The day I was asked to choose between caring for my preterm baby and my job in academia
There are stories that you would prefer to never hear. Perhaps this is one of them, especially if you are a mother in academia or if you plan to be one someday.
In 2019, I won one of the most prestigious and ferociously competitive research grants in Spain. I was planning to start my new job in the end of that year, when I discovered I was pregnant. The happiness did not last. One day I started bleeding heavily and the doctors said that it is extremely likely that I would lose the baby. I was put to bed rest and had to delay my starting date in the new job.
The months passed, the critical first trimester was over, and the doctors started smiling again. I was happy. I was told I could return to work, so I started my new job in February 2020. Three weeks later, at 20 weeks of gestation, a delivery was induced, because my life was in danger due to chorioamnionitis. My dear daughter was born sleeping. Too small to survive. I never saw her, I never heard her. Waking up without her was the most difficult moment of my life.
As soon as I was discharged from the hospital, COVID-19 entered our lives. We were confined. The pandemic did not break my spirit. My loss did not break my spirit. I worked hard throughout all that time. I published a lot, I recruited two PhD students and secured funds for them, I designed new experiments. In terms of research, I had been active even when I was losing my baby, even right after I lost her. In Spain, a sick leave for pregnancy risks is terminated upon giving birth and is followed by a maternity leave. Not for me, though. I had given birth, but I had no baby. What could I do? I put on my big-girl pants and returned to work, adapting to the new reality of remote working.
Eight months later I was pregnant again. When I started bleeding again, the doctors looked at my medical history and explained that the road would be bumpy. I was put on bed rest to survive the critical first trimester. Around week 13, I had a cervical cerclage to prevent early delivery as much as possible. Being operated while pregnant is terrifying beyond what words can say. Constant vomiting, pregnancy insomnia and a prescribed cocktail of vitamins and medicines made me dizzy and disoriented. However, once again, I tried to work as much as I could. Not because I am a workaholic or an overachiever, but because I wanted to be able to provide for me and my family. You see, my fellowship makes provisions for a permanent contract after the end of its five-year duration, and a good CV would maximize my chances of securing a stable employment. This time, though, I could not be very productive.
The weeks passed and as I reached the 20-week mark, Ι tried to keep anxiety at bay. The memories of my previous pregnancy were fresh. The doctors were certain that my pregnancy would not be full-term, but they did not know how much it would last. I was given an endless list of heart-breaking percentages. Most infants born at 22 weeks of gestation do not survive. Those that do survive are likely to have severe health issues, often caused by brain bleeding. At 23 weeks, the chances of survival improve. Still, the prognosis is not great. At 25 weeks things become much better. It is still extremely early (a typical full-term pregnancy lasts 40 weeks), but hope exists.
At 23 weeks, I was talking to the little one, asking her to hang in there a little longer. My cerclage was holding up, although there were clinical markers of labor approaching fast. Every minute, every hour, every day mattered. I kept saying to myself that I can and will win this battle.
My waters broke at 25 weeks and 1 day. Using a strong cocktail of various drugs, the doctors tried to delay labor. Intravenous steroids would help my unborn baby’s lungs to develop more quickly. At that point, I had no veins left from the many injections and blood extractions. I could hardly move my hands.
I gave birth at 25 weeks and 6 days. 1 May 2021, the happiest and scariest day of my life.
My daughter did not cry as infants usually do. She was too weak to do that. Born 780 grams, she could fit in one hand. I did not have the chance to see her or touch her; she was rushed to the Neonatal Intensive Care Unit. I asked the doctor whether she was alive. Their answer will haunt me forever: “We’ll try our best to make her breathe”.
Only a nurse stayed with me in the delivery room. Not even my husband was allowed in. I was paralyzed with fear. I kept saying to myself that we will make it, my daughter and I will win this battle. Some half hour later a doctor came by to tell me that a wheelchair is on the way, I would be taken to see her.
She was tiny, connected to a million machines. The doctors said that the first hours are critical. I sobbed next to her incubator, hoping that she will survive the critical night. She did. The next morning her brain scans came back good. No bleeding. However, her lungs were not fully developed, her ductus was not closed, she was extremely weak. The days passed. The ductus closed. She became stronger, she started growing well. The doctors said that we should wait, but we could start being optimistic about the future. Innumerable heart and brain tests followed. All results came back good. The doctors explained that my daughter is well; we have been extremely lucky. They also explained that extreme prematurity entails certain weaknesses for the first 1–3 years of life, depending on the severity of the case. We spent months at the Neonatal Intensive Care Unit. At the hospital, I was told that my maternity leave would be extended for the period of my daughter’s hospitalization, and that later, I would have the option of reducing my working hours to anything between 50%-99% in order to care for her. The doctors prohibited contact with other kids for fear of infections and this is when I first learned that my daughter cannot go to a nursery. Any virus she catches in her first two years of life can cause serious damage to her lungs. Her diagnosis has a scary name: bronchopulmonary dysplasia. However, if we follow all the instructions, if we keep her safe, if she does not catch any virus, it is extremely likely that her lungs will not suffer any permanent damage and by the age of 2 she will be like any full-term, healthy child of her age.
When I wrote to my employer in order to ask for a reduction of my working hours, they correctly said that they have to consult the Spanish Ministry of Science and Innovation to ask for the relevant permission. After all, the fellowship that pays my salary comes from the ministry. The devastating news came a few days later: Yes, maternity leave and sick leave during pregnancy can and will give rise to an interruption and extension of my grant but caring for a minor with disability (extreme prematurity is considered a disability during the first 1–3 years) does not. Yet, if I do not work and if the grant is not extended, I will lose all the money I fought very hard to win, right? Not their problem.
I was sure there was a solution to this problem. After all, I have been working so hard for so many years, that people would inevitably realize that if I needed some time off now, this is because my child truly needs me. I thought that since the law gives working mothers who care for children with serious conditions the right to reduce their working hours and given that extreme prematurity is included in this list of conditions, I must have the same right as everyone, without losing my grant.
I called a high-powered lawyer. She said she would investigate the matter. A few days later she called me back. I could not extend my grant. I can quit it of course (effectively quitting my job), but I cannot extend it, beyond the periods of my maternity/sick leave. I asked her how I am supposed to go back to working full time, when my daughter has an average of 4 medical appointments and 2 sessions of physiotherapy every month. Who would accompany her, if not me and her father? I explained that the doctors’ advice is to keep her at home, avoiding close contact with friends or strangers, for at least a year. Who would take care of her if I don’t reduce my working hours? The lawyer looked at me straight in the eye and said: “It seems that you must choose between caring for your daughter and keeping your grant”.
Years and years of hard work reduced to this. Fortunately, there are solutions, the lawyer added. “Go on a sick leave. The law grants you this right and this will automatically stop your grant clock from running and extend it accordingly. Doctors are very sympathetic and I’m sure they will give you permission once you explain the situation”. In other words, lie. Pretend I have depression, anxiety, anything. But I do not want to lie. I have never lied to avoid work. As a female scientist who has worked hard throughout her career, I want to be given the fundamental right to care for my baby. Without losing my job, without losing my grant, without being deprived of the opportunity to build a competitive CV. The lawyer shook her head, she said she understood, but that’s the situation we are facing.
Yes, there are stories that you would prefer to not hear. Probably this is one of them. I wish I did not need to tell it either, because it is a bleak, painful story. However, I must tell it because I refuse to endure this injustice in silence. I refuse to perpetuate the silence that surrounds pregnancy loss, stillbirth, birth and all their consequences for women’s professional life. I refuse to remain silent about the obstacles society puts to women. Specifically, in the case of academia, every other week I come across tweets from extremely hard-working scientists who wonder whether and how to account for their drops of productivity when miscarrying, when giving birth, when caring for a minor with or without problems. The struggle is real.
I will not quit my job. I will not stop taking care of my daughter. For as long as the circumstances (aka grandma’s invaluable help) let me, I will do both, working as much as I can. I hope that after years of hard work, this will be enough to get me a stable job at the end of my fellowship. If it isn’t, I will become a statistic, succumbing to the motherhood penalty. However, I have won battles harder than this one.
As I look into the eyes of my beautiful daughter, I borrow her strength in order to tell this story for me, for her, for all the women in academia, and especially for those women who are in a less privileged position than me. Next to the stories that society prefers to not hear, there are stories that describe victories, stories that little by little change the world and dispel ugly silences.
