Dear My Younger Sister Doctors

An Open Letter to My Younger Sister Doctors

Take it from an “elderly gravida” obstetrician, wait but don’t wait too long.

You see, I just had my second baby, she is four months old, and as I sit here and soak in all of her chubby sweetness, a part of my heart aches. A piece of my heart yearns to have just one more, to be able to experience all this one more time.

I grieve the finality of the tubal ligation I chose to have at the time of my second cesarean section. I grieve the finality of my age on my reproductive chances, and the finality of not having just one more baby. Even if my tubal were to fail (I can’t say I haven’t wished for it to happen a time or two), and I got pregnant tomorrow, I would be hovering around 43 years old when I gave birth, which doesn’t just make me an elderly gravida, I would be a SUPER elderly gravida (I came up with that distinction myself).

I know all too well what that age means. My risks for a child with a chromosomal abnormality would be somewhere on the order of 1 in 33. I would be at a significantly higher risk for miscarriage. If I made it past the first trimester, I would be at incredibly high risk for preterm labor, gestational diabetes, preeclampsia, and complications from a third cesarean section. If I had a successful pregnancy and delivery of a healthy baby, I would be 61 years old when that baby goes to college. If that baby waited until she established her career before having children of her own, I would be in my upper 80’s, and barring any significant advancements in anti-aging, I would be unable to help her in the way that my parents have helped me with my children.

Unfortunately, I waited just a little too long. I was taught to wait.

Wait until you finish your education, wait until you find the right man, wait until you have established your career.

So, that is what I did. I waited until I completed four years of college, four years of medical school and four years of residency. I waited until I found the right man and married, which was at age 28. I waited until I started my first job as an attending in a private practice, but this is where I waited too long. I heard the remarks of my senior partners, belittling doctor moms and their role in medicine. I heard their thoughts on maternity leave and how it affected the practice’s bottom line. I heard the comments that the group almost didn’t consider hiring another female physician because the last two got pregnant and left the group after they had their babies.

So, I decided to wait. I chose to wait until I proved myself to my colleagues. I thought that if I could prove my worth then they would be more willing to accept me as a doctor mom. I waited until I proved myself to my patients because I began to believe that once I became a doctor mom I would no longer be as dedicated to them. I slaved away my early 30’s in private practice. I worked 80 to 100 hours a week. And then, I woke up. I realized that I would never have a family if I continued down this path. So, I left private practice and became an Ob/Gyn hospitalist. However, despite this career move, I continued to wait. I waited until my husband was comfortably on his way to starting on a new career path. I waited until I was well established in my new job.

Then, one day, I realized that time was passing me by, and my fertility was at stake. I was 37, and I had waited long enough.

I got pregnant with my first child without any difficulty. I delivered the week before my 38th birthday by cesarean section due to arrest of dilation. The arrival of my first baby hit me like a hurricane with all the fury and unpredictable changes of a newborn. It was a steep learning curve, but I was completely content at the time. Then, about two years later I decided that my son needed a sibling. So, at the age of forty, I embarked on the quest to pregnancy. Unfortunately, this time around I didn’t get pregnant right away. After about 9 months of trying with no success I finally (with feet dragging) headed over to my local reproductive endocrinologist’s office (I know, I waited too long to seek treatment). After a round of IVF with no success, we gave up. I was staring down my 41st birthday, so I knew my chances were slim to begin with and we couldn’t afford to try again. Then, we received a surprise one month before my 41st birthday, I was pregnant! A tiny miracle. I was blessed with a healthy beautiful baby girl 4 months ago.

Let my story be a lesson to my younger sister docs. I absolutely believe in waiting until you are ready emotionally and mentally, but-

Don’t search for that perfect time in medicine.

Don’t wait for permission from your colleagues.

Don’t listen to the discouraging noise around you.

When you are ready take that leap of faith and act, motherhood is amazing. Being a doctor mom is hard but rewarding. It has made me a better more well-rounded woman and doctor.