Pregnancy And Disability

lindywhiskers:

First of all wanted to say thank you for changing my mind on abortion. I can’t believe I separated “fetus” from “human” for so long.

I wanted to ask you if you have any resources/advice for getting through pregnancy despite disability? I don’t want to take medication that’s not safe for baby but I also don’t want to get sick. I have bipolar disorder and fibromyalgia and almost none of the medications are safe, and the ones that are don’t always work. I’d rather go off my meds completely and risk myself than risk hurting my child, but if I’m sick it’s bad for both of us.

cultureshift:

First, I want to thank you for waking up to the reality that you are carrying your actual child, not some ‘blob of cells’. Incredibly, even in the age of information, it’s difficult to get people to realize this simple truth. And your child is now better off for it.

From the American Congress of Obstetricians and Gynecologists guidelines on psychiatric medication use during pregnancy and lactation…

An estimated 500,000 pregnancies in the United States each year involve women who have or who will develop psychiatric illness during the pregnancy. The use of psychotropic medications in these women is a concern because of the risks of adverse perinatal and postnatal outcomes. However, advising these women to discontinue medication presents new risks associated with untreated or inadequately treated mental illness, such as poor adherence to prenatal care, inadequate nutrition, and increased alcohol and tobacco use.

Ideally, decisions about psychiatric medication use during and after pregnancy should be made before conception. The use of a single medication at a higher dosage is preferred over multiple medications, and those with fewer metabolites, higher protein binding, and fewer interactions with other medications are also preferred. All psychotropic medications cross the placenta, are present in amniotic fluid, and can enter breast milk.

Extract from Harvard Vanguard Medical Associates

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.

From WebMD

There are few studies on fibromyalgia in pregnant women. However, a study at Temple University found that women with fibromyalgia had more symptoms of pain during pregnancy than women who did not have fibromyalgia. Also, fibromyalgia symptoms seemed to be exacerbated during pregnancy. Pregnant women with fibromyalgia may experience significant pain, fatigue, and psychological stress, especially in the first three months.

At this time, no fibromyalgia medications are completely safe to use during pregnancy. In fact, doctors recommend that women with fibromyalgia go off of painkillers and antidepressants before they become pregnant. However, be sure you talk with your doctor before you stop any medicines.

To avoid letting fibromyalgia interfere with pregnancy, know what steps you can take to ease the symptoms. Then seek support from your doctors, family members, and friends. Treatments for pregnant women with fibromyalgia may include massage, exercise, yoga, meditation, and rest.

If you suffer with fatigue and ache all over, make sure you rest 20 to 30 minutes at least two or three times a day. To ease the achiness of tender point pain, try moist heat applications twice a day. A warm shower or bath is a good way to apply moist heat. Just make sure that the water temperature is 100 degrees Fahrenheit or lower and limit use to 15 -20 minutes at a time. Water that is warm enough to raise your body temperature to 101°F or higher, may cause birth defects.

Being a mother is full of sacrifices. In fact, there are several examples of heroic mothers who have foregone cancer treatment to protect their children. You have the strength to be one of those heroes. Never give up on your child.

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