What to consider if you’re practicing while pregnant

Blogger Sampada Deshpande, D.D.S., practices in the San Francisco Bay Area. Author of the book “Persevering,” Dr. Deshpande earned her dental degree from the University of Washington and completed a general practice residency at Alameda Health System. Dr. Deshpande lectures nationally on treating patients with special health care needs in a private practice setting and using portable dentistry. You can reach her on her website, sampadadeshpandedds.com, for more information.

A majority of dental graduates today are women, yet there’s not a lot of guidance on pregnancy-related modifications in dentistry. The emotional and physical toll pregnancy takes on a woman is very demanding. It affects the way we approach our practices and also our careers.

Why do we not talk about this more often? Maybe some of it has to do with fear. Most of us keep pregnancy under tight wraps for the first trimester even though policymakers tell us otherwise. If we don’t share we are pregnant and are expecting accommodations at work, how are we going to be able to do our jobs safely?

Here are a few pointers to keep in mind if you are pregnant and working full time as an employee dentist.

1. If you’re a W-2 employee, consider sharing your pregnancy status with your employer in the first trimester.

It can be scary to do this because many people consider this a time to keep things under wraps, and of course, you are not obligated to share with your employer right away. However, the first trimester typically ends up being one of the harshest in terms of nausea and morning sickness. You may need more time off to attend doctor’s appointments. There are state laws that protect you as an employee when you need modifications like this at work. Consider sharing the news over email, not via text or a hallway conversation. There have been instances where information shared verbally has backfired without warning. If you email the news, remember you are protecting yourself against liability and your employer must provide a timely response. Employers are also expected to keep this confidential and offer accommodations.

Asking for accommodations is within our rights. This does not just include avoiding appointments that involve nitrous administration. It could also mean getting frequent breaks to walk around and stretch and paid time off to attend doctor’s appointments.

2. Get medicine on your side.

If you need modifications at work, consider speaking with your doctor or midwife first. Have them write a letter explaining exactly which modifications at work you are looking for. Attach a letter like this to the email you are sending to your employer. This strengthens your case and protects you further. States typically require official letters such as these written by a medical professional in order to qualify for state disability benefits.

3. Understand your disability insurance.

Hopefully all of you reading this have disability insurance. If you don’t, start there first. I had my disability insurance written up as a fresh graduate. Most of us have vastly different insurance policies. That said, a majority of disability insurance policies do not cover pregnancy-related disabilities if they last less than 90 days. When I had to stop working a few weeks before my due date, the first person I contacted was my disability insurance underwriter. The next thing I did was look up state disability benefits.

4. Understand family leave laws in your state and benefits you derive as a W-2 employee.

All of us come under different employment classifications. Some of us practice as 1099 contractors and others as W-2 employees. I was surprised to find that both 1099 and W2s can ask for benefits, depending on the state in which they practice. Many states offer family leave benefits based on your employment category and income six to 18 months prior to the time you are applying for benefits. The process for applying for these benefits could be easy or complicated based on your state and how technologically savvy they are.

We do not have to feel guilty when we claim benefits. This is money we have put into the system as taxes; it is meant to support us.

5. It’s OK to stop working based on your gut instinct.

Most of my colleagues in dentistry own their practices and manage multiple employees. Many of these colleagues worked till the day they went into labor and came back to work four to six weeks after delivery. It’s not an easy choice to leave your baby at home and come back to work when you are still sore from the delivery. This guilt played into my mind too. I had patients scheduled up until two weeks before my due date. I thought I should go until the very end as it would keep me more active. However, six weeks before my due date, I started to feel the sheer weight of my planet-sized baby. I do portable dentistry, so I travel upwards of an hour to see patients and spend 30% of my workday in the car. I also do all of my dentistry standing up since most of my patients are in wheelchairs. This was putting further pressure on my feet, causing them to swell and develop pitting edema.

My OB-GYN told me gently yet seriously, “Please don’t stay standing for long periods of time.” She knew what my job entailed. I decided to take her advice and take time off earlier than expected. Luckily, one of my colleagues stepped up and took over the care of my patients. Trust that the system will work itself out, and patients will still get the care they need. Don’t let the guilt eat into your mind.

6. Plan to take an appropriately timed maternity leave after giving birth.

This is a decision to be made with your partner, if you have one, or after putting some thought into your financial situation. Daycares and nannies can quickly become expensive, and the recommended amount of time at home with a new baby varies based on different cultures, traditions and your upbringing. Don’t let anyone else make this decision on your behalf. Know that if you take two weeks, three months or six months, it’s a decision that is right for you and your child.

State and employer benefits only go for a few weeks/months at most. And if you take longer than typical to come back to work, you may find yourself out of the job. An employer is meant to keep your job open for you as long as you come back within the allotted maternity leave time.

One comfort we have as dentists is that there is no scarcity of jobs. There will always be work for us. Finding an opportunity has never been difficult, although finding a great one may be.

For pregnancy-related resources from the American Dental Association, visit ADA.org.