Pregnancy During Training

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I'm a female nearing the end of my training and I wanted to create a post about my experience having children during residency. Over the past 5 years I have exchanged private messages with a number of women wondering if this is possible, and if so how to make it work. As a fourth year medical student I remember internet searching for information on the subject and feeling scared and nervous because I couldn't find much... and what I did find included many horror stories. So, here is some of my story and insight.

I found out I was pregnant right after medical school graduation and delivered my first child halfway through my transitional year internship. The first people in the program who I informed about my pregnancy were the program director and the chief resident. I think I was only 8 weeks or so, but I knew they would be creating our schedules soon and I wanted them to have this information. My intern year schedule was front-loaded (MICU, FM, night float, CICU, IM floors x2) so that by the time I had my baby I had completed most of the hard rotations for the year. In retrospect I would do this again, because having a newborn is EXHAUSTING... for me even more so than the vast majority of pregnancy. I also took Step 3 while pregnant and that was a good decision. I studied while on CICU and during one week of a light outpatient elective.

My second baby was born during my PGY-3 year. Again, I told the program coordinator and chief resident very early on (I think I was only 5-6 weeks) because they make our schedules. I was able to deliver during a portion of the year when I had zero call responsibilities. I extended residency by 2 weeks because of maternity leave and started fellowship 1 week late. While interviewing for fellowships I told every program director that this would be the case and only received a negative reaction on one interview.

I took 6 weeks of maternity leave with both of my kids and was fortunate to have uncomplicated pregnancies and deliveries. My programs also scheduled light/flexible rotations for my first few weeks back and this made the transition back to work easier. My husband has a flexible job and we have supportive/helpful family that live within driving distance. A few tips and thoughts that come to mind:

1) Do not complain and work HARD. 80 hour weeks while pregnant will be very, very challenging. Some people will appreciate these difficulties and some people won't. But NOBODY will appreciate constant complaining. Additionally, a good way to alienate your co-residents is for them to have to do extra work because of you. Don't expect or imply that you want an easier workload. Hopefully you can be a team-player and form strong relationships with your co-residents and attendings. That way if you truly NEED help they will be happy to help you. I remember one time while I was 7 months pregnant I had been awake for 36 hours after a rough call night and my co-resident and attending conspired to cover clinic duties together so that I could go home early and sleep.

2) That being said, do things to take care of yourself while pregnant and working. Stay hydrated, keep snacks in your pocket, wear compression socks/tights, have Tylenol/zofran/Tums on hand, and prioritize sleep as much as possible.

3) If you are a medical student applying for residency and you are thinking about having children, look out for family friendly programs. This can be hard to discern sometimes, but I think it's a good sign when programs have multiple residents who have children or recent graduates (especially female) who had children during residency. I also think it's frequently logistically easier to have children in programs that have at least a few residents per year. That way there are more people to cover call.

4) Have a strong support system and a childcare plan in place. A flexible significant other makes a huge difference. So does local family that are willing to help. If neither of these are options for you, then you will probably need to have a nanny or a daycare with extended hours.

5) My husband and I made the decision to incorporate bottle feeding early for both of our children. This enabled him to help with night feedings and allowed me to get more sleep. It's incredible how much more sane I feel when I get good sleep, so this was truly a lifesaver for us. I know this won't be everyone's preference, but it worked for us.

That's all that comes to my mind right now. Having children is HARD and having them while learning to become a physician is even harder. However, being a mom brings me INCREDIBLE JOY (usually... sometimes I want to pull my hair out) and I am so so grateful for my kids. I'm happy to answer questions here or via PM.
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