Hey all, I've been largely absent from this forum for the last two years, but just so happened to come back today to find this thread front-n-center.
I'm female. I'm married. And, towards the end of my PGY-2 year, I had a son.
Most women will spout meaningless BS, frankly, on the work-life balance. They'll say "you can make it work, you just have to be really organized" or "it's easy to have a baby in residency, you just have to prioritize" without really getting not the nitty-gritty. Well, here's the nitty-gritty: having a baby in residency, as a woman, is really really f*****g hard and you shouldn't do it.
I had a dream pregnancy. Was on call on my due date. Worked all the way up to 41weeks. The only accommodations I requested were not being assigned to endovascular cases due to the fluoro, which was fine. I had my son, had a 28-day maternity leave (sacrificing all vacation and flex time for the whole year in order to meet the RRC's 48 wks of active clinical duty requirement. Remember, trainees in other fields can actually take their FMLA for longer leaves, or arrange 'research electives,' but we can't, not if you want full credit for the year). Then I came back to transplant, with its erratic q2 40- hr calls and long procedures. When you're holding a liver retractor for 8 hours, how amenable do you think the attending is to you scrubbing out to go pump for 30 minutes at a time, q3 hours? I had a month-old baby whom I wasn't seeing, or nursing, for 2 days at a time. I was contributing absolutely nothing to his care, nothing. It is impossible for female trainees in other fields to understand how much more radically different the demands of surgery residency are on motherhood.
The other thing to keep in mind is once a child enters the picture, you examine your own working life in a new light. You have to find someone else to provide competent, reliable care for that child literally every single minute you're out of the house. What nanny-- or nannies, because you'll need at least two-- will arrive at 4:30AM when you leave, be content to stay till nine when you said you'll be home at seven because a patient had a complication, work overnights, weekends, holidays, covering 30+ hours at a time? At least 95% of the burden will fall on other people, be it your partner, family members, or commercial help. To make up for this, you also, out of inclination and biology, will be "on" from the moment you step foot in the door at night till you leave in the AM. Words really cannot express how completely exhausted you'll feel, being q1 for months on end, with absolutely no post call day to make it up. The worst, hardest month you ever experienced in residency is absolutely no comparison.
Finally, as prosaic at it sounds, you suddently do have competing demands which genuinely compromise your ability to be a good resident. I will say that unabashedly, if no one else does: being a woman and having a baby makes you a worse resident. The exhaustion honestly compromises your ability to think, speak, read and analyze clinical situations. I felt I was functioning completely on autopilot. I do not think any patient was harmed, but I cannot be sure. Then there are the time constraints: you are nursing your baby at 4 AM, since you need to be out the door at 445. The time comes and he hasn't finished. You can't make him drink faster. Do you leave him unsatisfied, or show up to work 10 min late? Or, you're signing out in the evening and you get a page that a patient is near to coding. Any decent resident would go look in on their own patient and manage the situation. But your daycare is closing-- staff is going home-- in 30 min. Your first duty is to your own child, isn't it? You have to go get him, no questions asked, else-- seriously-- he goes into protective custody via CPS overnight, as do all unclaimed children. Again prosaic concerns, nothing exciting, but you must make a million such small choices which will result in suboptimal residency performance and suboptimal mothering.
Ours is a system that runs on a permanent skeleton crew, with absolutely no slack or redundancy built-in. It is impossible to overstate the differences between having a baby as a surgical resident versus being in pediatrics, medicine, psychiatry, pathology, FM, EM, etc.
Marriage is completely different. Marriage involves almost no time or personal sacrifice when it comes to residency. Butif anyone is contemplating a planned pregnancy in Surgical residency, I would advise them not to do it. At least as an attending you have some control over your own day, schedule and normal workplace protections like FMLA. Otherwise, simply understand that you will be entirely dependent on other people to raise the baby.