Prenatal Series #4: Working in Healthcare While Expecting

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Working in healthcare can be challenging as it is, but adding the layer of carrying your newest addition to the family can turn your work world on its head. Mental and physical changes start coming left and right, and big decisions need to be made at what feels like the speed of light. You may find yourself reaching out to any family member, friend, or even strangers on Google to help you navigate, and it can feel like everyone has a different opinion about what to do. Sharing some of the details of my experience thus far feels like one of the best things I can do to help my fellow expecting mamas in healthcare! 

Let's Get Physical! - Movement

Fatigue definitely hits in the first trimester, but eating whatever you can stomach and staying hydrated can keep energy levels afloat. If you feel good enough to work out, your workouts don't really need to change much until the second trimester, and working out can give you a little boost of energy during the day while helping you get quality sleep at night. While many of my friends had this fairly straightforward experience, every now and then, a complication can emerge. 

At around the halfway point of pregnancy, I was diagnosed with placenta previa, or a low lying placenta, as an incidental finding on a routine ultrasound; this resulted in physical restrictions from my OB/GYN including no squatting and no high impact exercises, among other components of pelvic rest. With this in mind, I had to change the way I worked as a physical therapist. My demonstrations of squats were kept shallow, plyometrics kept gentle and short in duration, and I delegated the job of changing out the Deer Park water tank of our water cooler to others who could deep squat a heavy load a little more safely. While I would love some updated evidence on the risks of these movements with marginal to partial types of previa, and the average pace of placental migration as the uterus grows for possible earlier knowledge of resolution, the risks of performing these activities against my OB/GYN's recommendations did not outweigh the benefits of simply modifying and eliminating certain movements in order to maintain safety during pregnancy. At the time of writing, I am still on these restrictions, and am awaiting a follow up ultrasound around 30 weeks to check the placenta's position. 

I am definitely listening to my body a lot more and not pushing through workouts anymore, especially as I enter the third trimester. However, I will say that walking has been really accessible for me in that the outdoor spring weather has improved significantly, I'm not having back or hip pain that would limit my gait and I have found walking several times per week to improve my mood/emotional stability as well as energy levels. For those who can't walk as a workout option, low-impact strengthening has been my second favorite thing to do and has helped me to continue to perform my job duties (demo exercises, work on my feet all day every day) while my body undergoes drastic changes.

Of note, SI belts and belly bands have been helpful Amazon purchases for my fellow PT friends, especially those who work in acute care and pediatrics and need extra lumbar support while physically maneuvering their patients. Many have reported improvements in orthopedic pains while at work and while working out or simply performing ADLs at home while wearing such aids.

"Pregnancy Brain" - Memory & Documentation

This was one of the funniest, unexpected, and simultaneously frustrating experiences I've had while working! Around the early second trimester, I noticed that my situational memory was NOT on point; I would get to the end of an hourlong session with a patient and go to print out a handful of exercises and could not remember for the life of me what I had done with the patient the entire time. The sessions were fluid, patients always left feeling great and loving what we did, but I would really struggle to include every piece of education and exercise on a hardcopy. To combat this, I just had to do more multitasking - documenting each activity in the note in real time, as well as loading the exercises and education into our HEP system so that everything was ready to print by the end of each hour; ultimately, this will make me super efficient even when I'm not having "pregnancy brain," but I just couldn't believe how I would "blank out" so hard, and much earlier on in pregnancy than I thought would happen (definitely not reserved to the third trimester)!!

Sharing the News with Bosses, Coworkers and Patients

Everyone is different, but I preferred to hold onto my pregnancy news until it became necessary to share. When I became super sniffly as an early pregnancy symptom, like a light cold that I couldn't shake, I chose to let a close coworker in on my news, reassuring her that I was not contagious *for a particular reason*. With my boss, I had always planned on sharing in a timely manner at some point in the second trimester, but a water leak/small flood in our rehab gym accelerated my decision to share earlier, at around 15 weeks (I needed to ensure a safe working environment, free of mold and did not return to work until the gym was treated and cleared for damp/mold). My coworkers and bosses were all genuinely happy for me and have been ultra accommodating ever since, for which I feel very lucky and grateful. 

As for my patients, I waited until the last possible second before announcing or acknowledging to clients - as big a life change as it is, I just didn’t want it to become the subject of every conversation every hour of every day and I wanted to maintain some privacy on the matter for as long as I could. Every patient was extremely kind and there was nothing to fear; at 26-27 weeks*, it became clear that I was expecting, and patients felt more comfortable asking about it if they were curious. 

*I did not show for a while because this is my first pregnancy, but everyone is, of course, different. A friend of mine working in acute care told me that as she neared 30 weeks, she realized that she wanted more attention (lol), and starting wearing maternity wear to get her point across while she had a few weeks left. 

A Moment for Work Fashion

There is certainly a learning curve to getting dressed as your body changes shape at a pretty rapid pace. At the same time, job demands remain - I need to be able to raise both arms over head, demonstrate functional activities and exercises, and perform all the same manual interventions - but with a little more fabric to do so comfortably! I was (and still am) lucky that my work attire has always been pretty forgiving thanks to the athleisure options at Lululemon (not sponsored). Their looser fit athleisure dress pants and their Back in Action long sleeve shirts have always been my absolute favorites and are extremely pregnancy-friendly in that I've been able to grow (outwards) while still wearing my pre-pregnancy sizes. I will say I haven't quite committed to the classic rushed maternity shirts just yet but with a couple of months of growing left, never say never! 

As a PT, I must add that supportive shoes go a long way in combating orthopedic knee, hip and back pain, especially during pregnancy, and so far I've been very happy rotating a couple of pairs of New Balance sneakers for adequate support for the work days. 

From exercise to brain function, communication, attire, and everything in between, there is a lot to consider when it comes to working, especially in patient-facing roles in healthcare, while pregnant. Overall, it is most important to give yourself grace and patience in order to make the right decisions for yourself, whether it's choosing a prenatal workout or deciding when to tell your boss your news. If you have any other advice, comments, suggestions or questions, please leave them below! The more resources we create for each other, the better we are!