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Career Children

Each month, the WIN blog features an article from one of our state and territory representatives. First up is intensivist and educator from Wellington New Zealand, Kate Tietjens, who tackles the curly question: When is the best time in your career to have children?

I have been on parental leave for the last six months after having my third child earlier this year. In total, I have taken nearly 2 years of parental leave in the last 5 years. My husband (a doctor at the same career stage as me) has taken 11 weeks. This time around I was lucky enough to be in permanent SMO role prior to taking parental leave, but earlier times were not so easy – sitting exams while 36 weeks pregnant, navigating the first months as a new parent alone while my husband sat his fellowship exam, and moving to another country for a fellowship job with a 2 year old and a 10 week old.

So, when is the best time to have children? This is a question that several female trainees have asked me. Of course, this is question male trainees could be asking me too, but that hasn't happened so far! After all, becoming a parent is a big deal regardless of your gender.

Ultimately the decision about when to have children should be a personal decision which may be related to fertility, financial situation and other life events, and ideally should not be affected by work and training.

Although parenting is an issue for both men and women, the challenges of a demanding shift work roster or arduous exam study while pregnant or breastfeeding are unique to women. Returning to work after giving birth can be fraught with guilt. Annabel Crabb sums it up well- “The obligation for working mothers is a very precise one: the feeling that one ought to work as if one did not have children, while raising one’s children as if one did not have a job.” Even New Zealand’s inspirational Prime Minister Jacinda Adern, who has returned to work 6 weeks after giving birth to her first child is not immune. In a recent TV interview discussing the many doors now open to mothers in the workplace, she acknowledged this saying, “and absolutely there is guilt behind every door”.

So, what can we do? When is the best time to have a baby and why should this only concern female trainees? The question should not be when is best to have a baby but how can we best make it as easy as possible for women (and men) to combine parenting and a career in intensive care medicine. Once we see that this is not just a women’s issue we will be on the right track to addressing it. Intensive care as a speciality is often seen as demanding, with shift work and high rates of burn out making it difficult to balance family and career – this perception does not help our cause.

The current CICM guidelines have been updated to allow trainees (of any gender) to take up 52 weeks of continuous parental leave without affecting training, and a total of 104 weeks during the entire training programme. But is this enough? These guidelines don’t allow for minimising shift work and long hours in the late stages of pregnancy, or for missing out on part of a run that is of a set duration (for example a 6 month anaesthesia term) due to pregnancy. There is no return to training policy in place, although part-time training is permissible at any stage.

Once training is completed are mothers further disadvantaged? Unfortunately, the answer is probably yes. The motherhood penalty suggests that women returning to work encounter systematic disadvantages in pay, perceived competence, and hiring potential. It is well recognised that men do not suffer this penalty, in fact, there may even be a ‘fatherhood benefit’.

Despite all this, the next time a trainee asks me this question my response will be the same “you should not delay your plans to have a family due to your training”. I hope that one day I will be able to add that having a baby will make no difference to your career path. In the meantime, I’ll save that statement up for the day I get asked that question by a male trainee….

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