My stomach had been in knots that morning.
“Are you pregnant?” my classmate laughed after I returned to the gross anatomy lab for the second time after leaving to get a drink.
“No,” I chuckled, and returned to cutting through fat and fascia, teasing out the muscles and nerves for the day’s dissection.
But, I wondered.
On the way home after lab, I bought a pregnancy test to put my mind at ease. Being in my late 20s when I began medical school, my husband and I had had many conversations about when would be an appropriate time to start a family during my training. The first sets of exams had went well and I was getting plenty of time for myself while adjusting to life as a new medical student, so we had collectively thought I could handle being pregnant while in school. We had just begun trying to start a family, and I was convinced that there was no possible way I was already pregnant so soon.
However, the little “+” sign proved otherwise. We were both shocked and overwhelmingly excited to be parents. To be honest, though, I was also scared — now that I was actually pregnant, I wondered if my previous assessment of my abilities was overconfident. Was I so naive that I thought I could be both a medical student and mother-to-be? Then, only a few months into my first year of medical school, I wondered if I could continue to be a good student while being pregnant.
Classes did nothing to ease my fears; at times, class content made my fears worse. When I first learned of the embryo I was carrying, my class was in the middle of medical embryology. As my pregnancy continued, those worries changed based on my newfound knowledge.
“You are not allowed to be a molar pregnancy,” I would think toward my stowaway. “You are not allowed to have holoprosencephaly. You are not allowed to have a trisomy,” I thought, as another wave of nausea would break my concentration.
Knowing that the majority of spontaneous abortions occur in the first eight weeks of development, I was not comfortable with sharing the news with anyone other than my husband — I was scared to death that I would miscarry. Sweatshirts and scrubs were my outfits of choice, my mechanism for concealing my secret until I was ready to share it. I was afraid that my professors and classmates would think that I was not a serious student since I had chosen to start a family during my training. (Luckily, my obstetrician was not on faculty, and was located near campus so I could easily attend my appointments without drawing suspicion.) Being a non-traditional student, I knew that my time frame for a family was different than some of my younger classmates’, and I didn’t want to be judged as incompetent because of my “condition.”
As it happened, my “condition” had ideas of its own and it struck with a vengeance. I had not predicted that I would be so actively, violently ill every single day. For the first time in my life, there was something that dictated my day-to-day activities that I could not control. My style of learning had involved attending lectures, but this was abruptly halted as my morning sickness set in to stay. I was unable to keep my composure for extended periods of time, especially during three-hour-long gross anatomy dissections. There were days where I needed to stay home and take study break naps. Most days, I just wanted to function, which was difficult to accomplish. I tried to act as normal as possible because I didn’t want any special treatment or to draw any special attention, even on days when I was miserable.
Thankfully, I wasn’t always miserable. While there were plenty of doubts, there was even more joy. Seeing the ultrasounds, hearing the heart beat, learning that our baby was a girl, trying to decide on a name — all of these things were joyful, and I was grateful for something outside of school to help me feel like I wasn’t completely consumed in my life as a medical student.
However, the problem with secrets is that eventually they reveal themselves. Concealing my pregnancy was no easy feat. One of our assignments for first year was an eight-hour shadowing shift in our university’s emergency department, which was exceptionally busy that night. My assigned shift was during my period of extreme morning sickness, but there was no way to reschedule my shift without breaking my news to the administration. To keep my nausea at bay, I kept a large quantity of hard candies in my short white coat pocket. When there was a need for an x-ray, I quietly excused myself to a safe distance. The attending I was shadowing took notice, smiled at me, and returned to her work.
While my secret was safe that night, it was not to last. Not long thereafter, gross anatomy precipitated my decision to speak with my professors about my pregnancy. My stomach needed substance constantly, which meant I had to learn how much food to take with me to campus so I could be productive without too many breaks. I simply could not stay at my dissection table for long enough periods without having fresh air and a drink or a snack to settle my stomach, and I didn’t want to be accused of trying to shirk my responsibilities at the dissection table. Over winter break, I was into the second trimester of my pregnancy, the nausea was slowly subsiding, and my husband and I had a clear ultrasound of a healthy baby. It was finally time to share our good news.
To my surprise, my classmates and my institution were wonderfully supportive over the course of my pregnancy. When it was no longer a secret from anyone, I quickly realized that all of my fears were unfounded. It was such a relief to no longer hide a major part of my life from those around me. Speaking to the administration also provided me with a long list of mentors in a variety of specialties that also started families while in school or early in their careers, which made me feel much less isolated in my experience. The most encouraging thing I gained from my mentors was hearing how their stories and experiences turned out, and that this was a much more common experience than I had anticipated.
While the nausea did finally subside, other things that I did not expect appeared. The small, day-to-day things that I could no longer do for myself started to feel like a betrayal. I could no longer bend over to tie my own shoes, so I bought slip-ons. My clothes were constantly getting tighter. Even reaching things on shelves became difficult, as my growing abdomen would get in the way. When the baby would kick during exams, my concentration would break and I would need a moment to refocus. When the long walk from the parking garage to campus became too much for me, I started taking the shuttle and had to factor in extra time to make the trip into campus.
Other things that I did not consider: timing. I had failed the one-hour GTT (glucose tolerance test) and then had to schedule a three-hour GTT to make sure I did not have gestational diabetes. Finding a convenient three-hour block of time to be absent from coursework and exams was tricky. These were all minor inconveniences but took some time to get used to as my new normal.
When thinking about starting a family during medical school, it can seem like an insurmountable task. There were many things that I wish I would have known and thought about before trying to start a family during my first year. Even though my pregnancy was much more difficult than I expected, the experience itself was not as horrible as it could have been. I attribute this to the support I received from my husband, family, classmates, and school administration — my self-consciousness was a burden that I placed upon myself that was unnecessary.
At the beginning, I was not sure that the outcome would be as happy as it has been; in hindsight, having a baby during medical school was not a bad idea at all.
All about starting and raising a family while being a physician-in-training.