Medicine residency survival tips during pregnancy

by Dr. Whoo, MD

Q. I just found out last week that I’ll be a new mom in November, making me an official mother in medicine! I’ve been reading the blog for a while, because I love hearing what all of you have to say about your lives. Here’s my question: What tips would you give for surviving residency while pregnant, especially 30-hour calls (without caffeine)?

– From a future mom and Family Medicine resident in the Midwest

A. Congratulations on your pregnancy! I know that being pregnant during such a difficult time as residency seems daunting, but you can (and will) survive! Overnight call is never fun, but with a few small changes, you can get through a 24-30 hour call with relatively minimal discomfort.

Survival Tip #1. Bring lots of snacks to work with you. As a resident, especially on call, you often have an erratic schedule, and sometimes it is difficult to eat at regular intervals. If you are fortunate enough to avoid severe nausea in the morning, then try to eat before you leave the house. Pack your pockets with snacks that are portable, like protein bars, hulled sunflower seeds mixed with dried cranberries or raisins, or even the standard peanut butter crackers. Having something on your stomach at all times will help stave off nausea and fatigue.

Survival Tip #2. Some caffeine is still ok! No, really! I am not sure how much caffeine you have been consuming prior to pregnancy, but a small amount (150 mg-300 mg) of daily caffeine has been shown to be safe in pregnancy. The official March of Dimes recommendation, I believe, is 200 mg or less. One (regular) cup of coffee or 2 caffeinated sodas per day should definitely fall well within the safe range, not to mention the occasional chocolate fix (so needed on certain call days).

Survival Tip #3. Learn how to prioritize your duties while on call. It is likely that you already do this to a certain degree. Do the most physically strenuous tasks (procedures, lines, rounding) as early as you can in the call day, when you have the most energy. Try to chunk as many things as you can on a single floor, and “gravity round” (start at the top of the hospital and go down floor by floor).

Don’t be ashamed to use the elevator, but by going down steps, you can get a little physical activity without straining yourself. Do your best to anticipate any additional orders (nausea medications, sleep aids, pain medicine, diet orders, etc.) that may be needed throughout the day and write them while you are on the floor, saving yourself middle of the night phone calls for Tylenol during the 2 hours that you may have been resting! Another thing you can try is to do quick PM rounds. Alternatively, call and talk to the nursing staff, floor by floor, asking about any issues that may need to be addressed prior to trying to lie down, thus avoiding the “sit on bed, pager goes off” phenomenon to the best of your ability.

Survival Tip #4. Stay hydrated. I know it is hard to do, and even more annoying when you have to stop working and actually *use the bathroom* on occasion, but trust me, adequate hydration can stave off multiple discomforts of pregnancy and decrease the development of more serious complications like pre-term contractions. Have a bottle of water accessible throughout the day, and refill it often.

Survival Tip #5. Don’t stand when you can sit, don’t sit when you can lie down. Rest as much as humanly possible, even if it is just the short time between one clinic patient and the next. Go to the call room and lie down on the call bed instead of sitting around and chatting at the nurses’ station, even if you don’t sleep, you will be much better rested and prepared for that inevitable page from the ER at 3 am.

Survival Tip #6. Bring your meds with you. If you are one of the less fortunate ones (like me) who happens to be plagued with persistent nausea/vomiting throughout the pregnancy, Zofran will likely be your very best friend. Bring it to work with you, along with Tylenol, Sudafed, Zantac, Tums, and your pre-natal vitamins. It will help you to avoid having to get IM shots of Zofran from the nursing staff or walking around with an IV (both happened to yours truly) for fluids.

Survival Tip #7. Utilize any support that you have. I’m not sure if in your program you take solo call, or if you have a junior person and a senior person on call at the same time. If the latter is the case, then utilize your support person to their fullest potential (if they are amenable, that is). Try to “divide and conquer” tasks instead of tackling them together. If you are the senior, then trust your junior to do good work without you hanging over their shoulder. If you are the junior resident, don’t be afraid to ask the senior for help if you feel you are in over your head.

Survival Tip #8. It’s ok to whine, but don’t whine about your pregnancy discomforts to your co-residents or to the nursing staff. Call your husband or your best friend, or compose a long, whiny email and then delete it if you must. It is normal to feel whiny when you are pregnant, but it may ultimately foster unwanted and unpleasant feelings in your co-workers if you vocalize these feelings. It saddens me to have to write this tip, but this is a mistake that I made in my pregnancy that came back to bite me. Sympathy is not always rampant in the medical community, so try not to seek it there, and you will not be disappointed.

Survival Tip #9. Be aware of your limits. As you progress in your pregnancy, you should not be lifting more than 20-25 pounds, nor should you be feeling more than 4 contractions in an hour. Don’t push your body’s limits in order to be a “super resident.” It is ok to ask for help if you need it, and don’t ignore the warning signs that something may be wrong. Often, we as physicians will push aside our own physical discomforts and keep on working. Don’t ignore serious signs like contractions, shortness of breath, headaches, excessive swelling, or increasing abdominal pain.

Survival Tip #10. When you go home, do nothing else but take care of yourself and your needs. If you need to go home and sleep for 10 hours, then do it, dishes and housework be damned. Celebrate the fact that, in spite of being up all night, you have this time catch up on sleep. When the baby arrives, your call shift will never truly be over.

Luckily, in many ways, motherhood is infinitely more rewarding. I wish you all of the best as you enter this exciting new time in your life, you can do this.

Dr. Whoo is an obstetrician-gynecologist who blogs at Mothers in Medicine.

Submit a guest post and be heard.

Comments are moderated before they are published. Please read the comment policy.

  • KSG

    Great advice! I especially like the PM rounds suggestion. It is a great idea for anyone on call that values their sleep, pregnant or not! If you make it a habit, RNs will likely take care of the important items at that time and wait to the am for the rest. We implemented this in the ICU and it has helped a great deal.

  • Katie

    Super helpful! Thanks!

  • MB

    Great post!
    I am a very active PA doing UC, on her feet all day, who is due in Oct.
    The snacks tip is spot on.
    I figured out the nausea largely develops as a sign we’re hungry.
    Snacking every couple hours was a huge help for me.
    Also, sleep when you can as Dr Whoo suggests.
    My home went to pot this first trimester…
    But I got over it reminding myself of the larger job at hand: caring for myself, growing a baby and having enough energy to care for patients.

    Best wishes.

  • Molly Ciliberti, RN

    Sleep!! Blessed sleep!! Sleep whenever you can. After the baby’s birth sleep will be at a premium. But just as important sleep helps you during pregnancy because as you get further along into your 3′rd trimester and the large baby pushing on your bladder and nerves and just their thrashing around disturbs your sleep. Take care of yourself and be happy.

  • LynnB

    I went through IM residency , had my second and last child in my 3rd year . That sounds OK, but -nursing an infant as an intern, pregnant with a toddler at home year 2 ,year 3 delivered in October, had an infant and a toddler and spending my entire check on childcare , borrowed all that we lived on .That was 20 years ago BUT some things don’t change

    1. Find out what the sick leave and vacation policies are. I was able to deliver, then be sick for two weeks (legit) , then use my vacation , and I even accessed my old unused sick leave form when I had been a research assistant . I really wanted to benefits going when I had a newborn , luckily she was healthy . NICU bills are very high and even if your partner has insurance, double coverage is he ideal.

    2. Block out your continuity clinic after delivery . My schedulers would not do this for me , a mere resident, so get your program director to help with this . The permanent staff may like you but they don;t report to you

    3. Every day you are out while pregnant is one day less with your delightful newborn

    4. All residencies have a curriculum and if you don’t finish it you can’t take the board exam , which is given once a year (or was) so look up the policies on family practice board web site

    5. Fatigue eases a lot after the first trimester, so don;t expect to feel like a hibernating bear for 40 weeks. It gets much better . In the second trimester organize the first few weeks off, look at renting a pump from the La Leche league (if that’s your preference) , start stockpiling diapers , or I was so politically correct a had a “natural ” diaper services . You also need to think about babyprooofing the house, so you might get a list going and work on that and if you just ask people will be delighted to give you bassinets and cribs and I was so blessed that my colleagues had a very useful and generous baby shower . BUY TWO CAR SEATS EVEN IF YOU HAVE TO BORROW THE MONEY .

    6. Many of your colleagues, especially those of either gender who have no kids believe in the brain-uterine shunt. They will also describe you as “disorganized” once you have to do all they do plus be the best mother you can be. Forget them, enjoy those who are kind–they ranged from one department chair to the housekeeper who protected my water pitcher and let me into the chemo room at night to rest with my feet up.

Most Popular