Maternity Leave And Me, Part 1

Published 20/08/2019
Sarah Marsh
Consultant in ICM and Anaesthesia

Dr Sarah Marsh is deputy Chair of the Women in Intensive Care Medicine Sub-Committee and the Education sub-committees of the FICM. She is also course Programme Director for the FICM’s exam preparatory course.

As I write this, the baby is finally sleeping upstairs and I have a small window before setting off for the school and nursery run.  Ah, the peace and quiet.

Writing this blog has been quite a reflective process for me, and the below details the events as I found them which may be of use to someone else out there when considering taking on such a venture! I’ll start by saying that maternity leave is a funny old thing – it is both absolutely wonderful and thoroughly shattering at the same time….

So, this is my third and final maternity leave. Having been appointed as a consultant in 2012, I have gone on to have 3 boys in just under 6 years (making me the worst appointment ever – sorry about that).  Each time I have been struck down with pelvic instability resulting in crutches and an early bath due to immobility. Having literally never been “unwell” in my life this took some getting used to; the mind was willing but the body was not. 

It took me by surprise with the first, and as I’m a stubborn old goat, I doggedly continued to work despite being in a lot of pain and looking like a John Wayne stunt double until 35 weeks when I could walk no more. Number 1 didn’t appear however for another 7 weeks, during which I mostly felt guilty about not being at work and wondered what to do with myself. I was incredibly smug though, about what I thought was to come – I totally had this nailed.  I’d spent most of my adult life being up in the night, I’d seen plenty of deliveries and put in what felt like 8 million epidurals, and I’d looked after sick babies. I thought I had the whole thing sorted – I’d absolutely be able to cope with it all, and definitely still be able to put my make-up on every morning.  The reality (unsurprisingly!) was somewhat different. After a rather sporting “typical medical person” delivery, I was broken, and had no idea how to look after this little scrap that was handed to me. And I was certainly not prepared for the days, weeks and endless months of very little sleep. Plus we moved house when he was 2 weeks old into a “do-er up-er” aka a broken boiler, windy windows, squirrels in the roof type of place. I remember things calming down a bit by the time he was 3 months old, and then hitting the 4-6 month mark (which is feral) and realised that I had no control over anything any longer! However, like with most things, it all passed and before long I was looking at returning to work. As I hadn’t been a consultant for long, I felt that I hadn’t yet established myself and that I needed to “crack on” so to speak by getting back to work ASAP.

Lesson 1 – You are not indispensable. With nursery booked 4 days a week, I returned when my son was 10 months old, and very quickly realised that there was no fire that needed extinguishing immediately and that everything had ticked over just fine regardless of my absence. The NHS chugs along whether you are there or not. Sure, you are an integral little cog, but the machine does not break if you stop turning for a bit. You do however only have that time with your baby once, and for me it was perhaps a bit soon. 

Lesson 2 – That’s not long enough. On my return to work no-one was really sure what the best thing to do with me was, including myself. I therefore agreed to a week of supernumerary lists and some admin time (realistically 3 clinical days) before jumping back in the following week. That’s not long enough!

Lesson 3 – Make sure you write down your username and passwords for everything! You will not remember them 1 year down the line…

However, soon enough I had settled back in with the clinical work and started to develop my non-clinical interests. I enjoyed crafting my skills both in anaesthesia and intensive care medicine as a consultant, and developed important working relationships with those around me. I have a great interest in education and some interesting doors started to open for me too. After 18 months being back at work I became pregnant with number 2. The pelvic disintegration started shortly after, much earlier than with my first. This time I made plans to work around it. I went to see occupational health and discussed my situation with my clinical lead and rota coordinator. I set (what I thought was) realistic timeframes within which to start maternity leave and saved up annual leave so that I could be off for longer prior to D-day.  I didn’t find covering the ICU too bad, as there are short distances to cover between patients and always the opportunity of a chair to rest your weary bones on at each bed space. Anaesthetic provision however was more of a challenge. Trying to cover large distances each morning to see the patients pre-operatively who were dotted around the hospital was difficult and painful (and took me ages). There was the moving and handling – with the best will in the world there aren’t always enough people in the theatre to help, to allow you to sit out and then there’s the trundling to and from recovery.  Heaven help you if you drop something on the floor – some stuff just has to get forgotten about as that is a long way down! 

To help with this I asked to be doubled up as much as the rota could allow. However, inevitably, despite being on crutches again and still hoping to get to 35 weeks, I had to take sick leave for the first time in my life at 30 weeks. It was enforced by a good friend of mine who happened to be the consultant of the day one Friday, when I was trying to manage an all day upper GI list on my own. As I was limping to the coffee room to grab/inhale my lunch she saw the state of me and immediately said “That’s it!! You are going home and I won’t hear another thing about it!!”. I am glad she did that as in some ways I felt like I needed permission to go on sick leave, and for someone to tell me enough was enough. I was furniture walking at home, so why I thought I could manage, I don’t know. In the lead up to the arrival however, I filled my time writing articles, finishing protocols and attending meetings where I could. Ironically, I packed up the non-clinical work on the Sunday, bought 2 novels to read on the Monday and had number 2 on the Tuesday. Oh well. This time my maternity leave was quite different…