Dr. New Mom: Planning for baby and returning to work

August 22, 2019

Listen to the

Listen to the Defocus Media podcast interview with Jennifer Lyerly, OD, and Gabriella Olivares, OD, here

With optometry becoming increasingly female as a profession, doctors and workplaces alike are facing the challenges of providing the best work environments and balance for new mothers.

The American Optometric Association reports that 67.8 percent of full-time, enrolled optometry school students in the United States were female in the 2017-2018 calendar year, and 43 percent of all practicing optometrists in the US are women.1

These demographics are rapidly changing, and the industry is faced with making adjustments to accommodate the new workforce quickly. Just a decade ago, females comprised only 20.5 percent of practicing optometrists in America.1Previously by Dr. Lyerly: New research on improving contact lens comfort for dry eye patients 

New mom ODs
In this podcast, new mother Jennifer Lyerly, OD, talks with two other optometrists who are balancing their careers as new moms.

Gabriella Olivares, OD, has a 4-month-old son and practices in Pembroke Pines, FL, in a private group practice with five other ODs. She has been practicing full-scope optometry there for four years and recently returned to work full time.

Arian Fartash, OD, has a daughter who just turned 12 months old. Though she has not returned to traditional patient care since giving birth, she runs her online business Glam Optometry social media management and her pediatric sunglasses line Glam Baby as well as providing fill-in work a few days a month at a local optometric clinic.

Related: Why my passion for pediatric exams stays personal 

Planning to start a family
Both Dr. Olivares and Dr. Fartash agree that having a plan in advance and saving money is key to giving ODs flexibility as a new parent.

Depending on each woman’s pregnancy and birth experience, they may require more time out of work than expected. Both Dr. Fartash and Dr. Olivares had to have emergency cesarean sections, requiring them to take off work earlier than expected.

For most ODs, there is no paid maternity leave policy that offers full or partial salary benefits when out of the office as a new mother. Independent contractors or 1099 workers aren’t eligible for employee benefits through the workplace, including short-term disability or paid time off for maternity leave.

Taking time off for maternity leave requires saving and budgeting appropriately. Dr. Fartash recommends saving three to six months of salary, if possible.

Salaried optometrists or W2 employees frequently do not have a maternity leave policy Short-term disability insurance policies are available to purchase; however, doing so requires careful planning. Some offices may provide a short-term disability buy-in option through the workplace, but if not, ODs can purchase their own plans.

Short-term disability plans can vary, so reading the fine print is important. Dr. Olivares purchased short-term disability insurance independently through Aflac, and her plan stated that she would not be eligible for benefits if she got pregnant within 10 months of purchasing the insurance. For most plans, ODs cannot wait until they are pregnant to sign up for a short-term disability plan.

Related: Using medications in pregnant glaucoma patients 

In addition, plans vary in how much salary is paid during the short-term disability period. Most plans cover no more two-thirds of salary during the pregnancy and postpartum period, and many reimburse much less. Plans may limit payout to six weeks for natural childbirth or eight weeks for cesarean section.

Dr. Lyerly discovered that the short-term disability plan offered by her employer was so expensive that unless she had a C-section, she would have paid more money to purchase the plan than she would have received during her maternity leave.

It is possible to lose money investing in these plans. Keep in mind that standard disability insurance does not cover pregnancy or birth.

Many new parents are aware of the Family Medical Leave Act (FMLA); however, many optometrists are not eligible for this governmental protection.

FMLA states that new parents are entitled to up to 12 weeks of unpaid leave after the birth or adoption of a child. Both mothers and fathers are eligible for this benefit. During this time, employers must maintain healthcare benefits, but there is no requirement for salary payment during the leave. The employer must provide the same “or equivalent” work position when the employee returns to work.

But not all workplaces must comply with FMLA. Employees paid via 1099 or employers with fewer than 50 employees do not fall under FMLA protection.

Related: Managing risk avoidance

Returning to work
The decision of when to return to work after having a child is personal, and there is no right answer. After a week of being at home with baby, Dr. Olivares says that she was ready to go back.
“Being a mom is a lot harder than being an optometrist,” she says.

She started at three days a week for the first month that she returned to patient care to give her extra time with the baby before returning to full-time work, and she found this balance was perfect for her.

Dr. Fartash was planning on returning to patient care after having her daughter, but with an emergency C-section, a move to be closer to her family, and the launch of Glam Baby, the timing didn’t feel right for her life to return to the office as quickly. She discovered that fill-in work a few times a month is the perfect balance for her and allows her to focus on her entrepreneurial businesses.

“I definitely took a financial hit,” Dr. Fartash says. “I’m not having that lavish lifestyle that I once did, but I wouldn’t change it for the world.”

One of the most difficult parts of knowing when to return to work is choosing who will care for the child. Whether the final choice is daycare, a nanny, or family members who will help, the decision is not easy or straightforward.

Related: Optometry on fleek: part II

Dr. Olivares employees a full-time nanny to care for her child at home; Dr. Lyerly’s daughter will be attending daycare.

Dr. Fartash has had help from her mother, but family caregivers can also bring challenges.

“Everybody has an opinion,” Dr. Fartash says. “There is no right or wrong, but having a plan in place is essential.”

With the process of seeking external childcare, whether through a nanny or daycare, plans must be firmed up well before the child is born. Dr. Lyerly had to apply for daycare before she gave birth in order to be on the waiting list and save a spot for her child when she wanted to return to work.

Location may make child care options even more intense. Dr. Fartash shares stories of year-long daycare waitlists being common in big cities like Los Angeles requiring lengthy interview processes to be selected by the daycare for placement.

Also by Dr. Lyerly: What ODs need to know about YAG laser vitreolysis for floaters 

Nursing on the job
The American Academy of Pediatrics recommends that infants “be exclusively breastfed for about the first 6 months with continued breastfeeding along with introducing appropriate complementary foods for 1 year or longer.”

Nursing mothers returning to work need to balance their patient care load with time to pump breast milk to feed their children. In 2010, the passage of the Affordable Care Act included legislation that workplaces must allow women “a reasonable break time as frequently as needed” to pump breast milk “for up to one year following the birth of the employee’s child.”

New mothers must be provided a private space to pump that is not a bathroom and is “free from intrusion by coworkers or the public.” This federal legislation is mandatory only for workplaces that employ 50 or more people.

Dr. Olivares and Dr. Fartash say that pumping while at work has been a big adjustment and has taken investment in the right tools and accommodations to make possible. It can be hard to get into the mental space to pump when under the stress of patient care, so planning the patient schedule is essential to success, they say.

Related: How I built a customer service-centered practice 

Initially Dr. Olivares had two 15-minute blocks in her patient care schedule to pump, but she quickly found it wasn’t enough time. She now has 45-minute breaks which have given her the necessary time to pump the amount of milk she needs for her son. In total, she is spending about three hours a day pumping breast milk to be able to maintain her supply.

At work she uses a battery-powered dual pump, but she also brings a handheld pump as a backup option. Bringing an extra pump to work is advice she recommends to all new moms. Parts can break or go missing, and nothing ruins a mother’s work day faster than realizing she can’t pump. In addition to not being able to obtain needed milk, not being able to pump can cause extreme physical discomfort for nursing mothers.

Dr. Fartash recommends that new moms invest in several items to make pumping easier. A nursing bra can help because it anchors the pumps in place and allows mothers to be hands free to use the computer or chart. She loves the Symphony pump for work.

She also recommends investing in a small refrigerator in the doctor’s office for storing breast milk during the day.

As a new mom, Dr. Fartash continued to conferences and events around the country, and she recommends the Willow pump for travelling and easy portability; she loved it for flying or attending conferences because she could even pump and walk.

Related: Blog: 10 eyecare apps for more efficient patient care 

Follow along
While there is no one-size-fits-all approach for successfully returning to work as a new mother, planning in advance, investing in the right tools, and getting the support of family, friends, and the workplace can make the transition easier.

Follow along on the journeys of these new doctor moms on social media:
Dr. Olivares: @livingin2020
Dr. Fartash: @GlamOptometrist
Dr. Lyerly: @eye.dolatryRead more Defocus Media content by Dr. Lyerly here

References:

1. American Optometric Association. The Future is Female. Available at: https://www.aoa.org/news/inside-optometry/the-future-is-female. Accessed 8/21/19.