When should I have a baby? This is a question I often get asked by more junior trainees. Reflecting on the unwanted and inappropriate advice I frequently received as a female trainee one particular statement stands out – “I know I’m not supposed to be telling you this, but try to do your exams before you get pregnant. And for God’s sake – don’t get pregnant during the exam period.”
When I found out I was pregnant with my first child late in 2017, excitement turned to apprehension when I realised I would be 20 weeks pregnant for the written and 30 weeks pregnant for the clinical components of the CICM part 2 exam. I found myself at a crossroad. Thoughts of delaying the exam were weighed up against sitting the exam while being the primary carer for a small child. I felt it would take a miracle in order for me to pass. But I decided to press on.
A year and a half after the lines on the pregnancy test turned blue, I have made it through both pregnancy and exams successfully. While pregnancy makes things tougher, it is not impossible to navigate this tricky time in your life with an extra resident on board. Having sat another fellowship exam in the middle of a relapse of depression I can categorically state that at least in my experience, it’s much harder to sit an exam with the black dog trailing behind you than it is waddling around various intensive care units looking for hot cases.
Now before you say that I’m probably one of those geniuses that hardly needed to study anyway, I shall confirm that I possess neither a photographic memory nor an insanely high IQ! Also I’d like to state right here and now that women should not be expected to or insanely praised for “doing it all,” because to be honest, there were compromises, particularly from my employer and my long suffering (non medical) partner. If you get pregnant and don’t want to, or can’t sit an exam, that is probably a more normal thing to do. Feminism is about choice, after all.
I found that there were several important things that helped me along in this process. Exam periods breed bad self care habits, but being pregnant means self care becomes a priority. Working the exam around my pregnancy rather than vice versa made me take that necessary step back that allowed me to take breaks when I needed to, rather than getting lost in the exam completely. I feel it gave me perspective, in a sense. Saying no to things (being on the CICM trainee committee and WIN-ANZICS committee gives me many opportunities) and not taking any new things on in the department also helped. Purposefully choosing an employer that I knew could be flexible with rostering was also important, although many of us may not have such a luxury (in rural and regional areas for example).
By the time I got to the end, however, I was broken. Larger, insomniac and plagued with severe plantar fasciitis, I waddled around Sydney hoping that I had done enough. As I walked across the airport terminal to head home, I could hardly walk anymore. And as I lay my achy body down for the night, my little 30 week nugget decided to have a party and spent the night headbutting my liver (these nocturnal party habits have persisted well into infancy!) I was unsure as to whether or not I should be proud of myself and whether I had just fed into the unhealthy culture of medicine. It was then that I got my first taste of the uneasy choices that lay before all mothers. But with the pass letter from CICM squarely stuck to the fridge door, for now, it felt like victory.
So what would I tell my junior trainees now? I would tell them that it is not my place to comment on their reproductive choices but I will say this. There are times where medicine and work may be a priority, but that should not always be the case. That some mentors and seniors will give you biased advice that will prioritise the advancement of their careers without appreciating that sometimes, the life we have outside work needs nurturing from time to time. That ICU training is possible when you have a family or other responsibilities. That being pregnant should not be a barrier to sitting exams, but also, taking a step back from your careers from time to time is not, should not, mean career suicide. That organisations like WIN-ANZICS are doing everything they can to make sure that career advancements are no longer taking a singular, narrow road that everyone must take but a long, winding and adventurous one with many different routes that will get us to our destination.