In this essay published in the Journal of the American Medical Association, Dr. Helen Kim (an alumna of the CWMH) discusses the challenges of treating women with severe psychiatric illness during pregnancy:
“Would a physician tell a pregnant woman with epilepsy, ‘Stop your meds and ride out the seizures until you deliver’? Are the medications of pregnant women with mental illness somehow more “optional”?”
Read the full article here.
What a breath of fresh air! During my first pregnancy my dr took me off medications for anxiety and depression. Within a week I was in such an agitated/depressed state I was hospitalized. The doctors there told me the only medication I could take was benadryl. Benadryl!!! I was hopeless. It took a couple months of misery before my psychiatrist agreed that I should probably take something. My OB was on board with medication the whole time. Why was the mental health community not supporting me? With my second pregnancy I made an informed choice to stay on my medication. What a difference!
Thank you, thank you for providing this excellent reference for pregnant women. I will send it to each of my patients who have been told (by others, not me!)not to take lithium in pregnancy, and will cite it in my blog.
Thanks ever so
Ruth
Beautiful article–reasoned and beautifully written. Thank you!
Thank you. This has been my struggle for the past year as my husband and I attempt to responsibly plan for a pregnancy that is safe for everyone. Six months ago I ended a relationship with my psychiatrist of 15 years. He was unwilling to even consider any medication during pregnancy or leading up to it. Knowing my history, the inability of my former psychiatrist to partner with me around my care seemed dangerous to me. Thus, I was forced to seek out another provider (which is no easy task). My husband and I are now actively trying to get pregnant upon finding another psychiatrist who has been willing to rationally weigh the risks and benefits of all my options. This blog has been a GODSEND for me. I have been able to evaluate the risks and benefits of the care that I was getting and determine that the costs were astronomically high. I cannot afford medical care that is based on the unwavering gut reaction of my physician. I am seeking knowledge, my new psychiatrist is seeking too.
What an excellent article! The analogy of a pregnant woman drowning is powerful and appropriately so. It’s time for mental illness to be given the same treatment as other illnesses – depression cannot simply be willed away, and a depressed person cannot just “hold on”. Pregnancy can complicate matters, but this is why it is so important for each unique case to be evaluated. I received an evaluation at MGH when I was planning pregnancy and it was determined that I should remain on Zoloft, which had been very helpful for me in the years prior. I went on to deliver a perfectly healthy baby boy. I am able to be the best mom I can because I am healthy, and I believe the same is true during pregnancy.
This article, and this blog, have both been very helpful. I take several meds for mental health and other concerns and have been scared to even think about getting pregnant because the thought of changing meds, or going off meds, has been terrifying. Now I know that it’s important to consider my health, too–not just my potential baby’s. Thank you.