Thursday, July 31, 2014

MiM Mail: Time for a second child?

Hi there,

I've been enjoying and learning from MiM for several years - since before medical school and before I was a mother. So thanks for creating such a great forum.

Now I am a second year medical student with an almost-3-year-old. She is great. And for the most part, medical school is great. But that's right now. My husband and I have been through a lot in the last five years to get here. We've both gone back to school and dedicated ourselves to new and intense professional fields. These changes have required two moves. In that time we have also both had pretty significant medical problems that have since resolved, but that caused a whole lot of disruption and stress, including stress on our marriage. In my case, this lengthened the medical school process.

Things have finally settled down. My husband has recently found steady work that he loves and provides him exciting opportunities. And our daughter, almost 3, is thriving. And now I feel like I can fully enjoy her.

Some years ago I thought I'd be trying to get pregnant right now. I put that thought out of my mind as we worked through all our many challenges. But as things settled down recently, I started thinking about a baby. The timing of things are no longer what I'd planned. We could try to get pregnant very soon - in which case I'd take Step 1 very pregnant. Or we could wait another year. Another year means an almost 5 year gap between children. (I am trying to prevent another year of school, hence the timing constraints).

I think our daughter is ready now for a sibling. She is becoming independent, potty-trained, able to start to share, etc. And if it weren't for all the circumstances, my husband and I would be more than ready. But I am concerned about perpetuating that pattern of being in constant stress, in constant needs-only, no time for fun mode.

On the other hand, some of that is inherent to the early childhood period, even if we were not dealt a few additional challenges. We all have to balance family and career and if this time is not going to be great fun anyway - why not create another awesome creature while we're at it?

I worry about some of the details. Would being 35 weeks pregnant affect my ability to maximize my step 1 score? (I have lots of interests right now, including one that is very competitive). And would having a baby in early 3rd year be crazy? I was back at work with a lot on my plate three years ago. I know I can do it. But doing it while missing two kiddos instead of one seems worse.

These are all details. And big picture is that family is important to me. And living the kind of life I want to live and become a doctor (rather than living life to be a doctor) is important to me. But so is happiness. And I don't want to push myself and my family so hard we can't enjoy what we already have.



  1. Really hard question. No right or wrong answer, but I would talk to a lot of people before you decide. Do you have family around to help you now? I would go into this with as much of a support structure as possible. Also, you and your husband should talk about this a lot. My husband and I struggled a lot after my daughter was born and we're finally more stable now, but it scares me to think of going back to that way again and the uncertainty involved. There are many factors but ultimately its up to you and your family in deciding what is best your family and you as a whole person and in planning the future that you want for life. Good luck.

  2. Only you can decide what will work best for your family. However, my opinion is that if it were me, I would wait. I have 3 children. My eldest 2 are 2 years apart. They constantly fight. My 3rd came 7 years after my 2nd. The older 2 never fight with the youngest -- they are kind and patient with him and have fun. If only 1 of the big kids and the youngest are together, there is never any fighting. They get along swimmingly and there was no worrying about having 2 babies at the same time when he came along so much later. It's not going to hurt your family to wait. Children do not need siblings to be socialized and turn out to be good people. I would wait and rest and enjoy the child that I already have. If we have another one, it will not be until the 3rd is at least in school and honestly, probably not until he's at least 7 or 8 because that gap is fabulous.

  3. Third year is hard. Second baby was personally wonderful but definitely contributed to the dissolution of my marriage. It takes time, a lot. I might wait until fourth year.

    If you decide to do it now I agree with Cutter above line up major support.

  4. I think the question about what happens with the baby (and your family) after he/she is born is much more significant than Step 1. I took Step 3 38wks pregnant because of scheduling issues, and though I needed many bathroom breaks and the people at the testing center thought I was crazy, it was fine. Step 1 obviously counts more, but the test itself shouldn't be an issue.

  5. This is a tough decision, and it's always hard to push off having a baby by a year if it's in your heart to have one now. I don't know what will work best in your particular situation, but for me, getting pregnant about 3 months into my third year was by far the best possible timing. I was able to get step 1 out of the way and knew that I scored as high as I possibly could. This was very important to me as I also am interested in competitive residencies. Waiting a few months into third year allowed me to finish third year 4 weeks before I delivered. This way I was able to focus entirely on third year and give it everything. It got a little harder towards the end, having to be on my feet all the time at 33 weeks with twins, but while it was physically difficult and I may not have slept as much as I would have liked to, I am absolutely certain that it did not affect my performance at all (whereas having a newborn most certainly would). I took 3 weeks after finishing third year to study for step 2, took it at 36 weeks, and did very well. Again, by then I was sleeping very poorly, feeling uncomfortable sitting for so long, and needing to pee more often than I was able to, but I ducked it up, went into my toughest mode, and am sure that it did not affect my score. I had my twins a week later. I can't tell you how wonderful it felt to have step 1, third year med and step 2 all out of the way before having my babies. It truly was a huge relief and my babies felt like the greatest reward for all the hard work. Now that all of the 'hard stuff' is behind me, I can truly enjoy both my babies and 4th year. Obviously, I got really lucky to have carried to term and have had a smooth pregnancy so that I was able to accomplish everything I wanted. But with the way things went, it was the most perfect timing for me. I do have a friend who had her baby mid third year and resumed rotations shortly after giving birth - she felt like both worlds suffered (didn't get the grades she wanted, didn't get to spend time with the baby as much as she wanted). This is just my experience but I hope it helps. Good luck to you with the decision!


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