3rd Trimester
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Early FMLA maternity leave?

I'm going to start off by apologizing in advance for how long this is going to be. If you can make it through to the end and give advice, it'll be much appreciated!

I'm currently 31 weeks pregnant with my first baby. I work as an RN in a large hospital on a very busy unit, 3 nights a week. My husband works out of town Monday-Friday, so he's gone during the week and I'm home alone. I've always had issues with anxiety, but lately I have severe panic attacks before I go in to work. My heart rate gets up to 150-170, I feel like I'm going to pass out, I just cry and want nothing more than to just lay in bed and not move. I can't take my medication for the anxiety/depression because of the pregnancy. I'm embarrassed to tell my OB about this, even though I know I shouldn't be. I planned to today during my visit but he seemed in a hurry and I just couldn't make myself say it.

My husband and I decided that I wouldn't return to work after taking FMLA leave for the baby unless it can be an as needed position, which would mean I wouldn't have a set schedule and would only be obligated to work 1 night a month. I can't swap to the as needed position until after baby is born for insurance purposes, and I'm unable to swap to days or reduce my hours due to the amount of nurses on day shift vs night shift while Im working until leave.

Here's where my question or wanting "advice" comes in. I'm seriously considering taking an early leave. As early as they'll let me. I'm not concerned about time after the baby is born because I'll either swap positions, or not return to work. I'm thinking of asking my OB to approve early leave (I'll be 33 weeks my next appt).

Has anyone done this? Should I be up front with my OB of my intention of not returning to work so he'll be more likely to allow the early leave? Not only do I want it to eliminate the stress factor right now, but also because of how fast paced my floor is and how difficult it's already proving to be to continue working. I can't tell my supervisor or my intent to not return because of insurance purposes, as I can't be covered on my husbands until the next modification session, though the baby will be able to be. I also would love the extra time to get everything finalized around the house and get everything prepared for the baby. Any advice? Or similar stories? Anything is welcome!

Re: Early FMLA maternity leave?

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    If you don't return from maternity leave you may have to pay for your insurance. You should definitely look into that. You also need to tell your doctor about your anxiety attacks. If you aren't comfortable telling your doctor, you might want to find a new one since you should feel comfort pants talking about your health with your provider.

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    Sorry, I didn't clarify. I WILL be returning to work, but not the same hospital in a full time position. The hospital I work for only has 12 hour shifts - aside from in the ER. With my husbands schedule and for our family, we've decided a day shift position would be the best bet. I'll be applying for jobs after the baby is born, but will be maintaining the as needed position at the hospital to be able to work when I can without a set schedule since I'll still be on nights.

    Would it be silly to call and speak with his nurse tomorrow about how I've been feeling? Or should I wait until my next appointment in 2 weeks to tell him directly? It's not that I don't feel comfortable talking to him about what's going on, I just have a hard time telling anyone how I'm feeling. I know I need to tell him, but it's hard to explain my thoughts when I can't even make sense of them myself.

    Thanks everyone for the answers so far. I really appreciate your input.
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    I'm confused why you can't take your meds while pregnant?  If it is a medication that is not approved for pregnancy I would suggest switching to a med that is approved.  Not being on meds is most like the reason you are having the anxiety attacks.  The raised HR and attacks are really not healthy.
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    Ok, wow,  so many issues going on here.  First, let me say that I totally get anxiety attacks as I've struggled with them my whole life. 

    1) That being said- It is absolutely not at all something to be embarrassed about!  You definitely should, however, talk with your OB about this.  There are medications that are safe for pregnancy and as others said, the raised HR is a lot more dangerous than well controlled medication and your medical team being fully aware.  I also agree that your OB should be aware and monitoring you for PPD.  MH, my doctor, and I all went into this pregnancy knowing that I was at a higher risk for PPD and depression through pregnancy and we stay very open about it. I have also increased the number of counseling appointments that I have.  Even though it can be scary to talk about these things, it is best for you, your marriage, and your child.  Please, please, please be open about this with your care team!

    2)  As another PP said, if you loose your insurance because of switching to a PRN position (I work in HR at a large hospital, fyi), this is what is called a "qualifying event."  This allows your husband to add you onto his insurance even though it is mid year.  Other qualifying events include birth or adoption of a child, marriage, or divorce. So you can eliminate this from your list of worries!  If you need to drop to PRN now, you will be able to go on to your husband's insurance the day that yours is canceled.  Typically, his HR will just require a letter showing that you've lost coverage.

    3) I'd be very careful about going on leave without informing your employer of your intentions to drop to PRN after the leave.  If you do this, it can be considered insurance fraud and they can make you retro pay 100% of the premiums back for the time when you were on leave.

    4) This relates back to number 1, but I don't think its unreasonable to talk to your doctor about being placed on early leave.  However, personally with all of the factors from 2 & 3, I'd approach your employer, ask to drop to PRN now, be added to your husband's surgery and simply work as much as you are mentally/physically able until baby is born.
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    MapleMomma said: 
    4) This relates back to number 1, but I don't think its unreasonable to talk to your doctor about being placed on early leave.  However, personally with all of the factors from 2 & 3, I'd approach your employer, ask to drop to PRN now, be added to your husband's insurance and simply work as much as you are mentally/physically able until baby is born.
    @MapleMomma is spot on. I'm not returning to my job after my maternity leave (I accepted another position and instead of giving one month's notice, my current job asked me to give 5 months notice and is paying out my leave in return for my sticking around - it's a really sweet deal and I'm super lucky) and our HR person said that they could not pay out my insurance while I was on FMLA unless I returned to work full-time for a certain amount of time. Otherwise, it would be insurance fraud and I would be liable for the full premium payment (something like $500/month). Since I'm using the birth of the baby as a 'life event' to switch to my husband's insurance (as you could use going PRN as a 'life event') it's not an issue. You can use getting a new full-time job after your maternity leave as a 'life event' to switch off his insurance as well. ACA means that your husband's insurance would pay fully for the birth - since you're not due till 2015, it wont impact your deductible any differently. 

    As for your anxiety, I highly recommend speaking to your doctor ASAP. Maternal anxiety and depression are health problems and they are treatable by your doctor. If you had diabetes, your doctor would know and you'd probably be on meds - why should it be any different for anxiety?
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    When MH and I were dating and living together I lost my job.  He was able to put me on his insurance since we lived together and my loss of job and coverage was considered a life change.  I would not worry about the insurance like maple said you should be fine in that area.
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    I'm a fellow RN, and working night shift is awful for feeling rested and getting what you need to maintain your sanity. Absolutely muster up the courage to talk to your OB, they might be able to recommend something that could help you. If your OB feels that working day shift would be healthier for you and your baby than your job must oblige and do that. Good luck!

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    Yes! I think you should. I stopped working at 36 weeks. I felt horrible working, taking care of my son, and going to school. My husband also works out of town. Do what is best for you. Turn in your FLMA papers and apply for short term.disability ( if your job offers it)
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    I would definitely talk to your dr and just be open about everything. Also if your anxiety is that bad I would consider going on a small dose of an antidepressant that the dr deems as safe. Until then mAke sure to et enough sleep and try some other natural remedies like fish oil, vitamin d, diet etc. Sorry you're going through this. Best of luck.
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    You really need to talk to your OB about your issues....anxiety, etc.  There is nothing to be embarrassed about.

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    I took my leave early. My job is not stressful per se. However I am up and down a lot as well as I have a rather long and uncomfortable commute on public transportation. It was a getting too much for me. Also my replacement was taking on more and more so I wasn't busy. I felt silly for a while but honestly there's not much I can do about it now plus I am much more relaxed, swelling has gone down plus I got a lot done at home  which made me very happy :D
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