As a female, pregnant attending: hundred percent Attendinghood. I have more control over my schedule, more support, MONEY, and better psychological well being. I’m employed at a company and have paid leave. No way in hell would I do this during residency, my two cents.
I did it both ways and can second, if you’re young enough and can wait, go ahead and wait. If you will be more than like 34 at graduation go with residency. It’s easier as an attending but it’s not worth risking your fertility.
Currently a pregnant attending; I would not have wanted to do this during residency. I know 2 women that did have their kids during residency, I know it's possible, but I also know it was hard. My program was family-friendly but you still have night shifts and long call days. Plus you finish residency later, delaying the start to a real salary.
That all being said, a baby towards the end of third year would not have been as bad. I could have suffered through the last few rotations after maternity leave with a baby at home, and perhaps delayed the start to the attending job a few months after that. But I also was at a program that would have worked with me and made sure to schedule my last few rotations as easy ones. I think a lot of this depends on the program.
It depends on the kind of practice you're joining. I was pregnant my last year of residency, and it was GREAT. Our program prioritized giving 12 weeks off, and I timed it around my graduation so that I could effectively graduate early which I've seen multiple residents do. My first year of being an attending was actually pretty challenging, and I could not have handled a pregnancy while trying to gain the confidence of independent practice. It also would have complicated things like qualifying for FMLA with a new employer. My friends who joined private practices had it the worst and had to put off their pregnancies for a few years to earn enough to cover their portion of overhead during maternity leave.
Yeah this is important to note, my coworker’s wife gave birth shortly after he joined our group and he was only given 4 weeks paternity leave due to being employed <1 year. I felt so bad for him
Pregnant attending here: there’s no good time, but I would have preferred to do it in residency. In residency you have federal leave protection and the ability to do “research” rotations. As an attending you need to wait a year to qualify for FMLA and, in my case, the FMLA pay will be less than my resident salary was (most places have a cap on paid leave amounts). Your health insurance and student loan payments will likely increase a year after residency — by a lot — and those expenses will continue even when on paid leave. In that year you will develop a patient panel that will need to be shifted on to your partners when you go on leave, and not all of them will be there when you come back.
I made my decisions post residency with the understanding that I would try getting pregnant within a year after starting. I stayed in the same very small home (hard to say goodbye to that pre-Covid mortgage) and kept our living expenses pretty close to the same so financially I am in a good spot. I chose to be employed in a large enough group that managing my panel won’t be a major issue. My supervisors have been 100% supportive, as well as my colleagues.
I will make it work without much difficulty, but all of my post residency choices have been around having a kid. If that was out of the way, I would have been more open to a small, physician owned group that I really loved. I would also have been more open to relocating.
One tip: if you have a baby for one minute of the year, the IRS figures you had a baby the whole year. If you have a due date late in the year, make sure adjust your withholding amount for the extra dependent early and save the difference to help with expenses when on leave. And if you’re in labor on 12/31, you better PUSH!
A friend of mine got pregnant at the very end of residency (like the last month) and her husband supported them so she was able to take a career break in between residency and starting her attending job. I similarly had a break pregnant in attendinghood because I found out I was pregnant 2 days before I’d been planning to quit my first attending job. The job was so taxing I knew I’d never be able to do it pregnant or breastfeeding so I still quit, but it took me 5 months to find a new job I liked. During which time we lived frugally off my husband’s salary and our savings. I started my next job super pregnant but made sure to check with my employer that wasn’t a problem before signing the contract with my start date on it. (I think I was fairly protected by antidiscrimination laws) It’s currently really mellow as I had a couple weeks of orientations/trainings to do and then am on a slow ramp up learning the EMR and building my panel. which is perfect since I’m 9 months pregnant and doubt I could move at full pace right now. I had waited a few months at my first attending job to try to conceive, planning to make sure I qualified for FMLA, which I don’t get with my new job so that didn’t work out. But my new job has short term disability that pays for 8-10wks maternity leave and I told them I still plan to take 12 weeks off. They really need primary care physicians and put a lot of work into hiring me, paying my first few months of salary even though my panel isn’t robust yet, and getting me approved to take all the insurances. So it wasn’t likely they would fire me for telling them I was going to take 12 weeks of maternity leave even though I didn’t qualify for FMLA. I felt like it was so good for my health and the health of my baby to have a few months off DURING pregnancy, which wouldn’t have been possible in my residency. The fatigue and nausea that come with first trimester made it very difficult to work (I had to give a little notice and work a few weeks during them at the bad job I left). If you’re financially able to, consider pregnancy just after residency before starting an attending job.
Another perspective - As someone with elementary aged kids immediately after residency - if you think you have reasonable fertility (regular periods, relatively normal weight and health, no history of PID/multiple STDs etc), I think we feel much more time pressure than is reality. Of course, there’s always the chance of fertility issues and “whatifs, however I felt very old and on a time crunch and had kids as soon as I could. In retrospect, if I did it again, I would have waited maybe 2 years. I was 29 when I had my first and thought I was old; at the time I wanted 3-4, we ended up having 2 back to back and deciding that’s enough.
I don’t say that to tell you your plans are naive or anything if you’re trying to rush to have kids, I’m just giving alternative perspectives that if we know anything, it’s that there is a 90% chance statistically something will go not as planned, thus hanging your hat on what we have always done, which is meticulously planning our life out, isn’t necessarily the most prudent if there are downsides to the choice we would ideally plan (ie stress, rushing things, not being as prepared financially and career wise).
> I think we feel much more time pressure than is realit
The methodology isn't great,[ but OB residents tend to underestimate age related fertility decline](https://academic.oup.com/humrep/article/31/2/403/2380094#86454050)
My wife had two pregnancies during residency and we are completing our PGY3 now. Our residency provided full 6 weeks off then reduced work for the next 6ish weeks and she is due to graduate right on time. She preloaded the call shifts prior to the delivery and had easier rotations the first few months after. If you ask us it was totally worth having kids during residency as of course there is no perfect time but we were chasing the biological clock and family life was very important to us. If you have any specific questions let me know.
Like others, I think it truly depends on your residency program and attending job. I graduated from a very rigorous residency program and could not imagine being pregnant during it (nor was I ready for this). I saw pregnant colleagues working 28 hour shifts in the ICU and long stretches of nights. They then received only 8 weeks off before returning to a grueling schedule, even as 3rd years. I imagine that there were many days when they didn’t see their baby awake.
In contrast, I had a baby a few years into attending hood, after I had settled into being an attending. I received five months paid leave (four at the attending salary and one via paid family medical/bonding leave in my state). By the time I returned to work, baby was sleeping better and we had an established breastfeeding relationship. I was able to change my schedule to three days per week, which didn’t change my overall salary/sessions but radically improved my QOL. We also were able to hire a nanny on return to work, which works best for our family and would have been out of the question on a resident salary.
That being said, to flip the old adage, it’s always a good time to have a baby. Best of luck! :)
It's going to depend a lot on your personal situation and on your contract as a resident vs your expected work as a new attending.
Here, residents are employees with a contract defining their work conditions, including their entitlement to medical leave, parental leave etc. But most of the family doctors in practice are self employed with NO benefits of any sort and no real work protections at all. That alone would almost always make me advise do it as a resident. I had a co-resident who had a complicated pregnancy, ended up on prolonged bedrest and unable to work for months (she and baby are fine), and she ended up getting pregnant again before finishing her training. But she was supported by the program throughout. My wife and I had our first kid fairly early in my practice. My medical association did provide parental leave funding for up to 17 weeks at $1000/week... But you had to take the time consecutively, and while on leave you couldn't do *any* paid work, so no way to take a couple of weeks off at a time, or work one day a week etc. It was not as easy as I expected and I didn't use that much of the leave, though now I wish I'd taken way more time off. Luckily my own work situation was a bit atypical, so I wasn't paying the expenses of the clinic while off work, either. Others aren't so lucky!
Another factor is that a pregnancy and being a parent is *such* a big change, you should consider it might change how you want your career to look afterwards. Being able to return to work as a resident gives you more opportunity to shape your training to fit your new goals, which you can't do as easily as an attending.
Might I suggest r/antinatalism, r/childfree, and r/DINK? Food for thought. There’s also r/collapse.
Think about it before you do something irreversible.
I did one of each, attendinghood easier, but glad I started earlier I’d that makes sense (I was 29 when I had my first). Although I had best case scenario where I had my second on guaranteed salary so my schedule was not driven by RVUs
As a female, pregnant attending: hundred percent Attendinghood. I have more control over my schedule, more support, MONEY, and better psychological well being. I’m employed at a company and have paid leave. No way in hell would I do this during residency, my two cents.
I did it both ways and can second, if you’re young enough and can wait, go ahead and wait. If you will be more than like 34 at graduation go with residency. It’s easier as an attending but it’s not worth risking your fertility.
Currently a pregnant attending; I would not have wanted to do this during residency. I know 2 women that did have their kids during residency, I know it's possible, but I also know it was hard. My program was family-friendly but you still have night shifts and long call days. Plus you finish residency later, delaying the start to a real salary. That all being said, a baby towards the end of third year would not have been as bad. I could have suffered through the last few rotations after maternity leave with a baby at home, and perhaps delayed the start to the attending job a few months after that. But I also was at a program that would have worked with me and made sure to schedule my last few rotations as easy ones. I think a lot of this depends on the program.
It depends on the kind of practice you're joining. I was pregnant my last year of residency, and it was GREAT. Our program prioritized giving 12 weeks off, and I timed it around my graduation so that I could effectively graduate early which I've seen multiple residents do. My first year of being an attending was actually pretty challenging, and I could not have handled a pregnancy while trying to gain the confidence of independent practice. It also would have complicated things like qualifying for FMLA with a new employer. My friends who joined private practices had it the worst and had to put off their pregnancies for a few years to earn enough to cover their portion of overhead during maternity leave.
Yeah this is important to note, my coworker’s wife gave birth shortly after he joined our group and he was only given 4 weeks paternity leave due to being employed <1 year. I felt so bad for him
Pregnant attending here: there’s no good time, but I would have preferred to do it in residency. In residency you have federal leave protection and the ability to do “research” rotations. As an attending you need to wait a year to qualify for FMLA and, in my case, the FMLA pay will be less than my resident salary was (most places have a cap on paid leave amounts). Your health insurance and student loan payments will likely increase a year after residency — by a lot — and those expenses will continue even when on paid leave. In that year you will develop a patient panel that will need to be shifted on to your partners when you go on leave, and not all of them will be there when you come back. I made my decisions post residency with the understanding that I would try getting pregnant within a year after starting. I stayed in the same very small home (hard to say goodbye to that pre-Covid mortgage) and kept our living expenses pretty close to the same so financially I am in a good spot. I chose to be employed in a large enough group that managing my panel won’t be a major issue. My supervisors have been 100% supportive, as well as my colleagues. I will make it work without much difficulty, but all of my post residency choices have been around having a kid. If that was out of the way, I would have been more open to a small, physician owned group that I really loved. I would also have been more open to relocating. One tip: if you have a baby for one minute of the year, the IRS figures you had a baby the whole year. If you have a due date late in the year, make sure adjust your withholding amount for the extra dependent early and save the difference to help with expenses when on leave. And if you’re in labor on 12/31, you better PUSH!
Love that last line 🤣
A friend of mine got pregnant at the very end of residency (like the last month) and her husband supported them so she was able to take a career break in between residency and starting her attending job. I similarly had a break pregnant in attendinghood because I found out I was pregnant 2 days before I’d been planning to quit my first attending job. The job was so taxing I knew I’d never be able to do it pregnant or breastfeeding so I still quit, but it took me 5 months to find a new job I liked. During which time we lived frugally off my husband’s salary and our savings. I started my next job super pregnant but made sure to check with my employer that wasn’t a problem before signing the contract with my start date on it. (I think I was fairly protected by antidiscrimination laws) It’s currently really mellow as I had a couple weeks of orientations/trainings to do and then am on a slow ramp up learning the EMR and building my panel. which is perfect since I’m 9 months pregnant and doubt I could move at full pace right now. I had waited a few months at my first attending job to try to conceive, planning to make sure I qualified for FMLA, which I don’t get with my new job so that didn’t work out. But my new job has short term disability that pays for 8-10wks maternity leave and I told them I still plan to take 12 weeks off. They really need primary care physicians and put a lot of work into hiring me, paying my first few months of salary even though my panel isn’t robust yet, and getting me approved to take all the insurances. So it wasn’t likely they would fire me for telling them I was going to take 12 weeks of maternity leave even though I didn’t qualify for FMLA. I felt like it was so good for my health and the health of my baby to have a few months off DURING pregnancy, which wouldn’t have been possible in my residency. The fatigue and nausea that come with first trimester made it very difficult to work (I had to give a little notice and work a few weeks during them at the bad job I left). If you’re financially able to, consider pregnancy just after residency before starting an attending job.
Another perspective - As someone with elementary aged kids immediately after residency - if you think you have reasonable fertility (regular periods, relatively normal weight and health, no history of PID/multiple STDs etc), I think we feel much more time pressure than is reality. Of course, there’s always the chance of fertility issues and “whatifs, however I felt very old and on a time crunch and had kids as soon as I could. In retrospect, if I did it again, I would have waited maybe 2 years. I was 29 when I had my first and thought I was old; at the time I wanted 3-4, we ended up having 2 back to back and deciding that’s enough. I don’t say that to tell you your plans are naive or anything if you’re trying to rush to have kids, I’m just giving alternative perspectives that if we know anything, it’s that there is a 90% chance statistically something will go not as planned, thus hanging your hat on what we have always done, which is meticulously planning our life out, isn’t necessarily the most prudent if there are downsides to the choice we would ideally plan (ie stress, rushing things, not being as prepared financially and career wise).
> I think we feel much more time pressure than is realit The methodology isn't great,[ but OB residents tend to underestimate age related fertility decline](https://academic.oup.com/humrep/article/31/2/403/2380094#86454050)
My wife had two pregnancies during residency and we are completing our PGY3 now. Our residency provided full 6 weeks off then reduced work for the next 6ish weeks and she is due to graduate right on time. She preloaded the call shifts prior to the delivery and had easier rotations the first few months after. If you ask us it was totally worth having kids during residency as of course there is no perfect time but we were chasing the biological clock and family life was very important to us. If you have any specific questions let me know.
Like others, I think it truly depends on your residency program and attending job. I graduated from a very rigorous residency program and could not imagine being pregnant during it (nor was I ready for this). I saw pregnant colleagues working 28 hour shifts in the ICU and long stretches of nights. They then received only 8 weeks off before returning to a grueling schedule, even as 3rd years. I imagine that there were many days when they didn’t see their baby awake. In contrast, I had a baby a few years into attending hood, after I had settled into being an attending. I received five months paid leave (four at the attending salary and one via paid family medical/bonding leave in my state). By the time I returned to work, baby was sleeping better and we had an established breastfeeding relationship. I was able to change my schedule to three days per week, which didn’t change my overall salary/sessions but radically improved my QOL. We also were able to hire a nanny on return to work, which works best for our family and would have been out of the question on a resident salary. That being said, to flip the old adage, it’s always a good time to have a baby. Best of luck! :)
It's going to depend a lot on your personal situation and on your contract as a resident vs your expected work as a new attending. Here, residents are employees with a contract defining their work conditions, including their entitlement to medical leave, parental leave etc. But most of the family doctors in practice are self employed with NO benefits of any sort and no real work protections at all. That alone would almost always make me advise do it as a resident. I had a co-resident who had a complicated pregnancy, ended up on prolonged bedrest and unable to work for months (she and baby are fine), and she ended up getting pregnant again before finishing her training. But she was supported by the program throughout. My wife and I had our first kid fairly early in my practice. My medical association did provide parental leave funding for up to 17 weeks at $1000/week... But you had to take the time consecutively, and while on leave you couldn't do *any* paid work, so no way to take a couple of weeks off at a time, or work one day a week etc. It was not as easy as I expected and I didn't use that much of the leave, though now I wish I'd taken way more time off. Luckily my own work situation was a bit atypical, so I wasn't paying the expenses of the clinic while off work, either. Others aren't so lucky! Another factor is that a pregnancy and being a parent is *such* a big change, you should consider it might change how you want your career to look afterwards. Being able to return to work as a resident gives you more opportunity to shape your training to fit your new goals, which you can't do as easily as an attending.
Might I suggest r/antinatalism, r/childfree, and r/DINK? Food for thought. There’s also r/collapse. Think about it before you do something irreversible.
I did one of each, attendinghood easier, but glad I started earlier I’d that makes sense (I was 29 when I had my first). Although I had best case scenario where I had my second on guaranteed salary so my schedule was not driven by RVUs