Shortly after agreeing to write about my struggles in trying to have a child during medical training, I wanted to back out. "I should wait," I thought, "I shouldn't have done this until I actually had my baby." It's easier to look back and reflect on the darkness when you're finally out of the woods. Right now, I'm still in the darkness. And I'm not alone, especially as a would-be mother in medicine. One out of four female physicians who responded to a survey published in the Journal of Women's Health had been diagnosed with infertility. I'm not yet a physician; I'm a nontraditional third-year medical student. I came back to medicine after having walked away when I was younger. Despite the persistent ticking of my biological clock, I found a passion to improve the lives of others through healing. I'm still (relatively) young and (generally) healthy, I thought. I can have a baby during training. At that time, I was also apparently quite adept at rationalizing the subtle changes in my body... Many female physicians are surprisingly unaware about our inevitable and progressive decline in fertility. Research has shown that nearly half of ob/gyn residents overestimate the age at which this decline begins. Maybe our focus on identifying diseases in others blinds us to our own health considerations. My hope is that sharing my personal oversights, challenges, and lessons learned will help others to avoid the self-blame and isolation that I am currently experiencing. Putting Off Pregnancy My story is unique in that I was older than average when I first started medical school. It is not unique in that my husband and I postponed having kids because of our crazy work hours and because we just weren't "financially ready," given our combined mountain of educational debt. I have also discovered that my personal experience resembles that of so many who have witnessed warning signs of fertility trouble and ignored them. For me, it was changes in my monthly cycles, which were growing shorter and less robust. I'm frustrated that, despite being a physician-in-training, I was blissfully unaware of the so-called "30th birthday cutoff." One particular recollection haunts me: In my early twenties, I had been diagnosed with a condition that commonly causes infertility. My physician urged me to pursue pregnancy plans earlier rather than later. I'd like to say that I didn't understand her. The truth is, maybe I just didn't want to. I didn't even ask her a single question. At the time, the notion of having children was a fleeting thought about which I had very little emotional attachment. Too many of us in medicine ignore red flags about our fertility early on. Detachment is necessary to our survival as doctors, so we feel vulnerable when we see ourselves as patients experiencing our own problems. This is particularly true for medical students, who commonly force fertility concerns to the sidelines. At this stage in our careers, the competition is fierce. We bury our fears and any desires that aren't related to learning. Before making the decision a few months ago to step back from my education and focus on building a family, I was just starting a surgery rotation. By that time, my fertility situation was made clear to me: a pregnancy is highly unlikely if I continue to put my training first. I no longer have the luxury of postponing. The daunting hours associated with so many of our rotations, the inability to eat healthy food on a regular schedule, and severe deficits in sleep are the exact opposite of what my body will need to conceive. Source
