How residents who gave birth navigate postgrad training and motherhood

Residency is often intense and all-demanding—and frequently, pregnancy and the early years of parenting are, too. Many women take on both of these challenges simultaneously. A number of them shared with The DO that things like colleagues who weren’t understanding and pressure to take less parental leave made an already difficult time even harder.

A national survey of surgery residents who gave birth during training found that 39% strongly considered leaving their residency.

“If you want to have a child or if you face an unplanned pregnancy, you can make it work,” says Kristin Veneman, DO, who gave birth to two children during medical school and a child during her pediatrics residency. “I had several people tell me I’d never make it through residency, but being a wife and mom made me a better physician.”

Moms who gave birth during residency share their insights about pregnancy and growing a family below.

Sharing the news

Telling your program director and co-residents that you’re expecting can be intimidating.

Alexis Cates, DO, felt supported by her program director during her pregnancy. Her program immediately started working on Dr. Cates’ block schedule to minimize the impact of her leave on the emergency department and her co-residents.

“I constantly worried about negatively impacting my co-residents if I got sick or had to go on bed rest,” Dr. Cates says.

About 63% of women residents surveyed for a recent BMC Medical Education study worried about burdening colleagues by taking parental leave.

Ilana Solomon, DO, says her pregnancy during her family medicine residency forced her chief resident to change their initial rotation schedule, and she got flak for that.

“I understood her frustration and emphasized with her, but would have appreciated more support,” Dr. Solomon says.

Niti Vaid, DO,  also got mixed reactions to the news of her pregnancy during her internal medicine residency. While she felt supported by her program director, some of her preceptors and co-residents seemed annoyed.

Adjusting to a changing body

The further along Nicky Ottens, DO, progressed in her pregnancy, the more challenging it was for her to keep the same pace in her combined family medicine/emergency medicine residency.

“You feel a lot of guilt for not picking up as much work, and attendings are mad at you for not seeing more patients, but you physically can’t run from room to room like you did before you were pregnant because the energy just isn’t there,” Dr. Ottens says.

Dr. Cates found adjusting to her changing body as an emergency medicine resident to be challenging too. Intubating patients at the head of the bed became difficult, and she struggled with feeling sick during her fast-paced shifts and while performing procedures.

Taking leave

Jennifer Patterson, DO, took FMLA when she had her second child during her family medicine residency. Her intention to breastfeed was one of the reasons she was determined to take leave. Dr. Patterson graduated from her program in November instead of June after taking a full 12 weeks of FMLA.

“It wasn’t ideal being off-cycle, but we need to embrace the unpredictability,” Dr. Patterson says.

Graduating on time was a major priority for Dr. Ottens. Her program didn’t have an official leave policy. She strung together her four weeks of vacation time and didn’t take any additional time off so she could graduate with her class.

Dr. Vaid also used all of her three weeks of vacation time after she gave birth during her intern year. For her second child, she took six weeks of unpaid leave.

Due to inconsistencies across programs and specialties, the AOA House of Delegates recently called on ACGME to create a standardized parental leave policy for residents.

In a recent JAMA study, women physicians across specialties and levels expressed the need for additional support for maternity leave and for new moms returning to work after having a baby. Paid leave, time for breast pumping, on-site childcare and schedule flexibility are the most impactful things institutions can offer to support new mothers, the study concluded.

“The culture of medicine is such that you don’t take time off—that needs to change,” Dr. Patterson says. “I was making a stance by taking time off and I was fortunate that no one said I couldn’t.”

Overcoming guilt

While medicine is still a top priority for most residents who have children, for some, time with family becomes more important.

As a resident, an attending made a comment implying that Dr. Solomon should stay late to help out her colleagues with their patients, even though she had already seen her own. While she didn’t believe the attending realized she had an infant at home and lived an hour away from the program, the comment still weighed on her.

“I wanted to be a team player for my colleagues, but it was a sacrifice I wasn’t willing to make since I knew my son wouldn’t stay so tiny and dependent forever,” Dr. Solomon says. “During the first six months after I gave birth, being a mother was more important to me than being a resident who went above and beyond the call of duty.”

Dr. Solomon ended up graduating residency with a staff award reserved for residents who go the extra mile.

The pressure to continually choose medicine over family also impacted Dr. Vaid.

“I felt guilty leaving my child at daycare at 6 weeks old, but then also guilty if I couldn’t stay an extra hour at the hospital to help a patient or be at a meeting,” she says.

Breastfeeding

While many physician mothers breastfeed, many of them stop earlier than they would prefer and often face barriers such as finding a space to pump and lack of organizational support.

“If we say in medicine that breast milk is best for babies, then we need to give mothers, including physician mothers, the best opportunity to do breastfeed,” Dr. Patterson says.

Time management was a constant struggle for Dr. Vaid because she was breastfeeding or pumping all hours of the day. She didn’t have a designated place to nurse or pump, so she used the shared overnight room.

Dealing with stigma

While attitudes towards pregnant residents are generally improving, negative stigmas still exist for childbearing residents.

Feeling stigmatized was the hardest part of Dr. Vaid’s pregnancies. It almost stopped her from becoming a chief resident. She was told by some of the decision-makers that being pregnant and having a child would deter her from working hard in the program.

“Luckily I did get the spot and was told later what an amazing job I did handling both my family life and the chief residency year,” Dr. Vaid says.

Nearly 83% of program directors believe that becoming a parent negatively impacts a resident’s performance, reported a 2018 study on parental leave and pregnancy among ob-gyn residents.

Dr. Ottens’ program director and co-residents were encouraging during her pregnancy, but she got backhanded comments from other attendings and residents.

“We are child bearers and physicians and we’re not going to choose one or the other,” Dr. Ottens says.

Finding encouragement

With the help of family and friends, Dr. Cates found the challenges of returning to work more manageable. She suggests finding other moms who are in a similar situation.

“They will be your voice of reason and encouragement at 3 a.m. when you are breaking down and exhausted with a newborn,” she says.

Further reading:

Having a baby in residency? A call for standardized parental leave

Consider having a baby sooner rather than later, cautions fertility specialist

10 moms give 10 pieces of advice about parenting in med school and beyond

Giving birth during medical school