Defining “Mommy Friendly”

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I had a familiar conversation the other day with yet another female medical student.

“I really loved surgery!” she said, “but I was concerned about the lifestyle so I decided on _______________.” 

Lifestyle, it turns out, almost always seems to be code for having a family (maybe it’s just the kind of students who are apt to seek me out as I have yet to encounter someone who is concerned that a surgical career will hamper their aspirations to compete in triathlons or become national fencing champions or write books for the general masses–I personally know surgeons who manage to work full time and do all of these).

The other day, I came across yet anther discussion board on what advice to give to women in search of “mommy friendly” medical specialties. There were lots and lots of suggestions, some were full time jobs with predictable hours and others were part-time jobs but not one of the suggestions was a surgical subspecialty. 

Not. A. Single. One.

Sigh. This makes me sad for my chosen specialty and for all the promising young women who will not go on to realize their potential as amazing surgeons.

I would be lying if I said that surgery is lifestyle friendly. In fact, anyone who has followed this blog for more than a millisecond knows that many of our daily woes outside of work arise from the demanding hours and high stress of our career choice. But the question is: What does mommy friendly even mean? This is not the same as the “mother’s hours” often noted as selling points in help wanted ads. There may be ways to go really part-time or certain very specific specialties that enable a woman to only have to be at work when her kids are at school I suppose. But I have to believe that mommy friendly is about more than just the hours.

I know, I know. You are just waiting for me to launch into the cliche of it’s quality, not quantity. But I won’t. 

Because the truth is I wrote all the words above nearly 500 days ago. It turns out I never finished because I don’t know what mommy friendly means when it’s used as an adjective for a career. 

Since I first wrote the beginning of this blog post, I have spent well over a year of my life as a surgeon and a mother. I even wrote an open letter to young women with the same opening line evidently having forgotten about this draft. That letter, now read more than 15 thousand times, doesn’t define mommy friendly either.  

Paid maternity leave. Private pumping rooms. Childcare. A promotion clock that doesn’t penalize for maternity leaves. 

To be sure any work place can provide these but do the amenities in and of themselves mean the associated profession is mommy friendly? Not if the backhanded comments or outright displays of resent persist. Often, the culture of the profession is at odds with these progressive work place policies. And these replies on what medical career to choose clearly indicate that the culture of medicine has not caught up to modern times. 

Luckily, however, not every one is reading the same message board. And so this week across the country a whole new crop of women begin training as surgeons. They are less a minority and more just reflective of the demographic of modern surgery. Hopefully, they will all become surgeons (there is still some attrition in our programs nationally) and some will become mothers. And my hope is that, together with the men they are training with, they will foster a culture in which is it no longer necessary to ask if surgery is a mommy friendly. 

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1 (usually growing) reason why every single man in America should care about maternity leave

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You all have prostates.

Seriously.  But let me explain further to those people who simply can not fathom as to how a woman could dare ask for maternity leave and expect her other team members to “pick up her slack, because she chose to get pregnant”.  (yep, check the comments section on my last post here, pretty entertaining, in fact!)

Life happens to everyone.

If my profession as a trauma surgeon has taught me nothing else, it has taught me this.

“Life happens to everyone,” and unfortunately, a lot of “life” isn’t pleasant.  Car accidents, strokes, heart attacks, broken legs, and ill family members are just a few examples of life situations that happen to everyone, whether or not you have a uterus.  And guess what they all have in common?  A need for time off of work.

Now, the distinct disadvantage here is that women usually need a set block of time off for maternity leave that seems relatively long (to some, at least) and at an age where they are usually young and healthy, but let me tell you gentlemen, people are going to be covering for YOU when your prostates need to come out and your coronary artery needs a stent.  No, you may not need 12 weeks all at once, but, between doctor’s appointments, procedures, recovery, and complications, or at some other point in time in your life, you are going to need significant time off of work, with your partners/coworkers/etc. chipping in and helping out.  And, oftentimes without the 6 month’s notice that your pregnant colleague is able to give.  And guess what else?  That is OKAY.  That is what life is about – building relationships and working in teams to get the job done, even if someone is having a bad day, a stroke, or a baby.

Oh, and just as an FYI, let’s just say you break your leg while skiing and you need at least 6 weeks off of work… I don’t think people will judge you and say that went skiing and break your leg – accidents happen.  So being judgmental and saying that every woman chooses to get pregnant is pretty inane.  You chose to go skiing, she chose to have sex. Get over it.

Maternity leave = family leave. (Or, hopefully will equal family leave at some point soon in the future.)

I have to admit, I was blown away by the responses I received on our blog, through FaceBook, Twitter, and even my own personal email from my last post.  Women from all walks of life shared their stories, and overall, as Americans, and as humans, we should both be encouraged and appalled.  Some female physicians wrote how supportive their partners were, but as a group, would have to sneak around HR to get her time off.  Some women went back to work in less than one week to preserve their family’s income and sometimes their job.  Office administrators refusing to allow 15 minutes breaks for new moms to pump breastmilk.  A new mom, forced to use a surrogate, being allowed zero time off because she wasn’t actually birthing the baby herself.  The stories unfortunately go on and on.

Yet, the stories of finding support from male coworkers was encouraging.  And, I do think most men and women without children also, absolutely see the value in family leave – whether it is paternity, maternity, sick leave for themselves or to care for an ailing family member.  Bottom line, every single one of us is going to need time off of work, expected or unexpected, and we are all are going to have to rely on each other, and a system to help us out.  Unfortunately, for most of us, that system does not yet exist… and at the end of the day, we can do this better – for ourselves, and each other.

Hypocrites in our own house: Maternity leave and American Healthcare

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Netflix listens to doctors.  Google, Facebook, and Apple listens to doctors.  The United States Navy and Marine Corps listen.

The above “companies” have updated their maternity leave policies – lengthening them all past 12 weeks… and all paid.

But yet, healthcare doesn’t listen to doctors.  And let me tell you how.

I am pregnant.  Which is a blessing in of itself.  In fact, this is my 4th pregnancy, but I only have one child living.  So really, this is an absolute blessing that I have had a healthy pregnancy so far.  I should be over the moon excited.  Yet, there has been a black cloud over my heart since I first saw the “yes” on the pregnancy test.

Currently, I am the sole income for our family while my husband is in law school.  And yet, my job does not provide fully paid maternity leave.  The thoughts and stress of how we are going to balance our financial needs with my family’s emotional need for me to spend that precious, once in a lifetime time at home with our new son has left me downright drained.

I am currently in “discussions” with my large academic health physicians group as to how much paid leave I will actually receive for maternity leave.  And let me tell you, their initial response was significantly less than 12 weeks.  I think for me, the most disheartening part of these “discussions” with my employers is that they keep asking themselves, “Well, what have we done in the past?” instead of, “What should we be doing?”  Despite the fact that I will need a repeat cesarean section.  Despite the fact that due to short staffing over the past 3 years, I have given up 8 weeks of vacation and worked extended hours for years – including in-house calls up to 62 hours in a row.  Yep, folks, you read that correctly.  I have literally come in to this hospital on a Friday, and not left until a Monday morning.  And I have done it, because that is what the job required, what my hospital needed.  Trauma surgeons are a national shortage, and my profession often calls for dedication above and beyond the imaginable.

I always felt like that dedication was well placed – for my patients, for my hospital, for my community.  And that this dedication was shared by healthcare in general.  However, I feel that maternity leave is an issue that highlights my belief that for many institutions and practices, healthcare has lost its focus.  Healthcare should be about caring for people – our patients and each other.  Healthcare should be setting the standard for how other companies handle maternity leave – yet we are amongst the worst hypocrites.

After all, we are the ones recommending that women exclusively breast feed for a year – yet practice administrators dictate whether or not physicians can build 15 minute pumping breaks into their schedules.  We recommend women not return to work for 8 weeks after a cesarean section, yet we don’t pay them.  Several studies have shown that women who return to work before 12 weeks have children with more behavioral problems in early childhood, yet, if she doesn’t come back by 12 weeks, we take away her job.  We know that depression is directly linked to a lack of time off after the delivery of a baby, yet we continue to point to the letter of the law and say that what we offer is enough.  I wish these examples and studies weren’t real, but they are.

The dollars and cents seem to matter more for those that employ physicians than the health of their physicians.  The disparity of how maternity leave is handled amongst physicians here in the United States is downright shocking.  Some institutions automatically grant 12 weeks paid, but these unfortunately are in the minority. Most pregnant physicians are in a similar situation to me, and are left to fight, scramble, and scrap together time off after delivery and even time to pump when we do return to work.

And the kicker of it is, the physicians are usually the worst hit by these policies.  If I were a nurse, or an hourly employee, I would be able to roll over or accrue my vacation days. Other employees could even donate paid time off to me.  I would be mandated lunch and work breaks so I could pump.  I would never be left wondering how I could safely store breast milk for up to three calendar days. But yet none of these options are typically available to physicians.

I wish this were one of my usually snarky, humorous, Gomerblog worthy posts, but it isn’t. Unfortunately, I am writing today from a place of hurt, a place of feeling abandoned by my own profession – the people that are supposed to care about my health the most, seem to care about it the least.

I hope and pray, for the future of healthcare here in America, that these policies will change – to the benefit of the physicians, and the patients for whom we care.  After all, if we can’t take care of ourselves, how are we supposed to care for others?