Episode 15 - what to expect in nursing when you're expecting
May 11, 2026
About This Episode
For nurses, returning to work after having a baby requires balancing patient care with the realities of early parenthood. In this episode of Better, RN, hosts Alyssa Saklak, BSN, RN, CMSRN, and Laurin Henderson, MSN, RN, CMSRN, join Northwestern Medicine Neonatal Intensive Care Unit (NICU) nurses Moira Hoelting, BSN, RNC-NIC, and Kelly Kunkel, MSN, RN, to discuss the transition through pregnancy, the newborn stage and beyond.
They explore returning to work after leave, practicing routines like pumping or childcare in advance, and the importance of building a support system to manage the emotional and practical challenges of being both a nurse and a new parent.
“We are so lucky to work with people that are so supportive … they're always making sure you get out to pump or just take a break. I think we're just lucky to work in an environment that's so supportive of women and new moms.”
Moira Hoelting, BSN, RNC-NIC
NICU Clinical Coordinator, Northwestern Medicine
“For me, it was easier when I actually went back to work than the thought of going back to work. Once I was there, back in the routine of things, things felt better and easier, and I was feeling empowered.”
Kelly Kunkel, RN
NICU Nurse, Northwestern Medicine
For nurses, returning to work after having a baby requires balancing patient care with the realities of early parenthood. In this episode of Better, RN, hosts Alyssa Saklak, BSN, RN, CMSRN, and Laurin Henderson, MSN, RN, CMSRN, join Northwestern Medicine Neonatal Intensive Care Unit (NICU) nurses Moira Hoelting, BSN, RNC-NIC, and Kelly Kunkel, MSN, RN, to discuss the transition through pregnancy, the newborn stage and beyond.
They explore returning to work after leave, practicing routines like pumping or childcare in advance, and the importance of building a support system to manage the emotional and practical challenges of being both a nurse and a new parent.
“We are so lucky to work with people that are so supportive … they're always making sure you get out to pump or just take a break. I think we're just lucky to work in an environment that's so supportive of women and new moms.”
Moira Hoelting, BSN, RNC-NIC
NICU Clinical Coordinator, Northwestern Medicine
“For me, it was easier when I actually went back to work than the thought of going back to work. Once I was there, back in the routine of things, things felt better and easier, and I was feeling empowered.”
Kelly Kunkel, RN
NICU Nurse, Northwestern Medicine
transcript
[00:00:01] Alyssa Saklak: I'm Alyssa Saklak.
[00:00:02] Laurin Henderson: And I'm Laurin Henderson.
[00:00:03] Alyssa Saklak: On Better, RN, we get real about nursing --
[00:00:06] Laurin Henderson: the good and the gritty.
[00:00:08] Alyssa Saklak: We talk to real healthcare experts
[00:00:10] Laurin Henderson: with the goal of becoming better
[00:00:12] Alyssa Saklak: for our patients, our colleagues,
[00:00:14] Laurin Henderson: our family, our friends,
[00:00:16] Alyssa Saklak: our partners and ourselves.
[00:00:20] Laurin Henderson: Hi, Alyssa.
[00:00:21] Alyssa Saklak: Hi, Laurin.
[00:00:22] Laurin Henderson: We are back for season three. I can't believe they keep letting us do this.
[00:00:25] Alyssa Saklak: You have some awesome news to share with the listeners.
[00:00:28] Laurin Henderson: Yeah. A lot has changed since last season. I had a baby in September. It was the most incredible thing that has ever happened to me, so I just have this completely different outlook on everything. My whole life, my work — everything has changed.
[00:00:41] Alyssa Saklak: In this episode, I'm asking for a little homework from our listeners. I need you to share this episode with anyone that you know who is a new mom or new parent, because we're going to dive into it. And we have two awesome guests.
[00:00:54] Laurin Henderson: Today, we're talking to two nurses who work in our Neonatal ICU here at Northwestern Medicine. Kelly Kunkel is a NICU nurse; she just had her first baby last summer, and she is going to talk to us about returning to work. We'll discuss the challenges of being a first-time mom and how she and her partner navigate being two working parents with a new baby. And then we are also talking to Moira Hoelting. Moira has two children, and she's currently pregnant with her third. She is a clinical coordinator in our Neonatal ICU and works closely with Kelly. They've been friends for a long time, so I'm really looking forward to talking to both of them today.
[00:01:27] Alyssa Saklak: Families nowadays, with the beauty of medicine, can be created in so many different ways. I'm really excited and interested to learn about their experiences, especially as we look at the phases of pregnancy, postpartum, childcare, breastfeeding and pumping. There is so much information out there, but I am really interested to hear through the lens of healthcare workers and nurses, because there's a difference. We have different jobs, and we care for people in the hospital, and then we go home and have loved ones we have to care for, too.
[00:01:57] Laurin Henderson: It can be exhausting, but we're also going to talk about how beautiful and wonderful it is to be a parent, to be on the journey to become a parent, and to work with people who are supportive and understand the things that you're going through. I'm really excited to get into it.
[00:02:12] Alyssa Saklak: Welcome to the show, Kelly and Moira.
[00:02:14] Moira Hoelting: Thank you. We're excited to be here.
[00:02:17] Laurin Henderson: Before we jump in, Kelly, you wanted to share something?
[00:02:20] Kelly Kunkel: In this episode, we refer to our experience as being mothers and use the term "mom" a lot, but we want to acknowledge that these topics can apply to any birthing or non-birthing parent, in whatever way you identify yourself, and hope that our stories can relate to anyone along their journey of parenthood.
[00:02:33] Alyssa Saklak: Tell us a little bit more about your family, if you're comfortable, and where you're at. I know there are a couple of new moms here.
[00:02:39] Moira Hoelting: My name's Moira. This is my 15th year at Northwestern Medicine in the Neonatal ICU, the NICU in Prentice. I'm currently pregnant with my third baby, so I'm due in the next few weeks. My first is 4 and a half. My husband and I struggled with infertility for many years, so we also have a different take on starting a family. Our daughter is 4 and a half, and then we did IVF and have our second child, who just turned 2. And then with this third baby, we were prepping to do another embryo transfer and ended up pregnant on our own. So, it was a nice surprise. We've had babies in every different way.
[00:03:16] Kelly Kunkel: My name's Kelly. I also work in the NICU with Moira. I started in 2018, so this is my eighth year. I've been there ever since graduating nursing school, so all I know is NICU. We love it. I just have one baby; his name is Simon. He's now 9 months old. I'm in a same-sex relationship, so me and my wife, Gaba, went through our own fertility journey — not for the purpose of infertility, but we ended up doing two rounds of IUI and got pregnant that way.
[00:03:45] Alyssa Saklak: Laurin, what's your journey? Do you mind sharing?
[00:03:48] Laurin Henderson: Yeah, so I had my first baby at the end of September. Everything went really well with my pregnancy, delivery and postpartum. And then I came back to work after a little more than three months. My maternity leave would have ended right at the end of December, and I came back right at the beginning of January, so a little longer than that 12 weeks. Did you all take a little bit longer time too?
[00:04:11] Kelly Kunkel: We each did. We both extended our leaves. I had complications with my recovery after I delivered, so mine was extended by four weeks, so I ended up taking 16.
[00:04:21] Moira Hoelting: This is something we both talk about a lot. If nurses that we work with are asking about how to go about leave, one of our biggest topics is making sure you're really pushing for extending your FMLA portion of your leave if you're having medical complications, because so much goes wrong. Obviously, we see that with working with NICU families, but we are both big advocates for standing up for yourself and taking extra medical leave if you need it. For my first, I had medical issues with mastitis, so I extended my FMLA. And then for my second, my son, I ruptured early and had an antepartum stay, and then ended up delivering him at 33 weeks. With him being in the NICU, I took a personal leave. So, we both ended up getting around 16 weeks.
[00:05:08] Kelly Kunkel: I wouldn't have even known that this was an option if it weren't for Moira, so she helped me through that whole process. It's just hard to know how to navigate.
[00:05:17] Alyssa Saklak: It does require advocating for yourself and asking questions. I love the nursing profession because of the community we have. We learn from each other, and hopefully this episode can highlight that for people who are going through it themselves.
[00:05:29] Moira Hoelting: Yeah, I think that's a huge thing for nurses. Even now, I'm over 37 weeks pregnant, and people keep asking me when I'm going to stop working. We just work until our water breaks at work, literally. But there's so much you have to do to stand up for yourself and know what is good for you and your body. That's why I think talking about it and talking to other people about what your options are is so important. If coming back at 12 weeks isn't realistic, then don't come back at 12 weeks.
[00:06:00] Laurin Henderson: I think there's this — which we're getting better about now — but there is sort of this veil over pregnancy, postpartum and returning to work. It's like a badge of honor that, "Yes, I'm a mom and I'm working full-time and I can do both things perfectly." And that it's not hard and this is just what you do because you're a working mom. But people are talking about it more, that it is so hard. I don't know about either of you, but sometimes I feel like I'm not doing my best here. And then when I go home, I have those precious two hours before it's bathtime and bedtime with my family, and then I feel like I'm not doing my best at home. It's this internal struggle. I used to think it was only a "me" thing, but now I'm realizing more people are talking about it, thankfully. I don't know if you two share that experience, but that has been really hard for me in coming back to work — the imposter syndrome of wanting to be in the place that I'm not.
[00:06:58] Kelly Kunkel: My wife actually talks a lot about this. She's not a nurse, but she works from home. If Simon is sick or something, if he has to stay home from daycare, a lot of that falls on her because, as nurses, we are completely out of the house when we're at work. We can't be doing both. So, a lot of times she ends up having to half-work and half-be a mom, and she has a really hard time with that. I have a really hard time with the fact that when we go to work, we work these 12- or 12-and-a-half-hour shifts. On the days that we work, I don't get to see Simon at all. He's still sleeping when I leave and he's already asleep by the time I get home. If I'm working two days in a row or a weekend, I put him to bed on Friday night and I don't see him until Monday morning. I can give my whole self to him when I'm home on my days off, and I can give my whole self to work on my workdays. It's still hard to do both because you're just missing out on so much.
[00:07:47] Moira Hoelting: It really is like that. When I had my first daughter, I was still on night shift. We have a ton of nurses that stay on nights for a very long time because then you can still see your child every day. I would sleep less, wake up at 1 or 2 pm and go get her from daycare early so I could spend time with her before going to work. For my second, I was on day shift. Sometimes I look back and think nights were kind of nice because then I saw her every day. I feel that guilt now where, like Kelly said, you'll go two straight days without seeing your kids. There's always that guilt and questioning if this is the right way to go about this phase of life, doing 12-hour shifts. But then the trade-off is I have four days at home, where I am completely home the whole day. Even between me and my husband, those days just function so much better because we're both there and can both support the kids. It's really hard to take care of small children.
[00:08:40] Laurin Henderson: It's such a double-edged sword. I agree. When I came back from maternity leave at the beginning of this year, I cried the whole week leading up to it. The day before, I woke up crying because I just knew it was going to be such a change. I felt like I was just getting the hang of this and figuring out how to do this with a baby. I Googled positive statistics about children with working moms. I typed it up on a Word document, and I have it in my office taped by my phone and taped on my file cabinet in front of me. For the first month and a half, it was my phone screen background because I just needed this constant reminder. Yes, it's important to be a mom, but also, I hold so much value in the work that I do every day, the people that I work with and the things that I'm able to do as a manager in medicine. I wanted to be able to do both of those things, but I did find that I needed that reminder that this isn't all bad. Daycare is good, and they can get a "village" to help raise them and develop relationships with other people.
[00:09:41] Kelly Kunkel: This is very fresh in my life right now because Simon started daycare at six months. Me and my wife staggered our leaves, so we ended up waiting until six months to send him. Since then, over the last three months, he's just been sick on and off. We started daycare in January, so it's just been the peak of sickness.
[00:10:06] Moira Hoelting: I was in a situation where I had to extend my leave because of my son being in the NICU, and that completely drained my PTO. I came back with zero hours of PTO. Anytime he was sick — and a preemie baby going to daycare is definitely getting sick right away — I was either getting an occurrence for that or my husband would have to stay home from work.
[00:10:26] Laurin Henderson: How have things changed for you, being nurses, before you had children versus after?
[00:10:31] Moira Hoelting: You don't need to be a parent to be a great NICU nurse, but it just changed the way I feel for these parents and what they're going through. I think it definitely made me more emotional in a way at work, where certain cases hit me differently than they used to, just because we're in the midst of having children too. We're in that phase of life. Maybe that will change as we get older, but right now, some days I'm like, "Wow, that hit me hard."
[00:10:59] Laurin Henderson: Yeah, I feel like the hormones, too — I just had a baby seven months ago, and anything could make me cry. I could cry right now if you wanted me to.
[00:11:07] Kelly Kunkel: I was actually going to say that, too. Before having a baby of my own and going through it, moms would be crying in the NICU, and people would blame it on the hormone crash, postpartum hormones and everything they're going through. But going through it myself and not being able to control my emotions and just crying over nothing, now I see it is so legit. Obviously, they do have more going on with the whole NICU experience and everything with the baby, but the hormone crash is insane.
[00:11:34] Moira Hoelting: My son was in the NICU for a month, and Kelly took care of him, plus a lot of my favorite NICU people. I could cry about that every day, but it made me love my co-workers even more than I already do. I love what I do for a living. My daughter's 4 and a half now, so I can actually talk to her about how I am sad to leave her tomorrow, but also that I get to go and take care of these very small babies. Then I can tell her about the babies, and she'll ask, "How many babies were born today?" She can be a part of understanding why I go to work and why it's so important. I think that also helps as your kids grow up — being able to explain how important nursing is and what we do. Even though I'm sad to leave her, I also love going to work.
[00:12:24] Laurin Henderson: You hear so much about how hard it is. It's hard to have a newborn, it's hard when they start teething and it's hard to go to work. All of this stuff is hard. I saw this quote once that said you've been tired before, you've been stressed out before and your house has been dirty before, but you've never felt the joy that you will feel when your baby smiles at you for the first time or when you reach some other milestone. How do you find the joy in being parents?
[00:12:54] Moira Hoelting: We are so lucky to work with people who are so supportive. If you come to work, everyone asks to see a picture of your children and what they are doing. We have pictures hanging in the office of our kids. Everyone is so supportive, especially right when you come back. They're always making sure you get out to pump or just take a break. I think we're just lucky to work in an environment that's so supportive of women and new moms.
[00:13:18] Laurin Henderson: Definitely. I am currently breastfeeding, but then pumping during the day at work. But I am in a manager position, so I have more flexibility to be able to sit in my office and do administrative work while I pump. How do you find the time to do that, working in such a fast-paced NICU environment, if that is something that you do?
[00:13:35] Kelly Kunkel: Yeah. Moira and I have different roles. I am mostly at the bedside. In the way our unit is set up, it's what we call "pods." There are six babies in a pod and two to three nurses watching those babies. If you need to step out for lunch or to pump, the other nurses in your pod take care of your patients while you're gone. I came back from maternity leave at a time when our unit was extremely busy, and our unit is really good about working together. Our co-workers always tell you to go pump whenever you need to. Even if that means they have to do double the work, they pick up where they can. But it was tough coming back, having to find three different times in the day to step out for 20 to 30 minutes at a time. When I step away from my patients, there's nothing I can really do patient care-wise while I'm gone, so I'm leaving that entirely to my co-workers. Leaving that work on the person you're working with for the day was difficult.
[00:14:33] Moira Hoelting: And I'm in a CC role, so I feel like it's probably easier for me to step out because I don't have specific patients that I'm responsible for. I can just say that I have to go. But there is always that guilt when people are calling you for help, and you still have to find the time to leave. We're very lucky that our co-workers will say, "You need to go; go now, we're going to be fine." People really make sure that you leave to go take the pumping time. We have a whole room with a fridge and a sink, and it's very peaceful, so I feel like we have a pretty good setup.
[00:15:06] Alyssa Saklak: I was talking to my primary care provider about postpartum and risk factors. I asked if having previous mental health issues would put me at a higher risk, and he said the most driving statistic is the amount of support you have. That stuck with me — the importance of making sure that you're building that village and that support system. That community is going to help you so much during these tough times. I love the support that I've been able to see, and I can see it between you two and your co-workers. That community makes it so much easier.
[00:15:44] Moira Hoelting: My younger sister has a baby and she's going back to work next week. She's an engineer, so she is one of two female engineers in her office. I was talking to her this week and asked if they have a pumping room, and she didn't know who to ask about that. We're so lucky that there's so much ingrained in our culture already, and we have all these women surrounding us and encouraging us. She's in an environment where I don't think any of her co-workers even know what's going on with her. There are some big benefits to being in a women-led field.
[00:16:17] Kelly Kunkel: Logistically, for me, I was mostly breastfeeding before I came back, so pumping was pretty new for me. I texted Moira one day before I came back and she said she would just come over and talk me through everything I needed to know for my first day back. Even just that was so helpful.
[00:16:33] Alyssa Saklak: There's so much out there. There are wipes and different pumps, and it's overwhelming.
[00:16:39] Kelly Kunkel: Yeah, like, do I really not need to wash my pump parts? I can just put them in the refrigerator? Is that legit?
[00:16:43] Laurin Henderson: Yes! Oh my gosh, it changed my life.
[00:16:46] Moira Hoelting: We work with mostly pumping moms because, in the NICU, very few babies are ready to breastfeed. Almost all of our moms are pumping, so we do have a lot of experience with it. I feel like pumping myself really helped me take care of more patients and more moms at work because I can tell them what they need and what it's really like. Pumping is not easy, and it's not enjoyable.
[00:17:12] Laurin Henderson: Breastfeeding and pumping is such a journey. I did not prepare for it very well because you can read a couple of things, but until you are actually doing it... When my milk came in, I thought I was going to die. I had no idea that's what was going to happen. All my friends were having babies, too, and they said they didn't know how much to tell me or what I wanted to know. I didn't know the questions to ask. To have people who have done it before you who are willing to come over and give you a crash course is just so helpful.
[00:17:53] Kelly Kunkel: It's so funny that you say that, because we work with breastfeeding and pumping moms every day in the NICU. But when it's happening to your own body, I was still like, "Wait, what is happening?" The day my milk came in, I was so caught off guard. Even though we see this all the time, I can tell a mom a million times that it's normal that her milk hasn't come in yet. Then, when it was happening to me, I was crashing out and crying all day because I thought my milk was never going to come in.
[00:18:17] Laurin Henderson: As a nurse, we know too much, but then when it's me, it's like, “well, that doesn't apply.”
[00:18:22] Moira Hoelting: Of course. Your brain doesn't work when it's your own baby. I remember being terrified. Do I know how to take care of this baby? And then I remembered I'm actually a NICU nurse, but I was still terrified of this whole newborn phase because your brain stops working.
[00:18:36] Alyssa Saklak: That's so validating for people to hear because I think there's a pressure when you have this knowledge, but yeah, it's this immense pressure to be like, "Do I even know what I'm doing?"
[00:18:47] Laurin Henderson: I hope it's reassuring to know that even NICU nurses don't know what they're doing with their own kids.
[00:18:52] Alyssa Saklak: This is just a selfish episode so that I can be prepared.
[00:18:55] Laurin Henderson: So, Alyssa and her wife are on their family planning journey. What are your real-life mom tips and tricks for keeping a newborn alive?
[00:19:02] Kelly Kunkel: My real-life tip and trick for my own brain was that everybody has done this before me, and the baby is going to survive and be OK no matter what. I try not to get too fixated on the little things. I try not to go on the internet too much and look at what other people are doing. That might be helpful for some people, but for me, we needed to figure out what works for us and for our family. Alyssa, lucky for you, it sounds like you're married to a woman. So that's my real-life tip and trick: be married to a woman.
[00:19:30] Moira Hoelting: Kelly's wife, Gaba, was just bringing things to the bedside without being asked. Kelly had to be in bed a lot, and things just appeared for her.
[00:19:39] Kelly Kunkel: Yeah.
[00:19:40] Moira Hoelting: Gaba didn't even ask what she needed. She just knew. My husband literally never once knew what I needed; I had to ask every time.
[00:19:48] Kelly Kunkel: And your husband is great and wonderful, but it's a different brain.
[00:19:52] Moira Hoelting: Just understand women.
[00:19:53] Laurin Henderson: Yeah, the husbands try. My husband did his best, but I think you're just such different people; such different things are happening. How are you able in your own homes to prioritize your health and your relationships with your partner during these really challenging times, when your kids are sick and people are having to flex their schedules?
[00:20:14] Kelly Kunkel: Probably something that we need to work on in this household.
[00:20:17] Moira Hoelting: I think in probably every household, this is a bigger-picture issue in many industries. We work with a lot of moms who are going back to work after two weeks because they want to save their time for when their baby comes home.
[00:20:31] Alyssa Saklak: Throughout my time here at Northwestern Medicine, I've seen the different opportunities to pivot within nursing to make it work. We go for careers that match our passions, and both of you mentioned how that helps your "why" and balancing it all. But there are also different leadership or hybrid positions. The list of career opportunities is endless, and sometimes there are pivots in your career to match things outside of work. Have you had to consider different positions?
[00:21:03] Moira Hoelting: We both wouldn't leave the NICU setting. But something I see a lot as a CC on the unit is people coming to us about going part-time or casual. We have management that's very supportive if you need to cut back hours but don't want to completely leave. Being able to do that — where you can work two days a week or go casual — has been refreshing. We're not making people wait years and years to cut back their hours. If this is what you need right now in your life, you can go part-time. Often, it comes back around later when they reach a new phase and return to full-time. That is something really special in nursing that I hope all units are able to support.
[00:21:42] Laurin Henderson: What advice or words of encouragement would each of you give to a new parent returning to work from leave?
[00:21:50] Kelly Kunkel: I was working with a lactation consultant before I went back to work, and she suggested taking a few days, ideally a week, to simulate your pumping schedule at home. I was mostly breastfeeding up until then, and pumping is a different way of emptying milk, so it took my body a little bit to get used to it. It was really helpful to work out those kinks before being back at work and solely relying on the pump. For me, it was easier once I actually went back to work than the thought of going back. Once I was there and in the routine, things felt better, and I was feeling empowered to do it.
[00:22:33] Moira Hoelting: Yeah, I think that the anticipation is much harder than once you get there. For us, we work with our friends, genuinely. Once you're there and you get to see them and they're asking about the baby, it's refreshing to spend a day taking care of patients and other people's situations. It takes your mind away from hyper-focusing on how long your baby is napping or when they're eating. It's almost like a little bit of a brain relief to think about this mom and this baby and what they're going through. Someone also told me to do a "practice" daycare day the week before, where you are home — go get a massage or something — and send your kid to daycare. Then you go pick them up early and see that they are completely fine. They have no idea they're at daycare; they just figure it out. That really helped me; we did a practice day before going back with both our kids.
[00:23:38] Laurin Henderson: I did the opposite. I did a dry run of me leaving my baby — me coming to work — before we sent our baby to daycare. I wanted to get used to my new normal first, knowing she was home with her dad and okay. Then I'll worry about daycare once I've ripped the band-aid off of coming back to work. Either way, I love a dry run. I think it's so helpful before you come back.
[00:24:02] Moira Hoelting: And you can ask at daycare — on our first days back, I told them it was really hard and asked if they could send a ton of photos. They always did that for us during the first week, sending an overload of photos. That really helped me.
[00:24:15] Alyssa Saklak: Well, thank you so much for coming onto the podcast. I now have a long list of tips and tricks, and I'm also getting your numbers for house calls. Thank you so much for sharing your knowledge, your realness and your expertise on being a healthcare worker and parent.
[00:24:38] Laurin Henderson: Thank you both.
[00:24:39] Moira Hoelting: Thank you.
[00:24:45] Laurin Henderson: Thank you for listening. Please follow us wherever you get your podcasts, and rate and review the show.
[00:24:49] Alyssa Saklak: We'd love to hear your comments and any topics you might want us to explore.
[00:00:02] Laurin Henderson: And I'm Laurin Henderson.
[00:00:03] Alyssa Saklak: On Better, RN, we get real about nursing --
[00:00:06] Laurin Henderson: the good and the gritty.
[00:00:08] Alyssa Saklak: We talk to real healthcare experts
[00:00:10] Laurin Henderson: with the goal of becoming better
[00:00:12] Alyssa Saklak: for our patients, our colleagues,
[00:00:14] Laurin Henderson: our family, our friends,
[00:00:16] Alyssa Saklak: our partners and ourselves.
[00:00:20] Laurin Henderson: Hi, Alyssa.
[00:00:21] Alyssa Saklak: Hi, Laurin.
[00:00:22] Laurin Henderson: We are back for season three. I can't believe they keep letting us do this.
[00:00:25] Alyssa Saklak: You have some awesome news to share with the listeners.
[00:00:28] Laurin Henderson: Yeah. A lot has changed since last season. I had a baby in September. It was the most incredible thing that has ever happened to me, so I just have this completely different outlook on everything. My whole life, my work — everything has changed.
[00:00:41] Alyssa Saklak: In this episode, I'm asking for a little homework from our listeners. I need you to share this episode with anyone that you know who is a new mom or new parent, because we're going to dive into it. And we have two awesome guests.
[00:00:54] Laurin Henderson: Today, we're talking to two nurses who work in our Neonatal ICU here at Northwestern Medicine. Kelly Kunkel is a NICU nurse; she just had her first baby last summer, and she is going to talk to us about returning to work. We'll discuss the challenges of being a first-time mom and how she and her partner navigate being two working parents with a new baby. And then we are also talking to Moira Hoelting. Moira has two children, and she's currently pregnant with her third. She is a clinical coordinator in our Neonatal ICU and works closely with Kelly. They've been friends for a long time, so I'm really looking forward to talking to both of them today.
[00:01:27] Alyssa Saklak: Families nowadays, with the beauty of medicine, can be created in so many different ways. I'm really excited and interested to learn about their experiences, especially as we look at the phases of pregnancy, postpartum, childcare, breastfeeding and pumping. There is so much information out there, but I am really interested to hear through the lens of healthcare workers and nurses, because there's a difference. We have different jobs, and we care for people in the hospital, and then we go home and have loved ones we have to care for, too.
[00:01:57] Laurin Henderson: It can be exhausting, but we're also going to talk about how beautiful and wonderful it is to be a parent, to be on the journey to become a parent, and to work with people who are supportive and understand the things that you're going through. I'm really excited to get into it.
[00:02:12] Alyssa Saklak: Welcome to the show, Kelly and Moira.
[00:02:14] Moira Hoelting: Thank you. We're excited to be here.
[00:02:17] Laurin Henderson: Before we jump in, Kelly, you wanted to share something?
[00:02:20] Kelly Kunkel: In this episode, we refer to our experience as being mothers and use the term "mom" a lot, but we want to acknowledge that these topics can apply to any birthing or non-birthing parent, in whatever way you identify yourself, and hope that our stories can relate to anyone along their journey of parenthood.
[00:02:33] Alyssa Saklak: Tell us a little bit more about your family, if you're comfortable, and where you're at. I know there are a couple of new moms here.
[00:02:39] Moira Hoelting: My name's Moira. This is my 15th year at Northwestern Medicine in the Neonatal ICU, the NICU in Prentice. I'm currently pregnant with my third baby, so I'm due in the next few weeks. My first is 4 and a half. My husband and I struggled with infertility for many years, so we also have a different take on starting a family. Our daughter is 4 and a half, and then we did IVF and have our second child, who just turned 2. And then with this third baby, we were prepping to do another embryo transfer and ended up pregnant on our own. So, it was a nice surprise. We've had babies in every different way.
[00:03:16] Kelly Kunkel: My name's Kelly. I also work in the NICU with Moira. I started in 2018, so this is my eighth year. I've been there ever since graduating nursing school, so all I know is NICU. We love it. I just have one baby; his name is Simon. He's now 9 months old. I'm in a same-sex relationship, so me and my wife, Gaba, went through our own fertility journey — not for the purpose of infertility, but we ended up doing two rounds of IUI and got pregnant that way.
[00:03:45] Alyssa Saklak: Laurin, what's your journey? Do you mind sharing?
[00:03:48] Laurin Henderson: Yeah, so I had my first baby at the end of September. Everything went really well with my pregnancy, delivery and postpartum. And then I came back to work after a little more than three months. My maternity leave would have ended right at the end of December, and I came back right at the beginning of January, so a little longer than that 12 weeks. Did you all take a little bit longer time too?
[00:04:11] Kelly Kunkel: We each did. We both extended our leaves. I had complications with my recovery after I delivered, so mine was extended by four weeks, so I ended up taking 16.
[00:04:21] Moira Hoelting: This is something we both talk about a lot. If nurses that we work with are asking about how to go about leave, one of our biggest topics is making sure you're really pushing for extending your FMLA portion of your leave if you're having medical complications, because so much goes wrong. Obviously, we see that with working with NICU families, but we are both big advocates for standing up for yourself and taking extra medical leave if you need it. For my first, I had medical issues with mastitis, so I extended my FMLA. And then for my second, my son, I ruptured early and had an antepartum stay, and then ended up delivering him at 33 weeks. With him being in the NICU, I took a personal leave. So, we both ended up getting around 16 weeks.
[00:05:08] Kelly Kunkel: I wouldn't have even known that this was an option if it weren't for Moira, so she helped me through that whole process. It's just hard to know how to navigate.
[00:05:17] Alyssa Saklak: It does require advocating for yourself and asking questions. I love the nursing profession because of the community we have. We learn from each other, and hopefully this episode can highlight that for people who are going through it themselves.
[00:05:29] Moira Hoelting: Yeah, I think that's a huge thing for nurses. Even now, I'm over 37 weeks pregnant, and people keep asking me when I'm going to stop working. We just work until our water breaks at work, literally. But there's so much you have to do to stand up for yourself and know what is good for you and your body. That's why I think talking about it and talking to other people about what your options are is so important. If coming back at 12 weeks isn't realistic, then don't come back at 12 weeks.
[00:06:00] Laurin Henderson: I think there's this — which we're getting better about now — but there is sort of this veil over pregnancy, postpartum and returning to work. It's like a badge of honor that, "Yes, I'm a mom and I'm working full-time and I can do both things perfectly." And that it's not hard and this is just what you do because you're a working mom. But people are talking about it more, that it is so hard. I don't know about either of you, but sometimes I feel like I'm not doing my best here. And then when I go home, I have those precious two hours before it's bathtime and bedtime with my family, and then I feel like I'm not doing my best at home. It's this internal struggle. I used to think it was only a "me" thing, but now I'm realizing more people are talking about it, thankfully. I don't know if you two share that experience, but that has been really hard for me in coming back to work — the imposter syndrome of wanting to be in the place that I'm not.
[00:06:58] Kelly Kunkel: My wife actually talks a lot about this. She's not a nurse, but she works from home. If Simon is sick or something, if he has to stay home from daycare, a lot of that falls on her because, as nurses, we are completely out of the house when we're at work. We can't be doing both. So, a lot of times she ends up having to half-work and half-be a mom, and she has a really hard time with that. I have a really hard time with the fact that when we go to work, we work these 12- or 12-and-a-half-hour shifts. On the days that we work, I don't get to see Simon at all. He's still sleeping when I leave and he's already asleep by the time I get home. If I'm working two days in a row or a weekend, I put him to bed on Friday night and I don't see him until Monday morning. I can give my whole self to him when I'm home on my days off, and I can give my whole self to work on my workdays. It's still hard to do both because you're just missing out on so much.
[00:07:47] Moira Hoelting: It really is like that. When I had my first daughter, I was still on night shift. We have a ton of nurses that stay on nights for a very long time because then you can still see your child every day. I would sleep less, wake up at 1 or 2 pm and go get her from daycare early so I could spend time with her before going to work. For my second, I was on day shift. Sometimes I look back and think nights were kind of nice because then I saw her every day. I feel that guilt now where, like Kelly said, you'll go two straight days without seeing your kids. There's always that guilt and questioning if this is the right way to go about this phase of life, doing 12-hour shifts. But then the trade-off is I have four days at home, where I am completely home the whole day. Even between me and my husband, those days just function so much better because we're both there and can both support the kids. It's really hard to take care of small children.
[00:08:40] Laurin Henderson: It's such a double-edged sword. I agree. When I came back from maternity leave at the beginning of this year, I cried the whole week leading up to it. The day before, I woke up crying because I just knew it was going to be such a change. I felt like I was just getting the hang of this and figuring out how to do this with a baby. I Googled positive statistics about children with working moms. I typed it up on a Word document, and I have it in my office taped by my phone and taped on my file cabinet in front of me. For the first month and a half, it was my phone screen background because I just needed this constant reminder. Yes, it's important to be a mom, but also, I hold so much value in the work that I do every day, the people that I work with and the things that I'm able to do as a manager in medicine. I wanted to be able to do both of those things, but I did find that I needed that reminder that this isn't all bad. Daycare is good, and they can get a "village" to help raise them and develop relationships with other people.
[00:09:41] Kelly Kunkel: This is very fresh in my life right now because Simon started daycare at six months. Me and my wife staggered our leaves, so we ended up waiting until six months to send him. Since then, over the last three months, he's just been sick on and off. We started daycare in January, so it's just been the peak of sickness.
[00:10:06] Moira Hoelting: I was in a situation where I had to extend my leave because of my son being in the NICU, and that completely drained my PTO. I came back with zero hours of PTO. Anytime he was sick — and a preemie baby going to daycare is definitely getting sick right away — I was either getting an occurrence for that or my husband would have to stay home from work.
[00:10:26] Laurin Henderson: How have things changed for you, being nurses, before you had children versus after?
[00:10:31] Moira Hoelting: You don't need to be a parent to be a great NICU nurse, but it just changed the way I feel for these parents and what they're going through. I think it definitely made me more emotional in a way at work, where certain cases hit me differently than they used to, just because we're in the midst of having children too. We're in that phase of life. Maybe that will change as we get older, but right now, some days I'm like, "Wow, that hit me hard."
[00:10:59] Laurin Henderson: Yeah, I feel like the hormones, too — I just had a baby seven months ago, and anything could make me cry. I could cry right now if you wanted me to.
[00:11:07] Kelly Kunkel: I was actually going to say that, too. Before having a baby of my own and going through it, moms would be crying in the NICU, and people would blame it on the hormone crash, postpartum hormones and everything they're going through. But going through it myself and not being able to control my emotions and just crying over nothing, now I see it is so legit. Obviously, they do have more going on with the whole NICU experience and everything with the baby, but the hormone crash is insane.
[00:11:34] Moira Hoelting: My son was in the NICU for a month, and Kelly took care of him, plus a lot of my favorite NICU people. I could cry about that every day, but it made me love my co-workers even more than I already do. I love what I do for a living. My daughter's 4 and a half now, so I can actually talk to her about how I am sad to leave her tomorrow, but also that I get to go and take care of these very small babies. Then I can tell her about the babies, and she'll ask, "How many babies were born today?" She can be a part of understanding why I go to work and why it's so important. I think that also helps as your kids grow up — being able to explain how important nursing is and what we do. Even though I'm sad to leave her, I also love going to work.
[00:12:24] Laurin Henderson: You hear so much about how hard it is. It's hard to have a newborn, it's hard when they start teething and it's hard to go to work. All of this stuff is hard. I saw this quote once that said you've been tired before, you've been stressed out before and your house has been dirty before, but you've never felt the joy that you will feel when your baby smiles at you for the first time or when you reach some other milestone. How do you find the joy in being parents?
[00:12:54] Moira Hoelting: We are so lucky to work with people who are so supportive. If you come to work, everyone asks to see a picture of your children and what they are doing. We have pictures hanging in the office of our kids. Everyone is so supportive, especially right when you come back. They're always making sure you get out to pump or just take a break. I think we're just lucky to work in an environment that's so supportive of women and new moms.
[00:13:18] Laurin Henderson: Definitely. I am currently breastfeeding, but then pumping during the day at work. But I am in a manager position, so I have more flexibility to be able to sit in my office and do administrative work while I pump. How do you find the time to do that, working in such a fast-paced NICU environment, if that is something that you do?
[00:13:35] Kelly Kunkel: Yeah. Moira and I have different roles. I am mostly at the bedside. In the way our unit is set up, it's what we call "pods." There are six babies in a pod and two to three nurses watching those babies. If you need to step out for lunch or to pump, the other nurses in your pod take care of your patients while you're gone. I came back from maternity leave at a time when our unit was extremely busy, and our unit is really good about working together. Our co-workers always tell you to go pump whenever you need to. Even if that means they have to do double the work, they pick up where they can. But it was tough coming back, having to find three different times in the day to step out for 20 to 30 minutes at a time. When I step away from my patients, there's nothing I can really do patient care-wise while I'm gone, so I'm leaving that entirely to my co-workers. Leaving that work on the person you're working with for the day was difficult.
[00:14:33] Moira Hoelting: And I'm in a CC role, so I feel like it's probably easier for me to step out because I don't have specific patients that I'm responsible for. I can just say that I have to go. But there is always that guilt when people are calling you for help, and you still have to find the time to leave. We're very lucky that our co-workers will say, "You need to go; go now, we're going to be fine." People really make sure that you leave to go take the pumping time. We have a whole room with a fridge and a sink, and it's very peaceful, so I feel like we have a pretty good setup.
[00:15:06] Alyssa Saklak: I was talking to my primary care provider about postpartum and risk factors. I asked if having previous mental health issues would put me at a higher risk, and he said the most driving statistic is the amount of support you have. That stuck with me — the importance of making sure that you're building that village and that support system. That community is going to help you so much during these tough times. I love the support that I've been able to see, and I can see it between you two and your co-workers. That community makes it so much easier.
[00:15:44] Moira Hoelting: My younger sister has a baby and she's going back to work next week. She's an engineer, so she is one of two female engineers in her office. I was talking to her this week and asked if they have a pumping room, and she didn't know who to ask about that. We're so lucky that there's so much ingrained in our culture already, and we have all these women surrounding us and encouraging us. She's in an environment where I don't think any of her co-workers even know what's going on with her. There are some big benefits to being in a women-led field.
[00:16:17] Kelly Kunkel: Logistically, for me, I was mostly breastfeeding before I came back, so pumping was pretty new for me. I texted Moira one day before I came back and she said she would just come over and talk me through everything I needed to know for my first day back. Even just that was so helpful.
[00:16:33] Alyssa Saklak: There's so much out there. There are wipes and different pumps, and it's overwhelming.
[00:16:39] Kelly Kunkel: Yeah, like, do I really not need to wash my pump parts? I can just put them in the refrigerator? Is that legit?
[00:16:43] Laurin Henderson: Yes! Oh my gosh, it changed my life.
[00:16:46] Moira Hoelting: We work with mostly pumping moms because, in the NICU, very few babies are ready to breastfeed. Almost all of our moms are pumping, so we do have a lot of experience with it. I feel like pumping myself really helped me take care of more patients and more moms at work because I can tell them what they need and what it's really like. Pumping is not easy, and it's not enjoyable.
[00:17:12] Laurin Henderson: Breastfeeding and pumping is such a journey. I did not prepare for it very well because you can read a couple of things, but until you are actually doing it... When my milk came in, I thought I was going to die. I had no idea that's what was going to happen. All my friends were having babies, too, and they said they didn't know how much to tell me or what I wanted to know. I didn't know the questions to ask. To have people who have done it before you who are willing to come over and give you a crash course is just so helpful.
[00:17:53] Kelly Kunkel: It's so funny that you say that, because we work with breastfeeding and pumping moms every day in the NICU. But when it's happening to your own body, I was still like, "Wait, what is happening?" The day my milk came in, I was so caught off guard. Even though we see this all the time, I can tell a mom a million times that it's normal that her milk hasn't come in yet. Then, when it was happening to me, I was crashing out and crying all day because I thought my milk was never going to come in.
[00:18:17] Laurin Henderson: As a nurse, we know too much, but then when it's me, it's like, “well, that doesn't apply.”
[00:18:22] Moira Hoelting: Of course. Your brain doesn't work when it's your own baby. I remember being terrified. Do I know how to take care of this baby? And then I remembered I'm actually a NICU nurse, but I was still terrified of this whole newborn phase because your brain stops working.
[00:18:36] Alyssa Saklak: That's so validating for people to hear because I think there's a pressure when you have this knowledge, but yeah, it's this immense pressure to be like, "Do I even know what I'm doing?"
[00:18:47] Laurin Henderson: I hope it's reassuring to know that even NICU nurses don't know what they're doing with their own kids.
[00:18:52] Alyssa Saklak: This is just a selfish episode so that I can be prepared.
[00:18:55] Laurin Henderson: So, Alyssa and her wife are on their family planning journey. What are your real-life mom tips and tricks for keeping a newborn alive?
[00:19:02] Kelly Kunkel: My real-life tip and trick for my own brain was that everybody has done this before me, and the baby is going to survive and be OK no matter what. I try not to get too fixated on the little things. I try not to go on the internet too much and look at what other people are doing. That might be helpful for some people, but for me, we needed to figure out what works for us and for our family. Alyssa, lucky for you, it sounds like you're married to a woman. So that's my real-life tip and trick: be married to a woman.
[00:19:30] Moira Hoelting: Kelly's wife, Gaba, was just bringing things to the bedside without being asked. Kelly had to be in bed a lot, and things just appeared for her.
[00:19:39] Kelly Kunkel: Yeah.
[00:19:40] Moira Hoelting: Gaba didn't even ask what she needed. She just knew. My husband literally never once knew what I needed; I had to ask every time.
[00:19:48] Kelly Kunkel: And your husband is great and wonderful, but it's a different brain.
[00:19:52] Moira Hoelting: Just understand women.
[00:19:53] Laurin Henderson: Yeah, the husbands try. My husband did his best, but I think you're just such different people; such different things are happening. How are you able in your own homes to prioritize your health and your relationships with your partner during these really challenging times, when your kids are sick and people are having to flex their schedules?
[00:20:14] Kelly Kunkel: Probably something that we need to work on in this household.
[00:20:17] Moira Hoelting: I think in probably every household, this is a bigger-picture issue in many industries. We work with a lot of moms who are going back to work after two weeks because they want to save their time for when their baby comes home.
[00:20:31] Alyssa Saklak: Throughout my time here at Northwestern Medicine, I've seen the different opportunities to pivot within nursing to make it work. We go for careers that match our passions, and both of you mentioned how that helps your "why" and balancing it all. But there are also different leadership or hybrid positions. The list of career opportunities is endless, and sometimes there are pivots in your career to match things outside of work. Have you had to consider different positions?
[00:21:03] Moira Hoelting: We both wouldn't leave the NICU setting. But something I see a lot as a CC on the unit is people coming to us about going part-time or casual. We have management that's very supportive if you need to cut back hours but don't want to completely leave. Being able to do that — where you can work two days a week or go casual — has been refreshing. We're not making people wait years and years to cut back their hours. If this is what you need right now in your life, you can go part-time. Often, it comes back around later when they reach a new phase and return to full-time. That is something really special in nursing that I hope all units are able to support.
[00:21:42] Laurin Henderson: What advice or words of encouragement would each of you give to a new parent returning to work from leave?
[00:21:50] Kelly Kunkel: I was working with a lactation consultant before I went back to work, and she suggested taking a few days, ideally a week, to simulate your pumping schedule at home. I was mostly breastfeeding up until then, and pumping is a different way of emptying milk, so it took my body a little bit to get used to it. It was really helpful to work out those kinks before being back at work and solely relying on the pump. For me, it was easier once I actually went back to work than the thought of going back. Once I was there and in the routine, things felt better, and I was feeling empowered to do it.
[00:22:33] Moira Hoelting: Yeah, I think that the anticipation is much harder than once you get there. For us, we work with our friends, genuinely. Once you're there and you get to see them and they're asking about the baby, it's refreshing to spend a day taking care of patients and other people's situations. It takes your mind away from hyper-focusing on how long your baby is napping or when they're eating. It's almost like a little bit of a brain relief to think about this mom and this baby and what they're going through. Someone also told me to do a "practice" daycare day the week before, where you are home — go get a massage or something — and send your kid to daycare. Then you go pick them up early and see that they are completely fine. They have no idea they're at daycare; they just figure it out. That really helped me; we did a practice day before going back with both our kids.
[00:23:38] Laurin Henderson: I did the opposite. I did a dry run of me leaving my baby — me coming to work — before we sent our baby to daycare. I wanted to get used to my new normal first, knowing she was home with her dad and okay. Then I'll worry about daycare once I've ripped the band-aid off of coming back to work. Either way, I love a dry run. I think it's so helpful before you come back.
[00:24:02] Moira Hoelting: And you can ask at daycare — on our first days back, I told them it was really hard and asked if they could send a ton of photos. They always did that for us during the first week, sending an overload of photos. That really helped me.
[00:24:15] Alyssa Saklak: Well, thank you so much for coming onto the podcast. I now have a long list of tips and tricks, and I'm also getting your numbers for house calls. Thank you so much for sharing your knowledge, your realness and your expertise on being a healthcare worker and parent.
[00:24:38] Laurin Henderson: Thank you both.
[00:24:39] Moira Hoelting: Thank you.
[00:24:45] Laurin Henderson: Thank you for listening. Please follow us wherever you get your podcasts, and rate and review the show.
[00:24:49] Alyssa Saklak: We'd love to hear your comments and any topics you might want us to explore.