maternity
Having a baby and becoming a mom is stressful. There's no denying that. Planning for a maternity leave can be stressful, too. If you're expecting your first baby (or even a second or a third!), you might be wondering what a longer maternity leave looks like. Here's how I spent (and funded!) 16 weeks of maternity leave.
A Word About Stress
Everyone handles stress differently. No two births are the same. There are so many variables when it comes to maternity leaves.
For me, well, my leave was pretty stressful.
There was moving and almost dying along the way. At some point (OK, multiple points), I was overwhelmed and probably met criteria for postpartum anxiety. I spoke to a psychiatrist friend who pointed out that I pretty much experienced all the top life stressors except death of a loved one (and let's keep it that way!) within a 4 month period:
- New baby (especially the first one)
- Moving
- New Job
- Serious illness
She also pointed out that what's especially hard for new mothers is that no one is taking care of us. We are always taking care of baby (and spouse).
A Look at 16 Weeks of Maternity Leave
I feel lucky that my mother lives nearby enough and has been with us most weeks.
Breakfast of Champions – home cooked Korean food
So, I decided to give myself a pass on pretty much everything. For me, that meant a lot of stopping.
I stopped worrying about…
- Posting consistently on this blog.
- My new postpartum figure (well, kind of).
- Every single bit of what I was eating.
- Spending too much especially if it made my life easier during this time.
I am still trying to worry less about the not fully unpacked apartment.
Oh, and I finally figured out the biggest fallacy of “maternity leave” — nothing gets done despite not “going to work.”
Funding a Longer Maternity Leave
Throughout my leave, I was often asked how are we able to afford taking 16 weeks of mostly unpaid leave.
Let's back up and actually look at my leave. I took 16 weeks of leave, and it was only very partially paid. 6 weeks paid at my old base salary was all I got.
So how did we swing the full 16 weeks of maternity leave?
The answer is simple: We lived below our means, and we saved for it. Remember, you have about 9 months to save for maternity leave!
Let's go back to the idea of living below our means. In other words, we do not need our whole paycheck to get by. While I was pregnant, I stopped making extra payments to loans in favor of saving for this time.
Then, I had a cushion to pay for my maternity leave.
It definitely didn't feel good to watch my checking account balance only decrease during my leave, but seeing his face daily more than made up for it.
What are you looking at?
Final Thoughts on 16 Weeks of Maternity Leave
Isn't this what it's all about, Moms? I hope everyone about to have a baby can have the freedom to spend more than the typical 4-6 weeks of doctor maternity leave.
Look hard at your budget while your expecting, and see what you can do to save a bit extra. Even if you can't fund 16 weeks of leave, anything extra counts. You won't regret it.
What do you think of funding a longer leave? Comment below!]]>
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We were at my parents' in NJ when the bleeding started.
My first call to the on-call OB was met with reassurance. “One episode of bright red bleeding + clots is ok.”
Except it quickly became 4-5 episodes in < 1 hour.
The next call – “Go to the nearest ER.” Except that I wanted to be at my hospital with my doctors. I felt ok and the bleeding was intermittent so we took a chance and decided to head to Long Island. Google maps said it would take 1 hour.
So off we went. We left Eggy home with grandma. We let my OB's office know we were on the way.
I double diapered myself and brought chucks for the ride. I brought my donut pillow to sit on (3rd degree tear …).
The last 20 minutes or so were scary. I started bleeding profusely and constantly. I bled through the two diapers, onto the chucks, onto the donut pillow, onto the seat and seat belt. I tell M he may get rich sooner than planned …
But I feel fine. I check my pulse, seemed “normal”.
We roll up to the ED entrance. The security guard immediately puts me in the wheelchair as blood is spilling out of the passenger seat. M goes to park. I get wheeled into triage and the nurse starts to do intake and looks at the blood pooling below me, “I'll register you later…” then wheels me into the ED directly into a trauma bay – “Crit B”.
M parked and when he arrived at the ED entrance looking for me the guard says “Follow the trail of blood.”
The usual happens. Vitals are taken. I'm slightly tachy. My BP is high as my body is compensating for the blood loss. 2 x 18 gauge IVs are placed quickly. Blood is sent. My on-call OB arrives. An ultrasound of my uterus is done. 1 unit blood was hung pretty quickly as I am whisked to the OR for emergent D&C for presumed retained parts.
I wake up in recovery. I'm getting a second unit. Anesthesia did a great job as I remember nothing and have no pain. The NP examining me notices my engorged breasts and gets me a breast pump. I'm not sure how I managed to pump but I did (with assistance from M). I end up in recovery for several hours since a 3rd unit of blood is given. I finally get wheeled into a room at ~ 4am.
Two weeks prior to this, Eggy was born.
This sweet moment only lasted a few minutes as I started hemorrhaging after the placenta was delivered (yes I've had not one, but two hemorrhages).
After a few minutes of skin to skin with Eggy, I suddenly feel very cold and shiver uncontrollably. Things are a bit of a blur but I remember the room being suddenly full of doctors and nurses – the “OB crash team” so to speak.
Another IV is placed. I see M in the corner holding Eggy. I'm getting shots to stop the bleeding. M later tells me blood was pouring out and was all over the floor. I turned white including my lips. I received two blood transfusions.
After 5 blood transfusion in two weeks, it seems like more blood is foreign than mine.
A 10lb sand bag is placed over my uterus to contract it.
These recent experiences taught me that life is precious. I'm grateful I didn't have a home birth (was never a “dream” of mine). I'm grateful for the doctors (shout out to my OB – good friend from medical school) and nurses that took care of me.]]>
Before any big change in your life (hello, moving!), it's important to get your finances in order. We consider the cost of a move, and we compare our current salary with our future position. But what about saving for your future? It's probably not on your mind when you're thinking about moving. But for my recent move, a Mega Backdoor Roth IRA was something important to consider.
our move to a MCOL. I had less than 2 months before my planned maternity leave to figure out how to make sure I was maximizing benefits, particularly my work-sponsored retirement accounts.
My Work-Sponsored Retirement Accounts
To recap, here are the retirement accounts I have through work:
- 403(b) – I max out my contribution at $18,000 and receive a generous employer contribution + match. I am currently 40% vested in employer contributions.
- Private 457(b) – I max out my contribution at $18,000. There is no employer contribution.
- Cash Balance Plan (aka small pension) – Unfortunately, I am 0% vested, so I will lose it all.
In addition to these work retirement accounts, my Roth IRA for 2017 was funded in January.
Planning Ahead for a Move
Since the leave was planned well before our move to a MCOL, I had already increased contributions to my work's 403(b) and 457(b) so that my contributions would be maxed out by the end of September.
I was unable to get a straight answer from HR if I can continue to make contributions when short term disability pay kicked in for my maternity pay, so I played it safe. I also could not get a straight answer if I would continue to get employer contributions plus the match match if I front loaded the 403(b) and 457(b).
Thankfully, the employer contributions + match have continued!
Now, I will be separating from my job (I am employed until the end of December), some things will change. I am starting a new job in 2018 that only offers a 401(k). That means I'm losing my 457(b) and cash pension plan.
Because of that, I decided to take advantage of the Mega Backdoor Roth IRA (linked to excellent article by Mad Fientist).
What is a Mega Backdoor Roth IRA?
You might be wondering what exactly is a Mega Backdoor Roth IRA?
It is the ability to contribute an additional $36,000 a year into a Roth IRA. This is in addition to the regular or backdoor Roth IRA of $5,500 annually.
I knew this was an option through my work's 403(b) since they allow non-Roth after-tax contributions (aka NRATs). This is not the same as being able to contribute to a Roth 403(b) or 401(k). These contributions are in addition to my $18,000 employee contribution. You can contribute NRATs up to the total limit of $54,000 (for 2017).
Obviously, I want the free employer contribution + match, so I am limited to contributing an extra ~ $15,000 in after-tax contributions. But if you have no employer contribution then you can contribute the difference of $54,000 less $18,000, or up to $36,000.
Understanding Mega Backdoor Roths and Taxes
One caveat is that you want your plan to allow in-service distributions, meaning that you can move the NRAT portion of your 403(b) or 401(k) out of the account and into your Roth IRA. Some plans let you do this quarterly or annually. Mine only allows this upon job separation.
This is not a deal breaker, but this means that I will owe taxes on the gains only. One will still owe taxes on the gains with a quarterly or annual in-service distribution, but it will have less time to make gains, so they should be minimal.
Why This Money Move Was Right Before Our Move
I did not contribute to this in the past since I'm still paying down student loans. But now that I am leaving and losing a good amount of tax-advantaged space with the new job. It made sense to “fill up” this bucket before my move.
Final Thoughts on Mega Backdoor Roth IRAs
To summarize, here is how to tell if you are eligible for a Mega Backdoor Roth IRA. Ask yourself these questions:
- Does your plan allow non-Roth after-tax contributions?
- Does your plan allow in-service distributions? How often?
- If yes to both – you are lucky! And have an additional potential $36,000 to contribute to your Roth IRA
If you're eligible to contribute or you want more information about a Mega Backdoor Roth, make sure you swing by the Mad Fientist's article. Whether a Mega Backdoor Roth is the right financial move for you or not, before you move to a new city or simply change jobs, make sure that you think about your future money situation, too.
Have you heard of the Mega Backdoor Roth IRA? Comment below!]]>
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Sometimes, the right money move means an actual move. Here's everything you need to know about making the move to a lower COL based on my very own move.
Considering the Possibilities
I put in my 90-day notice at my job (my first job out of residency) the end of September. This nicely coincided with my maternity leave, so I won't be returning. M also gave notice around the same time. Why? M was offered an opportunity he (we) couldn't refuse.
Except the job was not in NYC or within commuting distance. Let's just say my initial response was “Hell No” as a New Yorker. Our first trip to Philadelphia together–aka the “I need to convince Bonnie trip”–didn't end well.
At first, I was excited. Philly is a lot like Brooklyn (Shhh, I've been told they don't like to hear that!). But then, as the day wore on, I was sad about leaving my friends and my life here.
I was a wreck.
Exploring New Opportunities
However, it became clear to me this was a job he could not turn down for his career. So, I figured, at the very least, I should check out the job market for me and see what turned up. There was no shortage of opportunities for me. I looked into both private and academic positions.
For a number of reasons (new addition to family being a top one), I decided to leave academics and join a private practice. The deal was clinched when M said “we can retire 5 years faster.”
I found a job that I am excited about. It doesn't hurt that both M & I will also be increasing our incomes significantly and living in a lower COL area. I took advantage of the job and location transition to take an additional month of maternity leave bring the total leave to 16 weeks.
Not quite LCOL, but for us New Yorkers, Philadelphia is a significant drop in COL. So we are practicing a bit of geographic arbitrage.
So here is what I learned from by making a move to a lower COL:
#1. Don't be afraid to see what else is out there.
Explore options job wise. Obviously, I knew I was making less being in academics AND being in NYC (doctors get paid less here…). But until I saw the numbers in front of me, it didn't feel real.
#2. Don't be afraid to move.
Moving is one of the top stressful events for adults (and children). I could see us living in NYC for the foreseeable future. Once I ran the numbers living in Philly vs. NYC (incorporating our new higher salaries, less taxes, less expensive childcare), it really was a no brainer. At the very least, it can't hurt to try!
Both WCI and Physician on Fire espouse living in a lower COL to get you to FI faster. I finally listened to them.
Thankfully, my parents live in New Jersey, so Philly isn't that much further away. Also, they can still be quite involved with helping out with our newborn.
#3. Sometimes you just gotta do what's best for the family.
We would've been “fine” staying here for a while or forever. I'd be lying if I said the cost of childcare (and private school if we went that route) in NYC didn't cause some heart palpitations, though.
Both of us have lived in NYC for several years and were open to trying something new.
NYC won't be going away if we want to come back.
Final Thoughts on Making a Move to a Lower COL
It's hard to give up what you know, what feels familiar, and what you call home. However, if you're feeling a pinch financially or want to accelerate your FIRE journey, a move to a lower COL area might be the right decision for you.
Have you moved to a lower COL? Comment below!]]>
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In Part 1, I discussed things you should consider prior to becoming pregnant. Here is the rest.
You're Pregnant!
Congratulations! Don't panic. The good news is you have about 9 months to plan!
1. Get insurances NOW if you haven’t already for the above reasons. You may get a pregnancy exclusion but just get it and you can re-apply and get more later. Find out your OOP expenses for your health insurance if you have not already as well.
2. You'll need a basic will in place to name the guardian of your child should you pass and notify the guardians you choose. This often becomes a non-urgent to-do item after the baby is born unfortunately.
3. Retirement plans at work: If you’re taking unpaid leave or any leave, you’ll want to frontload your 403(b)/401(k)/457(b) so they are maxed out before you deliver. I recommend you frontload these accounts at least 2 months prior to your expected delivery date in case of a preterm delivery. Although this won't be a deal breaker, you'll also want to find out if and how frontloading affects employer matching if you get any.
4. If you haven't already, find out what steps need to be taken to take your maternity leave:
- First, you'll need to decide how many weeks you want to take off. This is a highly personal decision. I've yet to meet a woman who said they took too much time off.
- Depending on your employer, you may get completely unpaid leave or a combination of paid and unpaid leave. You may be responsible for paying your benefits during unpaid leave.
- If you can use your vacation days towards paid leave, hoard them!
- Finally, tell your boss or administrator so everyone at work can start planning for your leave and coverage gaps.
5. Think about childcare options. It comes down to daycare vs. nanny vs. stay at home partner.
- Daycare and nanny costs vary significantly based on location.
- In some cities (ahem, NYC), there can be up to a 1 year waiting list for young infants. I'm not sure how this works since no one can actually predict when they can become pregnant.
- I recommend you pay a nanny on the books. Not only is it illegal not to, but you open yourself up to a ton of liability by not doing so.
6. Think about whose medical insurance the newborn will go under – you or your partner. It may just end being the one where the pediatrician is in-network and convenient for you.
7. Start drawing up a list of things you'll need to buy for the baby:
- Distinguish between needs vs. wants. I recommend making 3 lists: need, really want, want. Keep in mind the need list is shorter than you think! There are fortunately or unfortunately tons of items to fit any budget. I recommend using the book Baby Bargains and the website Lucie's List to hone in on the items.
- Whether you end up having a baby shower or not, I would still create a registry. Close friends and family will ask and they will want to buy you a gift. You might as well receive items that you want! I used Baby List for my registry.
- Remember, you don't need a ton of stuff when the baby actually arrives. I recommend a wait and see approach to avoid a shopping craze.
- Don't forget that you'll need some stuff too! Maternity clothing, postpartum supplies, nursing clothing and nursing equipment. At this time, breast pumps are required to be covered by your insurance.
8. Start saving for stuff (above) and for unpaid leave if applicable. This is a good time to curb your regular spending to get ready for the baby and all the expenses that come with it. Remember, you'll need to save for monthly expenses, not total income replacement. I hope you are living below if not well below your means so it should not be as much as it sounds.
9. This is not a financial tip (well sort of), but I highly recommend that you and your partner take a babymoon. A great time to do this is in the beginning of your second trimester. The nausea and unrelenting fatigue of the first trimester are over and you are not inhibited by your growing belly yet. Your lives will never be the same (for the better!). Do not forget the primary relationship (your partner). I also recommend you plan and budget for weekly date nights sans baby.
10. Outsourcing. While you're probably a type A, can do-it-all mom-to-be, the reality is it gets harder to do this as your pregnancy progresses. Don't be afraid to start outsourcing things like cleaning, laundry, and even cooking so you can get much needed rest prior to baby. You may also need to hire help with the baby if you don't have good support or family nearby. Remember, outsourcing will make you happier.
11. Find local mommy groups. Not only are they a source for used, unused and sometimes free baby items, but they are a source of support during this exciting and sometimes anxiety-provoking time. Consider joining Physician Moms Group (PMG) on Facebook. There are also local PMG groups as well. Remember, at the end of day, you will figure out how make it work!
Thousands of physician moms already have! What I have done/am doing:
- My second life insurance policy went into effect just weeks before I became pregnant. I may have gestational diabetes (as of writing this blog post I failed the 1 hour glucose challenge). Boy am I glad I had my policies in place!
- My insurance paid for 6 pairs of compression stockings – highly recommend you get some! 20-30 mmHG is recommended. I got Sigvaris Eversheer calf-high socks.
- M and I took a babymoon to Paris when I was 20 weeks pregnant. We used credit card points for flights and hotel so we only had to pay for meals, local transport and shopping.
- I am the breadwinning partner. I am taking
1216 weeks of leave. I am fortunate that at least 8 weeks will be paid. I‘ll have up to 4 unpaid weeks of leave. We live below our means so the unpaid portion is totally manageable. I am also thinking about taking an additional 4 weeks to work part-time before going back full time. Again, living below our means gives us this option. - I am on a waiting list for daycare (yes they told me 1 year…). The daycare is
$2600a month. We are still considering a nanny while the baby is very young as well. - I have started outsourcing a few things and do not regret it!
Recommended books:
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Earlier this year I announced my pregnancy and listed a few financial considerations along with it. Now that I am in the final stretch I thought I'd put together a financial checklist for those who are planning to have kids and for those who are currently pregnant! A few things that are unique to us physician women:
- Most of us won't become stay at home moms so will need to pay for high quality childcare or have a stay at home spouse/partner.
- Many of us do not get paid leave. This will definitely affect inflow and one must plan accordingly.
- Many of us are the breadwinning partner.
Ideally, certain things should be in place prior to becoming pregnant. So even if you're single and young I recommend you get some term life insurance now and disability insurance. You'll never be as young and healthy as now. Unfortunately, certain normal aspects of pregnancy such as a c-section, miscarriages and IVF are counted against you. Gestational diabetes, preeclampsia and postpartum hemorrhage can also ding you a few health classes as well.
As you know, there is never a right time to have kids but financially, the best time to have kids is as a medical student or resident. Why? You don't make much if at all so the income loss, if any, is minimal. Childcare can obviously be an issue financially in these lower income years. As an attending, every week you're not getting paid hurts that much more.
As an attending, you'll need to accept the fact that you will likely make less during pregnancy, during your leave, and even after your leave. This is due to how practices usually pay you and adjust your pay for time not seeing patients. Brace for impact.
As an attending, you'll need to accept the fact that you will likely make less during pregnancy, during your leave, and even after your leave. Share on XThings to think about before your first attempted pregnancy:
1. Before you sign that first attending job contract find out what happens when you take leave:
- Find out if you get any paid leave. Large hospital employers tend to have paid maternity leave by using a short term disability plan. Find out the terms of this. If you are pregnant prior to starting the job, you may not be eligible. You may also need to work there a certain amount of time prior to being eligible.
- Find out how taking leave affects your salary (if you need to make up a deficit for example) and find out how it will affect your bonus structure. Some employers will adjust target RVUs/collections and some don't – meaning you'll have to make up a sizeable deficit before you bonus again. There is a huge difference! I always recommend having a lawyer review your contract and definitely ask about this.
2. If you live in California, Rhode Island, and New Jersey, or New York (as of Jan 1, 2018), you may be eligible for state sponsored paid maternity leave. It won't replace your physician salary but it is definitely helpful!
3. Family Medical Leave Act (FMLA) – this federal law provides guaranteed job protection for 12 weeks (unpaid) to take care of your newborn. The 12 weeks can be taking at any time within 12 months of having your baby. To be eligible – you need to work for an employer with at least 50 employees and have worked there for at least 1 year. So this does not apply to small private practices.
4. As I mentioned above – get your term life insurance and disability insurances in order before your first attempted pregnancy. Otherwise, you may get a pregnancy exclusion, or worse, you develop gestational diabetes and your premiums double or more. Your partner should also get these insurances in order as well.
5. Health insurance – find out what your total OOP costs will be. This can range from $0 to several thousand. Definitely keep this in mind when looking at your medical insurance options. This is also another reason having children during residency is often cheaper – you work for a large hospital that often has great medical benefits for trainees. 6. Start hoarding vacation days to use towards paid leave if applicable.
Here is Part 2.
Recommended books:
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M and I are pleased to announce that we are expecting a baby boy this fall. We have nicknamed him “Eggy” – it means baby in Korean. As you know, you cannot exactly plan when you become pregnant. Honestly, we were not sure if things would happen au naturel due to my age so IVF was a possibility. Luckily my current job includes 3 cycles of IVF as a benefit but it is still not 100% covered. I know many ladies who have spent a small fortune on getting pregnant.
So here are a few things I have learned, financially, about trying to get pregnant and trying to plan for leave and childcare:
- Insurance coverage: Make sure you know what your insurance plan will cover and not cover and what deductible you'll need to meet, if any. Even if your insurance says “maternity is covered,” it may not cover all the tests. My costs: $40 (co-pay for the first visit only) is what my total out of pocket costs will be, including the delivery. This assumes I use an ob-gyn within my health system (I am) and that I deliver at one of their hospitals (I plan to).
- Maternity Leave: Think about how long you'll want to take for leave and what leave, if any, will be paid. This is a highly personal decision, but I have yet to meet someone who said they took too much time off. Unfortunately, paid maternity leave is not the norm in the U.S. If you have unpaid leave at least you'll have approximately 9 months to save up for this. My leave: I get 6 weeks paid leave (at my base salary) or 8 weeks (c-section). I can also use unused vacation. I will have at least 2-3 weeks of unused vacation to get to at least 8 weeks paid. I am taking at least 3 months off. So that means at least 1 month unpaid, possibly more. Since I only really need ~60% of my take home base salary, this won't be a huge burden on us and we will have more than enough saved to cover this unpaid time.
- Maternity clothes: Unless you only wear stretchy pants and dresses, you'll need at least a few staples. I do wear scrubs a few times a week to work so I did not have to buy a whole new work wardrobe. Gap Maternity is pretty inexpensive and I was able to use a 20-40% off coupon when ordering online. It also helps that it'll be mostly warm weather during my pregnancy so I can keep wearing dresses.
- Baby stuff: I am totally cool with second-hand everything. And due to space limitations of an NYC apartment, we definitely do not want too much “stuff.” Between a baby shower, a very excited grandmother-to-be, M's sister's hand me downs – we should have most of the basics for almost free. I have even scored a free Mamaroo and Ergo carrier already. I won't be shopping at baby boutiques for clothes.
- Post-partum help: If you don't have family around you may want to look into outsourcing certain things (clean and cook, etc) so you can focus on mothering. Baby nurses and night nannies are common in NYC – definitely a luxury – but a savior when you're sleep-deprived. Post-partum doulas are also a great idea, especially for first time moms, to show you the ropes, help you ease into breastfeeding (most are breastfeeding certified counselors), and help you take care of you while you recover from delivery. The U.S. is a bit strange in that moms are expected to recover and go back to work ASAP. Too bad there aren't any post-partum spas here like Korea. My plans: M will take 2 weeks off to help. I'm planning on hiring a post-partum doula for a few sessions for the above reasons. After 2 weeks, I'll be with my mom for a few weeks – letting her carry out a Korean tradition of taking care of a new mom. Slightly modified as I'll be able to shower :).
- Childcare: This blog is geared towards female professionals, so most of us probably won't be stay at home moms. I'd be lying if I said I wasn't worried about the cost of childcare! The going rate in my neighborhood is ~ $17/hr for a nanny. At this time, I prefer having a nanny for the first 6-12 months after I return to work. The convenience of someone coming to us vs. one of us packing up the baby and walking to a daycare (at least a 10-15 min walk – won't be fun during winter). Also, babies and kids often get sick in daycare and although M's work is more flexible, we don't want to deal with that. Right now, we are planning to have a nanny for 40 hours a week over 4 days and my mom for 1 day a week and for backup. We are *gulp* preparing to spend at least $3,000 a month in childcare. Unfortunately, daycare isn't much cheaper and with the convenience and flexibility of a nanny, this was a no brainer for us. After 6 months or so, we will reassess.
- Saving for college: It's never too early to start saving for a little one's college. You may recall that I started a 529 last year in anticipation of starting a family. I get a small state tax break for funding one so it was a no brainer to get started.
Any other financial considerations for a mom-to-be? Comment below.]]>
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