Knowing in advance that your return to work may be difficult, be sure to make a re-entry plan. Ideally, you already negotiated some components of this plan with your supervisor way back when you were pregnant and less tired than you are now. Can you start back to work gradually instead of all at once? Perhaps you could work half a day per week for one or two weeks when you first get back so that you have time to catch up on all of your paperwork. Maybe you can stagger your return to various responsibilities such as clinical care and the overnight and weekend call schedule. Since you will be on call every night at home for a while, one survival strategy for the immediate post-partum period is to stay out of the call schedule at work for as long as your colleagues and your bank account will tolerate.

If you work in academic medicine, can you also start back gradually? For example, try not to see patients in your first week back. Can you start teaching at one time and then resume your research at yet another? When you are making your schedule for the next six months, make sure that you take into consideration any “pay back” for any missed call or other clinical activities that you will need to do.

All of these strategies and suggestions are based upon the assumption that most women physicians in the US take relatively short maternity leaves for the financial and logistical considerations described in detail above. The irony of this situation is that a maternity leave that is six or even twelve weeks long is woefully inadequate and has known direct negative health implications for both mothers and infants (Staehelin, 2007). The US lags far behind all other industrialized nations in federal or even state-level mandates. Here we have discussed practical suggestions for taking a maternity leave in the context of the current US legislation and culture. In the final chapter, we address the length of paid maternity leave at the policy and advocacy level where the voices and actions of physician-mothers are and will be critical for substantive reform.