Planning a baby..when you take psych meds.

This is a topic I'm really passionate about and I've spent a lot of time studying. I've probably read every book and journal article I could find on it.

Have you ever talked to your partner about wanting to get pregnant (or maybe just considered a pregnancy alone)...then slowly realized that you have been stable on your medications for a long time. Then you question if you could even maintain a freaking PREGNANCY without medications. With hormone changes, and stress..and all of the life changes that comes with a pregnancy.

If you were to bring this topic to your primary care doctor or OBGYN, there's a huge chance they might advise you to come off of these medications prior to getting pregnant. If you already are pregnant, they might take you off of them or put you on something totally different (and less effective). Probably Zoloft. Because that's the only one anyone is ever comfortable with.

About a year ago now (omg), I had my daughter.

Prior to becoming pregnant, my husband and I talked at length about how my medications could impact a potential pregnancy.

I take Wellbutrin, Lexapro and Adderall for a host of different reasons. What I can tell you is that I am not a nice, organized, kind, happy or functional human when I do not take these. My husband told me it was a non-negotiable that if I were pregnant, I'd need to stay on my medications..and I agreed.

So I did a lot of research and training. And I stayed on my medications.

I had an overall uneventful pregnancy with some later unrelated birth complications. Mayumi had some health issues which were much more related to genetics and antibiotics that I was forced to have while I gave birth. On the psych med front, no complications.

I have a growing, happy baby that I continue to breastfeed on my medications.

So why is everyone so afraid of psych medications during pregnancy?

More often than not, primary care providers have minimal training in mental health management. Add in pregnancy, and that is terrifying to them.

For an OBGYN, they may be familiar with older research on Zoloft being noted as a safe option..but they may not be familiar with the other extensive studies out there.

Psych providers may be nervous about harming both a birthing person and a baby with a medication, and veer away from wanting to treat the dyad.

So let's talk facts.

1. Birthing people who are stable on their medications are going to be more stress free throughout pregnancy. This means they will have lower stress hormones transferred to the fetus during critical periods of development.

2. Pushing through anxiety, depression, mood disorders, PTSD, or other related conditions through pregnancy can increase stress for the birthing person. It has been found that being untreated gives the pregnant person a higher risk of miscarriage, smaller babies, stillbirth or preterm birth.

3. For those who have bipolar disorder, you are at a higher risk of postpartum psychosis after birth. This, if untreated, can lead into self harm, harming others, suicide or homicide.

4. It IS possible to take medications like Lamictal, Lithium, stimulants, anxiety-medications, antipsychotics (Seroquel, Olanzapine, Risperidone, etc etc) during pregnancy with careful expert management (yes, we sure do provide that!).

What about the risks of medications? Do medications have risks? Sure. But risk vs. benefit is what we need to look at.

With antidepressants such as Lexapro, Citalopram, Zoloft or Prozac, studies have followed babies exposed to these drugs in-utero for years, and found no impact on IQ/intelligence, learning, or health conditions. There are some associations with Wellbutrin and ADHD, but we need to know that it hasn't been studied enough so we can't say that it is related..especially when genetics are a huge component.

There is some however, research that shows 25% of babies exposed to these medications may essentially have withdrawal from them upon birth. That would look like 48 to 72 hours of a high pitch cry that is not consolable, low body temperature, feeding difficulties and sleep issues. Although this is uncomfortable for baby, there is research that there is no long term impact found on their brain development.

There are ways to reduce that discomfort for baby, and we can guide you through that if that happens.

So... my point is:

If you want to have a baby, and don't know wtf to do about your mood, ADHD, anxiety or psych meds, plz come see us. Or if you already are preggo and are freaked out, please come see us!

We can provide you with the information, risks and benefits to make a safe plan together. We will walk through it together, monitor your pregnancy, and monitor you postpartum for any postpartum depression, anxiety or OCD. We can get you set up with a therapist who specializes in peripartum. We can help you navigate things like the intersection of sexual trauma, pregnancy and birth. We can even talk about risks of the MTHFR gene mutation on birth and your baby.

We're here for it.