Maternity, Motherhood and Medicine – Part 1 of a 2 Part Series
C. Heather Rumsey, MD FAAEM
Emergency Medicine Residency Program
I’m convinced that there should be a section on child-rearing as part of the LLSA. How many of us have time to do a literature search for the best articles on toilet training, how to handle night terrors and the best methods for removing dry erase marker stains from your hardwood?
Until the administration at ABEM realizes the dilemma that we young physicians, both male and female, face, I will help to fill in the gap with some of my experience, which includes many trials, observations and experiments in conceiving and rearing my offspring.
Let me offer a “politically incorrect” disclaimer. I happen to be involved in what some people might refer to as a traditional “nuclear” family – with me (the wife), a husband and two children. I will try to use the politically correct term “partner,” but at some point I’m going to refer to my husband as my “husband” as I refuse to call him “the sperm donor,” “baby daddy,” or “my male counterpart” out of respect to him.
Many couples experience the dilemma of when to start having a family. Of course each situation is special, but the bottom line is (just like with many other major life decisions), THERE IS NO PERFECT TIME to conceive, carry, and deliver. I’m not going to belabor the point, so you shouldn’t either. However, if you think you want to have children, there are a few things you should consider.
1) Do you have a close circle of friends or couples that will support you through the next nine months and beyond? Conceiving is the fun part, or at least it should be if all goes as planned, but the prenatal period is not all nesting, shopping and baby showers. Many couples feel very stressed with impending financial pressures, changes and expectations that they are going to have all home projects completed by the birth. A close circle of friends, with or without children, is important. It’s good for both partners to have a positive outlet for issues that crop up. Maybe it’s just me, but a lot of my physician friends who have chosen motherhood have more than the average number of complications. Maybe it’s because we’re more aware of warning signs, most of us are close to “advanced maternal age” or we’re viewed by the obstetrics community as high-risk and are screened a little more vigilantly. I think it’s helpful, especially if your partner has a non-medical career, to have people in “your circle” who are also non-medical and who have experienced some of these life stressors. My husband has had times where he’s felt alienated, especially at some prenatal appointments where we’re discussing polyhydramnios and ketones, and he’s sitting with a smile of pleasant oblivion. Frustrating for him but manageable with some debriefing by me and others in our circle.
2) Do you have a good feel for what your co-workers response will be? Although it shouldn’t deter your efforts to become a parent, it’s helpful to have a sense of who your “allies” at work will be. If you’re a female physician reading this and planning a family, you might expect that your other female counterparts will be the most supportive, but I’ve not always found this to be true. I could speculate on why women are not always supportive of other women, but the bottom line is that you shouldn’t assume that just because a physician has ovaries she is going to be happy for you. Sometimes your strongest allies might be those who are older (even grandparents) whose life experience gives them that extra bit of grace and understanding that younger physicians might not have. Also beware of a “wolf in sheep’s clothing.” Most of the time I would not advise that you tell anyone that you are pregnant (especially before eight weeks) unless you are ready to tell the whole department. We in emergency medicine tend to be gregarious, social and yes – GOSSIPERS. If you’re ready to tell your staff, just let 2-3 people know, and you won’t have to spend the postage on each announcement. Of course, by the time the rumor goes through, you’ll be pregnant with triplets carrying the chairman’s love children.
3) Be realistic with expectations for your pregnancy and your career goals while pregnant. Listen to other nurses and physicians regarding their experiences, but don’t get your mind set that you’re either going to have the worst or best pregnancy. When I was pregnant with my first, I discovered that a woman I knew ran five miles a day up until her third trimester. This was WRONG on so many levels for me. First of all, the last time I ran five miles was in my early twenties, and I was definitely not pregnant. I had to put this into perspective for me and my pregnancy. Don’t start a radical exercise program the minute the little line turns pink on the dipstick. You’ll set yourself up for heartbreak when the physical exhaustion of the first trimester hits you at around eight weeks of pregnancy. You will gain weight – regardless of how nauseated you are! And no matter how much we may want to believe it is all “water weight,” nothing ever goes exactly back where it started – unless you know a good plastic surgeon. I’m not complaining, just trying to make you aware that if a perfect body was either one of your life goals or what you started with, just be open for change. Regarding your career, most physicians can work well into their eighth month barring pregnancy complications; but make back-up plans with your scheduler for the last four weeks in case things change. I have a friend who worked her last shift the day she was induced. She’s amazing regardless of this; but again, don’t plan on things being this seamless. The best way to deal with this point is to make a list (see below) to keep things in perspective.
Pregnancy Goals
Must
Might
Dreams
Career Goals
Must
Might
Dreams
Personal Goals
Must
Might
Dreams
4) Lastly and not least importantly – remember your spouse/partner. Let your partner in on the experience, including the embarrassing, the hilarious and the disappointing. Often after conception, the prenatal period becomes a period where we forget to focus on romance and relationship building. Everything’s about the baby…and this can put extra strain on a relationship, trust me. It’s still very important to date your partner (regardless of your marital status) during the prenatal period. Set a goal of at least one date night a month where you actually anticipate doing nothing but enjoying your partner. Sure, it would be nice to have the nursery mural finished and all of the baby clothes washed and hung in the closet, but those things are negligible if there are unresolved emotional needs and issues between you and your partner.
Conception, child birth and child-rearing change you in so many ways. It makes me chuckle sometimes that I can treat a myocardial infarction, be a chauffeur, cook, maid and an expert bottom-wiper all in one day. It’s crazy most days, but I can’t imagine having it any other way. There is no easy way to summarize the mixture of parenting and medicine. I do believe being a parent makes me a better a physician, and the converse is true as well. Stay tuned for the next edition in this series entitled “How to raise your children without locking them in a closet for 18 years.”