Habiba Tunau MD

Choosing to have children

As a female medical doctor I get asked frequently, “When is the best time to get pregnant?”…“Should I finish my training first before I have kids?” … Let’s assume you are pursuing a medical career (although some of my advice might be relevant to any female professional) and let’s assume you already know that the most likely time to get pregnant is by having sex around the time of ovulation which is around 14 days after the first day of your period. So you know the basics but you just want to know how to apply it to your life.

When to have a child during your medical training or career is a huge question that almost every female professional will be faced with- unless of course you have decided that having children is not one of your desires- and I respect that choice. Wouldn’t it be nice to have a fairy godmother who could tell us, “My Dear, this is the year to bring forth new life, have no fear!” Well, as much as I wish to give you the answers you need, the best I can do is give you some general observations and advice based on my own experience having had three children during training. In the end you will need to make the right decision based on your own circumstances.

In your late teens you are likely to be in college and in your twenties in  graduate school or  medical school, immersed in your studies. Most likely you still have  student loans and are not financially well off and taking time off to have a baby may disrupt your well laid out educational  plans. On the bright side, pregnancy is easier on your body and you have a lot more energy than some of the older mums.

The other extreme would be to wait until you are in your late thirties or  forties when you have finished training and have had time to build a career. You may feel financially secure, emotionally mature and finally ready and eager for a child; However, you now have to worry about advanced maternal age if you are over 35. The risk of complications increases, and so does the concern for genetic abnormalities, requiring you to have additional blood tests such as amniocentesis.  You may have to deal with fertility problems and even require in vitro fertilization (IVF).

My Experience as a Pregnant Medical Student

Ok, so let me tell you my pregnancy stories and then some conclusions I made from the experience.

During Medical school I made it a goal to graduate with a degree in one hand and a baby in another.  I had a supportive husband, so we started trying to conceive when I was in my third year of medical school.  We didn’t get pregnant as quickly as I thought and we almost gave up on the idea of having a baby -which didn’t seem so bad because for as long as I could remember my Jamaican grandfather had told me, “Don’t get pregnant until you finish school.” I am not sure he had realized how long my medical training was going to be! I was already 28 years old, which I didn’t think was too young and I had already been married 5 years. Anyway, we stopped trying to have a baby and my girlfriend and I took a trip to Costa Rica for spring break.  It was such a beautiful magical place, with the lush rainforest, green mountainsides, noisy monkeys, and all the exotic fruit you can eat.  We stayed in different places and took buses  to explore the country.  Despite all the wonderful sights & experiences we had, it was hard to fully enjoy myself because I felt nauseated most of the time. And my sense of smell was extremely heightened.  I thought perhaps it was the heat, or all the exotic fruit I wasn’t accustomed to eating.  The last thing on my mind was being pregnant. After returning home I finally took a pregnancy test and was shocked to learn I was  truly pregnant!  

My first & second trimester was pretty hard because I was always nauseated or had indigestion.  I could literally lean against the kitchen sink while doing dishes and feel like throwing up.  The smell of garbage, on my way to class as I ran up some back stairs, made me feel sick. It was also harder to stay focused on my course work and I felt distracted by all the changes that were  going on in my body while looking forward to my new baby and all the planning for his arrival.  My academic performance suffered and I remember struggling to keep up on rotations like Pediatrics –  of all subjects. During my last trimester of pregnancy I felt well and continued my studies.  I  remember driving my small sports car in the Charleston heat and the effort it took to get in and out of the low bucket seats. I was always hot and  I felt big and swollen with puffy ankles and I needed to sit down often due to back pain and occasional fatigue.  My schedule was set so that I could be off school a week or two before my due date. My mum came to visit us from New York in anticipation of the baby’s arrival. I woke up dressed and made pancakes and we went out  to my scheduled OB checkup.  Shortly after arriving I was told I would need to be induced because I had very high blood pressure, protein in my urine and  pre-eclampsia!  I was not expecting this, but after a long labor, our first child was born in the same hospital where I was a medical student.  

Adjusting to the demands of motherhood was not easy and I remember thinking medical school is hard but this is even harder! A new born teaches you what sleep deprivation is on a whole new level !

I had six weeks off for maternity leave and I remember the day I had to go back to the hospital like it was yesterday. It was the worst feeling watching my new baby in the car seat as my husband drove off after dropping me in the back of the Emergency room.  I wanted to start crying as I walked into the ER to start my shift.  I was still breastfeeding and working with engorged leaky breasts was not the most comfortable thing.  I had tried  using a breast pump before work and even tried to bring it to work but there never seemed an appropriate time or place to use it.  

I don’t think I could have juggled my responsibilities  in the hospital with my duties as a new mother without a supportive partner.  My husband would keep the baby overnight after a full days work while I went to the hospital in the evenings.

MY EXPERIENCE AS A PREGNANT MEDICAL RESIDENT

Fast forward to graduation and it was all worth it.  My medical degree, a bouquet of flowers and my healthy baby boy! But that wasn’t all – hiding beneath my graduation gown was pregnancy #2!

I was so scared to tell the program director at my new residency program in NYC that I was pregnant.  The Program knew I was married and had a child (who was less than a year old at the time) but they didn’t know I was pregnant. I assumed most programs were geared towards the average male doctor and I didn’t want to be seen as the weak link who would need to take time off just as she had started.  Luckily the director was very understanding and we arranged a schedule that would allow me to have the baby during an elective time with little to no disruption in my schedule.  Thankfully I had less nausea with this pregnancy and was healthy.  I worked until the week  before my son was born in December 2000.

Shortly before September 11, 2001, during my second year as a resident, I realized I was pregnant again with my third child. I felt overwhelmed and unhappy with the knowledge that I would now have three babies in the span of three years!  I felt immense pressure to keep up with my colleagues most of whom were single and male. I felt like I never had enough time for my family or enough time to study and I worried about what my other residents  thought of me.  Feeling panicked and embarrassed I went alone to see my OBGYN doctor to discuss an abortion.  My OBGYN was a beautiful older Indian woman who sat me down  and told me to reconsider my approach. She advised me to avoid making a permanent decision based on a temporary situation.  She told me that all these people I was worried about, people who I thought would judge me, I would no longer see once I graduated. Since I already had two sons she asked “What if you have the little girl you wanted?” She was so right!   I carried the pregnancy to term and worked up until the day before my baby was born!. I completed residency and then decided to take some time off to spend with all my babies then got a job as an Internist and life went on.   Now I have three beautiful teenage kids: two boys & a girl.

What I have learned

1. Stop waiting for permission to have a child from your medical school or residency or first job out of residency! You are not going to get it!
2. There isn’t the perfect time to have a baby during your medical training but with sacrifice it is possible to have a child and your career.
3. As my OBGYN said to me: Don’t make any permanent decisions based on a temporary situation.
4. Having to sit down occasionally while on long rounds or having back pain while bending down to draw blood is not a sign of weakness -its called being pregnant! Your colleagues should understand.
5. Medical school is hard, residency is hard, pregnancy while doing either is even harder.  If you are considering having a baby make sure you have a supportive, committed spouse, partner or very close relative. I honestly do not believe it is possible to go through medical school or residency as a single parent without adequate support.  

I hope my story and tips have been helpful. Please feel free to share it.  I look forward to your comments  and hearing about your own experiences.

If you want to hear me talk about my experience in detail please click on the link below.