Chapter 11- Babies

Michelle Rheault, summarized the Baby chapter. 



There’s no good time for a woman doctor to have a baby.

More and more women have been choosing medicine as a profession over the past 30 years, so the question of optimal timing of pregnancy has become a big topic of discussion among medical students, residents, and junior faculty.

But when are all those rapidly aging ladies supposed to find time to have a baby? With medical training extending to your 30’s for many women and junior faculty positions requiring a huge time commitment to achieve tenure, waiting to have kids until you’re comfortably settled in a faculty position or private practice will get you the dreaded “advanced maternal age” stamp on your chart. In Chapter 11, Dr. Grubbs begins by describing her experience of pregnancy with her first husband during internship. While her training program was accommodating, she felt guilty for making others pick up her shifts during absences and the inevitable kid emergencies. Although she doesn’t mention it here, being away for call nights and missing nightly tuck-ins takes a toll on a parent. My experience in my female dominated pediatric residency was a little different, as pregnancy was more the norm than the exception. I chose to delay my two pregnancies until my research fellowship, since my call responsibilities were zero and I seemed like I had so much time to spare. Unfortunately, babies limited my focus and research output and the bench research career was over shortly thereafter. Would it have been different if I had chosen to have children while an intern, like Dr. Grubbs? Maybe, but I wouldn’t change a thing and I suspect Dr. Grubbs wouldn’t either.

Next, Dr. Grubbs describes her devastating experience with infertility and in vitro fertilization. Unfortunately, Dr. Grubbs and Robert had a number of factors working against them including her age and Robert’s kidney failure and prior accidental cutting of his right vas deferens. Did her choice to donate her kidney also play a role? There is little data available on the risk of infertility after donor nephrectomy however this does not appear to increase risk. One study from the University of Minnesota in 1996 showed no difference in fertility rates among donors compared to the general population. After spending down their savings account that had previously been set aside for a new house for the brutal roller coaster of shots, implantation, and menstruation they were unsuccessful in achieving a pregnancy. Dr. Grubbs describes the difficulty explaining this deep sense of loss to others and coming to terms with her own feelings about the subject: 

“It has been years, but part of me has yet to come to terms with the fact that my dream of a little combination of Robert and me would never come to be.”