Balancing Act

anonymous:

What do you suppose is the solution to people who are on medications that cannot be taken while pregnant? I know that you’re aware that asking them to completely refrain from sex is unrealistic, and I HOPE you’re aware that it is also unrealistic for them to just stop taking their medications. There are occasionally alternative meds that can be taken during pregnancy, yes, but these won’t always work. So what is your solution? If you say the mother should quit her meds or take different ones anyway, it just proves you favour the fetus over the pregnant person. Please reply, I’d honestly really like to know your thoughts on how to solve this (keep in mind also that mental illnesses can put the mother’s HEALTH in danger).

cultureshift:

Extract from Harvard Vanguard Medical Associates, Dr. Jamie Dupuy:

While the decision around treatment often centers on the risks to the fetus of exposure to a medication, there are additional risks to both mother and child if mental illness is left untreated.  The time during and after pregnancy is a high-risk period for recurring symptoms in women who have had previous experience with psychiatric disorders.

Women must also consider that untreated mental illness, either during pregnancy or the post-partum period, also poses risks to the child.  These risks may include slower fetal body and head growth, pre-term delivery, and increased risk for operative delivery. Pregnant women with untreated depression or anxiety are less likely to have adequate prenatal care and nutrition and are more likely to abuse substances.  For these reasons, even from the point of view of protecting the child, it may not always be the best choice to discontinue psychiatric medications or to withhold treatment during pregnancy.

There are treatment options during pregnancy that go beyond medications.  Psychotherapy, usually in weekly sessions, has been shown to be effective for some conditions.  Increased support from partners, family members, friends, and medical care providers can be important as well.  Pregnancy is also a time to focus on overall health, including exercise, nutrition, and sleep. Speaking with your doctor about improvements you can make in these areas may be helpful for mood and anxiety symptoms.

Many mothers with mental illness challenges have given birth to their children without issue. The key to success is maintaining a close relationship with your doctor throughout your pregnancy to ensure any changes experienced are quickly and appropriately addressed.

See this American Congress of Obstetricians and Gynecologists Practice Bulletin on the use of psychiatric medications during pregnancy and lactation. It’s a great resource that breaks down the risks associated with many different psychotropic drugs, including terotogenic effects.

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