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Experience with maternity or paternity leave?

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  • Experience with maternity or paternity leave?

    Longtime WCI fan, and lurker, but first time poster. I am interested in seeing what the environment is like out there for women physicians who take maternity leave, particularly from an ED setting or mostly hospital based setting. I couldn't find an existing thread that really addressed some of my issues specifically.

    I work in a smallish ED group ~10 providers in a community setting affiliated with a large academic hospital system. We have a decent pool of moonlighters and the ability (theoretically) to pull providers from other hospitals in times of staffing shortages. Our maternity benefit is the same system wide, 10 weeks paid.

    I had planned to work up until my due date and take 12 weeks paid at my base rate, 10 weeks maternity and 2 weeks of my PTO. Subsequently, I've been asked to stop working 2 weeks prior to my due date (because having people on backup is unfair to the group) and told I need to work extra overnights and weekends to make up for the shifts people will cover for me while I'm on leave.

    The director is unwilling to ask if any moonlighters (who are paid at the same rate as full timers, so no extra cost using them) are willing to pick up some of these undesirable shifts or to consider any incentive-based pay to help encourage anyone to take some of these undesirable shifts. I feel that this puts me in a terrible position, since I feel that the load could be easily offloaded to moonlighters or those who want to earn some extra money if the rest of the group really doesn't want to cover me out of good will/camaraderie.

    I really don't want to be doubling my overnight load in my third trimester (current schedule has me going from three to six overnights in a month) and also don't want to give up 2 weeks (or more!) of my maternity leave waiting for a baby to come if I am capable of working (HR counts maternity leave as the day you go out, not the day you deliver). On the other hand, I do want to be sensitive to the fact that others will have to work more while I'm out (although I've been in the group several years and done loads of extra shifts to cover emergencies, vacations, illness without expecting payback).

    I guess what I'm trying to figure out is how other groups handle maternity leave, how much is fair to ask of my colleagues (many of whom look at my "vacation" as a "burden" on the group), and where I should compromise to be a team player. I'm not really interested in the legal aspects of this, I know there are technically discrimination laws that are relevant here, but don't want to threaten my director or cause ill will. I really just want to know how other physicians have navigated their maternity or paternity leave and to gain a sense of what are some reasonable expectations I should have for my own leave. Many thanks in advance!

  • #2
    I also work in smaller EDs affiliated with a larger academic system.  Maternity leave for us is up to 12 weeks off, with short term disability kicking in after the elimination period.

    A physician taking 12 weeks of leave (or any approved leave) is not required to make up any “undesirable shifts”.  They get plugged back into an equal number of weekends and nights when they return.

    Best of luck!!


    • #3
      I took 6 weeks, but all was PTO. If I wanted anything beyond that, it would have been unpaid. You get 10 weeks of paid leave, without it counting towards your PTO? That’s awesome, but maybe in other types of settings, that’s the norm, so I don’t have a good comparison view. What have others done with regards to this? You can’t be the only person in the group to ever get pregnant. I would imagine the group has a policy in how they handle this. If others have had similar requirements, then if I were in your shoes I would do them, given the generous overall leave policy. If these requirements are unique to you, and have not applied to people in the past, then I would have a sit down with the chair.


      • #4
        I got attacked on this forum awhile ago for thinking that my academic peds department was way behind in offering almost no paternity leave. They considered it selfish and a burden to others because dads don’t need time off.

        I’m in a peds EM group that’s mostly women — almost ALL of which have had babies as faculty. If they have to stop working earlier than planned then people cover the shifts.

        If they want you to be off the schedule 2 weeks early then maybe you just don’t get paid for it but no reason to work extra to cover it. We routinely drop the women off a couple weeks before the due date but I think our boss just pays them anyway — but idk if they get 12 weeks paid or not. Your 10 weeks paid sounds better than most healthcare places.

        Take what you deserve get and f*** the naysayers. Push back.
        An alt-brown look at medicine, money, faith, & family


        • #5
          Thanks, I know 10 weeks paid is pretty good, this doesn't come from my group, but rather our hospital system and was recently increased from 8 wks which I think is part of the problem. There is no formal policy beyond the 10 weeks paid leave and my contracted PTO (5 wks/yr). Expectations regarding length of maternity leave and "making up" undesirable shifts seem to vary considerably with each physician who has taken maternity leave. The last doc who went out on maternity leave was let go 10 days after returning. The doc before that was asked/told 2 weeks into her maternity leave to return 4 weeks early from her agreed upon maternity leave. So, not a good track record and while another (probably a few) discussions with my director are in order, I definitely feel the need to tread lightly. The group is generally very supportive, but not so on pregnancy/maternity issues which was surprising and disappointing to me. I feel that I need to be very careful about pushing back too hard and think knowing what the "norm" is would be helpful in those conversations.


          • #6
            Is this your first baby? If so I think it's ridiculous for them to require you to stop working two weeks early because it's really unlikely you will deliver early. I have had two babies and both times I worked it out with my OB to be induced on my due date. There was no way I'd take any time off without having that baby in my arms because I wanted every.single.second possible with my kids! And at the same time I didn't want to inconvenience patients by going into labor if they had scheduled appointments. So I'd push back on that piece, for sure. While keeping in mind the first lesson of Parenthood is you have no freaking control over anything and the baby will come whenever it gosh darn pleases ;-)

            As to the part about"making up" undesirable shifts . . . I think it's a load of crap. When you take actual vacation, do you have to make up the evening and weekend shifts? I'm not quite sure how it works in the ED. But really, you've always been a team player so I think others should return the favor and just give you the time off that you are legally entitled to and not make you jump through a bunch of hoops to do so. I'm sure many on the forum will disagree but it sounds like you're an employed doc and you should be able to take the leave that is a part of your benefits package without any caveats or undue burden on yourself.

            I'm an employed outpatient doc so I took my 12 weeks and everyone was really supportive and helpful in covering patients and I didn't have to deal with any nonsense.

            Good luck sorting this out and I wish you luck in the rest of your pregnancy!


            • #7
              I think you're in a tough position and your group, even if you like them, is actually quite discriminatory towards women who have children. I know it's too late now but I would not rock the boat currently and look on the bright side of what you are getting, but if you plan to have more children, I'd seriously consider leaving.

              10 weeks paid leave is very nice, and that's great they offer it. But the actual social support you get seems terrible. My wife (academic physician) worked all the way up to her due date with our 3 kids, no problem. We recently had the third. Before we went on leave my wife was told by an admin that she'd need to "make up" call (which she does from home every now and then) that she'd be missing while she's out for 12 weeks. She laughed at them and said no. That's because that's actually discrimination. I get that people need to work as a team, but she was right, and it's absolutely wrong for your group to force you to "make up" work that you'll be missing. You are being punished for giving birth.

              It's a huge red flag for me that a prior woman in your group was let go two weeks after coming back from leave. That sounds like grounds for a lawsuit, especially if it was within 12 weeks of her giving per, per fmla law.Whatever you do also get it in writing. Also, very not cool telling someone to return early from their leave once they've started. I'm sure that colleague of yours had to really figure out emergency childcare because she planned to be with her baby longer than what actually happened.

              I would try to be nice but asking you to work as much as they're asking in your third trimester sounds very, very not nice and discriminatory


              • #8
                we've not had women make up call for maternity leave, but the discussion of whether men should make up call for paternity leave was a very heated one.

                we don't have people schedule time off before delivery but the last three we got burned on when they had bedrest prescribed by their physician.  we just deal with it.  but if you are asking me whether I think about it when making up the schedule, I absolutely do.  we don't have a formal backup system, so it's always a pain.  but no more a pain than any other unexpected leave.



                • #9
                  when I went on maternity leave, I was out on short term disability for 4 weeks prior to the birth (twins, I was enormous, and I have joint hypermobility so it was not feasible to keep working between the instability and my size). after birth I had 6 weeks paid short term disability, followed by accumulated sick leave and PTO, ended up taking 13 weeks post-birth. I was paid the entire time. I had slightly fewer calls that year (normal was 8-9 weeks and I had 7 I think). However, I live in a more progressive state and work for a large hospital system. We had a locums to cover while I was out.

                  next time I am probably going to schedule patients up to about 38 weeks, and depending on how much accumulated sick/ vacation leave I can scrounge up I may take a little longer post-birth. I'm allowed to take 12 weeks after the disability period is over based on my state's law.

                  making up call doesn't make a whole lot of sense to me. nor does forcing you to cover more nights when you are at term. your legal protection may not be that great if you are considered employed by a 10 person group and not the hospital itself, as I think most places only require maternity leave policies for companies more than 50 employees.



                  • #10
                    The "norm" should be following the law of FMLA, assuming you work in a place where this law applies, which should include any reasonably sized medical system. Now whether that's paid or not is a different discussion--and will vary from workplace to workplace.

                    It does sound like there have been some very inconsistent practices at your workplace which is not good for anyone, and will eventually come to a head for your director if/when this affects someone who IS interested in the legal aspects. Demonstrating the need for a consistent clear policy is not threatening your director or causing ill will, IMO it is doing him or her a favor. These things don't improve without people bringing them up and moving them along. I'm sorry you are having to deal with this.


                    • #11
                      Our group of 23 ER docs requests (but does not require) going on leave 2 weeks before due date to avoid a mad scramble in shift coverage for an unexpected delivery. There is a 15k payment and up to 6 months off (obviously more time off equals more “unpaid” time). This is the same for men and women. No extra dues in terms of night or weekend coverage just enter the schedule back when you are planning. Your situation sounds both more generous and with more strings attached.


                      • #12
                        I'm obgyn. It is illegal for your employer to force you to stop working when you have no medical contraindication. If necessary, get a note from your OB stating it is safe for you to continue working up until labor or unless complications develop. I know it's inconvenient for them, but you do have a legal leg to stand on here.

                        Or, negotiate. If they are willing to pay you for those 2 weeks before delivery in addition to your standard paid maternity leave, then let them!


                        • #13
                          Is your employer the small ED group or the large hospital system? Because FMLA would only apply to one of them unfortunately.  If it's the large hospital system use FMLA to your advantage.  If its just the small ED group, FMLA may not apply (you can google the us gov fmla website for details). Before you approach your employer, you should figure this out.  Also some states (i.e- NJ) offer similar type protections for medical leaves.


                          • #14
                            Has anyone been asked to make up call after spine surgery or a hip replacement?  Increasing your call in the third trimester.  really?  I would look for a new job before baby 2.


                            • #15
                              Wow. I live in CA so we can take 4 weeks prior to due date and 12 weeks after birth as disability. I am not ED and work in a large group but certainly the people I know that do hospital/ call work tend to pick up extra shifts so they can take 5-6 months paid here, which would certainly be harder in a small group! Asking you to make up undesirable shifts in your third trimester is astounding to me and completely unacceptable. Frankly I would say no. If there are other men or women in your group that you could go to the director with to form a consistent policy for all leaves that may be helpful.