Each evening, the 7 p.m. cheers ring out in New York City. Some bang on their pots, some clap, while others hoot loudly. You would think this boisterous scene means our society is supporting healthcare workers with all the protections they need in this moment. You would be wrong.
Even as people spill out on their balconies and fire escapes to salute our healthcare and other essential workers, doctors and nurses are struggling through shortages of personal protective equipment (PPE) in overcrowded hospitals, all while exposing themselves to the risk of infection. But navigating this new reality has been significantly more complex for one particular segment of healthcare workers: mothers, who are often doing the majority of taking care of children at home as they also take care of an influx of seriously ill patients at work.
One of the biggest concerns that women with these dual roles have expressed is that they fear infecting their families when they come home after a long shift. “I feel like there’s really limited guidance and a lot of variability with how healthcare workers protect their families, and it’s even more dramatic when it’s the mother,” infectious disease specialist Christine Kerr, MD, told Refinery29.
The lack of support for working moms existed long before coronavirus in both cultural (e.g. the myth of “having it all”) and systemic (e.g. America’s abysmal maternity leave policy) forms. These pressures can be detrimental to a mother's mental health; one study found that not only were mothers more likely to feel guilt than fathers, but that guilt levels increased when a mother’s job conflicted with her family obligations. It should come as no surprise that in the face of longer working hours and heightened stakes, many of the mothers we interviewed for this article found that the tension between balancing work and home life had become especially difficult.
Even before the added stress of the pandemic, many women in healthcare were already juggling the full-time job of parenting on top of their career. According to the U.S. Census Bureau, women hold 76% of healthcare jobs and 85% of nursing jobs. They also shoulder a majority of the caregiving at home. The Family Caregiver Alliance found that over 75% of all caregivers are women.
Since schools have shut down, many parents are stretched even thinner. Former Planned Parenthood president and member of the We Demand More coalition Cecile Richards cited childcare as one of the most overlooked aspects in recovery and stimulus efforts. “It's the kind of systemic barrier that women face, which has been completely ignored by this administration,” Richards told Refinery29. “It's interesting when you look at the $50 billion that was spent to bail out the airline industry, but I believe that Sen. Elizabeth Warren and Sen. Tina Smith's bill to actually save the childcare industry would also be $50 billion. We need to question what the priorities are as we go into recovery.”
Ahead, we spoke to several mothers on the frontlines of the fight against COVID-19 about what it’s like to balance work and motherhood in these unprecedented times.
Margeaux Christopherson, 32, anesthesiologist in Fort Collins, CO
Christopherson is the mother of three kids, ages 1, 4, and 6. She is expecting her fourth child in August.
“One of the hardest things about being in anesthesia is that we are in control of putting that breathing tube in, and that is the highest-risk procedure for us getting infected because you are literally in the patient's airway. Our hospitals formed intubation teams, and it was decided that only anesthesiologists were allowed to perform intubation. So every time there was a COVID patient who needed a breathing tube, we were the ones responsible. Another challenge is that many physicians aren’t salaried, so we don’t have paid sick leave. If I were to get sick and be out for two weeks, I would make no money for those two weeks.
“This pregnancy has just been so challenging. I feel sick a lot during the day. It’s hard when you’re wearing a mask. You can’t drink as much water as you want to. You can’t sit down because you are constantly responding to emergencies. When you go in to take care of a coronavirus patient you can’t take any of that equipment off, so for however many hours you are caring for that patient you can’t go to the bathroom, you can’t eat or drink, and the entire time you’re thinking very diligently about not contaminating yourself. It’s exhausting physically and mentally. Because we are not able to drink water or sit down, there’s a huge risk of preterm labor and growth restrictions. All my doctor’s appointments have been good. I’m very grateful that I’ve still been healthy, but it has been just a more physically trying and exhausting pregnancy.
“The hardest thing for me is the dichotomy in my mind that I took an oath as a healthcare provider to care for people, but as a mother I’m putting my family at risk to keep myself on the frontlines. It’s just an extra level of stress because if I mess this up at all, putting on all the protective gear, if my N-95 doesn’t fit right, if I don’t sanitize constantly, am I gonna get infected and bring that home to my children? When I come home, I’ve been taking all my clothes off in the garage. I don’t let my kids touch me until I’ve taken a shower, and that’s very confusing for them because they really don’t understand what’s going on. We really want to communicate what's happening to them, but we don’t want to scare them.
“It’s really taxing for my husband to be with my kids all the time, and there’s no reprieve. But he’s never once made me feel guilty about continuing to work. It’s also hard for me because I’m just exhausted by the end of the day, but kids don’t really get that, especially young kids. I can’t come home and say, 'I’m just going to rest.' They don’t understand that. They want to be with me and spend time with me. So until they go to bed, I can’t just watch a show and put my feet up. I’m working two full-time jobs because when I come home I need to be with my kids, and they need me to be with them.”
Rohini Harvey, 43, assistant professor of internal medicine and pediatrics in Springfield, MA
Harvey is the mother of 8-year-old twins.
“I am a hospital-based doctor (hospitalist) who cares for adults and children. I also teach medical residents and students to do the same. Perhaps one of the most unexpected ways in which COVID-19 has affected my work is how it has shaped my interactions with all patients — whether or not they have COVID-19. Because my face is mostly covered with a mask, I wonder how well I am conveying my empathy and understanding to my patients. I wonder how my words come across when my voice is muffled and the lower half of my face is unreadable.
“There’s so much more stress at work, but there’s more stress at home, too, since our children are home from school. There is no break and very little downtime. An unanticipated struggle of my husband and children staying home together all day while I am at work is that when I come home, often still lost in the struggles of a day in the COVID era, I’m a bit of an outsider because I haven’t been a part of their day until the very end of it.
“My kids do know what’s going on, and they know that some patients who have COVID-19 get very sick. They haven’t connected that I might be at risk of illness, and I haven’t made that connection for them. Like many, I have exchanged my professional clothing for scrubs at work. I change and shower as soon as I get home, and only after that can we have hugs and conversations. I think that I’m more nervous about bringing something home than the rest of the family is! They trust that this process will work.”
Lisa Solomon, 41, cardiothoracic anesthesiologist in Rockford, IL
Solomon is the mother of three kids, ages 15, 17, and 22.
“The role of anesthesiologists is to help in emergencies like when patients can’t breathe or their heart stops beating. We run to essentially rescue patients. It’s a high-risk procedure, and there’s a risk of exposure to the individual. It’s very important that the most experienced physicians are the ones that respond to these types of patients.
“There’s an added layer, which is that these COVID-19 patients are not surrounded by their families. It’s important for us to care for a patient as an individual, making sure they know we are there to help them. It’s even just a matter of stroking their head before they are going off to sleep to let them know that we are going to get them through things. That’s been a different emotional toll in trying to help these patients.
“Many women physicians still have an increased responsibility at home. Typically you see anesthesiologists’ schedule structured anywhere from 60 to 100 hours of work a week. Alongside that we still have the responsibility of our second job, which is maintaining a household. I do have children that are a little bit older, but there’s still dinner to be made. I do highly respect every parent out there taking on the new e-learning process. We also need to make sure our children are able to manage the emotional aspects of dealing with the pandemic.
“There have been differences in how hospitals have defined what PPE is needed for certain surgical or high-risk procedures. That part has created some confusion and a lack of consistency across different hospitals. While my hospital has PPE, and they’ve been proactive with that, there was definitely a period of time where we had to take the ownership as physicians in order to ensure that we were personally protected. Initially ensuring that we had the proper N-95 masks and they were being used with all patients regardless of their COVID status would have created less anxiety for working moms.
“At the end of the day, I hope that our patients know we are there to comfort them and help them. I hope they know they are not alone. I also hope my children know our family’s sacrifice to the duty of helping others is an important cause to be part of. Physician moms now require more resiliency, courage, endurance, and strength. I am humbled and honored to help serve our community in the fight against COVID. At the end of the day, when the Rocky theme song plays to announce a patient is discharged, this is all worth it. I also try to remind my children that someone was lucky to be able to see their family again.”
Sonia Nhieu, 37, cardiothoracic and critical-care anesthesiologist in Santa Clara, CA
Nhieu is the mother of an 18-month-old son.
“Being a mother is already riddled with anxiety, fear, and self-doubt, and COVID-19 only heightened all those feelings. In the beginning, when we didn't know exactly what we were dealing with, I would lay awake at night filled with worry about what would happen if I got sick. What if my son had to grow up without a mother? How could anyone ever relay to him just how much I love him? Will my husband really only feed him PB&J every day? For myself and a lot of my female colleagues, the balancing act of being a mother and physician has become quite difficult. But abandoning my role as physician never crossed my mind.
“My husband is an anesthesiologist as well. Since we're a two-physician household, our nanny who had cared for our son since he was 3 months old understandably asked to stay home. Because elective surgeries are on hold, my husband rarely works so we are now mostly dependent on my income. I feel fortunate to still have a paying job, despite it being high-risk, as we still have a mortgage and student loans to pay off.
“With parks, zoos, and museums closed and no contact with other adults during his time at home, our marriage became strained as I worked more and more hours in the ICU. There was resentment as he was responsible for all meals, learning, playtime, bath time, naps, bedtime, cleaning, grocery shopping, and caring for our senior beagle and rescue beagle. He had no time to take care of himself. While I fully acknowledge that this is a regular day for a lot of families pre-COVID, transitioning from being a full-time, equal financial provider to a stay-at-home dad with no help was difficult, especially since our toddler was learning the effect of temper tantrums, hitting, and spiking his sippy cup. Fortunately, after two months, my husband has found a rhythm and as the curve has flattened, I am working less.
“My son recently started walking, and one of the best feelings was when he would run to hug me when I got home from work. However, since the pandemic started, I go straight to the shower when I get home. This results in him running after me, crying, wondering why mommy won't pick him up and hug him. So I now sneak in through the back and shower first to avoid the meltdown and chase. He also now no longer lets me put him to bed. He prefers daddy and the few times I've tried, he points to the door and cries for ‘Dada.’ This one really hurt in the beginning, as it was one of the few times in the day when I would get to snuggle him and look at his tiny, peaceful face buried in my chest.
“I want to reiterate that I am very fortunate to have a job and be able to pay our bills during this pandemic. But I look forward to the day when I can cut back even more to spend more time with my son, given that time is flying by so fast. And from what other parents tell me, this time is precious and I will never get it back.”
Carmen Chinea, 62, chief of clinical strategy in Spring Valley, NY
Chinea is the mother of two daughters, including medical student Olivia Richman, 31.
CC: “The NYC Office of Emergency Medicine developed contracts with hotels in the city that were all empty, and started sending patients there who had been in the hospital but couldn’t go home because they still needed to be in isolation, or who lived in places like shelters. The city asked Hudson River Healthcare, who I work for, if we were interested in taking care of the patients in the hotels. One floor was a nursing station. We took all the beds out of the rooms, and the rooms became an exam room and medical office where I saw patients. As they were telling me this over the phone, my daughter was here in the house studying for her last part of the Boards [a test taken at varying stages in medical school]. I looked at her and said, ‘Do you want to come?’ and she said, ‘I’ve got my lab coat on. I'm ready.’
“I did my residency in the South Bronx exactly when the AIDS crisis hit. That crisis was so dramatic in my medical training. I’ll never, ever forget it. In the South Bronx, people were dying and on ventilators. We didn’t even know what the disease was. I almost felt like this was the exact same thing all over again, with a new disease. I just wanted my daughter to feel the same thing and understand what a crisis was in medicine, because that’s what you’re prepared to do when you’re a doctor.”
OR: “It was humbling working with her because at home I only see her as a mom telling me what to do, cooking and doing chores. Being out in such an intense environment where you’re dealing with people’s lives, working side-by-side with her, I saw her in a different light. I was like, ‘You are incredible.’ I was just blown away seeing her handle and speak with so many patients in the crisis we are in and her ability to manage it flawlessly.”
CC: “The new generation is more about balance. You have outside relationships; you have other activities and interests. When I was a doctor that’s all I did at the expense of marriage and even children. Both my daughters say all the time ‘Mom, don’t you remember this? Of course you can’t ever remember that. You were always working.’ Female doctors today know they want a family and know they have to find a balance. We didn’t have that when I was 30. We had to still prove ourselves, and it was still a man’s world.”
OR: “When you’re little you think, ‘Oh my god, she’s my mom. I want her to be here doing mom things with me,’ but that’s only because you don’t see the impact or the contribution that she’s making being a doctor. Working with her and seeing how she is making an impact on people's lives, I look back and I’m like, ‘Well, that was worth it because that’s the role model I have.’ I have this role model who selflessly gave herself to others, to serve others, to help save others from pain and suffering.”
CC: “There have been studies that show women spend more time with patients, they look them in the eyes more, and they touch them more in a caring way. Women have brought things to medicine that weren’t here before. But the profession still has to evolve further for women, because if we are in all the leadership positions, then maybe that guilt [around not being home enough] will change. Maybe if the hours and expectations changed, and there was more flexibility in the job, then those feelings would improve for women.”