I came back from ACOG feeling invigorated. This year’s theme was “Leading from where you are,” and let’s just say the leader in me was re-activated. I identified with so many qualities of the speakers; I felt inspired and ready to make an impact. Specifically, I felt ready to serve on committees and lead. Once home, I was ready to pull out my laptop and write down my goals. But, when I got out of the Uber with my husband and nine-month-old, my four- and two-year-olds came bursting out from the door with my dad, jumping and screaming as they could hardly contain their excitement that we had come home. I immediately had that moment of realization—oh, right. For the last five years, while working full-time clinically, my time outside work has been dedicated to growing and raising my family. This includes physical labor, of course. There are the pregnancies and breastfeeding, and the times the eldest still needs to be carried after a boo-boo. In addition, it has taken psychological labor, energy, and passion as I have embarked on a full education on parenting and hence, re-parenting myself while being there for my partner as he re-parents himself too. This essay is a nod to those doing the invisible labor for yourself and your families. This leadership is needed for our families, our world, our patients, and our institutions.

I first took notice of this labor when I was asked to submit my CV this year for review. For some context, my physician partner and I moved from the East Coast to the Pacific Northwest one year ago with two little kids while 34 weeks pregnant, and we both started new positions. Once returning from maternity leave, I had worked less than six months before submitting an even more recent CV for my upcoming review. It felt daunting. The Imposter Phenomenon was fully engaged. I scrolled through my CV and realized nothing was new. “What have I even been doing?” I could hear the voice in my head panic.

There was a section at the end for “other employment and responsibilities.” I jokingly wrote, “Exclusively breastfeeding infant while transitioning into my new faculty position, pumping every three hours while on 24-hour shifts.” I shared this with a friend who shall remain nameless, asking if it was unprofessional, and she texted me back, “It acknowledges your unpaid, unrecognized reproductive labor while working full-time. It highlights work ethic, flexibility, and self-sacrifice. It demonstrates pride in this decision and your efforts. Why should ‘I ran a marathon’ get a line and not this?” (Yes—I have great friends). I laughed, thought about it, added “parenting three children under five years old,” and submitted it.

For those of us in the generation of parents raising little kids, perhaps differently than how we were raised, I want to commend this hard work. I have a stack of parenting books on my nightstand about the neuroscience of child development, conscious parenting, and learning how to navigate sibling relationships. In my spare time at night, I listen to Dr. Becky Kennedy’s workshops from her platform Good Inside. The lessons I have learned and am practicing carry over into my daily practice with patients and work with colleagues, trainees, and nurses. The leadership training I have received through learning how to parent is the best investment I could make for myself, my family, and my career.

I can confidently say that I know how to respond with empathy and set clear boundaries when a toddler and an adult are having difficulty regulating their big feelings. In parenting, it looks like, “I see you’re having a tough time playing with your sister. I will bring you to your room and sit with you until you’re ready.” It might look like, “It sounds like you’re having a hard time, but I won’t let you speak to me (or my colleague, trainee, or patient) that way.”

I have learned to avoid power struggles and instead look at a scenario from the other’s perspective, sit on the same side of the table, and look forward in the same direction. In parenting, it looks like, “You were really looking forward to a Pop-Tart for breakfast, and we’re all out, and that stinks. I’m sure cereal doesn’t sound great now, but that’s what we have.” At work, it might look like, “I understand this labor is going very differently than what you envisioned and very differently than your past labors. Ugh, that stinks.” When we take the time to look at the situation from the patient’s perspective, we stop fighting over whether to start Pitocin. Instead, we are looking in the same direction, and the plan for Pitocin will make the most sense to the patient too.

For fans of Dr. Becky, the statement “Two things are true” will ring a bell. I can confidently hold space for two truths simultaneously and speak to each of them. I listen intently and validate when people have a hard time with pain or a difficult situation while acknowledging they will get through it. In parenting, it looks like, “I know learning to ride a bike is so scary, and I know you will be able to do it.” In labor, it looks like, “I know it hurts so badly you don’t feel like you can push, but I know you can do it, and this pain will get better.” For a trainee, it might look like, “Doing this procedure for the first time might feel intimidating. It might not be perfect the first time, but you will get through it and get easier.” Holding space for both the validity of a difficult experience and acknowledging that it will get better allows me to connect and helps people stay grounded through difficult times or challenges. From that grounded state, we can more accurately reflect on how the experience went. For me, practicing the mantra, “It is hard, and I can do it,” before a difficult case or shift is what carries me to the end, protects me from burnout, and launches me into a reflection about how the experience went so that I can grow.

Most importantly, I can ground myself and practice self-compassion when I make a mistake, which allows me to take accountability and repair relationships when necessary. This is only possible if I divorced a mistake from my competence as a parent and a doctor. Only with self-compassion is true accountability and the ability to learn from a mistake even possible. In parenting, this looks like, “I’m a good parent who wasn’t able to make it to my kid’s dance recital today.” From here, I can repair and take accountability. “I’m sorry I didn’t make your recital. I’m working on leaving work on time.” Or, if leaving earlier wasn’t possible, just “I’m sorry I didn’t make your recital. It’s hard having a physician parent sometimes.” At work, it might look like, “My patient had a complication, and I am still a good doctor.” From this mindset, “I’m so sorry you are experiencing this complication. This was not anticipated, and it makes sense you are upset. Let’s work together on a plan to help you get better.”

Parenthood is gradually becoming more visible at work. I see residents and faculty discussing plans for building their families more openly, working out leave and coverage, pumping, and advocating desperately for more childcare resources. These are welcome and necessary changes if we want to see parents, particularly mothers, step fully into their power in the workplace. However, workplaces must also acknowledge the effort and self-transformation it takes to parent, regard parenting leadership skills as valuable and worth elevating, and recognize sturdy parent leaders as assets to their organizations. But, if your work has not yet garnered a title or a line on your CV, just know that it matters; it is transformative, and your families, patients, and institutions are lucky to have you.

Victoria Chiaro is an obstetrician-gynecologist.