Am I crazy to consider doing this?! Starting first year as doctor (FY1) @ 34 weeks pregnant

[pregmedic]

Hey everyone, name change for this to maintain anonymity. Any input much appreciated, especially from people from similar backgrounds or those with similar experiences.

I am a mature student who is reaching the end of medical school studies. We were recently delighted to discover we were pregnant again, after a previous loss. I am currently 10 weeks, all is looking good and all going well I will finish up with medical school in a few months. I am due to start my first job in the August intake but I will be 34 weeks pregnant at this point.

I obviously can't predict how I will be feeling at this stage but I'm hoping to be able to start with everyone else and then work as close to my due date as possible. I can't take off anymore than a couple of weeks without the need to extend my programme for ANY reason and I won't know how I feel about returning to work quickly once baby is here but I'd like to take as little as possible. I'm not against taking between 3-6 months if needed and would consider longer obviously too. A large reason for my desire to return quickly is that it makes much more financial sense for me to be at work than my partner. My partner is very willing to take time out of work to care for the baby and we have discussed all this at length.

I would also aim to breastfeed and express and/or go home in breaks to breastfeed baby once I return to work.

Do I sound completely crazy by even considering doing this? Am I missing something and not being practical?

Y might be U to think that you’ll be able to go home and BF on your breaks ...

I don’t know much about your field of work, however I can’t imagine you will be able to make breastfeeding work if you return to work when baby is 3 months old. You would need to express milk about every 3/4 hours at this point to maintain your supply which I can’t imagine is possible as a doctor? By 6 months it might be more doable as you could probably go 5/6 between pumping.

I returned to work then DS was 9 months and if I fed him at 7:30am before work I would need to express by 11:30 and would then feed him at 3:30pm as soon as I picked him up. I couldn’t go any longer between stretches without feeling like my boobs were going to explode.

Thanks for the responses so far. I am entitled to up to 2 x 45 minute additional breaks per shift as part of the breastfeeding policy for the NHS which, depending on where I am working, should be enough time to travel home and bf if necessary.

I didn't think about time needed between expressing too so I appreciate you flagging this up. Breastfeeding policy also highlights the need for managers to make 'reasonable adjustments' which may mean not doing shift work or out of hours work whilst breastfeeding so that might allow me to nip away for a while to breastfeed every 3-4 hours...again this in theory. I guess it would really depend on how understanding the area in which I end up working is.

I didn't mean breastfeed in previous post, sorry, meant express obviously!

My F1 this year started when her baby was 6 weeks old. She managed to breastfeed - she went to express a couple of times a day and when she was working long shifts her husband would sometimes bring the baby to her to feed (they lived locally). She said it was really hard, particularly when she was tired after long shifts and the baby wasn’t sleeping well but her husband was very supportive and did everything other than feed the baby when she was at home. She excelled at work and will no doubt complete the year with no issues.

You won’t be able to go home and feed though - even when you’re on your break you will still need to be contactable and to get back to the ward if there’s an emergency.

Best to go over to doctors.org.uk for more experienced advice.
I'd defer personally, there's an awful lot of running around as an F1. I certainly wouldn't be on call so late in pregnancy, there's often no chance to stop- and no protected breaks.
The breaks for expressing, you need to know if they are bleep free before planning to leave the hospital. You also need to think about the affect of sleep deprivation on hitting a very steep learning curve.

That sounds like a brilliant policy so well worth giving it a go. Just remember breastfeeding also takes it toll on you physically. You will need more calories yourself and it can be exhausting so don’t beat yourself up if you find using formula works better for you.

@welshweasel That gives me some hope, thank you! I know it will be exhausting but that I know my partner will be very supportive

Are you on the pmguk Facebook group? If not then join and ask the question there. You’ll get lots of help and advice.

@welshweasel I thought that might be the case, I will need to express or see if my partner could come and meet me at hospital with baby

@chickenvindasaag Part of me is thinking just to see if I can take a year out and another part is thinking to ask if my allocated school will consider allowing me to defer for 4 months or 8 months and start with the 2nd/3rd block. There's also the option of trying to get a 6 month FY1 LAS job to earn a bit of cash before starting a year later.

But the stubborn part of me wants to just start with everyone else!

Where will you be working and what jobs? Some hospitals leave F1s off the nights rota which will obviously make it easier, and doing something like public health will obviously be worlds away from a busy surgical on call.
I struggled after 32w with tiredness and just made it to 38w but used my annual leave to be "part time" and was in GP! Coming back before 6 months is optimistic because you might still not be sleeping much, especially if BF. I've not heard of the protected BF breaks but I'm not sure how it would work with on calls/getting bleeped.
Have you thought about posting on tea and empathy?

Take the year out if you can afford to. 6 months at least, if not? Seriously. I know it seems like a race at the start but really, at the end of the day it’s just a job and your family is more important. I do understand where you are coming from, we all get brainwashed into that race but I barely know anyone post-CCT who doesn’t think they should have chilled out and paced themselves along the way. And so many regret putting career progression ahead of spending time with their kids.

45 minutes isn't going to be enough time to travel home, breastfeed and travel back to site. I think you probably haven't factored in the time it takes to find a parking space at a hospital, let alone anything else.

Also, don't forget that FY1 jobs are based on national rankings now. You could be sent anywhere in the country.

I think you are being completely unrealistic

In theory doctors are allowed to go to the toilet or stop and have a drink during a shift but in actuality it often doesn’t happen

You will be often be the only doctor covering a whole raft of wards especially out of hours so who will manage them whilst you ‘pop’ home to breast feed?

Your only hope is to secure a post where you are supernumerary. The best way to do that would be a LTFT post. If you are LTFt and SN then yes you might manage.

Full time no. It’s absolutely physically emotionally and mentally exhausting even without kids at all let alone a newborn.

The potential for error from exhaustion is already high.
Imagine being in a crash call situation and you can feel your boobs leaking as you are overdue a feed and you imagine your 13 week old screaming at home wanting their milk. How can you make appropriate complex decisions with that going on?

Don’t put yourself through that.
You can extend or defer or do all sorts of things.
You waited this long to be a doctor why plough through this scenario now.

If you FF then I guess it might be more doable but returning after just a few weeks feels very pressured.

In my experience FY1s do a lot of walking about the hospital

Whilst I started my mat leave (as a nurse) at 39 weeks, I took 4 weeks of annual leave before that as I could no longer do my job (so went off at 35 weeks)

Obviously you don't know how you'll be feeling, but it won't be easy.

@pregmedic
if you do start with your cohort, you'll need to be very very clear with your team and the nurses what you need-breaks, time to express, and absolutely stick to it. The NHS is ridiculously heirachial, even if it is slowly improving. You'll need to be firm.

Sorry, I think that sounds nuts. Defer.

I think you'd be better planning to switch to formula when you get back to work, otherwise you're making things really hard for yourself. But good luck making it all work - I'm sure you will, one way or another!

We really can't afford for me to take too much time off. I think I am going to be causing myself a lot of stress by trying to return too quickly, especially wanting to breastfeed too. I don't want to not give bf a proper try, I am open to formula feeding if needed but doing it because it's convenient for me to go back to work makes me feel sad and selfish.

I think I will be entitled to MLA at least because of my part time job I've had during medical school. I could also possibly defer 6 or 12 months and do short (5-6 hour shifts) a couple of times a week if needed if my part time job would keep me on

I think deferring would be best.

Starting as an F1 is hands down one of the most stressful things I have ever done and I wasn't 34 weeks pregnant! I went on maternity leave at 36 weeks 2 weeks before I was due to complete my registrar training. I was quite ready to finish work then with 9 years of experience under my belt.

I think the breastfeeding policy sounds very idealistic and unlikely to work in reality. As PP said I certainly can't imagine you would be able to go home to breastfeed.

Maybe things are different under the new contract but in my experience 'scheduled' breaks don't exist. You take a break when you can. Or in reality you eat and drink whilst trying to make inroads into your mammoth list of jobs for the day with the hope you might only leave 1 hour late. And all of that is before one of your patients gets unexpectedly sick.

Defer and enjoy time with your baby.

Hi,
Just on the breastfeeding part, I was in a similar situation to you (different job but I'm guessing fairly similarly pressured) and my son did start feeding a lot more at night- be prepared for NO sleep! I was really anti ff but actually in the end it worked out best to combo feed after 7 months, I still felt I had done a good job ebf until then, he's a year now and he still breastfeeds in the evenings and weekends and milk/water at nursery. It's definitely doable!
On a side note and I'm sure you know this, maybe make some plans but you don't know what is going to happen/how you're going to feel. You may not be able to breastfeed (hopefully not but possible) you might feel absolutely ready to go back or you may feel you need more time.

You sound like a super organised, well prepared woman, just don't tie yourself in knots about things you can't possibly know. There's nothing like the first few months of a new baby so enjoy it.

I’m 35 weeks and walking very slowly - the tiredness is pretty horrendous and I do a desk job. I can’t pick anything up from the floor without it really hurting, and the bump gets in the way of everything. I think you’d really struggle to be honest.

Can’t comment on the breastfeeding etc as baby isn’t here yet but is mix feeding an option?

Also you don’t know how your pregnancy will progress - I had to take early maternity leave / holiday from the day job I have as as it was tiring to stand up for long along with pains and couple other issues which needed monitoring and was signed off by the hospital without me even thinking I needed any sick time off. That was at 32 weeks I’m now at 36 weeks and it’s tiring having a human in you.

But every body is different and you may be totally fine - but you just don’t know how it’ll progress.

@Languageasaflower Thank you so much for your kind words. It's so important I remember that I can make these plans but things may change, and this is okay too!
I would be delighted if I could breastfeed as long as you have! I am not against FF at all but I just don't want to feel like I'm making the choice for my own convenience without giving it a proper try. But as you say I might not be able to for other reasons regardless x