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Taking Medication While Pregnant: I’m Not Sorry

Hello to everybody! I know I dropped out of sight for a while, not just in terms of posting but also in terms of commenting. I wasn’t ready to talk about why, but having just received good news and passed a benchmark, I am now.

After years of trying to maneuver myself into a good situation and despairing, and not as many tries as I had feared, I find myself pregnant! I am delighted—I know I’ve mentioned on these boards how much I want to have a baby, and how anxious I was getting as the calendar pages flipped over with no possibility in sight. I just passed the first trimester, and my screenings have all come back with good news—my baby (because this is a wanted pregnancy and I’m thinking of it as a baby, I will use the word “baby”) is healthy, as far as modern medicine can tell thus far. What I hadn’t realized was how exhausting pregnancy is. I’d been told, but I hadn’t fully understood. Six o’clock rolls around and I’m ready to pass out. I haven’t been able to engage as much as I would like in any number of things, Feministe included.  And I’m sorry.

I feel and am extraordinarily lucky to have the family I have, the support I have, the health insurance and access to medical care that I have.

One of the major decisions I had to make was what to do about the medications I’m on to keep my depression in remission. There’s a lot of anxiety flying back and forth about pregnant women taking any medications, let alone one as new and unknown as one of the meds I’m taking. Hell, if you order sushi in the US someone is likely to tell you off. I originally tried to do what I thought was the good, responsible thing and taper off my meds.

This went over like a lead balloon. I went down one milligram on one of my meds and within a few weeks I was passing the time by idly wondering how I would kill myself if, you know, I decided to do such a thing, not that I was planning on it, but I wanted to make sure I would know what steps to take if I did decide to, just because you never know. Because that’s a totally normal train of thought to follow while zoning out on the subway. Nothing crazy about that, no sir. (It’s my mental illness, and if I want to characterize the thought processes it entails as crazy, I will do so. I know it’s pejorative. I mean to be pejorative. My depressive thought processes are the product of mental illness and also should be condemned. They are detached from reality, incorrect, irrational, self-destructive, and corrupt. But if you would feel better if you mentally substitute “fucked up” for “crazy,” that’s fine by me.)

So I went to see a specialist in reproductive psychiatry (I live in New York City, don’t you know)—and again, believe me, I know exactly how lucky I am to be able to do that. She met with me during a four-hour consultation and at the end told me that whatever possible, minor, and even as-yet-unknown potential side effects my medications might have on my developing baby were completely dwarfed by the significant, major, and enduring effects my depression would definitely have on my developing baby. I was floored—I’d never before considered that my depression could hurt a baby I was making, but indeed, the doctor told me that they can test children even at three or four and still find significant differences—and not good ones—between children whose mothers were depressed during pregnancy and those whose mothers were not.

Why should I have been surprised? I think it’s part of the bizarre mentality in the US that somehow we can separate the interests of a developing fetus/soon-to-be baby—or even an actual child—from the interests of the woman making it or raising it. This has gone on for a while, to the point that scientists actually had to prove that if pregnant women are malnourished, their babies will suffer. The original incarnation of welfare in the US was just ADC—Aid to Dependent Children. No provision was made for their mothers—because as long as the kids get some food, having a starving mother won’t hurt them, right? Alcoholism is bad for the babies of pregnant women. Smoking is bad for the babies of pregnant women. Guess what? Alcoholism and smoking are bad for the women as well. But we don’t give a shit about women, so instead of understanding those things as self-destructive, and the women who engage in them as making the best they can of a difficult situation we run around acting as if pregnant people—people with wanted pregnancies—are willfully trying to harm their babies.

Depression is a whole body illness. It upsets eating and sleeping patterns. It dampens your immune system. It causes physical pain and difficulty as well as draining you of energy. It removes your ability to care for yourself. We can see it in the physical make-up of our brains. Why wouldn’t it affect my baby? To say nothing of my misery. I count too. I am not just an incubator.

The New York Times would not run an article encouraging women with asthma to abjure maintenance medications while pregnant. Or women with diabetes. Or women with any other chronic non-mental illness. But shortly after I made this decision, it did run one attacking the wisdom of staying on anti-depressants while pregnant. I know this because my grandfather helpfully emailed me and asked if I’d like him to send it to me (I said no thanks, I’d consulted with doctors and was perfectly happy with my decision.).

I think that’s irresponsible. It’s dismissive of mental illness. It’s dismissive of women’s suffering. It’s dismissive of the damage depression can do to mother and child.

And I’m glad to link to this rebuttal piece by psychiatrists specializing in the field.

Forgoing anti-depressants is not like skipping one’s daily latte (and quite frankly, unless you’re consuming superhuman levels of caffeine, having a latte is fine). It’s not like having seltzer with dinner instead of wine or beer. It’s not like skipping the sauna. Anti-depressants are not a minor indulgence, a luxury, a frill on my daily life. They are, for me and for many other people, an essential medication that prevents a debilitating chronic illness from consuming my life. I depend on them. That means everybody who depends on me—my godson, my family—depends on them too, because without them I can’t function. That’s what it means to have a chronic illness. And being pregnant doesn’t make that go away.

I’m writing this to provide information for anyone else out there who takes anti-depressants and is contemplating pregnancy, or is already pregnant. You have a right to your health, and so does your baby. You’re not being “selfish” if you stay on your meds—you are taking care of yourself and taking care of your baby too.


55 thoughts on Taking Medication While Pregnant: I’m Not Sorry

  1. Using a Fisher-Wallace cranial electrotherapy stimulator: https://search.yahoo.com/search?ei=utf-8&fr=aaplw&p=fisher-wallace+cranial+electrotherapy+stimulator
    or an Alpha-Stim cranial electrotherapy stimulator: https://search.yahoo.com/search?ei=utf-8&fr=aaplw&p=alpha-stim%C2%AE+aid+cranial+electrotherapy+stimulator
    is an effective way to treat depression without the unwanted side effects of drugs. Yes, there’s the initial expense of purchasing one (not covered by insurance), which can be lessened by getting a refurbished one, but you get to try it for a good chunk of time, to see that it works, and then return it for a refund, minus a stocking fee, if it DOESN’T work for you. There’s NO chance it could affect a fetus.

    1. Thanks for the info. I do think that if a person has found meds that work for them, staying on those meds rather than experimenting with new treatments is a very valid choice, but the more options people dealing with depression have, the better.

  2. I did not use anti-depressants while pregnant, but I had cause to use other medications that I had questions about. Utah has a pregnancy risk line where you can call to ask about taking any particular drug and it’s potential effect on pregnancy, OTC or prescription. For example, dextromethorphan (common cold suppressant in OTC medications) is teratogenic – it can interfere with fetal development. What isn’t a problem to take is hydrocodone cough syrup (I have asthma and had a horrific cold and needed something that could suppress my cough and let me sleep). I was cautioned to draw down my use during the 8th month of pregnancy because there was a strong chance that the baby could suffer withdrawal symptoms if I didn’t. I had my cold in my second trimester, and gratefully took the medication I needed to stop trying to cough up a lung for two weeks and then stopped because I didn’t need it anymore.

    The service is pretty awesome, and a free instate call, and a normal long distance out of state call. I probably called the risk line maybe 5 times during my pregnancy and their help was great – they always backed up their advice with data. Their site is here: http://health.utah.gov/prl/ From their mission statement, “…is dedicated to providing evidence-based information to mothers, health care professionals, and the general public about medications and other exposures during pregnancy and while breastfeeding.”

  3. I read both articles and the new York Times piece seems to discredit or leave out the very real ways untreated depression can impact families. Their stated research conclusions that apparently lack consensus. Also it seemed to focus on the future child’s well-being while ignoring the mother’s well-being and the effect the mother’s health can have on the infant.

    Frankly, depression could impact everything from a woman’s ability to prepare for parenthood to her suicide risk. These are very real dangers.

    That said, I don’t the article intended to equate coffee with antidepressants. Instead, suggesting that if medicine suggests removing coffee it should question the use of something so much more powerful.

    1. I hear what you’re saying, but there’s a faulty logic at work in that idea as well (which I don’t attribute to you, but to the NYT): if it’s not a big deal to give something up, like caffeine, then you don’t really need much evidence to decide to err on the side of caution–what the hell, I like having a drink when I go out, but it’s not a big deal to me to put it off for nine months. When something is having a powerful effect on you, it needs more evidence of harm, not less or even the equivalent.

      (And the evidence of harm from caffeine is iffy at best. Some studies show harm, some don’t. From what I’ve read, the current consensus is that even to be most cautious, you shouldn’t go above 200 milligrams of caffeine a day, or one cup of coffee, or four cups of black tea, or literally 100 servings of coffee ice cream. So everybody should just lay off pregnant ladies who like their chocolate!)

      1. Yea, I see your point. Their cost benefit analysis is flawed because they aren’t proving enough harm.
        Caffeine is also a good example of specific doctors making statements on iffy evidence.

        Congratulations on you pregnancy EG.

  4. I should keep this on hand for my patients with exactly these concerns!
    There are a few meds that if possible transitioning should occur, but not that many, and YES your health and well-being matter as well! This really shouldn’t be discounted or undermined at all! And it isn’t just NYT or well-meaning family members that come up with this concept that the person carrying the pregnancy matters a lot less than the baby and any suffering is probably better for the baby, I had one patient who told me that her family physician told her not to go to her asthma doc while she was pregnant because “they’ll just try to give you meds that will hurt the baby, just do without if you can.” Ugh ugh ugh.

    Best of luck with the rest of your pregnancy!

    1. Thank you!

      Wow, I’m really horrified that an actual doctor told a patient that. Asthma can be deadly, and even when it isn’t, a free-flowing supply of oxygen is pretty much our most basic need. I’ve been very fortunate that my ob-gyn has been really supportive of my decisions.

  5. 1. Congratulations on your pregnancy!

    2. I also call my depression “my crazy” – I never call anyone else crazy, but I completely feel you on wanting to label it something mean and pejorative. It fucking sucks.

    3. This post is great – I don’t think we, as a broad community, link feminism to mental health treatment enough. I love this post so much because you do a great job of it here.

  6. Congrats! Babies are pretty great.

    My medical doctor was really unhelpful with my depression during both of my pregnancies. During the second I was seeing a counselor that helped me get medication-free under her surveillance. I’ve been pretty good over the last few years without meds. I took meds off and on during my pregnancy as a stop-gap for when the situational stress I was in (and trust, it was severe) peaked. Unfortunately everyone with access to this information had strong opinions about it, whether I needed it, and whether or not I was poisoning my child. I had to draw hard lines around the subject, among others.

    In my family we have kids spread out far apart — it’s nothing to have 5-10 years between consecutive siblings — and one of the things you quickly notice is that the practices and policies around raising children, especially infants, change so much in a few years’ time that some of the hurrah around particular parental practices is overrated. Get informed, be reasonable, then do what’s best for you.

    1. Thanks!

      My mom noticed that between me and my sister (we’re eight years apart), and I think that’s helped to make me a bit suspicious of all-or-nothing “wisdom” too…

      Although my mother is still telling me that I “have to” read to the baby; I keep telling her that it can’t hear anything until the 26th or 27th week, so there’s no point…

  7. Congratulations! I was so ridiculously exhausted my first trimester. I took hour naps in my car on work days.
    And look, no matter what, almost everyone will have opinions about what you do during pregnancy. But like anything related to reproduction, decisions are between you and your health team. I’m not expert, but I strongly agree with the reproductive psychology specialist. Good wishes for a boring and uneventful pregnancy!

  8. Congratulations first of all.

    The NYT and other sources also don’t seem to take into consideration that the mother to be may ALSO have other children to care for, an would also need to keep herself in a frame of mind too care for them as well as herself.

  9. Congratulations!
    I wish I’d been on my current medication for anxiety before I’d had the children. Would have been better all around; as it is, it’s taking a lot of time for me to get out of the habit of “thinking anxious”. Might have prevented at least one freakout during pregnancy, who knows?
    Noticed they mentioned a possible higher rate of autism as one effect. I do get tired of that being spoken of so negatively.

    1. Noticed they mentioned a possible higher rate of autism as one effect. I do get tired of that being spoken of so negatively.

      Yeah, I noticed that too. Dislike.

      1. I’m really confused by this sentiment. Is this about an acceptance of neuro-diversity and an appreciation for people like Temple Grandin? Since autism is a spectrum disorder, there people who with profound functional impediments. It seems reasonable that there are pregnant women who hope to avoid this.

        1. Well, in my case, trees, it’s about being on that spectrum, and having two children on that spectrum, and being spoken of as a possible negative consequence of women taking necessary medications kind of cheeses me off. But that’s just me.
          Just gonna say it right out: I don’t know how I could have coped with neurotypical children. At least my children make sense to me.

        2. Ledasmom, thank you so much for sharing your perspective. When I think of autism, I think about the families with whom I’m acquainted whose kids are much farther along on the spectrum who have very serious developmental and medical issues like intractable seizures. While it is obviously not true for you and your family, it seems the popular image of ASD is of people like Temple Grandin or characters like Sheldon on The Big Bang Theory, and nothing like the folks I know. It’s like the image of Down Syndrome as shaped by the visibility of a few talented actors with Tri21, and shows like Life Goes On. My frame of reference is the families I know that (like myself) are made up of single moms with profoundly disabled children. I know a couple of families with multiple children with developmental disabilities who, even with a stay-at-home mom, a partner, and extended family support, are not able to care for all of their children at home. Pregnant people choosing, or not choosing, this for their families should be a shame-free informed decision.

        3. Trees, seizure disorders are often comorbid with autism, but they are not actually the same thing. And as for the neurodiversity movement, most people with so-called low functioning autism whose writing I have read have agreed with the goals of the movement (as opposed to the parents of such people, whose opinions are often the ones cited in these debates). And the movement’s goals are not to celebrate people like Temple Grandin (whom many autistic advocates resent for being held up as the model for how autistics “should” be), but to advocate for our rights and our ability to be treated with respect. And that advocacy is for all autistic people, not just the “high-functioning” ones.

          (Also, I don’t have children yet, but I’m with Ledasmom in that I am a bit afraid to have a neurotypical child, whereas an autistic child I know I’ll have an easier time understanding)

        4. Trees, seizure disorders are often comorbid with autism, but they are not actually the same thing.

          Yes, yes of course, and intractable epilepsy is more common in ASD than without.

          And as for the neurodiversity movement, most people with so-called low functioning autism whose writing I have read have agreed with the goals of the movement (as opposed to the parents of such people, whose opinions are often the ones cited in these debates).

          Yes, I’m familiar with these writings, but for the folks with whom I’m acquainted, those affected do not have a mode of communication, much less write books.

          And the movement’s goals are not to celebrate people like Temple Grandin (whom many autistic advocates resent for being held up as the model for how autistics “should” be), but to advocate for our rights and our ability to be treated with respect. And that advocacy is for all autistic people, not just the “high-functioning” ones.

          Yes, I’m acquainted with this position, and I’m not sure where we disagree. What is it that you hear me saying?

          (Also, I don’t have children yet, but I’m with Ledasmom in that I am a bit afraid to have a neurotypical child, whereas an autistic child I know I’ll have an easier time understanding)

          Cool.

        5. Yes, I’m acquainted with this position, and I’m not sure where we disagree. What is it that you hear me saying?

          OK, sorry if I misread you. Your post seemed to be demonstrating the very common sentiment that the neurodiversity movement is about celebrating differences without acknowledging the difficulties they bring, and that it’s entirely by and for the less severely disabled among us. I see both those sentiments so often, but I apologize if in your case I was seeing them when they weren’t actually there.

        6. And oops, I am in fact the same person as ch– my ipad had this name memorized but my phone did not, and I’m enough of a lurker that I forgot which nym I used here most often!

    2. Agreed 100% on side-eyeing the autism mention. Not to mention, since the causes of autism are not well known but there does seem to be a large genetic component, it seems like a tenuous conclusion for them to say that this correlation means that SSRIs cause autism; if anything, I would posit that the causation might go the other way; adults with autism are more prone than average to depression and anxiety; it would follow that mothers with undiagnosed mild autism or broader autism phenotype traits (so, women who do not themselves identify as autistic but who are likely to have autistic kids) are likelier than average to need antidepressants. (Just spitballing here; not saying that this is actually the connection, just that it is a possible hypothesis).

      And EG, congratulations and thank you for this article. I’m at a point in my life where I’m starting to think about pregnancy as something that is a concrete possibility rather than a far off eventuality, and in all likelihood I will need to stay on SSRIs for my anxiety when I am pregnant. So this was a really helpful and heartening article to read.

      1. Hey ch/epinetron

        OK, sorry if I misread you. Your post seemed to be demonstrating the very common sentiment that the neurodiversity movement is about celebrating differences without acknowledging the difficulties they bring, and that it’s entirely by and for the less severely disabled among us. I see both those sentiments so often, but I apologize if in your case I was seeing them when they weren’t actually there.

        It’s all good. It’s pretty darn easy to talk pass one another on this topic; thank you for engaging me.

      2. ch: Don’t know how old you are, but certainly when I was in school girls were very unlikely to be diagnosed with ASD, and anything that wasn’t straight-out classic autism wasn’t on the radar at all. Probably there’s lots of mothers on the spectrum who don’t really know that they are until they have a child on the spectrum. I wish there were a group for autistic parents of autistic children.

  10. Thank you for your post. I fully support your decision to stay on your medication. Only individuals who have never personally experienced mental illness could recommend going off of them. There is a physiological difference between feeling sad and being depressed.

    I took Zoloft during both of my pregnancies. I’m not sure what I would have done without it. I always say, if nothing else, at least I know my kids will be happier! 🙂 There is a genetic component to mental health. If my body is not producing enough of the appropriate neurotransmitters on its own, and I need assistance to keep it in balance, pregnancy is a super important time to take medication. I’m confident that emotional balance during pregnancy has more of a positive impact on infant brain development than not taking medication. I’m sure it also helps to reduce the potential for developing mental illness later in life.

    Research supports and shows that if mom is under a lot of stress or duress during pregnancy, the developing fetus will have difficulty dealing with and managing stress later in life, and may have attention or behavioral challenges. For the mental health and wellness of BOTH mom and baby, we would be complacent to not address mom’s mental health as well as physical (because, of course, they are all connected anyway).

  11. Congrats EG!!!

    And thank you for sharing your experience. While every person should make the best decision for themselves, for those who have a similar experience to yours, I hope your article gives them support. 🙂 🙂

    1. Thanks! Absolutely, no one choice could be the right one for everybody. All pregnant people need the freedom to find the best solutions to their health issues without financial pressure or alarmist rhetoric or sexism.

  12. This is a wonderful piece. I’m sure it will be beneficial to many women.

    I hadn’t read the New York Times article. I think its comparison of anti-depressants to swordfish and brie is repulsive and insulting. I liked this one comment:

    Anti-depressants are not drugs of convenience, nor are women taking them Stepford wives who are intent on maintaining a certain lifestyle. There are drugs meant to treat a serious health condition, which if left untreated, has significant ramifications for herself, her existing children, her partner, and many others. To compare withholding an anti-depressant to forgoing brie or swordfish is incredibly insulting to the women who have to make this difficult decision. Shame on you, Roni Caryn Rabin, for perpetuating such degrading stereotypes about women who suffer from mental health issues. It’s articles like this that prevent people from seeking and maintaining the proper treatment they need, pregnant or not.

    To any woman reading this article who is concerned about how to treat her depression in pregnancy, I strong recommending disregarding this alarmist propaganda and instead engage in in-depth conversations with their OB and a reproductive psychiatrist.

    And most of all, I am so, so happy and excited for you. I’ve understood since I first knew you how much you wanted a baby, and — as a parent myself — have always hoped your wish would come true.

    1. Thank you, Donna! And that is a great comment. I didn’t read the comments, so it’s good to know there’s good stuff in there…

  13. I’m 35 weeks along with my first. I did slooooowly taper one of my antidepressants to a half dose, which has worked okay, but I stayed on my full dose of the other. I feel just fine about this decision. I just got back from a trip to see family over the holidays and only fell apart a few times (I lost my mom suddenly in April, so between holiday grieving, pregnancy hormones, and my typical biochemical issues, that’s pretty good). My kiddo needs a mother who can function, walk around, eat reasonably, etc. None of those things would be happening without my medication.

    Best wishes for a boring pregnancy! Sleep as much as you need to. I never got the fabled 2nd trimester energy burst, but I did stop needing daily 2-hour naps for most of it. Now I mostly just go to bed really, really early.

    1. I don’t believe in this second trimester energy burst! I think they’re just messing with us when they tell us that.

      Thank you for the good wishes! I hope what remains of your pregnancy is also boring and that your labor is smooth and easy and results in a happy, healthy baby with a happy, healthy mom!

  14. Congratulations and best wishes. I have my delightful Prozac baby! who is now twenty. No problems with his growth and development. he was a happy healthy baby hitting all the milestones earlier that expected engaged and mellow. I don’t know if it was the Prozac i took during the pregnancy that helped with the post part depression with my previous pregnancy. Whether it was because we treated him slightly different that his brother or because of his nature he is empathetic caring and compassionate. His friends all come to him with their problems and he comes to me. We talk and I believe he will make a wonderful therapist one day. Right now he just wants a job that makes a difference in peoples lives. I took prozac before, during and after conception. I continued taking porzac while breastfeeding for a year. I am coming up on 25 years of being on projzac at various doses and I don’t believe I would be here without it. It has helped me manage my severe cyclical depression and helps with with my ptsd sysmptoms as well.
    Blessing upon you and your new baby. may happiness and peace run through both your lives
    teri

    1. Thank you for the good wishes and for telling us about your son–it is always reassuring to me to hear about kids who turned out great!

  15. OH MY GOD, I AM SO FUCKING excited for you, I can’t STAND it. Congratulations! I would like to invite you to email me, if you’d like to, so we can prattle on and on about all things BABY and PREGNANCY.

    And go YOU, staying on the anti-depressants. Awesome sauce! You’ll be fine, baby will be fine. Most important thing is a healthy & happy mother! I agree with you 100%.

    Did I mention how excited I am for you???

  16. Congratulations!! Best wishes for a healthy and easy pregnancy.

    whatever possible, minor, and even as-yet-unknown potential side effects my medications might have on my developing baby were completely dwarfed by the significant, major, and enduring effects my depression would definitely have on my developing baby.

    Wow.
    What a blindingly obvious, and yet completely surprising, assessment. Thank you for posting – information like this really needs to get out there.

    I think you’re spot-on in blaming the weird invisible-woman discourse around pregnancy for the fact that this is so surprising.

  17. Congratulations EG–looking forward to more of your take on the whole pregnancy/motherhood stuff!

    1. I meant to go Woohoo Congrats when I did first see this, and then stuff happened. Apologies for the delay EG, and Woohoo!! Congratulations!!

  18. Oh, congrats! I know you have wanted a kiddo to raise, and now you will have one!

    When I first got pregnant, (surprise!) I was a smoker, and my prenatal health care worker actually told me that if I thought it was going to be too stressful to quit outright I should just cut way back on the cigarettes, because stress would be worse for the developing fetus than the nicotine. That is the story I tell when I hear someone start policing someone else’s pregnancy.

    Yes, there are some drugs that just Don’t Do Well with a pregnancy, (I, for example, would have to think long and hard about continuing using one of my meds should I get pregnant and want to stay that way) but we ought to be able to trust the pregnant person and their doctor to know what is best going forward.

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