Experience of Surgeon - Warrior - Mother During COVID-19 Pandemic

INTRODUCTION

Surgery has conventionally been considered a very male-dominated specialty in spite of the increasing numbers of women who are graduating from medical schools over the years.[¹]

As females, we were advised that if we became a surgeon, we would never have a personal life. We would not have time for children. It became a tug of war between choosing a lifestyle profession versus something we truly loved with all our hearts. In spite of all the warnings, we still chose surgery and spent our whole life navigating that balance. However, emerging of COVID-19 has increased our challenges more as surgeons and mothers.

There is never a good time to have a baby when you are a surgeon. At least it can feel that way. When we are in training, we usually advocate for ourselves to be relieved from night shifts in the third trimester, to limit on-call duties, to protect our maternity leave, and to cope with the change in our professional identity that can result from time away from work. COVID-19 has put further pressure on the existing tensions between professional roles and parental choices. The pandemic's looming unknowns have been worsened by a lack of occupational, research, and governmental efforts to provide answers. In this article, I want to discuss the challenges of a surgeon mother faced during the COVID-19 pandemic through my personal experience.

PERSONAL EXPERIENCE

As a learning and enthusiastic young surgeon, I was working hard and attending long hours of surgeries instead of being pregnant for 3 months. Pregnancy was never an obstacle for work; however, last March 2020, when the first wave of COVID-19 started in India, it brought lots of pressure on me. I can seriously say that my anxiety and fear have doubled and includes anything and everything that could come to a person's mind. I was under intense stress for the first few weeks after the official confirmation of the epidemic in the country. This stress rose as the infection and mortality rates increased. I was afraid of becoming infected during my pregnancy and childbirth. Since the health of a fetus and its mother is inseparable, this fear was mostly for the safety and health of the former.[²]

I gave my best at my work and fulfilled duties toward a patient, but the fear of getting infection and its consequences on my fetus was always there. Working in PPE kit during pregnancy was very difficult and exhausted. COVID-19 cases were at their peak, and I applied for early maternity leave in the 7^th month, but I was denied due to as there were no current studies that suggest COVID-related complications in pregnancy and its effects on the fetus. Hence, I decided to quit my work as it is always better safe than sorry.

It's because no matter how careful I am, I'll still be at exposure at work. I followed every safety measure. No one could leave the house. Everything we required was delivered to our doorstep. Every doorbell required a mandatory interval before being answered. Every package that arrived at home was sanitized. I kept myself in isolation from my family members as well.

“I would anxious whenever I'd hear that a newborn was died due to infection. I didn't want this to happen to me”.

I was worried about the hospitals as cases were rising in my state. Most of hospital converted in Covid hospital. I was worried that my baby or I would get the infection. Hence, I moved to my father's house in another state for delivery, as cases were less there. Unfortunately, cases started rising there as well. This was my first pregnancy. May be that's why I was so worried. With these stresses, how women can be healthy and give birth to a healthy child. I had preterm labor at 34 weeks. It was the middle of the night. My gynecologist was not available. We went to the hospital. I got refusal from the hospital due to nonavailability of a bed. They advised me to get delivery at some other hospital, and the baby could be shifted to their nursery for care. Other two hospitals also refused due to the temporary shutting down of emergency facilities due to COVID pandemic. In the middle of the night, I had wondered in severe pain from hospital to hospital. Being a doctor, I had suffered that much due to nonavailability of non-COVID facilities at the peak of the pandemic. I kept on praying as I felt I would lose my baby. Somehow, my family managed to get a bed. I delivered preterm, low-birth weight baby through emergency cesarean section after suffering from labor pains for 6 h without any medical help. However, when I saw my baby for the first time, I forgot all the pain I went through. It was challenging and emotionally draining at times to manage everything. There has not been any celebration, and we have hardly stepped out of the home. When I think about my last year's experience, I feel I have lived 10–15 years of motherhood in just 1 year. Lactation phase had become challenging during COVID, but I followed all safety measures to protect my child.

DISCUSSION

Doctor mothers from all walks of life attest to their struggles in balancing professional and personal responsibilities. These struggles often complemented by a sense of “mommy guilt” really have intensified amid this pandemic. With the paranoia of transmitting the virus to one's family, the endless guilt of working long hours and missing out on children's activities has multiplied.[³] It is true pandemic is distancing mothers from their children. It is very difficult to protect your child from this as you are the main source who can bring infection to him. Fear is definitely there. I am super conscious and taking all the precautions to keep my baby safe. I have developed new decontamination rituals before leaving the hospital and before entering the home.

Practicing optimal hand hygiene measures can help protect my family's health and everyone else's. I think it is also about staying positive, taking maximum care of the baby, and doing what is needed.

Now, every day has become a new lesson for us as a doctor. The rising number of cases keeps me on my toes all the time. As doctors, we have been trained well to do that. This process is no doubt a traumatic experience for every parent. The need of the hour is to adapt to the “new normal.”

CONCLUSION

1. Government officials worldwide should take action today to shield all pregnant frontline workers from exposure to SARS-CoV-2. We need to respect pregnant women's autonomy to choose whether or not to continue working during the pandemic. We should provide pregnant workers in conventionally public-facing roles with alternative means to contribute, such as teleworking opportunities. When that is not possible, we must ensure pregnant workers, regardless of gestational stage, have the option of a viable temporary off-ramp from professional duties, comprising an early paid maternity leave with stable health-care coverage, and a clear path to career re-entry.
2. Coronavirus pandemic has a significant potential for creating anxiety, adversity, and fear, which has a negative emotional effect on pregnant women. Conditions that have a negative impact on pregnant women include worrying about their own health and their baby's health. Unnecessary paranoia about this pandemic just aggravate pregnancy-related complication, which I have experienced too[⁴]
3. As doctor and mother serving during a time of pandemic, COVID-19 is often a call to conscience. Guided by profession, we choose to serve patients first and address their concerns.