Good morning forum!

I am a 2nd year IM resident and wife of over 2 years. My husband and I are looking to get pregnant soon but I am having guilt with the fact that I am still a resident and when the baby comes will still have year to go.

I feel like if I wait a year things would be better as I am not quite sure I want to specialize and would be done with residency and onto working on my own. How did you all decide when to have kids? To be honest, I feel guilty because even though I want a baby, I feel like it would be unfair to the baby since I will be gone - and just to wait one year. On the other hand though we have waited so long already because of my schooling/residency it's hard to fathom another year waiting...

Any words of wisdom?

If you deliver a baby during your first 12 months of employment somewhere, you do not qualify for FMLA. So really you are looking at 2 years. If other residents at your program have had children, talk to them. By now you should know what the general atmosphere is regarding mothers there. Also consider what kind of workload you have as a 3rd year resident: is it easier or harder than the first 2 years. What does your husband do, and can he be the primary caretaker, at least at times? These are some of the things to think about.

I had a baby (my third) in the 2nd year of my FP residency, then spent the 3rd year with my husband living in another state and our closest relatives 3 hours away. It was doable, with some community support, but it was hard. I then had #4 after my first year in practice, and it was inifinitely more difficult to take time off as an attending than as a resident, as there really wasn't anyone who could replace me while I was out, and maternity leave affected my income. Good luck to you.

I'm a third year IM resident, due with my second child in five or six weeks. My opinion is that now is probably a better time than later to have your first child, with some caveats. Namely, if you're going to apply for fellowship, you need to figure out how the timing's going to work. In IM, any time you miss in excess of your allotted vacation must be made up; otherwise you can't sit for boards. So if you're planning to go straight through to fellowship AND have a kiddo during residency, you'll either end up taking quite a short mat leave OR you'll need to show up late for the start of fellowship. I'm doing the latter, personally: taking a total of 12 weeks for mat leave, five of which are vacation, leaving seven to make up. I'll do these in July/Aug of next year, and start fellowship as soon as I've made up my time. My fellowship is cool with this -- as it happens one of the first year fellows this year is pregnant and so she'll be making up time in July/August as well. Felicity, all around.

Anyway, in my case, arranging a decent maternity leave as an IM resident has been totally straightforward and -- as RM said -- probably much simpler than once we're out in practice. The nice thing about most IM programs is that they tend to be larger, so there are likely enough residents to cover for you without creating ill will. Not true in other programs. Also, I'm basically getting a fully paid maternity leave, which is a nice bonus and something that I suspect doesn't happen much in the real world.

If your baby is born mid-way through third year, you can also likely get some of the worst rotations out of the way prior to delivery. I did my ICU rotation last month and honestly, it was sucky to be taking Q4 overnight call as a very pregnant person but now that it's done I'm so grateful I won't have to do it as the mother of a very small baby.

PS. One more unsolicited tip: let go of the guilt. Just stop. There's nothing wrong with being a working mother. You'll provide stability for your family, value to your community, a great role model to your kids. Children don't need 24/7 skin-on-skin to grow up to be decent people.

I agree that if anything, depending on your program, it may be easier now than when you're newly on your own. Also, if you're willing to just slow down by a year, that can add a huge amount of flexibility - particularly if a program will let you come back part time for a while (which mine does - something I'm definitely planning to take advantage of for #2). In some ways, residency can be a way more supportive time for having kids - you don't have to be recruiting and building your own patient load, when you're gone there are built in people who cover (better in a bigger program where people go on and off leave all the time, obviously)... it can be quite nice!

And I agree with Emily - don't wait because of guilt. The vast majority of the time I think the situation ends up being a mom who really wishes she could spend more time with her baby for her own sake... but a baby who's doing just fine.

One thing that pushed me not to wait is remembering (this sounds obvious and dumb, but I'm serious that thinking about it changed my thinking) that I'm not just having a baby and wanting to optimize that experience... I'm having a baby who will turn into a toddler who will become a preschooler who will turn into a grade schooler who will become a teenager who will eventually become an actual adult, likely to go to college and/or get married and/or have kids of his or her own. And I want to be a part of that person's life all the way along, for as long as I can. Waiting for 5 years might (although it's a wild card) make the first 5y better... but it chops some time off the end, in a way, too. Plus, I wanted to maximize the time that my own parents and my in-laws were healthy and around for my children to develop a real relationship with them. For me, waiting just began to feel like it had real costs as well.

Anyways... some random thoughts...!

excellent point Amma, sometimes we focus too much on the babyhood when in actuality it is such a short time.