Home » Pregnant Physicians

Category: Pregnant Physicians

Working in Medicine–Supporting Pregnant Physicians

At some time in everyone’s life we all start needing a little help
–Jim Robbins


It’s been a long time since I wrote my last blog post.

I apologize for the hiatus. This whole ‘having a baby’ thing hit me harder than I expected it would. I have been unmoored by the experience, and have taken this time to get back to what now is our ‘new normal.’ Baby Cole came early via C-section at 33 weeks after I started bleeding at home for the second time. Fortunately, he was big at 5 ½ lbs and only needed respiratory support for 2 days. Afterwards we played the waiting game while he learned how to eat and were finally able to take him home at three weeks of age.

Having my family separated and an inability to fix it left me feeling like a failure on all fronts. My toddler didn’t have the language or comprehension skills to understand what was going on, only that his parents, those who keep him safe, weren’t around. For all he knew, we were abandoning him. I couldn’t nurture my infant like I wanted, the first few days I was discouraged from holding him, and subsequent days when I would come to the NICU, I felt like a bystander, a guest rather than his mother. I was also in significant pain from my C-section which made it difficult to move around. And it was Christmas. And my 40th birthday was Christmas Eve.

I spent the holiday in tears thinking about my infant laying alone in a bassinet in the hospital with no one to comfort his cries. Then, when the festivities were over and we tried to go see him, my toddler cried and screamed for us not to leave. Things were chaotic and out of control and I was needed in all places at all times.  I wasn’t getting space to process that we actually had another baby, to heal from my surgery, or to just bask in the warmth of our beautiful growing family. I was also terribly sleep deprived, furiously pumping trying to keep up my milk supply. It was like we were running a marathon with no end in sight. All I wanted was to have my baby home, to rest on the couch, feeding and doing skin-to-skin, with everyone together.

When we were finally able to take Cole home, I wasn’t prepared to then have to re-acclimate our life yet again, this time with the baby at home, and me being even more sleep-deprived with wake-ups about every two hours. I wasn’t ready for the mental fog and the feeling of being borderline insane that occurs when you don’t sleep for longer than 4 hours at a time for MONTHS. Combine that with needing to return to work only six weeks after baby comes home from the hospital, and life feels impossible. I was not emotionally ready to return to work, take care of a newborn, and ALSO write a blog.

Last night I actually got 4 hours of sleep in a stretch. So I am feeling better than usual.

I am eager to share my experiences as a mom of a NICU baby, but I must tie up the loose ends left by my last blog post. This latest post (that is 4 months late) is the one where I was supposed to talk about what pregnant physicians need. How we should advocate for ourselves so we can take better care of our pregnant body and our unborn babies.

Pregnancy is crazy hard and being a new mom is also really hard. As physicians we have learned ways of minimizing our needs and coping with life struggles that don’t really serve us. We constantly under-prioritize our own health and well-being, priding ourselves on needing little or no help. In actuality, we probably could get through these challenging times much better if we feel like it is acceptable to have needs and ask for help. This doesn’t apply just to pregnancy, but illness of family members, stress at work, etc.

So instead of saying what we ‘should do,’ to support our pregnant colleagues, I am going to talk about things we SHOULD NOT be saying to ourselves or to our pregnant friends who may be in similar situations.

1. I don’t need anything—As much as we sometimes don’t want to believe it, we DO need things. We need to eat. We need to sit down sometimes. We need to slow down a little. We need naps when we have the opportunity. We also need to take better care of ourselves and our bodies while we are pregnant.

2. I can do it—I hate this phrase, particularly because it is one thing that enters my mind 1000 times a day. It entered my mind so much when I was pregnant, it was like for some reason I felt I could be super human, and not always take the appropriate precautions a pregnant woman should. I think some of this was proving that pregnancy didn’t incapacitate me, that I was strong or capable or superior in some way to not need help. In reality, this is NOT the time to be the hero. You can’t see all the patients. You can’t go into the room with the patient who has CMV, or flu, or whatever infectious disease is circulating. You can’t work if you are vomiting non-stop. You also really shouldn’t be doing all of the sedations with the X-ray machine. You can’t carry that heavy equipment, and you shouldn’t volunteer for all the extra shifts. This is the time where it is OK and entirely understandable to take a pass.

3. I’m OK—The thing is, most of us actually ARE OK, but I want us also to be able to talk about it if we aren’t. When I started bleeding at 30 weeks with my most recent baby, I kept telling myself and others that I was fine, that I could go back to work, that I didn’t need special accommodations or treatment. In actuality, I wasn’t fine. I was hospitalized for 7 days and had a real risk of hemorrhaging. Had the hemorrhage happened at work, it could potentially have been disastrous. Stepping away from work at that point was a necessity, and I struggled with acknowledging that things were not just ‘OK.’

4. Don’t worry about me—We should all care and worry about our pregnant colleagues. Working in medicine (in most areas) can be a bit of an occupational hazard with long hours and precarious situations (x-ray machines, viral illnesses, combative patients). Stating that we are not to be worried about minimizes our situation, which is exactly what I am seeking to avoid. Our situation should be taken into consideration.

In addition to all of the above, we should be advocating for 6 months of maternity leave. It might sound egregious to some of you, but let’s discuss my situation. I took leave early, out of fear of the likely possibility that I would start hemorrhaging on a shift. My baby and I were at a significant risk for this. Despite precautions, I started bleeding again at 33 weeks and I had an urgent C-section. Baby was surprisingly large and healthy, but still spent 3 weeks in the hospital. I feel fortunate to have been able to take home home so early,  as I was told to expect him to be there until his due date.

I had a total of 12 weeks of maternity leave, and I went back exactly 3 months after I started my leave with bleeding. This was 6 weeks after baby got home from the hospital. He was 9 weeks old, but only 4 weeks post due date. So the most fragile of my two babies only had me at home for 6 weeks. Not only did this feel really early,  I felt even more uncomfortable about leaving him because of his prematurity. There was no option other than unpaid leave.

I shudder to think what would have happened if my baby had been 30 weeks, or 25 weeks. What if he had been really sick? How would I have managed returning to work? What about the moms that actually have to make this decision? We should be better at supporting families, from a societal perspective, but also from an occupational perspective. We as physicians should collectively take better care of ourselves and our families. It is what we want for our patients, so we should advocate it for ourselves, too.

Do any of you have experiences like I have had that you would like to share?


Thanks for sticking around! I hope to be back to some regular blogging in the near future…..

Working In Medicine–Experiences of Pregnant Physicians

“I lied and said I was busy. I was busy; but not in the way most people understand. I was busy taking deeper breaths. I was busy silencing irrational thoughts. I was busy calming a racing heart. I was busy telling myself that I am okay. Sometimes this is my busy, and I will not apologize for it.”



So, here I am, taking time off to rest before my delivery. I have been advised to do this by my physicians, but it still feels rather unnatural. I am struggling with the ‘down-shifting’ required, as I think I function best when I have a lot of things to do. When life is slower, I am uncertain what I should be doing, because I am not always comfortable relaxing. It feels too much like I am wasting precious time. Then I judge myself, and I (usually mistakenly) think others are judging me too.

It has been helpful to have my Department be fully supportive of this time off, as well as hearing the support from my husband, my family members and my friends. But I am still uncomfortable, despite all the reassurance.

This experience has caused me to worry about my fellow pregnant colleagues. As I have grown in my own personal awareness, I have subsequently become concerned that my sisters in medicine are also struggling with trying to figure out not only how to put their families first, but also how to advocate for oneself when pregnant.

I got lucky, I had a doctor tell me I couldn’t work anymore. How would I have managed a similar situation if I felt as though my activity and/or stress level was putting my pregnancy in jeopardy? What would I have done if I was in residency or fellowship, where there is much less buffer in the system to support time away?

During my first pregnancy, I was 37 weeks when I started bleeding, so the plan was just to deliver the baby. I went to the hospital and didn’t leave. The thing that has haunted me is that I was on the schedule to work back to back overnights, single coverage the following two evenings. What would have happened if I had started bleeding the next day at 4 am instead of 7 pm? Would I have been able to stand up for myself and call in back up? I can honestly say I don’t know the answer to that question. Now, I think I could do it, but I am not sure I could have done it 2 years ago. The fact that it was even a question terrifies me. It makes me so much more sensitive about the environment we are in, and it also made me incredibly pro-active about my schedule this time around.

In my current pregnancy, I had been working a lot. I was concerned about working too much close to my due date, so I scheduled myself to work almost 50% more in October and November, late second trimester, early third. The day I started bleeding, I had been taking care of my two-year old all day, took a nap before my shift, and then went in at 7 pm. I essentially worked from the time he got up at 6 am, until I got home from work at 230 am. That is a very long day, and those hours aren’t that different that hours I kept as a trainee. Is it possible that working contributed to my symptoms?

We are taught to believe that we are not to blame when things like this happen. However, there is a part of me that thinks we are absolutely responsible for taking care of ourselves and our babies. Motherhood starts early, and it is important for us to realize when we don’t take care of ourselves, it is not an ideal environment for our fetus either.

As a physician, data is very important. There is minimal actual data regarding physician work hours and pregnancy complications. Most of the studies have looked at resident physicians, and have found positive correlation between work hours and complications, from preterm labor, miscarriages, and other issues like high blood pressure. I personally had no knowledge of this data until I started looking into whether other women in my same situation were having similar experiences.

In addition to doing a mini-literature search, I also knew that I could probably find other women physicians struggling with these concepts. Considering that training and school take up a large portion of our most fertile years, I knew there would be other women with their own stories. Their own challenging and heartbreaking moments of wanting to be strong and resilient physicians, yet working under conditions that make being pregnant really challenging.

So I decided to reach out to the one group of women I knew could identify with my feelings.  Physician Mom’s Group (PMG) is a group of momma physicians on Facebook that is currently 80K strong. It was started by Hala Sabry, DO, MBA, who practices emergency medicine. Dr. Sabry was looking to create a female physician community for support around fertility and raising children. It has grown tremendously since inception in 2014, and has also become a place where doctor moms talk about everything, from aggravating patients, favorite scrubs, what to buy your husband for Christmas, to personal health concerns, death, depression, and childbearing.

While I was in the hospital, I asked the group if anyone had struggled with working while pregnant. I asked if anyone else felt a sense of needing to work to the point that they might be putting their health at risk, and what that was like.

I received close to 100 responses, women of all stages of life recounting their stories of struggle as they navigated being a working physician with being pregnant. One fellow physician shared her already published account. Some of the stories were horrifically tragic, like losing 17 week old IVF twins to miscarriage after a previous loss at 10 weeks, or stories of women saying that they knew they were straining themselves and working too hard, only to miscarry a few days later. Other women shared they had to sit while rounding at the hospital so they didn’t pass out, to having to return to work post-birth as soon as two days. TWO DAYS.

There were stories of women being asked to come in to work by their supervisors despite being told by their physicians not to, or women who were forced to continue working after their back-up refused to relieve them. Like anything, there were also stories of hospitals and training programs that were very accommodating to any requests to slow down, but most shared the opposite experience.

What was striking was the number of stories women were sharing, as well as the general knowledge that we as a collective have early babies, small babies, poor fertility, and we miscarry more often. I don’t think I was ever told that information, which now adds an element of increased risk  in my mind, for all of us choosing to have children.

Most of the women who responded talked about the struggle between feeling the need to work with feeling the need to take care of themselves. Almost all shared that they wished they would have slowed down, advocated for themselves more, or had someone advocating for them.

I identified with every woman that responded, and although most stories ended with healthy babies, there was palpable agony in the ones that did not. It was also common for many of these women to have had miscarriages and then grieve in silence. We as a community have a lot of work to do, and I feel that with advocacy and information, we can start to change the way we care for ourselves and our colleagues. Hopefully, we can pave the way for those coming behind us.

Do you have a story that you would like to share?


Next week–Working In Medicine–How to Support Pregnant Women