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Wednesday, March 9, 2016

MiM Mail: Share your anecdotes about pregnancy and maternity leave

Hi fellow mothers in medicine, I'm currently a resident and pregnant with baby #2. I must say that the attitudes I have encountered throughout this pregnancy from my attendings and peers have been discouraging. I'm working on writing an op-ed piece about attitudes toward pregnancy and maternity leave among US physicians and would love to have more quotations and anecdotes from your experiences. Positive and negative comments are welcome (please comment below)! Sadly, mine have been mostly negative. Thanks so much!

14 comments:

  1. I'm an anesthesia resident at a large academic program. men or women can take as much maternity/paternity leave as they want, they just have to make it up at the end of residency. Similar policies apply for sick leave, family leave of other types, etc. We have 75 residents plus some CRNAs who can provide coverage for the people on leave. I have not personally been pregnant as a resident, but my understanding is that pregnant residents spend a lot of time on lower intensity cases, particularly during the third trimester. The last month is spent on lates, which I suspect is to allow the pregnant residents to go to doctor appointments. And no call during the last month of pregnancy.

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  2. I'm a psychiatry intern at a large academic program and we can take up to 12 weeks of leave, half paid without extending residency. We have a fairly large intern class and 2-4 calls/month with 1-2 of those weekend days and 2-3 short weekday calls per month. I had a baby (my second) winter of this year and felt well supported. I finished pregnancy with 2 lighter rotations and had no call my last month prior to leave. I felt like my colleagues were very respectful and protective of me during my pregnancy and no one gave me a hard time for ducking out for ob appts. I did front load my calls for the year and had 2 pretty rough months hours-wise in my second trimester where I was on call most weekends but that was my choice. I took 10 weeks off. I'm back at work now and am happy that for the remainder of the year my call schedule is back to normal.

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  3. IM resident here. It's not as rosy on this side of the world. At my (relatively) small program my pregnant female colleagues have either taken off their entire four wk vacation to be able to recuperate or, in the case of one woman, taken off a mere few days to be in the hospital then returned straight to work (!!). Paternity leave is unheard of.

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  4. I am a family physician at a fairly small physician owned practice (8 physicians). We do full spectrum family medicine including OB and hospital medicine. With my first pregnancy I just took 12 weeks off and did not have to make up my call. Second time around one of my partners was leaving and another of my partners was also pregnant (and conveniently due 12 weeks after me). Because everyone was stressed out about our partner leaving, three of us females (the two of us who were pregnant and another one who was planning to have another child) agreed to cover call for each other during their maternity leaves. So this meant 50% more call for my one partner at the end of her pregnancy, 50% more call for me coming back from maternity leave and 6 months of extra call for my third partner who went on to have another child and we paid her call back. It allowed us all to have the 12 weeks off that we wanted, but it was added stress. Plus, some of my male partners were not too happy about my blocked time to pump after coming back from leave. My partners are great people and I enjoy working with them, but the men just don't quite get it.

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  5. Former ER resident. Graduated two years ago. I had a baby my third and final year. I was off for six weeks total. I used two weeks of my paid vacation (had already used one first week of July prior to finding out I was expecting). For the other four weeks I picked up extra shifts during my pregnancy, to total a month's worth of shifts. I could have just taken four weeks off but it would have been unpaid and I would have graduated a month late. Concerning attitudes many of my fellow residents (mostly male) were very scornful about me having "an extra six weeks off." My female program director was also less supportive than I would have hoped. She helped me change my schedule so I would not be doing any ICU rotations my third trimester, but was not verbally supportive in front of other faculty or residents. In addition, I was a chief resident so I still had to do scheduling and a few other duties while out. Support for pumping as either a resident or attending is not there at all. I cannot obviously block off time in the ER. Overall I felt lucky to graduate on time, and would have gotten pregnant again if I had to do it all over.

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  6. Current resident in 3rd tm of pregancy. I have had a mixed-bag experience with pregnancy. I have had fluoro, which I have gotten coverage for, fortunately. However, it was only after repeatedly asking my PD and my chief residents. And even then, when the shifts do come around, the coverage is mostly not arranged, and I have to repeatedly ask them about it. So the whole situation makes me feel like I am bothering them, and also makes me feel unnecessarily guilty about it. Regarding call, I have been doing 24 hr shifts and nightfloat late into my 3rd trimester. I tried switching my nightfloat earlier in the year, but my PD said it wasn't possible. My 24 hr shifts got so tiring, that I finally caved and asked another resident to split the shifts with me. People who saw me coming off of my shifts would always exclaim, "I can't believe you're doing nights/call while 9 months pregnant! You must be so tired." And I was tired! So that makes me secretly wonder inside, if they felt like they could say things like that, why they wouldn't just switch with me or something. For maternity leave, I get 6 weeks fmla time, fully paid, plus hopefully 2 weeks of vacation that I have saved. When I return though, I do come back to more 24 hour shifts and nightfloat. It will be interesting to have to juggle that with breastfeeding. Bottomline feelings about pregnancy in residence are: I only get consideration when I ask. People don't seem to want to offer help out of the blue, even though they know it is hard. Even your female co-residents. I have the general sense that people just don't truly care about my well-being, and it makes me resent the whole experience/residency. But hopefully, it will all be worth it when LO arrives.

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  7. Third year medical student with baby #1. Most of my attendings and other team members did not know I was pregnant until into the third trimester. Mixed blessing as I did not receive any accommodations. Luckily the way the schedule went, I was off four weeks before my due date. Then I took two eight week blocks off (15 weeks of baby time) but am finishing the PhD during this time. Still cannot complain. Have requested accommodations for the Step exams. They give you an extra break time after lunch but nothing in the middle of the testing sessions when pumping really needs to happen. So you get to pump for five minutes during the fast ten minutes breaks built in to make you a bit more comfortable...probably standing in a bathroom. I guess standardized patients will have to forgive a leaking medical student. We will also see how attendings (especially on surgery) are with me stepping out for pump breaks once I'm back in rotations.

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  8. I had baby #1 as an anesthesia resident. My program was relatively small so it was difficult to make accomodations. I took call until delivery, I was not taken out of fluoro ORs, I pushed and lifted heavy patients, I did a lot of stuff I should have not done but was afraid to ask for considerations. I really agree with Unknown above: "People don't seem to want to offer help out of the blue, even though they know it is hard." I could take the max allowed by FMLA (12 weeks--6 paid, 6 unpaid) if I wanted, but I would have to extend my residency by quite a bit. I ended up going on bedrest at 39 weeks and took a total of 6.5 weeks off (I had a csection and came back as soon as I was allowed)--which included 2 vacation weeks and 5 sick days. The rest I made up, so my residency was extended by about 1 month. It was not a problem to start my fellowship a month late, fortunately. When I returned from maternity leave, there were no accomodations made for pumping so I ended up having to stop breastfeeding early. I am pregnant now as an attending (at the same hospital) and it is totally different. A lot has changed in the culture due to many pregnancies since mine. Everyone has been very supportive and considerate. My boss has been incredibly wonderful and has done a great job scheduling me for lighter days at the end. I was told not to take any call during third trimester but I did take some at 30 weeks and 33 weeks in order to make some extra $$. I'm taking 12 weeks maternity leave, 8 of which is paid. It has been quite a dream this time, and I am grateful.

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    Replies
    1. Oh also, meant to add that my husband, who has been in training for both of my pregnancies, took 5 paternity days the first time. This time he will likely take less as he is in a very small fellowship and it will create a big hardship on the other fellows.

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    2. When would you say is the best time in anesthesia residency to have a baby?

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  9. Thankfully, my PD was very understanding but I've encountered many negative opinions from fellow residents and other specialties. I also wasn't lucky enough in that I took all my vacation as leave and I have to make up the rest at the end.

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  10. Anonymous comment sent in to MiM:
    I had a baby at the very end of my 3rd year in IM residency. Overall, I felt supported but looking back now, it could have been much better. I was able to front-load my 3rd year schedule so I had my hard rotations early in the pregnancy. (I told my PD about the plan to try to get pregnant and my wishes for a front-loaded schedule. Fortunately, I got pregnant according to plan.) I ended up taking 6 weeks off, using 2 weeks of vacation and had to make up 4 weeks at the end of residency. They let me do a sort of elective month with some clinic time and no call. I remember not knowing who to talk to or how to make any requests about pumping, so I pumped in the bathroom. I had my second baby after working as an attending for several years, hoarding my leave for this purpose. My colleagues were supportive when I had to leave work for appointments and I was able to use 4 months of paid leave after delivery. When I came back to work, I pumped in my office while continuing to chart.

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  11. I have had three kids all during residency and fellowship and did not really get paid leave any time. Each time I was "off" for 12 weeks, but used vacation and sick days in order to receive approximately 6 weeks of salary. The remaining time off is unpaid leave at my institution, which is quite large and well known. Where I live the cost of childcare for two kids is equivalent to my fellow salary, and the cost for three children far exceeds it.

    I think it is an embarrassment that premier medical centers do not offer basic parental leave for the physicians (house staff) who are at the front lines of patient care. If I were ever to be in a position of power at an academic center, this is the first thing that I would change.

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  12. Surgical resident here. I am fortunate that my program is very supportive of all residents (male and female) who have had children. When I had to take off a couple days for two D and Cs earlier this year I was told to take as much time as I needed. No questions asked.
    Now that I am pregnant again I will be on research time during the last two months and for four months after delivery. My coresidents rearranged their schedules to ensure I was on research when it mattered the most. I will not have to worry about paid vs unpaid maternity leave. I do not know how things would work if I delivered while on service but given my program's attitude towards family, I feel confident I would be well supported.
    As far as appointments, I have scheduled all appointments when I am post call so it has not been an issue. However, I can see that would be difficult if we did not have enough residents to cover cases.

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