By all appearances, I was just another sweaty-palmed medical student taking the first neuroanatomy exam of the semester. The stakes are high with every step toward becoming a doctor, but they were even higher for me that day. Failing the test would mean withdrawing for the semester, effectively delaying my education by a year. Such a precarious position was the consequence of my decision to do the unthinkable, or at least the highly impractical, to have a baby during my first medical school year. Five days before the start of the Spring semester, I gave birth to a healthy baby boy. Every delivery nurse, lactation consultant, anesthesiologist, and OB/GYN doctor who waltzed into my hospital room either held their breath, rolled their eyes, or flat out told me I was crazy when I confirmed my intention to start the next semester. Surely, I must have had no idea what I was doing by even considering such a course of action.
Of course, I would never have had the confidence to attempt such a lofty goal without my husband’s support. Thankfully, he had a job that afforded him a month of paternity leave and relieved me of all domestic concerns except for breastfeeding (biology hadn’t granted him that ability). I am among the privileged few women in medicine who had the opportunity to focus on providing the best nutrition for my child while pursuing rigorous training.
While family was visiting and cooing over the baby, I laid in bed, watching online lectures. Either I was lying on my side like the Queen of Sheba with an ice pack on my stitches, or I was holding my baby who alternated between nursing and sleeping on me.
After missing the first week of classes, I knew I needed to return to the required labs and small group discussions. I swallowed a postpartum cocktail of ibuprofen, Tylenol, caffeine, and Colace to rally enough fortitude to show up for the essential activities on campus. Despite soaking a couple of shirts with breastmilk while at school, I made it to that first exam at the end of week two.
A passing score would be my litmus test of continuing or not; anything less meant I would bow out for a year. I set down my donut seat cushion and gingerly arranged myself at the desk. Everything else that day is a blur to me, but I can still distinctly recall when I hit the submit button to see my grade: 75. The screen got blurry as tears distorted my vision. I was going to make it. Other women can make it too.
Thus, I plunged through the weeks. The long-awaited breath of fresh air known as Spring break was finally upon us. Then, in a flash, world news became terribly relevant—we would not be returning to class due to the COVID19 pandemic. The stay-at-home accommodations I had desired as a policy for new parents were now being forcibly applied to the entire student body. Many salient points can be made about how online classes fail to meet traditional in-person format standards. However, for this season of my life, I felt guilty over how much I personally benefitted from the lockdowns. Now that I was no longer going back and forth to campus, no longer trying to find a parking spot, no longer storing milk for the baby and pumping while at school, no longer dealing with all these hassles that came with simply showing up for class, I had several extra hours to spend with my child and my spouse. Whether it was a product of a well-rested mind or improved mental health from being home more, my grades immediately improved.
Currently, there is no standard model whereby a woman with children pursuing a medical education has an outlet to seek support. While pregnant, I initiated requests for a respirator and testing accommodations for anatomy lab. After birth, I went to the Department of Transportation and my university’s parking services for a temporary disability parking pass since my third-degree perineal tear initially forbade me from prolonged walking. My curriculum coordinators worked with me in finding labs and small groups that fit the window for when I had childcare available. One day, I had to chase down a janitor to find out how I could obtain a key to the lactation rooms that were generally only assigned for staff. These processes should be available, perhaps automatically recommended, to any pregnant female rather than forcing her to pursue an ad hoc plan on her own. No female had previously had a child in the pre-clinical years at my school, and I heard stories of women who deferred matriculation due to pregnancy. It becomes a self-fulfilling prophecy by preaching that it is impossible – “crazy” – to do both. Yet once I approached each door and knocked, I always found a way through graciously.
It seemed that before the SARS-CoV-2 pandemic forcing itself upon the consciousness of higher education, the medical establishment had been unable to allow flexibility into its curriculum. Nearly every school’s website hails the advancement of women in medicine, yet I found this only rings true to the point where that woman decides to fulfill her biological capability for reproduction. All it takes is stepping outside the box to reject that refrain that can be so destructive: “We’ve always done it this way.” The fields of medicine and medical pedagogy have done an exceptional job adapting to the novel coronavirus’s extraordinary challenges. Together, we can likewise adapt by creating a culture that nurtures, rather than strains, the transition into parenthood during medical school.
The author would like to acknowledge Andrew De Haan for his loving support and for providing permission to share our family’s story.
Jessica De Haan is a physician assistant and medical student.
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