After Leave

Returning to Work after Maternity/Parental Leave

Returning to work is a personal decision that should be made with your family. It can be helpful to get input from colleagues and friends, who have been there before, but ultimately the decision is up to you. While becoming a parent is a life changing event, you are still you, and you know yourself best. Factors that you should consider when planning the length of your leave might include if you want to split your parental leave with a partner, your financial situation, child care availability, and where you are in your residency training.

While on parental leave you may decide that you need to shorten or lengthen your leave. Keep in mind, until you meet your child you will not know how easy it will be to return to work. Some babies are easy going and good sleepers, while some, though still adorable, are not. Be willing to change your plan based on the temperament of your child, because sleep is important to your function at work.

Any time taken off residency must be made up, which will prolong your training.

  • First Rotations

    When planning your return to work, select rotations that will help make your transition back to work as smoothly as possible. If you are still breastfeeding, you might choose rotations that have no or very little call so you can physically be present to breastfeed more easily. Other people find they just want to “get the worst of the call over with.”

    Your schedule will already have been disrupted if you have taken any parental leave, so it is generally not much more trouble to amend your schedule with your Program Director. Plan out your return-to-work rotations when you are arranging your parental leave. It will save you time, hassle and worry about returning to a demanding schedule. Even if you have not taken any time off, your program may be able to rearrange your schedule so that you are on a lighter schedule when your child is a newborn. Given the distributed model of medical education in BC, you might want to consider requesting rotations closer to home in advance.

  • Breast Feeding

    RCH Breast Pump Location
    Royal Columbian Hospital has a Staff Pumping Room located on the Maternity Ward (3E) in the Health Care Centre Tower. Ask at the nursing desk for directions. The room is down the hall to your right as you walk in to ward, in a corridor on the left (next to the patient pumping room). Not all nurses know that there is a staff pumping room so if the first person you talk to is unsure, be persistent. The room is equipped with a Medela institutional breast pump. Nursing staff are very helpful and will happily show you how to use the institutional pump. Sterilized attachment parts are available for your use. The attachment parts are stored in the patient pump room next door. Once you are done, rinse the milk off the attachment parts and place them in the “dirty” bin in the patient pumping room. There is a logbook in the room. Try to remember to sign it, as it shows how much use the room gets and how important it is to breastfeeding staff.

    BCWH/BCCH Breast Pump Location

    A Medela institutional breast pump is located on Arbutus Ward at BCWH. The key to the room is at the nursing desk. Pump attachment parts are located in the back room behind the nursing desk. Nursing staff are very helpful and will happily show you how to use the institutional Medela pump.

    Locations without Pump Facilities

    • Queen’s Park Care Centre
    • Eagle Ridge Hospital
  • Childcare

    Returning to work, whether shortly after your child’s birth or at the end of a full year of leave, is a time of adjustment. There are many options for childcare and may include care within your family (your partner, grandparents) or getting help outside the family (day homes, day cares, live-in nannies, live-out nannies, on-call nannies). Each has positives and negatives, and many residents utilize a combination of the above. Trying to find available, quality and affordable childcare that can work with the busy schedules that residents keep can be difficult. If local daycare is an option for your family, apply for a position as soon as you have a positive pregnancy test or confirmation from your social worker as spaces are often limited and there are long wait lists.

    The provincial government has several online references to help you understand your childcare options; these can be invaluable in the planning stages. They also have a child care programs map to help you locate child care in your area that meets your needs. You can also visit your local Child Care Resources and Referral Centre for more options

    The Westcoast Child Care Resource Centre in Vancouver has a number of informative brochures on childcare available on their website.

    Family Care

    Your spouse may be interested in being a stay at home parent either part-time or full-time. Grandparents or other relatives may also be interested in providing childcare either part or full-time as well.

    Day Homes

    These may be licensed or unlicensed. Usually, an individual offers childcare within their own home to others; they often have children themselves. Whether they are licensed or unlicensed depends on the number of children in their care, the goals of the program (tutoring vs. childcare), and how long the care is offered for (occasional vs. regular care).


    Daycares can be hard to come by. Some health regions or hospitals have daycares associated with them. In the lower mainland, Vancouver Coastal Health has contracted the YMCA to provide daycare sites at VGH (Kids at Heather), and BCCH/WHC/GF Strong (Kids at GF Strong).

    There is a provincial childcare subsidy for parents in financial need.

    In many communities across BC there are Child Care Resource and Referral centres, which can provide you with guidance on choosing a child care provider and referrals to providers that can meet your family’s unique needs.

    The Ministry of Children and Family Development also provide a childcare programs map which allows you to search for childcare in your area, based on your needs.

    The Advantages of Daycare

    With so many toys, activities, and other children, daycare can be highly stimulating. Good daycares have educated and experienced teachers, who can give you lots of advice and will have your child potty-trained by age one. Daycares are registered and regulated by the government, and you don’t have to open your home to anyone. Daycares are great places to meet other families and form lasting friendships. Your child will develop social skills and some daycares have extensive education programs to teach your child everything from mathematics to languages. Conveniently, certain health regions and hospitals have daycares associated with them: In the Lower Mainland, Vancouver Coastal Health has contracted the YMCA to provide daycare sites at VGH (Kids at Heather), BCCH/WHC/GF Strong (Kids at GF Strong).

    The Disadvantages of Daycare

    With so many other children, germs are unavoidable, which means you will have to deal with finding alternative care if your child is too sick to go to daycare. Having to pack up your child every morning may be stressful and time-consuming, and if your work schedule doesn’t coincide with the daycare’s hours you may have to pay more for extended care or arrange for someone else to pick-up/drop-off your child. Some daycares may dictate when your child has to be off the bottle, take naps, etc. Turnover can be high, so if caregiver consistency is important to you this may be an issue.


    Nannies can be Live-in, Live-out, or On-call.

    Live-in nannies live in your home and provide childcare. The Live-In Caregiver Program is a federal program that “helps Canadians hire foreign workers to live and work in their homes to care for children.” This link summarizes the obligations in BC to hired domestic employees.

    Live-out nannies live outside your home, but provide childcare in your home. They may be permanent full-time, part-time, occasional or temporary.

    Nannies on Call are able to assist with permanent placements, and also provide on-call and temporary nannies.

    If you don’t have a stay-at-home spouse and family assistance is unavailable, you will likely find yourself looking at the big question of “nanny versus daycare.” So how do you decide? Ultimately, the decision will be entirely personal and depend on convenience, finances, and the needs of your child. You may decide to use both, starting with one and switching to the other later on, or having a part-time nanny to fill in the times daycare is unavailable.

    The Advantages of Nannies

    Nannies provide one-on-one care, and can cater to your child’s individual needs and schedule. She works out of your home, so all you have to worry about in the morning is getting yourself ready since the nanny will take care of dressing and feeding your child. In addition, your child is being cared for in a familiar and comfortable environment. If you child is sick, you don’t have to worry about staying home from work or finding back up childcare. Nannies can be either “live-in” or “live-out,” and the services they provide range from basic childcare to full-fledged housekeeper. With a nanny, you have more control over what values and rules are taught. A good nanny can be almost like another family member, a true Mary Poppins, taking care of the children and helping you keep your family life in order.

    The Disadvantages of Nannies

    The most obvious disadvantage is cost. Nannies can be quite expensive, as you are essentially paying someone’s salary. (On the other hand, with multiple children the cost can actually work out to be more economical.) Other concerns include privacy, as she will be in your home, and security, as there is no formal registration process for nannies and you don’t know what she is doing all day. If your nanny is sick or takes vacation, you will need to find alternative childcare. And don’t forget about the paperwork involved in paying someone’s salary; unless your nanny is self-employed, you will have to deduct EI, CPP and income tax from their wage. Finally, finding the right nanny to fit with your family can take a long time, and you may have to go through a few people to find the right person.