A Drug-Free Pregnancy... I Wish!
I wrote in my last blog about my hyperemesis, which hopefully (all fingers crossed) is on the way out now. I still have nauseated times, but I haven't been sick in almost a week.
While sick, it was extremely hard because we just couldn't tell anyone. However, I found a great group of women online (on Mumsnet) who are all suffering in various stages of hyperemesis and pregnancy. Now that I have been part of that group for a while, the thing I notice most frequently is women searching for the answer to this question:
"Is it okay for me to take the medicine the doctor has recommended? I've been told by everything and everyone that all medicine is bad, especially in the first trimester, and I don't want my baby to have birth defects."
To give a decent answer, I feel like I should go back to my first pregnancy.
I was suffering badly then with hyperemesis, but because I had zero experience being pregnant, I thought it was just what pregnant ladies did. I was working as a temp about 40 minutes away, and I spent the whole bus ride every day barfing into a plastic shopping bag. Then when I got to work I would spend most of the day in the toilet. Bless the company and my supervisors (both women) as they were extremely sympathetic (given that they were essentially paying me to sit in the bathroom all day). One day, I had had enough and told the bus driver to stop halfway to work. I called my mother-in-law and asked her to come take me home. That was my last day of work that pregnancy.
I went to the doctor and explained to him what was happening. He was sympathetic, but he assured me that it was normal, and that if I could at least keep some liquids down, it wouldn't have an adverse effect on the baby. Not knowing any better, I though "Okay, so this is what a normal pregnancy is." After another two weeks of nothing but sips of water and no activity other than lying on the sofa crying, I went back to him. He gave me what I now know to be an extremely safe, first line drug for severe nausea and vomiting in pregnancy...with a caveat.
"You probably shouldn't actually take this."
Talk about conflicting information! The pregnancy books I had read were clear, and also Dr. Google. Medication is not safe in pregnancy, particularly in the first 12 weeks. But my doctor had given me medicine...and told me not to take it? I was so confused. I opted not to take the medication, but as a result, I lost 25 lbs (about 11kg) in the first half of my pregnancy. Ella was tiny, and I don't think it was just a coincidence.
At about 30 weeks of pregnancy with Ella, I went to a normal midwife appointment then was rushed to the Antenatal unit of the hospital. My blood pressure was really high. Out of the blue. They gave me a medicine, Labetalol, to take to lower it. Again, I was really conflicted. The pregnancy books said "No drugs - not even ibuprofen for headaches!" And surely the blood pressure was only affecting me? But it wasn't. It meant that my placenta wasn't getting enough blood to my precious baby. I talked it through with the midwife, and although it took me another two weeks to get up the courage to actually take it, I eventually did. Not taking it could mean that my blood pressure harmed both of us and could have led to more serious problems.
And what about my "normal" medication, which was essential for my mental health? Most people would say: "Well, you could just stop taking it and see what happens?" Well, I did for the first trimester, but when you spend weeks lying on a sofa crying, it's basically simulated depression. When I spoke to my Perinatal Mental Health Team (who are amazing), they said "you need this to be well for your baby. The minuscule risk of problems with the baby is far outweighed by the damage an episode of depression could do to you. So I went back on my medication at 11 weeks 4 days.
And what about totally acceptable pills to take? Like folic acid (to prevent neural tube defects) or iron tablets (to prevent anaemia). Many of these are given to pregnant women in food (like folic acid and iron enriched bread) because they are so essential.
So here are my four situations, and most pregnancy medication conundrums, in a nutshell:
1) Biggest sufferer is mother. Baby unaffected by condition. Medication given but not recommended.
2) Biggest sufferers are mother and baby. Could lead to serious medical problems. Medication required and needed.
3) Chronic condition affecting mother. Could lead to problems with baby or postnatal complications. Medication recommended but other non-drug steps (like therapy and extra support) are also available.
4) Medication taken to prevent birth defects or complications in mother and baby. Not just recommended, practically pushed on women by every health professional.
Here's the difficult thing: for everyone, these decisions are extremely personal. That's why the pregnancy book dictating "No drugs at all in pregnancy" is just dangerous. It makes women terrified to listen to medical professionals and even seeps into healthcare training and experience. That undermines the whole maternity care system.
That's why when I went to the doctor extremely dehydrated, unable to pee and and not having kept down any food in days that he said "Have you tried ginger and taking little sips of water? It's not really safe to take medicine for nausea in pregnancy." I won't get into the lack of sympathy from him, but having armed myself with information this time round, I knew that there were in fact NINE different safe medicines that were available to me. In the end, I still had to go to the hospital before I could get them, but by that point, Josh and the Mental Health Team were fighting on my behalf. If it weren't for his persistence (and a complaint letter and copy of the NICE guidelines), I would have suffered more and for longer.
But you know what? It turned out fine for me. I didn't end up losing quite so much weight, and they uncovered my high blood pressure earlier. I'm getting great care. Other women might make the decision not to take medicine for a variety of reasons, but my justification came down to something my Clinical Psychiatric Nurse said:
"Some medicines have a chance of affecting the baby, even though they might not. But what will affect the baby is being bathed constantly in stress hormones because you are anxious, in pain and suffering. Our job is to keep you well so that baby has the best chance of a healthy mum and healthy relationship with you. That's worth the risk for you."
And I agreed with him. Fast forward a few days, and I am in Boots buying an old lady pill box to hold all the meds I need to have a healthy pregnancy. And that's okay. It was the best choice for me and the munchkin.
Pregnancy sucks. But I'm not going to risk bonding with my little one because I was too terrified to think of my own mental and physical health. Don't be frightened to ask for a second opinion, get more information and definitely don't skip medicines that might protect baby (like folic acid, iron or blood pressure medicine). If your doctor recommends it, or you are suffering, take the help. Take the drugs. Pregnant mothers are not just robotic baby carriers. We are people too.
While sick, it was extremely hard because we just couldn't tell anyone. However, I found a great group of women online (on Mumsnet) who are all suffering in various stages of hyperemesis and pregnancy. Now that I have been part of that group for a while, the thing I notice most frequently is women searching for the answer to this question:
"Is it okay for me to take the medicine the doctor has recommended? I've been told by everything and everyone that all medicine is bad, especially in the first trimester, and I don't want my baby to have birth defects."
To give a decent answer, I feel like I should go back to my first pregnancy.
I was suffering badly then with hyperemesis, but because I had zero experience being pregnant, I thought it was just what pregnant ladies did. I was working as a temp about 40 minutes away, and I spent the whole bus ride every day barfing into a plastic shopping bag. Then when I got to work I would spend most of the day in the toilet. Bless the company and my supervisors (both women) as they were extremely sympathetic (given that they were essentially paying me to sit in the bathroom all day). One day, I had had enough and told the bus driver to stop halfway to work. I called my mother-in-law and asked her to come take me home. That was my last day of work that pregnancy.
I went to the doctor and explained to him what was happening. He was sympathetic, but he assured me that it was normal, and that if I could at least keep some liquids down, it wouldn't have an adverse effect on the baby. Not knowing any better, I though "Okay, so this is what a normal pregnancy is." After another two weeks of nothing but sips of water and no activity other than lying on the sofa crying, I went back to him. He gave me what I now know to be an extremely safe, first line drug for severe nausea and vomiting in pregnancy...with a caveat.
"You probably shouldn't actually take this."
Talk about conflicting information! The pregnancy books I had read were clear, and also Dr. Google. Medication is not safe in pregnancy, particularly in the first 12 weeks. But my doctor had given me medicine...and told me not to take it? I was so confused. I opted not to take the medication, but as a result, I lost 25 lbs (about 11kg) in the first half of my pregnancy. Ella was tiny, and I don't think it was just a coincidence.
At about 30 weeks of pregnancy with Ella, I went to a normal midwife appointment then was rushed to the Antenatal unit of the hospital. My blood pressure was really high. Out of the blue. They gave me a medicine, Labetalol, to take to lower it. Again, I was really conflicted. The pregnancy books said "No drugs - not even ibuprofen for headaches!" And surely the blood pressure was only affecting me? But it wasn't. It meant that my placenta wasn't getting enough blood to my precious baby. I talked it through with the midwife, and although it took me another two weeks to get up the courage to actually take it, I eventually did. Not taking it could mean that my blood pressure harmed both of us and could have led to more serious problems.
And what about my "normal" medication, which was essential for my mental health? Most people would say: "Well, you could just stop taking it and see what happens?" Well, I did for the first trimester, but when you spend weeks lying on a sofa crying, it's basically simulated depression. When I spoke to my Perinatal Mental Health Team (who are amazing), they said "you need this to be well for your baby. The minuscule risk of problems with the baby is far outweighed by the damage an episode of depression could do to you. So I went back on my medication at 11 weeks 4 days.
And what about totally acceptable pills to take? Like folic acid (to prevent neural tube defects) or iron tablets (to prevent anaemia). Many of these are given to pregnant women in food (like folic acid and iron enriched bread) because they are so essential.
So here are my four situations, and most pregnancy medication conundrums, in a nutshell:
1) Biggest sufferer is mother. Baby unaffected by condition. Medication given but not recommended.
2) Biggest sufferers are mother and baby. Could lead to serious medical problems. Medication required and needed.
3) Chronic condition affecting mother. Could lead to problems with baby or postnatal complications. Medication recommended but other non-drug steps (like therapy and extra support) are also available.
4) Medication taken to prevent birth defects or complications in mother and baby. Not just recommended, practically pushed on women by every health professional.
Here's the difficult thing: for everyone, these decisions are extremely personal. That's why the pregnancy book dictating "No drugs at all in pregnancy" is just dangerous. It makes women terrified to listen to medical professionals and even seeps into healthcare training and experience. That undermines the whole maternity care system.
That's why when I went to the doctor extremely dehydrated, unable to pee and and not having kept down any food in days that he said "Have you tried ginger and taking little sips of water? It's not really safe to take medicine for nausea in pregnancy." I won't get into the lack of sympathy from him, but having armed myself with information this time round, I knew that there were in fact NINE different safe medicines that were available to me. In the end, I still had to go to the hospital before I could get them, but by that point, Josh and the Mental Health Team were fighting on my behalf. If it weren't for his persistence (and a complaint letter and copy of the NICE guidelines), I would have suffered more and for longer.
But you know what? It turned out fine for me. I didn't end up losing quite so much weight, and they uncovered my high blood pressure earlier. I'm getting great care. Other women might make the decision not to take medicine for a variety of reasons, but my justification came down to something my Clinical Psychiatric Nurse said:
"Some medicines have a chance of affecting the baby, even though they might not. But what will affect the baby is being bathed constantly in stress hormones because you are anxious, in pain and suffering. Our job is to keep you well so that baby has the best chance of a healthy mum and healthy relationship with you. That's worth the risk for you."
And I agreed with him. Fast forward a few days, and I am in Boots buying an old lady pill box to hold all the meds I need to have a healthy pregnancy. And that's okay. It was the best choice for me and the munchkin.
Pregnancy sucks. But I'm not going to risk bonding with my little one because I was too terrified to think of my own mental and physical health. Don't be frightened to ask for a second opinion, get more information and definitely don't skip medicines that might protect baby (like folic acid, iron or blood pressure medicine). If your doctor recommends it, or you are suffering, take the help. Take the drugs. Pregnant mothers are not just robotic baby carriers. We are people too.
Comments
Post a Comment