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MS4 just lost baby, considering a year off

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5 years 7 months ago #94597 by ElisDrMom
I just finished up 3rd year. My husband and I were trying to time our 2nd pregnancy so that I'd deliver in the early fall of 4th year and combine my maternity leave with later fall interviews. It magically worked out perfectly - I was due in early October. Then at our 19-week anatomy sonogram, we received the devastating news that our baby girl had multiple defects - spina bifida, an omphalocele, syndactyly. An amnio provided the final diagnosis of Triploidy. It was a miracle that she'd made it so far into the pregnancy - Triploidy usually results in an early first trimester loss. We decided to continue to carry her until her natural end, not having any idea when that might be, but knowing that we couldn't live with being the ones to decide when her life would end. We spent the next month making as many memories as we could, getting a 3D/4D ultrasound, recording her heartbeat, having a maternity photo session done, preparing a kit of keepsake-making supplies for whenever "the time" came to deliver. We desperately hoped that she'd just pass away on her own, but there is also an increased risk of early preeclampsia with triploid pregnancies, and I started having BP issues shortly after the diagnosis, so we knew that we might be forced to deliver while she was still alive.

Unfortunately, at 23 weeks and 5 days, I went to the hospital with a horrendous headache and pressures in the 150s/100s and had developed preeclampsia. Our little girl, Gracie, was peacefully born into heaven on June 18th at 1:20am. We buried our daughter on June 21st.

Needless to say, it has been an indescribable heartbreak. We're doing pretty well now roughly two weeks out - my 2 1/2 yo son has kept me going :) But now we're left to figure out what to do about the future. We desperately wanted a second child and that hasn't changed. If anything, our arms are just aching more. We can never replace Gracie, but we still want to add another child to our family. The problem now is the timing. Obviously we don't know when my cycle will return or how long it might take us to get pregnant again, but odds are, if we just launch right into trying to conceive again as soon as my fertility has returned, I'd be due very early in my intern year. That seems like a terrible idea. Not only would it be pretty tough on me, it would be pretty tough on my co-interns! Not to mention the fact that I'd like to be able to focus a reasonable amount of time and energy on my new baby, and if I'm forced to take a bare-bones maternity leave and then return to intern-level crazy hours... that would suck for both of us. I probably wouldn't be showing for interviews so I don't think that would be a big issue, but everything else about that scenario seems pretty awful.

My husband is not in medicine, so we only have my residency issues to contend with, which is helpful. I just don't know what a "year off" would look like. What do people do? We can't afford for me to just be off - I'd have to be pulling student loans or making a paycheck. Not to mention just being "off" seems to be frowned upon as far as residency programs are concerned. It seems like I'd be better off extending my 4th year and applying as a student vs as a graduate, but I also took time off (which ended up being 2 years) around the time my son was born, and I'm just terrified that my school is going to balk. Granted, I've just been through a pretty awful trauma. But I worry that at some point it's just going to start to look like I'm just not as serious about medicine as I am about having babies. The reality is that my family is my priority, and especially in the wake of what has happened to us, I feel like I owe it to myself and my husband and our family to pursue what feels right to us when it comes to adding to our family.

I guess I'm mainly asking for some ideas regarding how to spend a "year off" or an extended 4th year, and some opinions on taking the year off vs powering through, letting whatever happens happen and dealing with a maternity leave during intern year.

"Nobody can go back and start a new beginning, but anyone can start today and make a new ending” ---maria robinson

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5 years 7 months ago #94599 by AmmaMD
@ElisDrMom, I am so sorry to hear of your loss. I had a friend who lost a baby at delivery not that long ago, and I can only imagine the heartache you must be experiencing.

I have to admit, my first thought is that at this point, you might be better off just going forward, and the further you are into residency when you have a baby, the less of intern year / residency you'll have to do with two young ones. But, of course, a lot probably depends on the details of what you want to go into / how family-friendly a program you are likely to end up at, etc. Also, I'm probably biased by my own experience, having had my second child halfway through my second year of residency, once I was through (in my program) the worst of it....

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5 years 7 months ago #94601 by ElisDrMom
I guess it would have been helpful to mention that I'm going into emergency medicine. Based on the reviews of recently graduated students who interviewed at the programs in our surrounding region, there are definitely a few family friendly programs around. My home program is probably less family friendly than some of the others, as it is rather competitive for EM. Just based on mentoring conversations I've had with the PD, it doesn't seem to be as family-friendly a program as they'd like to think it is. I am about to do an away rotation at one of the more family-friendly programs, starting next week actually. They know all about what has happened (I felt I had to let them know when all this went down and I suddenly wasn't sure that I'd be able to do the rotation at all), and have been incredibly supportive. They even reserved a spot for me to do the rotation in November, in case I wasn't able to do it in July as planned, or in case it was interrupted (had I still be pregnant at the start and lost her sometime during the rotation).

I can certainly see the benefit of waiting, believe me. It would certainly be easier in many respects. Waiting would just be so emotionally difficult, and my emotional state is already at an all-time low. I just don't know if I can be ok with saying "oh well, it's just gonna have to wait another year". At the same time, I know that the reality is that it would just be really difficult to have another baby anytime in the next year, in many respects. In every respect, really! Sometimes I just really hate how much sacrifice goes into this career choice. My own personal sacrifices, all that my husband sacrifices, all that my son sacrifices... and now I'm facing having to sacrifice this too, after just losing my baby girl.

"Nobody can go back and start a new beginning, but anyone can start today and make a new ending” ---maria robinson

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5 years 7 months ago #94602 by tr_
I'm very sorry for your loss as well. It must be so hard to have to think about the logistics of training when you are still grieving your baby.

I do agree with AmmaMD on this as well though. I think in your shoes I would just try to power through, but avoid conceiving until you start intern year. Otherwise you will take a year off, maybe at significant financial hardship, you'll further delay the point when you can finally make money and have some control over your schedule, and you'll still have to do intern year with a young child (albeit a 1-y/o is much much better than a newborn). This is assuming you are going for a residency that will get significantly easier after intern year of course (i.e. not surgery, ob/gyn, maybe not IM either depending on program).

I wouldn't want to have a baby during or just before intern year. I would do anything possible to avoid that scenario.

I think the additional time off is another option - you could do research in an area of interest which will boost your application and can be arranged so as to be flexible/low-key if you choose the right advisor and project. It might be troublesome trying to get paid for that though, and if you did something that got paid it might not be as flexible as you would like given you will be having a baby. You could probably stay enrolled and keep drawing student loans but that's going to add a lot of debt.

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5 years 7 months ago #94629 by AmmaMD
Upon further reflection, I want to add: while from my current vantage point waiting makes so much sense, it also occurs to me that when my first was 2 and a half and I had suddenly hit the point where I wanted to HAVE NUMBER TWO NOW, I had ZERO interest in waiting. I knew what spacing I wanted my kids and that was all there was to it. And that was without the tragedy of losing a pregnancy.

In addition - in general, I feel the really, really important things (like when we have kids) we should probably just do and let the impact on our career fall as it may, to a large extent.

So: even though I'm trying to provide an objective, "this would seem to make the most sense for your situation" kind of response - I can also say it that if I were in your position, I would very likely not give a hoot and would just do what felt like the right thing for me/my family without a second thought =)

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5 years 7 months ago #94634 by ctenj
I'm not as far along as you are in your training so am afraid I can't really provide too much advice on taking time off except to suggest research as a possibility, but just wanted to say that I'm terribly sorry about your loss. I'm sure it's hard to start having to make all of these plans on top of everything else you're going through. I do hope that everything works out for you :)

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