Moms in Medicine: Dismantling Cultural Norms and Fighting Maternal Discrimination
“My mom’s a doctor and she takes babies out of tummies!”
Dr. Erica Montes is an OBGYN whose three sons (8, 6 and 3) are so proud to have a doctor as a mamá, always sharing with others what she does. “They know they have to be quiet when I'm on a call and when I have to leave in the middle of the night [for a delivery], they like to ask me questions the next morning.” Dr. Montes had all three of her sons after residency and says her working has made them both independent and self-reliant.
Being a mom and physician, and consequently having to balance and juggle so many roles, has also helped Dr. Montes in realizing what is truly important in life. “I have to make sure what I'm doing is going to benefit me and my family and my patients.” However, that doesn’t mean it’s always so easy to do so much. “You want to be a good mom and a good doctor. You want to be everything to everyone. Some days, you don’t feel like a good mom; some days, you don’t feel like a good doctor. But you just have to give it your best.”
Dr. Montes’ advice for moms and future moms in medicine involves joining a specialty or job that has a good work-life balance. It also includes having help from people you trust. “[This support] makes a world of difference because at work, you can focus on being a doctor, and at home, you can focus on being a mom.” Throughout my interviews with moms in medicine, this theme of support became abundantly clear as crucial to being both a mom and a healthcare student or professional.
This was also the advice of Martha Carmella, a physician associate (PA), athletic trainer, business owner and mother. Martha has three children - a stepson (18) and two children of her own (10 and 7) - and entered medicine when her kids were very young. Martha was commuting two hours to school and made the decision her second year of PA school to move to campus by herself while her husband took care of their children. Monday through Friday, she was a student. On the weekends, she spent time with her kids. “Even when I was with my kids on the weekends, school was still in the back of my mind.”
Martha describes her experience in PA school as incredibly stressful and brutal, accompanied by lots of mom guilt, but she stressed the importance of a support system that consists of people willing to go on the journey with you. “Some might not understand the sacrifice you’re making because they’re not in medicine, but find people who will support you throughout the entire process.”
I asked Martha how she balanced being a mom, a PA, and a business owner. “When people ask me ‘How do you do it?’ I often say ‘I don’t know’ but each aspect comes back to drive and determination.” Moreover, being in medicine, being a mom, being involved in fitness and business all require a mindset that emphasizes discipline, structure, and goals. You believe in the ability to do anything you set your mind to and just figure it out as you go. As Martha put it best “If you’re a mom, you can do anything.”
Martha with her family.
But what if your own supervisors and coworkers don’t want you to do it all? Dr. Racquel Carranza is a mom to two kids (5 and 2), having her eldest during her fourth year of medical school, and her second during her third year of residency. Dr. Carranza describes her experience of being a mom and physician as an overall positive experience. “Having children grounds you and there are very few things that give you deep worth like being a mom. I knew that my life had value outside of medicine and the best part of me was waiting for me at home.” However, she also describes the experience as one crippled by repeated trauma. Dr. Carranza spoke of attachment anxiety and work often severing the ability for you to be there for your kids when they need you the most. Additionally, when Dr. Carranza suffered a miscarriage during her intern year, she wasn’t awarded the time to process what had happened mentally or physically.
Worst of all, Dr. Carranza experienced abuse from administrators. During residency, she met with a medical director who said “I don’t believe women doctors with kids are as good as women doctors without kids.” He also offered her a lawyer to divorce her husband and no longer have custody of her children. Dr. Carranza is not the only physician to experience maternal discrimination with about 80% of women physicians whom are or will become mothers reporting maternal discrimination based specifically on their motherhood status. Despite people gaslighting her experiences and even peers questioning why she won’t just “let things go,” Dr. Carranza was inspired to start a study about maternal discrimination (maternaldiscrimination.com). She wants to make improving the experience of being a mom in medicine her life’s work. She also encourages those contemplating having children to be prepared for constant change with the added advice that “there’s no good time or bad time to have children.”
Dr. Carranza with her kids.
For first-year medical student, Karina Hernandez, it was not a matter of when to become a mom, but if she would be able to. Karina was accepted to medical school in the Class of 2019 but delayed her academic career to have children. After suffering a miscarriage right after undergrad, it took a while for her and her husband to be able to have children. She had a procedure done but doctors advised her to not do anything stressful, like attending medical school, in hopes of becoming pregnant. Finally, Karina and her husband won a fertility grant and became pregnant during their first round of IVF.
Thus, Karina waited to start medical school until this past year and her daughter is now two and half years old. Being a mom and a student has allowed Karina to improve her time management skills and use her time wisely, as she must study while her daughter is sleeping or busy.
Before Karina was both a mom and medical student, many discouraged her from trying to do both. They told her “you have to pick between school or being a mom.” Even other moms warned her, “You can’t do both.” But Karina is proof you can do both. She says other students in her medical school have kids as well and wants to encourage future moms that “you can do both and you can do both well! You just have to believe in yourself and push through.”
Karina and her daughter.
Janet Roa, a registered nurse (RN), is also not a stranger to having children while being in school. Janet was an RN student when she gave birth to her daughter, who will be three years old in June. She actually decided to work as a Labor and Delivery RN after giving birth at the very hospital where she now works.
But being both a student and a new mom was difficult. Sometimes Janet would only sleep 2-3 hours because she had to take care of her daughter and prepare for tests and do homework. And the busyness did not stop when Janet officially became an RN. “Sometimes I have a 12-hour shift and then I get home and my daughter wants to play and I’m so tired.” But Janet has surprised herself. “I didn’t know I was capable, but my mindset was ‘I really want this.’ I look back and I'm like ‘Wow, I’m here. I did that!’”
Janet encourages other moms or future moms in medicine to remind themselves the reason they’re going into medicine. “Check back in with that reason. My reason was my daughter. I want to be a role model for her.” Another reason Janet pushes herself is her community. Few healthcare workers at her hospital, and in medicine in general, speak Spanish. She wants to eventually pursue a masters or doctorate as a nurse practitioner in women’s health because she knows the impact she can make as a Spanish-speaker.
Janet and her daughter.
Dr. Veronica Contreras, family medicine doctor and mom to three (17, 16, and 13) also wants to make an impact in her community. Mentorship is a huge part of her experience as a physician and she wants to share her story in hopes of helping others. Dr. Contreras had two of her children in medical school, and one during residency. Thankfully, she had the help of her family while balancing being a mom and a student, allowing her to not be worried when she was at school or in rotations.
However, having sacrificed so much during her academic and medical career, Dr. Contreras emphasizes that family comes first for her. “My family and kids come first before anything. Medicine often teaches us to give so much of ourselves to our patients and our careers. But ultimately, who is there for you at the end of the day? Your family.” Having children in medical school and residency, Dr. Contreras no longer wants to miss out on her kids’ events as she knows there will be a time when she is no longer a physician, but she’ll always be a mom.
When I asked Dr. Contreras about balancing being a mom and doctor, her response involved prioritizing what is most urgent at the time. “Plan things out. Sometimes you just have to go with the flow. It’s not always ideal, but you can get to the same endpoint.” She also mentioned that there is never a perfect time to have kids. “If you want to have kids, just do it. Things will always work out in the end.”
Dr. Contreras with her family.
Sandra Garcia is another mom in medicine with a positive attitude toward doing it all while being a mom. Sandra currently works as a vascular surgery RN and is expected to graduate from NP school next summer. She is also a self-proclaimed “advocate of self-care and living your best life.” Her daughter is one and half years old, and despite being an unexpected, pandemic baby, has brought a ton of structure into Sandra's life. “Having my daughter has helped me keep focus on my personal goals.”
Sandra was born in Chicago but grew up in Jalisco, Mexico. Since she was an American citizen, her parents encouraged her to return to the U.S. to pursue a career. This was a difficult experience for Sandra both in coming to a new country and being a first-generation college student; but the experience of becoming a nurse without any guidance has also resulted in her being inspired by herself. Now she’s a first-time mom and learning how to set boundaries between being a healthcare employee in a demanding industry, being a wife, and being a mother. She likes to wake up before her daughter and husband to work out, meal prep, and do things for herself. “Prioritize yourself,” she says. “You can’t hit the ground running while you’re burnout.”
Although she dedicated the first year of her daughter’s life to raising her, she is now back to working full time. She encourages working moms to not be afraid to ask for help and support, which can mean picking a great spouse and having to dismantle cultural norms. As a Latina married to a Latino, Sandra has also had to educate her husband and help him understand that he needs to be a team player. Just because she’s the mom does not mean it's her sole responsibility to take care of their child.
Christy Ruiz, PA student and mother to three boys (11, 7, and 2 months) is all too familiar with tackling cultural perspectives and stigma. Christy had her two eldest sons before PA school and her two month old as a PA student. Some weeks as a student are busier than others for Christy and her sons as she completes different rotations. However, she keeps her eyes on the end goal and encourages moms to keep their kids focused on the goal as well. “I include my kids in on the goal and keep them in the conversation. Every year they understand more of what I’m doing.”
Christy also encourages moms to know who their support system is because you cannot do it all by yourself. “Even if you think you are doing it all by yourself, you’re not.” She wants to motivate others to use all available resources, like Medicaid, WIC, food stamps, and scholarships, as she is aware of the stigma surrounding using public system programs and little awareness about such programs in the Latinx community. “You have to be willing to ask for help and swallow your pride. Don’t be afraid to ask for help before you need it.”
Christy is working to break the poverty cycle within her own family while setting an example for herself and her kids. “It’s very hard as a mom [in a Latinx family] to justify going to school and following your dreams. You’re labeled as selfish and self-centered.” Christy has realized that it’s sometimes necessary to shut out negative family members and their conceptions for the future and family you’re trying to build. She also reminds moms and future moms in medicine that it’s okay to take breaks in your medical journey too. “Remember that taking a break is not the same as quitting and sometimes we need to. It’s all about finding the balance of working for our goals but also knowing when we may be giving too much of ourselves to others and need a break.”
Christy with her family.