There is no good time to have a baby. This is especially true in the medical education pipeline. Having children before medical school delays your career. Waiting until residency allows for parental leave, but the allotted time goes by quickly. Babies and 80-hour work weeks are far from ideal. Some women may be able to wait for attending life, but the risks of waiting too long are well-documented. This has led many doctors-to-be to ask how babies might fit into medical school. The answer? Not perfectly, but you can do it.
Having a baby in the first year of medical school wasn’t my original plan. Thing Two was supposed to arrive the summer before MS1, leaving me three months to ohh, ahh, and cuddle before starting school. Procreation, however, doesn’t always work out as planned. Thing Two would arrive at the end of my MS1 year, just a week before my final exam. Though not perfect, her timing allowed me to expand my family without delaying my education. I only needed to get through MS1 pregnant and pass a single, fateful exam with a newborn at home. It wasn’t my first rodeo, so I had a decent idea of the challenges to come. It sounded manageable. Knowing and living, however, are two very different things. The year was much more difficult than I had expected. Here are some things to consider before you jump into an MS1 pregnancy.
My morning sickness journey was perhaps the easiest part of being pregnant in MS1. Though I did feel nauseated from time to time, I was only physically ill in the morning. For most of the first trimester my mornings consisted of an unpleasant coughing up dance that left me feeling pretty okay for the rest of the day. Yes, even in anatomy lab. Had the smell of formaldehyde triggered my morning sickness, I am not sure what I would have done. As luck would have it, my anatomy lab was well-equipped with stools, my cadaver was not overly smelly, and the embalming fluids had basically zero impact on my capacity for nausea. You might not be so lucky.
Exhaustion was more of an issue and something I hadn’t worried about nearly as much. I spent the first trimester studying in the library. I have many an unpleasant memory of trying desperately to keep my eyes open, only to succumb and allow myself twenty minutes of blissful rest. I couldn’t keep my eyes open and my mind engaged for any substantial stretch of time. My exhaustion, in conjunction with my inability to make our mandatory lab time productive and the unyielding pace of the class, nearly cost me that first year of medical school. After a lifetime of A’s, I passed Anatomy by the skin of my teeth. Though I had more energy later into the year, getting into the groove of medical school was significantly harder than I expected.
I remembered pregnancy brain, and I was determined to ward it off for as long as possible. Mind over matter, I told myself. If I didn’t believe in it, it couldn’t get me. Christmas break killed that theory. The moment I stopped actively trying to not act “fuzzy,” the haze attacked with a vengeance. My vocabulary tanked. I was at a loss for simple words, making up terms with the expectation that others could figure out their meaning contextually. Not a good look for someone who was expected to expand their vocabulary by a few thousand medical terms. I was worried, but there wasn’t much I could do other than solider on.
In retrospect, multiple choice exams saved me. I didn’t need to know every syllable of every word. The general sounds and key syllables were enough. I managed to recognize the relevant terms for exams and master the concepts needed to succeed as a first-year medical student. It was a struggle and I worried that I wouldn’t make the cut more than once throughout the year. In fact, I was almost always worried. I can’t wait to begin MS2 with a clear head on my shoulders. It is going to feel like magic.
I am not usually an overly emotional person, but pregnancy is a hormonal ride. My first pregnancy left me a sobbing blob of hardly-human over such profound issues as poor architectural design in my neighborhood and the realization that I might have to study at a table that was (gasp) the wrong shape.
I knew that this indulgent behavior could not stand in medical school. Beyond being embarrassing, it would have been entirely unprofessional. Keeping the crazy at bay was easier than expected. My resolve led the show. I managed the pregnancy with only one uncontrolled episode of tears—which I thankfully managed to contain until I was safely in a bathroom stall. It was over a cheesesteak sandwich (sigh).
Maintaining emotional professionalism was, however, complicated by clinical correlates. Even not-hormonal-or-pregnant me might have had a hard time keeping dry eyes as a mother explained her young son’s Tay Sachs diagnosis, the subsequent degeneration of all the baby milestones he had achieved, and ultimate death. Pregnant me didn’t stand a chance. I spent the talk alternating between rapt attention and trying desperately to think of anything else lest I burst into tears. I managed unscathed, but it was a close call.
Embryology and Medical Genetics While Growing a Small Human
Another unexpected challenge to pregnancy during MS1 was the content of our curriculum. An uncanny percentage of the factoids I was expected to learn seemed to apply to pregnancy.
Our “dead baby lab,” where preserved fetuses with disabilities incompatible with life were presented to the class, left me bee-lining for the anatomy professor to announce my pregnancy and make sure Thing Two would be safe in lab. This despite the fact I had already researched it online, decided it was fine, and resolved not to tell anyone about the pregnancy until I was showing. (Our professor kindly told me that I would be just fine, but that I could step out if I felt I needed to.) For the record, the literature on how formaldehyde might impact pregnancy is inconclusive and medical schools have wildly different policies. I was comfortable being in lab without special precautions, and my school allowed this. Other mothers-to-be may prefer to wear a ventilation mask and other schools might have different policies.
The parallels to pregnancy-disasters didn’t end with anatomy lab. The diseases that a child might be born with seemed to never end. Could Thing Two have Treachers Collins? Spina Bifida? Trisomy 16? A rare organic acid disease? These aren’t things that had been completely off my radar during my first pregnancy, but being pregnant during MS1 left them front and center in my mind. I was constantly anxious about the health of Thing Two. And then I wondered if my anxiety might cause problems for the tiny, half-baked one (face-palm). It was a viscious cycle.
In addition to the nuts and bolts of being pregnant, the logistics of birthing and caring for a newborn are essential for successfully completing a year of medical school with a baby on the way. I would highly recommend taking administrative policies into account if you intend to have children during these training years. The few stories I found on med school pregnancies online had led me to believe that flexibility and understanding were the norm. This was not my experience. My school has two hours of mandatory classes each day. Missing too many results in an immediate failure of the class.
My school also has no formal maternity policy, which I have since learned is relatively standard among US medical school. My pregnancy was treated as a “significant medical issue,” for which there is a policy. I was allotted two days of excused absences for labor and delivery, given an extra week to take my final exam, and the attendance-based failure policy was waived. The prospect of losing both attendance and participation points—adding up to around four percent of my final grade—when I was already concerned about keeping up with my studies added additional stress to my final few weeks of school.
Had my pregnancy not been so perfectly timed, my school’s attendance policy may have forced me into a leave of absence independent of whether I was able to keep up with our curriculum.
All’s Well That Ends Well
Being pregnant during MS1 wasn’t all rainbows and butterflies—there were rough times. Starting medical school feeling nauseated and physically exhausted made adjusting to the unexpected volume of work more challenging than it otherwise would have been. Mastering so much when my mind wasn’t operating at peak performance required extraordinary effort. Preparing for and taking our final neuro exam two weeks after giving birth was no picnic. I will never know what grades I might have made if I hadn’t been pregnant. That said, I mastered the material I needed to survive MS1, will be proudly moving on with my class, and am now spending a glorious summer with my bubbly, healthy baby girl. I can’t ask for much more than that.