Preparing for maternity and paternity leave

OB/GYN News, Nov 15, 2004 by Doug Brunk

Justin Woodhouse, M.D., was just a few weeks into his first-year dermatology residency at the Cleveland Clinic when his second child was born. But the thought of not taking 2 weeks of paternity leave never occurred to him.

"Paternity leave is an absolute must to help you adjust both mentally and physically as well as help your wife and family adjust to a new baby," said Dr. Woodhouse, who is now a third-year resident in the department.

"It shouldn't be something that you feel like you have to do because somebody's telling you that you should. I think it's something you should feel like you want to do. Your priority at that time--considering what a monumental event it is--should be to be at home."

Few things are as life changing as welcoming a new child into your life, but preparing for parenthood can be challenging for physicians in particular, noted Susan K. Perry, Ph.D., a psychologist and coauthor with Barry Herman, M.D., of "The Twelve-Month Pregnancy" (Los Angeles: Lowell House, 1997).

"Because most patients are ignorant about whatever it is they're coming to see you about, you the physician play the role of knowledgeable person," she noted. When it comes to raising a first child, "you're going to be dropped back to kindergarten. You are not the expert in being a first-time parent. That's not a shame--it's a chance to experience something novel and handle it well."

Dr. Perry and physicians interviewed for this column offered the following advice on how to best manage paternity and maternity leave:

* Arrange coverage for your patients while you're gone. Reassure patients that you are leaving them in good hands and let them know you will be coming back.

* Learn together. Before the baby arrives, find ways to learn with your partner about your pending parenthood, whether by taking a class, reading a book, or sharing what you've learned about cribs and strollers on the market.

Jeannine Rodems, M.D., and her husband read "What to Expect When You're Expecting" (New York: Workman Publishing Co., 2002) and "What to Expect the First Year" (New York: Workman Publishing Co., 2003) before their daughter was born in August 2002.

"We find ourselves going back to the first-year book and now the toddler book fairly readily so both of us are on the same page for parenting," said Dr. Rodems, a family physician who took a 10-week maternity leave before returning to part-time practice at Cedar Medical Clinic in Santa Cruz, Calif. "It's a good idea to be coordinated and discuss these things well before the baby comes so you have an idea of how you're going to approach things when they occur."

Dr. Perry advised visiting family or friends who have a newborn, even if just once. "If you go and watch a couple dealing with a new baby, it will be more familiar when you have your turn," she said.

She added that learning together creates a bonding experience for new parents. "There won't be time and energy for a lot of exciting new projects other than this one," she noted. "This is it: baby and work. The more you can find ways to approach it together, the more bonding it will be."

* Be prepared for the unexpected. "Even if you are having a very smooth transition [to parenthood], your partner might not be," said Dr. Perry, who is the mother of two grown children. "Be prepared for low points, regardless of how much you think you know about medicine or psychology. People tell you that you cannot predict what you're going to feel like [adjusting to having a child], and it is really true. It is always a surprise."

Dr. Rodems remembers struggling to allow herself time to recuperate from having her first child in August 2002. "I didn't recognize the amount of fatigue that would be involved. Giving myself the time to be fatigued and slow down my schedule if I needed to was the issue."

Continuing breast-feeding once she returned to work was another challenge.

"There would be times in the office I'd scramble off to pump," she said. "I wasn't real consistent in making sure that I had the pump going as I probably could have been."

* Plan for your return to medical practice. Will you go back full time or part time? What kind of child care arrangements will you make?

"Envision the ideal situation for you, and go about taking the steps necessary to achieve that," advised Meg van Achterberg, M.D., a child psychiatrist in Annapolis, Md., who intentionally planned to have her son shortly after she completed her fellowship training in September 2002. "We were fortunate to be able to plan it that way."

She chose to stay home for at least the first year of her son's life because "this early childhood period is never going to come back for him," she explained. "I really wanted to be there. Now that's he's 18 months old, I'm starting to look for part-time work. I feel that I'm ready to do that and that it would be OK for him. Otherwise, I would have felt that I was working and trying to run home to take care of an infant. I would have felt like I wasn't doing either job as well as I wanted to."