Mother Lode

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altThe phrase ‘no pain, no gain’ must have been coined by a very pregnant woman. I found this out for myself while expecting my first child approximately 18 months ago…
One EP’s strategies for balancing motherhood with a burgeoning career

The phrase ‘no pain, no gain’ must have been coined by a very pregnant woman. I found this out for myself while expecting my first child approximately 18 months ago.

In my practice alone, pregnancy has involved zofran backpacks, impending nephrostomy tubes and months of bedrest. I was on a cantaloupe and Tang diet for four months, followed by emergent C-section, yet all of these things were immediately forgotten as I lost myself in my newborn’s eyes.


As I gazed into her blissful, perfect face, I wondered how, in a few short weeks, I was going to have to concentrate on EKGs and pneumonia protocols. Shouldn’t I be cherishing the moments of new parenthood that go by too fast? In order to make the most of this complicated time, I realized that I would have to have to simplify my life as much as possible. It has taken much work, many lessons learned the hard way and the support and wisdom of others, but I’m beginning to understand how to balance the role of motherhood with my career as an emergency physician. Here a few things I picked up along the way.


Get Professional Help
You have three hours. Would you rather sleep, spend time with your baby or vacuum? To a normal person, the worst answer is obvious. To a new mother determined to return to her previous level of independence, this question presents a serious moral dilemma. Multi-tasking is at the core of emergency medicine, and we all expect the same of ourselves at home. The trick, however, is to multi-task with things that involve your family and your baby. If that means letting someone else mop your floors, so be it. Now more than ever your time is precious, and best spent on those most precious to you.


Breast is Best?
While we extol the benefits of nursing to our patients, as emergency physicians, it is near impossible to share this benefit with our own babies. With multiple shifts stacked together it’s nearly impossible to keep our bodies or our babies on a strict schedule. And forget trying to pump at work. There’s nowhere to go, and leaving for 15 minutes is rarely possible. Bottom line: nursing is meant to be a nutritious, bonding experience for you and your child, not to make you dread feedings. If it becomes the latter, it’s time to stock up on formula and find somewhere else to displace your mommy guilt. Certainly, nursing offers immune protection and superior GI absorption that formula cannot. But walk through the baby aisle at any grocery store and you will find a formula for any and every dietary need. We all know how vulnerable babies are in the neonatal period, but they all naturally become more resilient as they grow, regardless of whether their milk comes from a bottle or from you.

Don’t forget the guy living in your house
It’s likely that your spouse did not spend months memorizing every baby book and parenting web site prior to the birth of your little one. He may not have found it fascinating when your baby grew from the size of a shrimp to that of a chicken nugget. This will lead you to believe he is totally under-qualified for diaper changes and feedings. The truth is, he is just as terrified of making mistakes as you are, and will find his way in his own way. Instead of hovering and criticizing, be grateful that you have an equally doting parent taking the reins while you sleep post-night shift.

Use Your Family (but know the risk)
Geography permitting, grandparents and extended family will appear out of nowhere offering to help with your new baby. While no one will make you feel safer about leaving her for an evening, family does carry a price tag. Your mother might not understand that daytime sleep is not laziness if you worked till 4am. And a judgmental eye is not helpful when you finally get to see a friend you haven’t been out with since you stopped wearing elastic pants. Family is a blessing, but sometimes a neutral babysitter is well worth their hourly rate simply because they don’t share your gene pool.

Don’t Cry During Neonatal LPs
No, I didn’t really cry during my first post-partum neonatal spinal tap. But I wanted to. Somehow a simple diagnostic test had become a cruel punishment for a sweet, innocent baby whose only crime was to have a fever. Overnight, motherhood had instilled an empathy and fear I had previously never felt.


At times, my raised index of suspicion is helpful and at others is my own devil’s advocate. However, I now ask detailed questions that previously would have never occurred to me, and I know from personal experience that parents more than appreciate genuine concern and a sympathetic ear from someone who’s been there. Instructions on clear liquid diets and 10 days of antibiotics become a lot more detailed after you have had to follow them yourself with an ill child. Using what you have learned at home and voicing your own concerns will reassure parents that their fears are not overblown if even physicians share the same thoughts.

Give Yourself a Break
Motherhood has been a gift far beyond my heart’s imagination. But it can also be isolating and incredibly overwhelming. I expected the same perfection from myself in mothering that I demand at work, as if nine months of pregnancy were equivalent to seven years of medical training. In the emergency department, you rarely get a second chance to make the right decision and even more rarely are forgiven for your mistakes. I extrapolated the same demands of myself at home, just waiting for that terrible Press-Ganey score from my daughter. But as it turns out, parents are allowed to make mistakes, and second chances are always followed by thirds and even fourths if you need them. What makes a good emergency physician may not be what makes a good mother, and vice versa, but with a little practice, you certainly can be both.

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