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. Click To Tweet
Things 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.