I share my experience taking drugs for anxiety in pregnancy because I believe that the benefit of better maternal mental health is sometimes worth the risk.
This is one of those blog posts that have sat half-written for quite some time. Like most of my more “personal” shares (infertility, anxiety, orthorexia, body image etc.), I worried about being judged. But after reading so many stories on #BellLetsTalk day, and making so many new connections as a result of it, I knew I was in a safe place to make a difference. I mean, Abbey’s Kitchen is my home, and I don’t welcome trolls into my home. So if you’re here to comment below shaming me then just #getthefuckout.
Why Everyone Forgets that Moms’ Mental Health Matters
So let’s talk about mental health and motherhood, something that is all too often overlooked. When I joined the special mom club (and the obligatory troll-laden internet mom groups that accompany it), I learned that there are a lot of ways to parent your child. Some moms use cry it out to help their kid go to sleep. Others prefer to co-sleep as long as they can. Some moms do baby-led weaning to introduce solids. Others prefer to start with a spoon. Some moms use cloth diapers. Others go disposable. Sure, there’s a lot to disagree on and sometimes things get a little judgy online, but I often feel there’s one universal rule that most parents (and non-parents) seem to believe – now that you’re a mom, your kids always comes first. The moment you pee on a stick and see two faint lines, you are no longer just able to live life your way. You eat better, because it affects the baby. You stop smoking, because it affects the baby. You go to all your weekly prenatal appointments to keep tabs on the health of the baby. And while eating well, smoking cessation and medical attention all arguably benefit mom too, what happens when there is a discrepancy between the needs of mom and babe? Do our needs as mothers now always have to suffer for the (even potential) benefit of the child?
This seems to be the controversial question when it comes to anything related to mental health and pregnancy. Let’s back up to get some context for just a hot minute.
My Anxiety in Pregnancy
I’ve suffered from anxiety all my life and have written about it in detail here. I have spent virtually all of my adult life in therapy (with questionable levels of effectiveness) and a few years ago decided that an occasional dose of drugs for anxiety would be helpful. It was. Tremendously. But then I got pregnant.
The first thing I did was call Mother Risk (this AMAZING help hotline that is run by Sick Kids out of Toronto). The very amazing non-judgemental operator walked me through the very limited research and basically told me that there wasn’t much evidence on the safety (or danger) of the drug I was using but in the very low and infrequent dose I was taking, he couldn’t foresee an issue. He suggested I just follow up with my doctor to confirm my plan. It’s not uncommon for there to be little to no research when it comes to drugs and prenatal care. For ethical reasons, we can’t just perform randomized control trials on pregnant women not knowing what the effect of a drug is, so we have to look at population studies of women who ARE taking a particular pharmaceutical product and follow their pregnancy to see if anything bad happened. Obviously, I didn’t love the lack of solid evidence but I did feel some relief with Mother Risk’s lack of concern.
So I made an appointment with my doctor (a white man) to ask him about my meds, expecting he would give me my blessing, a refill for my script and I could move on with business as usual (plus bump). His response? “We don’t have research on its safety so I recommend you just don’t take them.”
Don’t take them. Quit cold turkey. Venture out into the world in your already more anxious, worried, pregnant state without the safety vest I’ve been wearing for so long.
I panicked. My heart filled with shame and guilt and worry. This doctor, this medical professional just told me that I was about to do was potentially dangerous for my unborn baby! What if I took something that harmed him/her?! I would never EVER forgive myself.
My emotional brain was losing its shit spiraling into “what if” scenarios. My rational brain demanded a second opinion.
I told the next doctor I saw (another white man) that I found it really hard to not take my anxiety medication during pregnancy, and that it was interfering with my ability to work. Again, I was met with, “well we just don’t really know” and that he couldn’t recommend I take anything. That was not what I wanted to hear…
As my medical team failed to help calm my (now extra heightened, unmedicated anxiety in pregnancy), I went where no anxious mom-to-be should ever go – the internet. Here I found some people who said “my doctor and I decided a small dose was fine”, but the overwhelming response was, “medications cross the placenta and make it to the baby! Can’t you just try not to be anxious?!”
Um.. NO. I cannot just not be anxious when I’m reading that I’m going to kill my baby just trying to not be anxious! AM I GOING CRAZY HERE?!
I went back to my doctor and begged to see a prenatal psychiatrist who I hoped would have more insight into my specific drug and fetal health, but she was booking far in advance. Like, I would be half way through my pregnancy by the time I got in. I made the appointment but obviously I had to make some hard choices in the interim while I waited.
Armed with so much anxiety, guilt, and shame, and no one officially willing to evaluate my unique situation’s from a benefit risk perspective, I quit the drugs cold turkey. Boy, did that ever back fire. Anxiety, at least for me, can be augmented by my state of mind, and just the thought of not having my pharmaceutical crutch made me spiral out of control. This state literally took me MONTHS to dig my way out of through hundreds (if not thousands) of dollars in therapy, and hours of meditation.
Why I Started Taking Drugs for my Anxiety in Pregnancy
Then about a month or so before I finally got in to see the prenatal psychiatry specialist, I realized that the anxiety I was currently harbouring just from the thought alone of not having my medication was not conducive to growing a healthy baby. I have no randomized control trial to prove this, but my mama intuition told me that I was doing more damage to my body (and therefore potentially to my baby) walking around on the verge of a perma-panic attack than I was taking an occasional anti-anxiety drug to calm my nerves.
I made the choice to take my anxiety medication during pregnancy. Thankfully, when I finally did get to see that psychiatrist specialist (whom I am SO grateful I got to work with), she confirmed that (while again, there wasn’t great evidence either way), she didn’t think my dose was something to worry about either way. And while it still took a lot of therapy and self-talk to get myself back to baseline even with the anxiety drugs since I had developed some pretty horrible anxiety associations sans drugs, I slowly started to feel like myself.
When Doctors Overlook Mothers’ Mental Health
So here’s what I learned in this process. Unless you have the ability to seek out specialized help, the general health care system doesn’t prioritize mother’s mental health. In fact, for the most part, I was made to feel like a frivolous, selfish mom-to-be who clearly had not grasped the universal mom code that our needs now come last. Interestingly, this seems to be associated with the fact that still, in 2019, mental health in general is not prioritized in health care. If a pregnant mom-to-be was suffering from some sort of chronic physical illness, we wouldn’t be telling her not to take her meds. But anxiety? It’s like we’re told it’s within our control and therefore just “not worth the (largely unidentified) risk”. And the reason it’s largely unidentified is because in comparison with medications for physical ailments, there just isn’t a lot of money invested in research on mental health. I get that doctors are covering their asses, but we need some advocacy so that woman, like me, can go through those 9 months of their lives feeling like they can function.
Now, as a breastfeeding mama, I have chosen to just avoid reading too far into the fear mongering and mom-shaming that happens between women online. I feel confident in my decision to put my mental health first, because I know I am a healthier, happier, better mom with a little help. This isn’t a sign of weakness, in fact, I’m choosing to see this as a strength. I have the strength to oppose the pervasive cultural rhetoric that a mother’s job is to prioritize herself last. I have the strength to share my story in an effort to stop the stigma around moms taking control over their mental health. They say that when you’re on the airplane and the plane goes down, you need to put your oxygen mask on before assisting others (even your sweet baby next to you). I needed to help myself to be of any help to others in my life.
I’m now 10 months postpartum and I am probably in the best place with my mental health and anxiety that I’ve ever been in my life. For that reason, I can say – without guilt or shame or self-consciousness – that my choice to take my anti- anxiety medication during pregnancy and breastfeeding was absolutely worth the (likely small, but truly unknown) risk. Had I continued dragging on drug-free, my prenatal and postpartum experience could have had a very different ending.
So moms, tell me – have you felt pressure to compromise on your wellbeing and mental health for your baby?
Have mom groups played a role in your anxiety in pregnancy about doing everything “right” as a mom?
What has been your experience with health care providers prioritizing your mental health needs?
Leave me a comment below with your thoughts!
Abbey Sharp is a Registered Dietitian, an avid food writer and blogger, a cookbook author and the founder of Abbey’s Kitchen Inc.