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?

I don't have experience of the medicine side but I do of pregnancy and public sector.
My job was office based but I had over an hour commuting - walk, train, 2 tubes. By 34 weeks I had sciatic pain. Walking was slow and painful and only possible for short distances. I was very uncomfortable. I went on mat leave at 37 weeks exactly and my baby came 4 days later!
I breastfed exclusively for 6 months but actually I'd wanted to be able to express so my partner could help feed. Unfortunately my baby had other ideas and refused all bottles entirely until we'd started weaning. Mixed feeding just wasn't a goer.

My time in the public sector suggests to me that the breastfeeding policy is just a policy and it's not really expected to be implemented. 45 mins to get home, feed and be back just isn't realistic. Maybe it's possible to do it in a few jobs at some levels but it doesn't sound likely for your job.

I think you need to find an alternative to your current plans.

Another vote for deferring - pregnancy is hard later on. I'm 25 weeks and struggling to sleep as I'm so uncomfortable, I'm a support worker and have stopped because I got very anxious around people (especially if ill) and very protective of my bump. Plus, don't make any final decisions until you know youre just having one baby - I found out at 12week scan that I'm carrying twins - whole different ballgame. and it was completely out of nowhere and I had no reason to think I had two in there!

It is ideal timing imo to defer at 34 weeks - there are ways around money issues, but if your health and babies health goes to pot from stress and overexertion thats harder to deal with.

Good luck and congratulations!

I think you are being a little naive thinking you will be able to feed on breaks. I'm a HPC and have had FY1s crying on my shoulder many times because they are exhausted overwhelmed and not had anything to eat all day. The reality is that they fit it eating, drinking, peeing etc where they can rather than getting set breaks and still carry bleeps when on breaks. You would need to check if your breast feeding breaks would be bleep free. Realistically though if there's an emergency you can't just down tools and go for your break at a set time. I've just started my Mat leave at 34 weeks, I definately wouldn't want to be starting a new job right now either.

My first kid fed every hour and the up to every 20mins sometimes in the first 6 months. Not every baby will fit a schedule of eating. I also went back to work about 6 weeks in and in nearly broke me. DH would have to come with me to meetings so I could pop out and feed. It was a nightmare.

What are your finances/debts like? You are walking into a secure profession. Doctors aren’t paid anything like they used to be in real terms (no real pay rises alongside inflation means consultants and GPS earn 30-50k less than 20 years ago) but it does tend to be a secure income. This might be a time to bank in your future and take a small loan.

Leaving a baby, especially a breastfed baby, in the first 3 months is tough and best avoided if you can. You and baby are a little feeding dyad, with very little difference from pregnancy other than having to carry the baby in your arms rather than your belly. This is why you hear people talk about the 4th trimester. 3-6 months you do start to shape a routine and get your arms back. 6-9 months is where the fun starts with feeding, interactive play etc. You would be unlikely to regret being there for as much of that time as possible. Speaking from experience -did 5 months with DC1, 9 with DC2 and taking 14m for DC3 having learned my lesson, twice!

I found a leaflet online that suggests that employers that all NHS employers should provide provision for breastfeeding to returning employers who wish to continue

ask them the details of who holds your bleep in those 45 minutes. I guarantee it'll be either you, or some admin person who will just take messages. I don't mean to be bitchy, but you are a bit naive thinking that 1.5 hours of work as an F1 is going to disappear, unless you're in an unusually quiet job.

The leaflet is just to comply with the legalities. It won't happen in practice.

Your medical career will be there for you after 6m or a year your newborn won’t they will be growing up. As other posters have said passing through medical stages isn’t a race and should be a learning / experience in itself. I returned at 9m and still breast feeding at 2 and half years - I know we are entitled to breaks but even taking time to express meant had to stay longer to finish work off so in end just went 10h between feeds on 3 long days - also my baby fed on demand so wouldn’t have fit into a fed slot. Good luck with your decision x

So, I'd think the choices would be 4 months, 8 months or 12 months. Most of the stand alone posts need full registration. I suspect your best bet will be apply for standard foundation rotation, then as soon as you know where you're going contact the TPD. I suspect you'll end up out of synch, for instance doing FY1 Dec to Dec, or even April to April, but that should not be organisable. The odds are that they'll let you do an out of synch FY2 following on through....there are always gaps. And then do a partial FY3/locum, to get back into synch before continuing training.

I suspect you'll be getting more advice now from your other posting. (I just find it easier to type on here than on FB...)

I think I will need to just add in some formula feeds to take some of the stress off me!

You do realise that when you are mainly bf-ing a hungry baby your breasts, just like the baby, don't really cooperate with timetables? Sometimes your breasts will let down at work and milk will gush down your front soaking through your clean work clothes despite the layers of breast pads you'll be using. It feels like they are exploding. Sometimes they'll become rock hard and engorged and the slightest brush against them will be agony.

As a final year med student you are already a highly successful person and you will be used to achieving difficult things in life.You have most likely never really 'failed' at anything before and so you are optimistic that this new challenge of doing FY1 with an infant will be another achievement on your growing list, like a problem that can be solved or an exam that can be passed. Perhaps it can. Perhaps you can complete your F1 year, become a good doctor and breast feed your baby so they are healthy and happy and pay the bills. Perhaps you can be Superwoman.

But at what cost to you? (And to your baby, your patients, your partner and your mental health?)

I say again, no money in the world is worth that time at home with your newborn. Plan to defer at least for 6 months and you can always rethink if that feels wrong once your baby is born. Being superwoman is not worth it.

What you think F1 life is like as a medical student is very different from F1 life reality.

As a medical student you go off to revise if nothing much is happening on the wards, you don't have responsibility for a huge amount of admin plus clinical needs. There may be breaks promised, but at the end of the day, you will have a list of jobs which need to be done. The longer you take to complete them, the later you still. Patients will get sick, and emergencies will happen, delaying your jobs and adding to that list.
We had F1 teaching which was bleep free, we always went home extra late on Tuesdays as the work load didn't change. We just paused for teaching. If you do get breaks for breast feeding, the work load won't change, you'll pay for it in other ways later.
You may also be faced with the never ending ward round. A few weeks ago I was on one which finished at 7pm. We stopped for food on the way, but they are long and physically draining.
I struggle with them on my period, let alone pregnant.
At 34 weeks most doctors I know have stopped nights (there's obstetric guidance advising higher risk of still birth and pre term labour if you do nights after 28 weeks). Many are stopping oncalls and struggling with the physicality of the job.
There are lots of doctors out of sync with training programme dates, honesty no one cares. Its not a big deal. Defer until at least 8 months.

Hi, just to add to the others saying don’t worry about being out of sync. I had mat leave as an F2, came back part time and then ending up finishing in December. There was more than enough locum work to keep me busy until the CT job came up. Plus there’s a February intake for many specialities depending what you want to go into! Congratulations on your pregnancy!! I would echo to enjoy those precious newborn days, they go so quickly. Best of luck with everything