When it came time for the big conversation, I told my husband (a family medicine resident) that I didn’t want to be pregnant on my PICU rotation. I looked ahead at my schedule for the second year of my pediatric residency, and I really couldn’t imagine waddling through the PICU during the winter respiratory season. So we waited and ultimately I was pregnant at the end of my PGY-2 year. I was then faced with the challenge of thinking about how I would prioritize my schedule while pregnant, to optimize my work schedule once I had a baby at home. 

Did I want to get all the time-intensive, “harder” months out of the way during pregnancy, in order to have an easier schedule after giving birth? Or did I want to give myself a break while pregnant so that I would actually have time to eat, sleep and make it to all of my prenatal appointments on time? Like many residents in my position, I ultimately decided to do as much of my inpatient, call and night time rotations while pregnant, to have as much time at home as possible to be with my new baby at home.

So what did that look like for me? I was 7 months pregnant waddling through the PICU during the winter respiratory season. I did procedures, helped get a patient on ECMO, comforted families and patients, and became a better pediatrician that month. I got through it, moved on to my next block working 12 day stretches on the inpatient service, and then welcomed my baby girl into the world.

You will be told that it is hard and exhausting and overwhelming. And those things are true too. That doesn’t mean you shouldn’t do it, though. My husband and I felt like it was the right time for us to expand our family and I am so thankful that we did. 

Below is a list of very basic things that we thought through before moving forward with having a child. This list is certainly not comprehensive, and it may or may not be a good fit for you and your family. But for us, once we thought through these few things, we felt brave enough to become parents as residents.

1. We looked closely at our insurance

Our residency medical insurance was less than stellar. We found out which doctors and delivering facilities were covered by our health insurance plan. We also looked into pediatricians that accepted our insurance. We were able to get an approximate cost for prenatal and delivery care to make sure it was something we could afford. My advice is to ask OBGYN offices if they have late or weekend hours, because that will help you fit in all your appointments. (PS: did you know you will need to go weekly in your 3^rd trimester?! Not an easy feat.)  

2. We found childcare options

We started looking into daycare before I was even pregnant. We were fortunate that the hospital had an associated daycare, but the waitlist was over a year long. Because we had looked into it ahead of time, we knew to join the waitlist as soon as I found out I was pregnant. It is not uncommon for daycare waitlists to be this long. So if you are thinking about getting pregnant, you should inquire to join waitlists ASAP. If you decide that daycare is the best option, you should try to find one with extended hours and limited days off. You will also need to think about childcare for weekends, days the baby is sick, or times when you are urgently called into work. Basically, you are going to need a backup childcare option. Close family or friends can be very helpful for this, but that’s not an option for everyone. Honestly, I think childcare is the hardest thing to navigate during residency because of the long work hours and the inflexibility. This is something to think through as best as you can before deciding to start a family in residency.

3. We asked our residency programs about their parental leave policies 

My husband and I both met with our respective residency program directors, coordinators, and co-residents to find out our options for leave. My husband took 4 weeks after our daughter’s birth, 3 of which were vacation weeks. I took 9 weeks, 4 of which were vacation weeks. You need to know if you have any guaranteed leave and what your options are for extending your leave past that (using vacation days, sick days, etc.) Ask if it is an option for your program director to forgive residency time. Determine how you will have to pay back any additional time.

What I hope you take away from this is that being a resident and being pregnant, or a new parent, is doable! It just requires a lot of thinking ahead and schedule planning. That be said, plan as best as you can, while remembering that circumstances will always change. What you need and what your baby will need are both moving targets. So be flexible, have open communication with your program, and lean on your support systems. If this is what you want, then you can do it!