Pediatrics board should modernize its maternity leave policy – Boston, Massachusetts

Wow When the daughter started to reveal how comfortable she was in the womb, I wasn’t about to leave the hospital right away. I immediately sent a message to the obstetrician and gynaecologist. “You have to administer an inducer.” I was worried that I wouldn’t have enough vacation time from my Adolescent Medicine degree.

She scheduled the introduction within a few days and told me with a gentle nod that she was also seeing maternity leave coming past the scheduled date.

Most of my residents and my doctor’s colleagues were women and were open about me. Conflict as a Doctor’s Mother When I returned to work six weeks later, my colleagues were surprised and sympathetic, but I discovered that the American Pediatric Commission was in charge of the program and my recovery.

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The Accreditation Body has established a list of strict policies regarding pediatric scholarships. This does not allow fellows to take more than 12 weeks of vacation. Without extending the 3-year degree, maternity leave counts towards the past 12 weeks, so I made an informed decision not to spend all my vacation in a year. What if my daughter Mira gets sick or my parents and husband get sick? In this year when unimaginable things became a daily occurrence, I had to extend my education.

The irony of the American Pediatrics Commission, which drafted this provision, also applies to interns learning the benefits of breastfeeding, such as advising patients not to start milking six weeks in advance. When I realized the sand in the hourglass had run out, I started pumping in three weeks.

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Luckily, I didn’t realize how hard it would be to recover from childbirth. I ran 4 miles a day until the 39th week of pregnancy, and I was relieved that my blood pressure was normal and my prenatal diagnosis was “low risk.” The introduction also went relatively smoothly. Meera appeared after 1.5 hours of pushing. However, the split in the lip caused genu valgum for weeks, followed by heavy bleeding. For over a month it was painful to empty my bowels, urinate, laugh and cough. To get to the bathroom I had to support my body along the wall.

Running was a way to stay healthy during my childhood workout. During that absence, I sobbed to see how weak and bedridden I was. I didn’t like hearing the actual physical and emotional trauma that benignly sounds like the “baby blues.”

In non-delivery situations, even the laziest doctors will be unable to walk, lose urinary incontinence, and hesitate to discharge patients who have been soaking blood every hour in industrial-sized compresses from the hospital. Physical and emotional problems continued for the next 6 weeks.

As a resident, when I checked a woman’s postpartum depression during her first newborn visit, I remembered countless things without anyone getting positive. When a healthy and beautiful baby was born, in my form, I was ashamed to admit that I was depressed. “Are my patients afraid to answer honestly?” I wondered.

Even my training in pediatrics did not properly recognize how vital the mother’s health was to the baby’s well-being. How long does it take for the body to recover when caring for a demanding newborn? Will it last? And how much help does the new mother need from family, friends, physiotherapists and other caregivers?

And even with all the support I got, I was overwhelmed and unprepared to get to work. I wasn’t breastfeeding well, so I tried not to leave the house without a zip-up jacket over my shirt. My hips were loose and my walking was unstable. I went to work with a napkin after delivery because the bleeding was faster when I walked fast. And my mind was divided by postpartum anxiety and depression: Was I a good mother? Did my parents or in-laws decide that I was leaving behind such a small baby? Can I go through the clinic without pumping??? If not, will my colleague rate me?

It was hard to deal with concerned parents when my own fear of inappropriate parenting caused their own static.

When it was announced by the American College of Obstetrics and Gynecology Guidelines for Postpartum Care in 2018, it literally realized the future and how national policy is in the care of those who reconsidered postnatal care as more than a one-time, six-week permit to return. return to normal across the Rubicon River. Admittedly negligent. The guidelines instead recommend a 12-week interval between frequent and meaningful check-ins rather than ensuring healing stitches.

Thirteen weeks have passed since Mira was born. She’s been sleeping for quite some time now (although we’re definitely cautious in case of sleep regression). I can easily milk enough milk to make her last longer, even at work. I set up a postpartum support group and had the hardest days. I can run again. And it took me one day a day to heal over 90 days.

It is necessary to change the policy of the organization that stands up for the well-being of children. The total allowable leave during a pediatric fellowship cannot correspond to the standard 12 weeks maternity leave. Pediatricians are already in short supply due to the long need for training and low wages. The majority of pediatric donors are still women, and the peak of labor coincides with fellowship training.

Strict fellowship training and maternity leave need not be mutually exclusive. Nothing is more rigorous for a pediatrician than doing a newborn page every two hours and making a differential diagnosis (drowsy, tired, hungry, moist). Fellowships have ways to meaningfully structure maternity leave to meet programmatic requirements. My residency program at the University of New Mexico is a generous new way to discuss how parenthood has changed the way we approach patients and their families for a month without a phone call after taking annual paid leave. There was an elective for parents. Their own challenges and prejudices. Grow as a parent for a month.

Fellowship training in pediatrics is mandatory for three years, so if you have enough time to choose, you can take a similar approach. In juvenile medicine, this is a month-long elective course during which the physician’s parents can effectively meet their teenage parents once a week. Patients and doctors rarely have the opportunity to humbly listen to the same task and speak on an equal footing. I say once a week mentors will walk other professional fellows through matters in their area of ​​interest to discuss how counseling, diagnostic discussions, and limiting patient expectations can be approached differently from their parental experience. You can imagine a similar approach.

If you expect a woman to continue to care for her child as a doctor or parent, you cannot continue to give her an impossibly short maternity leave. Is American Obstetrics and Gynecology Commission For fellowships, we offer a maximum of 12 weeks of vacation per year, up to 20 weeks for 3- year grants and up to 16 weeks for 2-year grants. If the American Pediatric Commission can’t be the leader on this matter, it should at least be a follower.

Megana Dwarakanath is an Adolescent Medicine Fellow at the University of Pittsburgh Medical Center.

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