Pregnancy during residency? It’s possible, but keep these factors in mind

Most people say there’s no right time to have a baby. For medical residents, that’s especially true. Balancing the rigorous demands of residency programs, which typically last anywhere between 3 and 7 years, with a burgeoning family is no easy task.

Between rounding on and caring for patients, interpreting diagnostic test results and other data sets, being on call, and squeaking in whatever self-care is possible, individuals completing residency programs have a lot on their plates.

Balancing acts

The number of women in medicine continues to grow, and with that the number of residents who become pregnant each year.

They may be advised to take a year off, complete their training part-time, or switch to research while pregnant and in the first few postnatal months. But many don’t have family support nearby, or they have excessive student loan balances that must be repaid, so they need to weigh their options carefully.

It’s no wonder many residents worry about being effective, much less present, parents while completing their medical training. However, it is possible to have both. Understanding medical resident leave policies can help, as can giving some consideration to the timing of a pregnancy during residency training.

Varying leave policies

As of yet, there is no standardized parental leave program for medical residents in the United States. In female-dominated specialties, such as OB/GYN, yearly leave limits generally adhere to Family and Medical Leave Act (FMLA) standards. For example, an OB/GYN resident may take up to 12 workweeks off during a one-year period to care for a newborn. However, the same resident may not take more than 24 weeks total over the 4 years of their residency program. Doing so typically extends the length of the residency, as extended leave interrupts the training schedule.^[]

In family medicine, residency programs generally last around 36 months. Residents are required to see patients for a minimum of 40 weeks during each year of training, with no more than 12 weeks of leave taken during a calendar year. Any leave extending beyond this limit may require the resident to extend their training program to cover the time they were away.^[]

Data published in 2019 by the American Medical Association showed that 7 out of 15 medical institutions surveyed provided an average of just 5.7 weeks of paid, designated childbearing leave. Additionally, the average duration of paid maternity leave was found to be only 6.6 weeks.^[]

The right timing

There are certain advantages to having a baby during residency:

• A larger pool of colleagues means it may be easier to find people to cover patients when parental leave kicks in. Keep in mind that reciprocity is always appreciated.

• From a financial perspective, residents typically have access to great health insurance coverage. They also still get paid while out on leave. Compare this to being an attending—after residency training, doctors usually don’t get paid if they don’t work.

•  Younger people likely have more energy than older first-time parents. It might be easier to pick up extra calls or shifts during pregnancy to help offset upcoming parental leave.

Also, research indicates that, as children age, problems like separation anxiety are more likely to arise. Babies, on the other hand, are generally happy, provided their needs are met. In reality, a newborn probably doesn’t know (or care) if their medically minded parent isn’t the one taking care of them.

Keep in mind that you can also still breastfeed even if you’re working. The US Department of Labor requires employers to provide reasonable break time and a private space for pumping. With proper storage of breast milk, it can be made available to new babies via a caregiver if the mother isn’t present.

It’s true, many residents begin relying on childcare before they’d like, but friends and nearby family members can lend a hand.

Avoiding risks

On the other hand, waiting to have a child can also have consequences. Fertility rates decline around age 35; and by the time residency programs are finished, most people are approaching 30 years of age. This might not impact a first pregnancy, but it can make getting pregnant again difficult. That, in turn, may lead to years of expensive fertility treatments.

There is also a greater risk of harm to both mother and baby when the mother is of advanced maternal age. While certainly not guaranteed, gestational diabetes, chromosomal abnormalities, hypertension, and miscarriage are all more likely the older a mother gets.^[]