Prior to going off on maternity leave it wasn’t really a question of if I’d return to medicine, just when and how much I’d work, as I’d always knew that I’d be returning to work after having a baby. I’d spent the past 10 years getting to where I was in my career, a GP trainee and I needed to make it through another 9.5 months (part time) to finally complete my training and become a fully qualified GP. Although there are downsides to my job, I do really enjoy working as a doctor – it’s challenging, rewarding and I can’t imagine doing anything else. With Evelyn, I was fortunate enough to have 11 months maternity leave – I finished work at 35 weeks pregnant (3 weeks before Evelyn was born) and I returned to work when Evelyn was just over 10 months old. I knew that it would be hard returning to work after having a baby, but it has been a lot harder than I expected and actually having a child made me reassess my life and what I want from it.

Maternity leave was such a special and precious time which I really appreciate, even more now being back in work. Though maternity leave wasn’t always easy. At times it was exhausting, relentless, demanding and lonely. And for all the amazing things that I gained becoming a mother, I also felt that I sacrificed parts of me. It took me quite a while to admit it, but I think that I needed to return to work in order to regain those parts of me again. I felt a lot of internal conflict because of this, a real head vs heart dilemma. I wanted to return to work, to take back some of my independence and my old identity, but I’d lost my confidence in my previous abilities. I didn’t want to leave Evelyn, I feared that I would miss out and I doubted if I could ‘do it all’. Leaving my precious baby in order to return to work was heart breaking, and I expect its difficult for any mum no matter how old their baby is or what type of work you do. There were times when I seriously doubted whether being a working mum was the right decision for me, and on bad days those doubts come back. I’ve found figuring out how to make the new ‘mum me’ fit into my old working life challenging, and juggling it all whilst battling the inevitable mum guilt has been physically and emotionally draining.

Life as a doctor, and even more so life as a doctor mum, is all about the work/life balance. Being able to leave your work at work is not always easy in medicine but is essential in order to preserve your own sense of perspective, wellbeing and sanity. Over the past 9 months at times my work/life balance has not always been where I’ve wanted it to be. I think that I’m probably not alone in feeling the pressure to be perfect all the time, in every aspect of your life – a professional, a parent, a person. Which is obviously unrealistic, but the mentality of ‘trying to do it all’ is hard to shake. It’s taken me over 4 months to actually finish writing anymore than that for this blog, which just goes to show that I haven’t quite got this work life balance thing figured out.But with time, a few adjustments and a few things learned, the balance is now a bit better, albeit a constant juggling act. So I decided to right this blog about the reality of being a working mum. But this blog isn’t here to say that being a working mum is any harder than being a full time mum. Work can actually be a break, especially from those toddler tantrums. Nor say that my work as a GP trainee makes it harder than other careers, I’m lucky not to have to travel away for work nor regularly give up my weekends. Although it’s easy to feel like the grass is greener on the other side, sometimes you don’t get to see the whole picture and the struggles that the other mum goes through. And every mother’s situation is different and her reasons for her choice takes into account whats best for her, her baby and her family, plus what her finances/childcare/time/careers allow her to do. But at the end of the day, I do feel that although we don’t all have to love our job, there should be enough reasons to justify the sacrifices that you go through as a working mother.

Separation anxiety

For the first few months of maternity leave I was able to completely switch off from work. Being a new mum learning the ropes consumed all of my time, thoughts and energy. The fact that I didn’t feel able to visit work to show everyone Evelyn until she was 4.5 months demonstrates how long that I was in ‘the bubble’ for. The chaos of motherhood took over. I didn’t have chance to think about my old working life. However from when Evelyn was around 6 months old I started to get nervous about returning to work and started to dread my maternity leave ending. I had no idea how I was going to combine the old pre-baby working me with the new mum me. Looking back I spent way too much time worrying about the future, I wish I’d just enjoyed it more whilst it lasted, but everything is always easier said in retrospect.

Prior to returning to work, I hadn’t left Evelyn very much at all as I found it really hard being away from her for any length of time. I think that it was the post partum anxieties that I struggled with that made the separation so difficult. It took until Evelyn was 7 weeks old for me to leave her for just a few hours with someone other than her dad Rob. And when I say left her, she was actually just downstairs with my parents whilst I went upstairs to sleep for a few hours. It’s pretty pathetic looking back now but I even got tearful saying ‘goodbye’ to Evelyn. I went on to only occasionally leave Evelyn with family for a couple of hours and so that she wouldn’t notice that I was gone and to avoid issues feeding her, as she always refused the bottle, I would usually arrange the babysitting for when she slept for her lunch nap. This time would be so that I could run errands or maybe even just do something for myself. On that note, date nights weren’t that frequent either, it took us until 12 weeks for Rob and I to have our first evening ‘off’ together when we went to a friend’s 30th birthday party. We had 3 weddings when Evelyn was under 6 months old and took her to all of them, but by the 4th wedding we needed a break (as they were pretty challenging!) and it wasn’t until then when Evelyn was 7.5 months old that I felt able to leave her for whole day. The first night that I spent away from Evelyn wasn’t until she was 8.5 months old, an overnight break to London. This was a last minute decision of which I’m sure that if this trip was planned in advance I would have pulled out! Although I didn’t feel completely ready to leave her overnight, emotionally or physically (as I was still breastfeeding her at night so needed to express) it was still a welcomed much needed break. I think that it did both Evelyn and me good to have a bit of space. As a mum friend told me, sometimes it’s good to have some time apart so that both you and your baby appreciate each other more. Note despite being apart for 28 hours when we were in London, Evelyn didn’t take a drop of bottled milk from my parents, therefore highlighting how much she protests when I’m gone! Other than a couple of creche sessions whilst we were on holiday in Ibiza, nursery would be the first time that we were leaving Evelyn without family/friends.

I really take my hat off to the mums who manage to return to work when their babies are much younger, juggling weaning and ongoing the sleepless nights whilst they are in work. Fortunately Evelyn was well established on food and had been sleeping through the night for 3 weeks before I went back to work, though of course we hit several bumps in the food/sleep road when I was back in work. Although I’m so lucky to have had such a long time off for Maternity leave, I did still wish that I’d had more time. However, I needed to return to work at that specific time for several reasons – financially (all maternity pay ending) and educationally for my GP training (time to ‘get back up to speed’ with medicine and then to revise for a looming GP exam). It would have been nice though to have had more time on maternity leave whilst I was getting a full nights sleep. Maybe then I would have actually had the energy to exercise and lose the last bit of baby weight! At 10 months old, to me Evelyn still felt too young and small to leave her, especially for 2 x 10.5 hour days in nursery. She was still my little baby, dependent on me, especially because of the breastfeeding.

‘Thank you my gorgeous girl, you and I have had a blast,
But this past 10 months have gone by much too fast.
The highs, the lows and everything in between,
I’ll cherish every moment, its been better than a dream.
As Mummy goes back to work, we’ll now be apart,
Don’t worry you’ll have lots of fun and make friends, this is only the start.
The days may be long but you’ll be ok,
As mummy will always be there for you at the end of the day.”

I wrote that poem the night before I returned to work from maternity leave with Evelyn. Now over 9 months down the line it still brings a tear to my eye. To say that the reality of returning to work was daunting is an understatement to say the least. That evening whilst I wrote the poem I had a heavy heart, I dreaded it. On her first day in nursery I came up with any excuse to keep her at home longer, like wanting to give her breakfast at home despite all her meals being included. I was just clinging on to her to be honest and Rob persuaded me to let go. It broke my heart saying good bye to Evelyn on that first morning at nursery, I cried before I’d even handed her over (Evelyn was fine by the way!). In leaving Evelyn I felt as though I was leaving a huge part of myself behind. I was full of sadness, guilt and fear. I would not be there for her and would miss out. Sadly I missed one of her biggest milestones because I was in work – her first steps. Although I found this upsetting I took comfort that her first steps were with Rob. I have come to terms with the fact that regardless of whether I am in work or not, there is always the chance that I may miss something that she does. I guess that’s part of being a parent, letting your child have their own independence from you. A friend of mine, who is also a working doctor mum, was very supportive in those early days of me being back in work. She told me how she had 100 reasons as to why being a working mum was a good thing and if I needed to know them all she would continue to tell me a different reason each day. She only actually needed to for a few days, but I took great comfort in remembering the ‘bigger picture’ because at times it was as small and as simple as “I just don’t want to leave my baby”.

Practicalities of returning to work

Childcare

I hadn’t realised how early we needed to find a nursery and book Evelyn a place. Fortunately we have an amazing nursery with a great reputation local to us so deciding on that one was easy. But we were recommended to book her a place as soon as possible before I planned on returning to work, so we enrolled her when she was only 5.5 months old, 4 months before I planned on returning to work. I returned working 3 days a week and we put Evelyn in nursery for 2 of those days. On the third day Evelyn is with Rob, however for the first 2 months my mum and Rob’s parents took it in turns to look after Evelyn on this day each week. Organising temporary family childcare cover wasn’t as straight forward as it sounded as you need to take into consideration the fact that my work and their homes were in different directions, our houses were some distance apart and the traffic at rush hour is terrible, definitely wouldn’t want Evelyn to be sat in the car in traffic with you for 1 hour! Now that Rob has a day off each week he is really enjoying having this day with Evelyn. He feels that it is allowing him to develop his own personal bond with Evelyn whilst appreciating the challenges of looking after a toddler by yourself all day!

In order to get Evelyn used to nursery and prepare both her and me for the separation, she had a number of ‘settling in’ sessions for the month prior to me returning to work. She visited the nursery by herself twice a week starting with 30 mins visits, then an hour and then 2 hours. As part of the settling in, it was suggested that she try having a meal and a nap there to see how she got on. Evelyn was happy enough having a little food there, but I personally chose not to attempt a nap during a settling in session as I was very skeptical as to whether she would actually nap or just resist sleep the whole time. I thought it would be best to just wait until her first full day in nursery when I had my first day back in work, I thought that surely in a 10.5 hour day of 7:30-6 she would have to nap! Fortunately she did! This 10.5 hour day was quite a big jump for both of us, but I do think that Evelyn definitely coped better than she would of if she hadn’t of had any settling in sessions. On the whole Evelyn has adapted to nursery really well. She rarely cries when we hand her over and other than the initial cold shoulder that she gave us for leaving her, she is now happy to see us when we pick her up.

Working hours

I had to establish my working hours and clinic times to make sure that they allowed for me to do the nursery drop off and pick up. Although Rob and I decided before hand to alternate the nursery drop off, so that we could take it in turns, generally I do the nursery pick ups. My working hours needed to factor in time spent in traffic (which frustratingly became longer due to long periods of road works), doing admin/paperwork accumulated from the day and time to allow for me inevitably running and finishing late in clinic. I had to revise my working hours after a few months as I was struggling to fit it all in in time to leave to pick up Evelyn. Nevertheless, often I’m still getting there with 2 minuets to spare before nursery closes.

Continuing to breastfeed

A lot of mums reduce/stop breastfeeding when they return to work. It may be because it feels like a natural time to stop, but also because it’s difficult to keep it going with a job. Prior to having Evelyn I would have counted myself lucky to have breastfed her for any length of time. My initial goal was 6 months, but by 10 months feeding was still going well and I didn’t feel like we needed to stop. She was only breastfeeding 3 times a day (first thing in the morning, straight after her lunch nap and just before bed) without any night feeds. As babies ideally should have breastmilk/formula until they are at least 1 year old, and Evelyn still doesn’t accept the bottle I decided to continue breastfeeding her after 10 months of age as I returned to work. I breastfeed Evelyn on waking and before bed when I was in work and on the days that I was off I would add the afternoon breastfeed back in. I chose not to express during work both for practical reasons and because the breastmilk would probably end up just being thrown away anyway. Nursery does try to give her cow’s milk in a cup in nursery but she is yet to take anymore than a sip.

It’s important to say to remember that work should support you if you wish to continue breastfeeding on your return to work i.e. flexible working hours and room/time to pump or feed during working hours. There are many benefits to continuing to breastfeed on returning to work such as fewer absences from the workplace due to breastfed babies being sick less often and greater staff retention. There is also a long-term public health impact of continued breastfeeding and workplaces should be encouraging women to breastfeed. This leaflet is a good guide on accommodating breastfeeding in the work place.

Training in medicine

I returned to work as a less than full time GP trainee. I do the same as a full time trainee just over a longer period of time, i.e. what a full time trainee does in 3 weeks, I do in 5 weeks. My normal working week is shortened to 3 days with the additional mandatory GP Out of hours shifts on top. We also have a training portfolio, which nowadays gets done late into the evening after a long day of looking after Evelyn.

In addition to work based training we have to complete two exams before we qualify as GPs. I had fortunately done the one exam before having Evelyn, but needed to do the other, a simulated GP surgery style exam in London, afterwards. Revising when you have a young child is definitely something that I’d hoped to avoid. I never thought that I’d actually miss the previous flexibility and opportunities that I had to revise (and complete any work outside of work) that I used to have before having a child. Theres next to no chance of doing any work/revision when I’m looking after Evelyn so fitting that in would usually always be once she napped or had gone to bed and we’d eaten. Pulling out the books and revising at 8/9pm for an hour or so for 3 months running up to my exam was a hard slog. I had to be careful not to burn out and be kind to myself. Saying no to people was important, something which I often struggle to do. I’m so lucky that Rob, also being a GP, was able and willing to revise with me pretty much every evening for those 3 months. Together we practiced over 200 scenarios and I know that I wouldn’t have passed my exam if it wasn’t for him!

The working day

After over 9 months of being a working mum the biggest thing that I’ve learnt is the importance of being organised and efficient with my time. Time just seems to gets more and more precious as time goes on. I know that we’re all busy, that’s not surprising nor new, life before a baby was busy, then life with a baby felt busier, but incorporating work into being a mum really has been a military operation. And I expect that if we have another child, life as a working mum will become even more challenging! The analogy of spinning multiple plates sums it up pretty well. On my days in work, there physically doesn’t seem to be enough hours in the day to do everything and I often feel like I genuinely don’t stop all day from 6am to 9pm. Before I’ve even got to work, the whole process takes me almost 2 and a half hours, which seems crazy but after sorting both Evelyn and myself out, doing the nursery drop off and then the travelling time to work, I really can’t get the morning routine any shorter. Previously I always used to get up as late as possible as it’s all about those extra minuets in bed in the morning. I got the morning routine down to 30 minuets, just enough time to shower and get ready for work (even less if I was fitting in a pre-work gym session), make a quick nespresso coffee and grab my overnight oats to drink during the drive in! Nowadays it takes 1hr 30mins to leave the house. I quickly realised that its a bad idea getting ready whilst Evelyn is already up, so as long as she’s still asleep, I try and get up 30mins before her so that I can shower and get ready first. I always factor an hour for sorting out Evelyn as I’ve found that I should always allow an extra 15 mins than it should take as you never know what they’ll throw your way! I breastfeed Evelyn as soon as she wakes up (changing her first usually ends in a meltdown) which does take some time (15-20mins usually). I found that trying to squeeze in a pre-work gym session whilst continuing to breastfeed in the mornings too challenging and as a result the gym has been sacrificed. However my plan is to not breastfeed Evelyn 2 mornings a week so that I can reintroduce the gym and so help maintain my mental wellbeing and manage my chronic back pain from my scoliosis.

Because I am restricted by the times of nursery drop off and pick up, condensing what could be a 10.5 hour working day in general practice into a 8.5 hour day has taken some focus and organising. In medicine most doctors don’t have a scheduled ‘break’, and although in general practice there is usually a 2 hour ‘break’ between morning and afternoon clinics, this is easily completely filled up with admin (bloods, referrals, documents, telephone calls, jobs), house-call(s) and potentially a practice meeting or educational session. The day is pretty constant. Nowadays the drive to and from work might be the only alone time that I have to ‘switch off’ and think (although when I was revising for my exam driving time was used for listening to revision pod casts so that I could make the most of every minute of the day!). The drive is when the mum shift ‘ends’ the profession work shift begins and vice versa. Although the ‘mum shift’ never ends. No matter how busy or far away you are in work, they are always at the back of your mind and you are always ‘on call’ in case of problems. I struggled with my anxieties of leaving Evelyn especially in those early weeks, I found the ‘Xplor’ app that our nursery uses to share information (sleep/feeding/changing) and photos of Evelyn doing activities with us invaluable. I was nervous as to how she would sleep and eat during nursery so it was good to know how she was actually doing real time as opposed to nervously waiting until the end of the day when I picked her up. It was also useful to know if I needed to put her down to bed earlier to compensate for the lack of sleep or give her an extra milk feed or snack before bed. In the first couple of months she definitely ate and slept less than she would have at home so by the time I would pick her up she would be grumpy, overtired and wanting to breastfeed. Even waiting to get in and for me to change into a nursing bra was too long for her to wait. I often skipped the bath on nursery days as she’d end up falling asleep breastfeeding.

Although Evelyn was ‘sleeping through’ for 3 weeks before I returned to work, a peaceful nights sleep has not been a constant or a given since I’ve been back in work. Between Evelyn’s separation anxiety, sleep regressions and illnesses, a disturbed nights sleep has been a more than a frequent occurrence. And in comparison to the previous relatively ‘quick’ 30 min wakes to feed then going straight back to sleep, nowadays her wakes are for 1.5-2hrs at a time and she just basically screams the whole time until she falls asleep. After one of those nights I definitely end up with a migraine the next day in work due to sleep deprivation!

It’s draining trying to keep each plate spinning (child, family, work, training, housework, cooking, exercise, family, friends, mental wellbeing, other commitments etc). Every now and then I seem to be on top of things, but before I know it, the balance tips and I’ve dropped a plate. A sure fire way to bring several plates crashing down is a disturbed nights sleep! I can feel that I spread myself too thinly and I question whether I’m able to give 100% to whatever I’m doing.

Final note…

I’m proud to say that I’ve now completed my final 9.5 months of GP training and qualified as a GP. For all the challenges that have come with being a working mum, the anxiety, the stress, the guilt, it has been worth it. In being a mum I feel that my work has actually improved, as I can better relate and empathise with other mums. I also now much more appreciate my time with Evelyn. Her smile and hugs can make the worst of days in work better and I feel as though I make the most of my time off with her, and that doesn’t have to be doing lots, just being together and enjoying one another is enough. Although leaving Evelyn is still hard, it does get easier with time, and for now this is our new normal and its working for us. I read a fellow doctor mum quote saying to ‘Remember, you are more than just your career. Not only are you a wife, friend, sister, daughter, you are a person. You are a multifaceted and complex woman. Don’t forget yourself’. This really rang true with me and made me remember that we all need to be kind to ourselves, we are only human and what we do is enough. So to all the mums and working mums out there – You’ve got this momma!