meant to blab on for so long!!x

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  11. Against all advice I had 2 children during my training...one at age 26 in my internship and one at age 30 in my fellowship. With both babies, I was pregnant after only 2-3 months of trying. I am now 32 and in my second year of practice and we have been trying to conceive a third for the past year without success. I have been diagnosed with unexplained secondary infertility and despite rounds of clomid and IUI, still no 3rd baby. All this to say...I am so grateful to have had my children in training. If I had not, I would likely be childless.

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  12. Good thoughts! I did not meet my hubby until 3 years after I finished my residency and we now have a beautiful 14 month old daughter. I'm 36 now and we're TTC #2. I worry about difficulty getting pregnant this time around, but we'll see what happens! One thing I am happy about is having a scheduled C-section next time since I had a 2 day induction with 3 hours of unsuccessful pushing and then a C-section since she was 9 pounds 8 ounces!

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  13. Anon@8:43: That's exactly what I was worried about. Just because I got pregnant easily in my 20s, there's no guarantee it would have been as easy if I waited. I was willing to sacrifice some of my training, but definitely not having children.

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  14. Love this post. I had my daughter before I started med school (I'm 25 now) and will hopefully have my second child during residency. I've had plenty of discussion about this with other women at school and many stress about the prospects of not being able to handle a career and family. Some are even considering freezing their eggs just in case. Personally, I want to finish having kids while I'm relatively young so that I can enjoy my family and the rest of my life and career without the stress of wanting a child and the difficulties that come along with that at an older age. Overall, having a child, in general, is difficult. You choose the best time for you and have faith that the decision you make is what's best.

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  15. You've made some excellent points!

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  16. Hello,
    I'm very encouraged/enlightened by the posts on this forum. I am 28 years old and currently I'm a middle school science teacher and loving it. I majored as a microbiology/premed student during undergrad and lately I've been thinking about going into medicine. I don't have kids yet (I desperately want them though) but at this point I'm thinking if I haven't had kids all this time (been married for 3 years) then maybe I should still just go for it and go into medicine. As was said earlier, there is no perfect time to have a baby; and we do need to change the medical industry to be more mom-friendly. Any words of advice?

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  17. I was researching this issue today and the only downside to having kids during residency (besides the crazy schedule) is that you may have to extend your training. I am an undergrad planning to attend medical school in a couple of years, but the idea of having kids at that time just seems crazy. In med school, unlike in residency, I would not get ANY paid time off and I really hope to take advantage of unique experiences like doing medical electives abroad. Gosh, there really is no perfect time to have kids....in any career. Heck, I am a little jealous of my high school friends who had a kid or two by the time I was ready to begin my junior yr of college! Yeah, they're mostly working retail jobs but still...it seems like in the 21st century, women still have to make a tough choice between pursuing their dream career (which often entails years of education) and pursuing their desire for a healthy, successful family life. Best of luck and lots of prayers to those trying to navigate these conflicting waters!

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