Help! My residency program does not offer Maternity Leave

[MacularStar]

Hi All,

I am expecting a baby this fall and about to start my residency program this July. My residency program's website states that it offers "Maternity Leave, " and I assumed that this meant a paid leave of absence, usually at least 6 weeks. BIG MISTAKE. When I finally told my Program Director that I am expecting I found out that what they are referring to is FMLA or Family Medical Leave of Absence and this is nothing special. It is available to almost any working person. It includes up to 12 weeks unpaid, absence, but benefits are included. This is not ideal, but manageable. However, after reading the eligibilty requirements I quickly discovered that I am NOT eligible for FMLA because it requires that you have been employed by that program for at least 12 months. My only other options are to take 2 weeks of my vacation (and even this is a stretch because we are only supposed to take 1 wk per month) or take an Unpaid Leave of Absence which means the obvious, plus I lose my benefits, and delay my graduation and I am thinking of doing a fellowship and am worried that it may delay that a whole year.

Has anyone dealt with anything like this in the past? Do you have any suggestions? Is there anything I can do to make this situation better?

FYI: For anyone thinking of getting pregnant during their residency with no ML, consider buying Short Term Disability Insurance. This just means that you will be paid 70% of your salary while you are on leave. You have to buy it before you are pregnant, otherwise it is considered a pre-existing condition. I had no idea this existed before today.

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[Geekchick921]

Firstly, congratulations! And I'm sorry you're dealing with this.

Unfortunately, yeah, FMLA only requires that they hold your position for 12 weeks, they don't have to pay you or anything. Sucks. Canadians get a whole year, and I'm pretty sure it's paid.

Is it that they are required to offer FMLA after 12 months of work, but can still offer it to you after only a few? I believe the FMLA policy at my work was X amount of hours within the last calendar year. As a resident, you may rack up enough hours for that. Just putting it out there.

From my own experience, if you have a C-section, you will probably not feel up to hustling back at work 2 weeks PP. I was told not even to drive for 3 weeks, and not to do the stairs more than once a day if I could help it. Also, do you have child care arrangements? If family will be watching your baby, then that's fine, but most daycares will not take infants younger than 6 weeks. I'm sorry if I'm being a downer, I just want to make sure you've considered that as well.

Good luck to you!

P.S. I believe Aflac can be used for maternity leave as well, but you have to have had it for... I want to say 7 or 8 months at least before you can utilize it. I might use it myself next time.

 

[Tigerz_Fan]

This also almost happened to me. Yes, you have to be employed for 12 months to qualify for FMLA. I just started a fellowship in July, so I also didn't qualify. I took an unpaid leave, but went to HR early and investigated my options. As long as I had filled out the correct paperwork, then I didn't lose my benefits (insurance). I even had to take extra time off due to complications from the delivery. I just filled out more paperwork, and all was well.

I don't know if your institution will be the same, but I recommend talking to your dean of GME, your program director, and your human resources now. You also need to contact your new insurance company (whoever they may be when you start in July), and find out how to switch over quickly since you are already preggo. You don't want a lapse in your prenatal care while waiting for paperwork to go through.

Agree with the previous poster that you really need to plan to take more than 2 weeks. If you have a section or any complications, you need to have that time available to you. It may prolong your training, but keep in mind that time with your little one is worth it!

And congrats!

 

[montessori2md]

See above post, the advice is good.

The best advice I got when pregnant was to never do anything that made you feel resentful. So take my advice w/ the understanding that I don't know what you might resent.

You are not going to want to go back after 2 weeks, even with SVD, and it would be dangerous to go back post C-sec that early. As a mom, I relate to your feelings, but I ask you to find a way clear your head -perhaps you could talk to someone at your school who is known for being practical and calming. I advise that you go into meeting w/ whomever is in charge of determining your leave with a PLAN, and talk as if you are a corporate executive negotiating salary. Don't be a demanding jerk, but be committed to your needs as a human, and explain that you are there to figure out how to work together to meet those needs in a way that is least stressful for all parties. People do amazingly stupid things that REQUIRE them to miss work (they fall off buildings, they crash cars). Getting pregnant or having an illness is not one of those stupid things, though some people seem to think otherwise.

I would also ask if there is a way you could do a research year at your program, in order to do something lower key than intern year with a new baby in the house. I would talk to an advisor from my medical school about what I should expect from my new program re: maternity, and ask if they know of PGY2s, 3s at the school who delivered in their intern year, ideally in your specialty, and ask if you could talk to them about their experiences (I'd ask whoever runs your grad ed program).

I know it seems like a really big deal, but delaying your graduation is not as big a deal as it seems. Life is now and post-grad. The debt is bad no matter what, but it will still be ok.

If it were me, honestly, and the program was being malignant about giving me the 12 weeks, I'd walk and rematch (find a research job someplace for a year), unless matching at all this round was really hard for me. I want to be learning somewhere with a program that wants ME. If they want you, they should be cooperative with things like being a parent, because you are a parent. It saddens me that this is a shocking concept to some students and attendings.

Do NOT use your vacation time. You will need it. I have watched a lot of moms do this, it makes them miserable about 6mos postpartum when they are tired and stressed and their best friend is coming to see the baby and they have no leave. Don't use sick leave, if you have it, you'll need that too.

Aflac does pay for maternity leave, but I don't think it applies unless you had it before you were pregnant.

 

[dotdash]

Congratulations -- it is a wonderful thing (most of the time) to be pregnant and a lovely thing to be a mom.

Frankly, given my experience with babies' sleeping habits and internship years -- yikes!

How much support do you have? Will you have live-in help with the baby (husband who will be able to do most of the work, parent living with you, full-time nanny)? That may be the biggest determiner of how well you can manage next year. If you will be on your own (or with a hard-working spouse) in a new city, it will be very, very difficult. If you are breast-feeding, I just don't see how it can be done. Maybe others have been through it and will say it's all okay, perfectly doable, but I'm a little scared for you.

And (I hate to be the one to say this), unless you are very very careful, your co-workers may resent you. (I don't know what your program is like, maybe it's big enough that there will be lots of cover for you?) Things will happen: the baby will get sick and not be able to go to daycare, you will have to pump milk in the middle of the day, your nanny's car will break down, you will have to take the baby to get shots. If you've read Intern Blues you'll know what it was like for the mom in that group -- don't let that happen to you! You might want to seriously consider montessori2md's suggestion to take a year off, or at the very least, take her advice about creating a practical, doable plan with the powers that be.

I wish you all the best -- more power to you, and to the little one.

 

[dotdash]

Wow, sorry! I reread that it sounds all doom-and-gloom. Please don't take it like that. I'm all for knowing what you are looking at and organizing your way out of it. If you know what it is you are facing and what your goals are, you can plan and negotiate something that will work for you. There must be many women who have successfully taken on what you are taking on, and I hope they will continue to comment on your thread.

I have only one more piece of advice: Now is not the time to save money. If you have to take out more loans to get babysitting help, or to fly your mom in to help, or to get an apartment big enough for a sleep-in nanny, do it. Even if it seems like a lot of money now, it will be worth your peace of mind and your baby's comfort. Promise.

 

[MacularStar]

Hi All,
Thanks for all of your great advice! I am a bit calmer now that I have had time to process. I think I may do what Tigerz_Fan did and take an Unpaid Leave of Absence. I probably should have been more clear, but I am completing my Intern Year now (Transitional Year) and will be starting my subspecialty residency (PGY2) in July. BTW TY is awesome and if you do the right one you will learn lots and have plenty of time off ie. I prob averaged 40 hrs per week overall and have yet to hit 80 hrs. Really I should have had the baby this year. So my TY and subspec residency are at two separate institutions, but at least in the same city. Taking a year off would be nice, but I probably would not be able to match into this subspecialty again and I love the field way too much to give it up. Research is a great idea though, and I am going to see if I can do a month of research after having the baby since the hours are more flexible than clinic. So don’t worry, I won’t be an intern or in a super demanding residency such as Gen Surg or Neuro Surg or even IM. My call schedule is q7 home call and I will have most WE off. Yes, part of the reason I chose this field is that it is very family friendly.
As for being resented by co-residents, this is a real concern of mine. I would probably be resentful too if someone relied on me to take up their slack all the time because they chose to have a baby while I waited. Fortunately one of my co-residents had a baby this year and hopefully we can cover each other as needed. I am also going to offer to take call and attend didactics during my ML, at least after the first couple weeks, again this will just be q7 and from home, so not that bad and I will prob enjoy the stimulation of the didactics after gooing and gagaing all day with baby.
Currently my husband does not have a job, but he is actively searching. Man, the job market sucks these days! If he does land one then we will prob hire a live-out FT nanny and use a nearby drop-in nursery for back-up. Unfortunately we are in a new city and don’t have any family or close fam friends nearby. If my husband does not find a job then he will be Mr. Mom!
I will meet again with my PD in a few weeks. Apparently he has some creative ideas so I will keep you updated on what ends up happening. Thanks again!

 

[MellowYellowCA]

Hi All,
Thanks for all of your great advice! I am a bit calmer now that I have had time to process. I think I may do what Tigerz_Fan did and take an Unpaid Leave of Absence. I probably should have been more clear, but I am completing my Intern Year now (Transitional Year) and will be starting my subspecialty residency (PGY2) in July. BTW TY is awesome and if you do the right one you will learn lots and have plenty of time off ie. I prob averaged 40 hrs per week overall and have yet to hit 80 hrs. Really I should have had the baby this year. So my TY and subspec residency are at two separate institutions, but at least in the same city. Taking a year off would be nice, but I probably would not be able to match into this subspecialty again and I love the field way too much to give it up. Research is a great idea though, and I am going to see if I can do a month of research after having the baby since the hours are more flexible than clinic. So don't worry, I won't be an intern or in a super demanding residency such as Gen Surg or Neuro Surg or even IM. My call schedule is q7 home call and I will have most WE off. Yes, part of the reason I chose this field is that it is very family friendly.
As for being resented by co-residents, this is a real concern of mine. I would probably be resentful too if someone relied on me to take up their slack all the time because they chose to have a baby while I waited. Fortunately one of my co-residents had a baby this year and hopefully we can cover each other as needed. I am also going to offer to take call and attend didactics during my ML, at least after the first couple weeks, again this will just be q7 and from home, so not that bad and I will prob enjoy the stimulation of the didactics after gooing and gagaing all day with baby.
Currently my husband does not have a job, but he is actively searching. Man, the job market sucks these days! If he does land one then we will prob hire a live-out FT nanny and use a nearby drop-in nursery for back-up. Unfortunately we are in a new city and don't have any family or close fam friends nearby. If my husband does not find a job then he will be Mr. Mom!
I will meet again with my PD in a few weeks. Apparently he has some creative ideas so I will keep you updated on what ends up happening. Thanks again!

Sounds like you have some good ideas, hope everything worked out!

I am not yet pregnant, but want to plan ahead. I am wondering under what circumstances will my residency training be extended with additional time for missed work? Is the 12 week FMLA mean that I will have 12 weeks (or however long less than 12 weeks I take) added to the end of the program?

Also how much variation should I expect to find when choosing residency programs in how much paid maternity leave is offered? What is considered good (generous time off) and what is considered bad?