The Maternal Instinct
I work in an outpatient setting as a physician assistant at an ambulatory care center. I help see roughly 10-15 patients each day with my attendings in a large office setting. When Governor Cuomo initiated the lockdown of New York, we restricted patients from coming to the office. We canceled all in-office visits and procedures and offered telemedicine visits instead. My attendings had a lot of video visits, and I had mostly phone call visits. These visits allowed the patients to continue to have care so they would not have to resort to going to the emergency room. At this time, I was only around 4.5 weeks pregnant — I had just recently found out. Only my husband and two close girlfriends knew about my pregnancy.
As weeks progressed, the number of COVID hospitalizations in the hospital dramatically increased. I received several emails from higher-ups requesting for volunteers to help in the hospital. These were mass emails sent to attendings and advanced practice practitioners asking for volunteers to help in the inpatient COVID units. All of my attendings volunteered — some were in the ICU, some in the Emergency Department, and another in the Respiratory Screening Center. I felt shameful for doing so, but I brushed off these emails, as I was afraid to volunteer myself. This virus is so novel and we barely knew anything about it. We only knew that it seems to be highly infectious and that it can be fatal. There was not much information on how the virus affects pregnancies. I told myself I would not volunteer. I decided I would only work in the hospital if I was mandated to go.
Eventually, the hospital was becoming so overwhelmed, that the chief of internal medicine personally reached out to my chief attending asking for my help. My chief attending asked me if I would be willing to volunteer. Given that I had inpatient experience, he thought I would be of great help. I did not give him a straight answer. I was hesitant to tell him about the pregnancy as I was still in my first trimester. He told me that I should look out for an email as the internal medicine chief would be reaching out to me personally. I received the email the next day, and it was at that moment that I immediately felt my stomach churning. I was feeling more pressure to help at the hospital. I tried to convince myself that I should be proud and willing to help my colleagues in the hospital during this crisis — that it is my duty as a Physician Assistant, a healthcare practitioner. But, deep down my maternal instinct was telling me to not go. What if I contract the virus? Will I have a miscarriage? And if I do contract the virus and recover — would my child have significant health problems? No one knew the answers to these questions.
The next morning, when my chief attending asked if I had made my decision, I broke down and told him I was pregnant and would not feel safe working in the hospital. I felt very unprofessional as I could not control my tears. He was the fourth person to know about my pregnancy — my parents did not even know at that time! To my surprise, he was delighted with the news and seemed genuinely happy for me. He told me his daughter also recently found out she’s pregnant and that she is also terrified at the possibility of contracting the virus. My attending told me not to worry as he would do everything he can to prevent me from working in the hospital. I felt the weight come off my shoulders and my heart was at ease again. From that moment on, I no longer saw my attending as just my boss — he became a father-figure to me at work.
Weeks later, after my first trimester finally ended, my husband and I gradually revealed our pregnancy to family, friends, and coworkers. Many were concerned about my pregnancy and warning me to be extremely cautious given the pandemic. No one has once criticized me for not volunteering to help in the COVID units. Everyone I've discussed this with seems to understand and agree with my reasoning. My only critic is myself. Now and then, I look back and reflect on the decision I made and would feel guilt. I became a physician assistant so I could help those in need. Hospitals in NY were in such dire need of assistance, but my maternal instinct had greatly influenced my decision to not step in.
The maternal instinct is unquestionably spectacular and peculiar. The need to protect my baby had trumped over everything else in my life. Though she was only a blob on ultrasound at first, she had already become my #1 priority. I was already willing to do everything possible to protect her and to bring her out into this world safely, before even having a baby bump or feeling any movement in my belly. The bond I have with her is even stronger now that she actually looks like a little human on ultrasound, and that I can feel her cute hiccups and strong playful kicks every day. I can only imagine the sacrifices I'd be willing to make for her once she arrives in this world.
