Daughter pregnant

[aliceinshackles]

My 24yr daughter announced she's pregnant.
I'm worried sick.

She has serious mh issues and medication resistant epilepsy. She's on waiting list for brain surgery.
She takes 11 tablets of various anti convulsants and mh meds.
I've used the BNF to check these meds and pregnancy and a lot of the meds are toxic to the baby and can cause bad withdrawals.

She's known to social services so I imagine they will be in touch when she goes to the midwife.

She did drink a lot and take drugs.
Both her and her partner have been in prison so low on the council house list, she wants to move closer to us.

Not sure what I want but my head is flying everywhere, I'm epileptic as well and both her & her brother were effected by my meds during pregnancy. Withdrawals and mainly didn't feed for 3 days and very sleepy.

I'm worried about her mh , we think this is because some of her close friends have recently given birth.

Please calm me down.
She's coming to see me today with her partner.

and get her on birth control

@lisaJN1986 OP’s DD is 24, how on earth do you suggest she ‘gets her on birth control’? She has no control over her DD’s contraception choices.

OP you have had some fantastic advice here. I have no words of wisdom but just to say I am thinking of you today whilst you have this difficult conversation.

I feel so sad for your daughter. Brought into this world with drug withdrawals and then going on to have all those difficult mental and physical health issues. I hope she gets all the help and she her partner needs and are able to turn their lives around. Th

This! Your dd needs to understand that if she has the baby there is a limit to the support that you and dh can offer.

You know your dd better than any of us but she needs to have clarity about the help she will be able to expect.

I think you and your husband will surprise yourself when the baby arrives.

My parents were exactly the same and had the same response but when my nephew was taken into care at 6 months old they fought with everything they had to get him out of the system.
He was placed with them along with DB and his partner but she then left.

Your DD is highly likely to need to be in a mother and baby unit so it's worth her knowing this upfront and where your closest one is they are difficult to get a space in but far better then the alternative.

Gosh, that's a tough situation OP. But I honestly feel you shouldn't have give up your own career that you've trained and worked hard for. It feels to me like giving up work to help her would be really a "bottomless pit" for your efforts - you could never do enough. I think you should do your utmost to stay in your job and not look after her DC. She has made her choice, she has a partner; there are other agencies to step in if you are not there. However, if you are there waiting to pick up the pieces they will let you.

I discovered this with my DMum - whilst I was running myself ragged try to help her and be with my family and keep my job they did nothing. As soon as I stopped picking it all up they stepped in.

Hiya , sorry I replied somewhere up thread that she's not on sodium valproate.
I gave a list of some of the meds she's on.

This is a huge list of meds. Not helpful now, I know, as she shouldn’t change or reduce meds while she’s pregnant, but a consideration for afterwards…

Levetiracetam (Keppra) is notorious for emotional side effects (“kepp-rage”). This definitely happened to me - I felt like a teenager and couldn’t control my mood swings at all. Combining with a low dose of Lamictal worked for me in the end. I wonder if reviewing the Keppra or other anti-epileptic drugs could help her come off some of the MH ones.

If her epilepsy is not controlled and she’s not been taking folic acid till now, she’s at high risk of fetal malformation and increased seizures. Maternal mortality is about 10x higher for epileptic mothers - still very rare but something to consider. If she decides for an abortion that will give her time to work with her neurologist and get in a healthy place to conceive. It doesn’t mean she won’t be able to have children ever. Changing from valproate to Keppra delayed my pregnancy by a few years. It was emotionally hard to wait and epilepsy is still not completely controlled, but I was able to prepare with lots of folic acid and have a good support system in place for the pregnancy.

If she does decide to go ahead, my experience till now has been:

1. Informed doctor and neurologist straight away to get early appointments with specialists. Has she done this yet?
2. Seizure at 7 weeks. Baby was unharmed but really upsetting.
3. Neurologist did baseline blood medication levels and upped my dose.
4. Took annual leave from 9-11 weeks as I was too tired to work without risking more seizures. I’ve been seriously slacking off since then.
5. Blood levels taken again at 15 and 25 weeks and meds upped. Will be done again at 32 weeks.
6. Very detailed ultrasounds at 12, 16 and 20 weeks with echocardiogram to check for spina bífida etc and heart malformations. All confirmed ok.
7. Doctor will sign me off sick at 31 weeks (hopefully) on neurologist recommendation so I will not get too tired and risk seizures.

Has she thought about how the timeline of her pregnancy will play out?
Has she considered what she will do if the baby is diagnosed with a serious issue at 12, 16 or 20 weeks? Does she understand what the most common complications are and incidence rates compared with the general population?
And has she agreed with her DP on the commitment that will be needed from him during pregnancy and postpartum to reduce her risk? Eg my DP will be taking at least the first 6 weeks as paternity leave and is aware he will need to wake up with me during the night to help even though I plan to EBF. He will do basically all cooking and chores for a while.
Also is she compliant with her meds? Really really important she is taking them at the set times every day and not skipping any doses.

Maybe you can talk her through all these practical points and help write down the answers clearly so she can read it back and mull it over in the coming days.

Thank you everyone for your replies. I will try and answer your questions, sorry if I miss any.

@lisaJN1986 thank you for your comment. There but the grace of god.

@HikingforScenery things were different when I was pregnant. Times have changed. I felt horrible as a young mum with a baby going through withdrawals. But I had to take the medication for my own health as well.

@Krakinou thank you for your experience.

You have all mostly given me some things that I hadn't thought about to mention, and actually calmed me down.
A lot of food for thought.

and get her on birth control

If I can add to this comment. Due to the meds it's difficult to find a contraceptive that doesn't have contradictions.
I found this problematic myself over the years. I personally can't take the pill or have the implant. I had the depo but that came with its own risks.
The pill made my anticonvulsants not work properly and I had seizures.
I'm on old school carbamazepine and lamotrigine.
Her sister is on keppra.
End of the day good old condoms but their not 100%

To answer another pp (sorry can remember who)
She is compliment with all medications, attends all appointments, works with mh services had single and group therapy.

Honestly, you would not be unreasonable to draw your line in the sand now and make it abundantly clear that you will not change your working hours to be on available to babysit or help out. Explain in very small words that you are literally just catching up financially and simply can’t and won’t take this on. Make this especially clear to SS even if you have to call them daily.

You haven’t said if your daughter is sounding happy to be pregnant.
If she is then this could be the making of her.
Little steps, listen to what they have to say and find out how aware she is of the meds risk.
I hope it goes well.

Venafalexin , diazepam, eslicarbazepine, levetiractam , promethazine , clonazepam

Sorry, I am unsure how I missed this, levetiractam is one of the safest medications for pregnancy in terms of anti-convulstants. Clonazepam and Diazepam - are they both PNR?

Promethazine is safe. I'm unsure about the others. I think venafalexin the risks come towards the end of pregnancy so she may be weaned off it. it will be good to ask to speak to a specialist in obstetrics pharmaceuticals. It may be a bit of a trek to get one but it's worth it.

You’re not selfish at all! You sound like a really kind caring mum who’s already made sacrifices. What a difficult situation. Hopefully this will be a turning point for her, she’ll get some good medical help and her partner will step up to the mark. for you

*She is compliment with all medications, attends all appointments, works with mh services had single and group therapy.

I hope you are very proud of her, this a huge undertaking and it's awesome she's so engaged - it puts her on a really good footing for the pregnancy.

Sure, but that should be the last resort IF the daughter decides to go on.

Due to the meds it's difficult to find a contraceptive that doesn't have contradictions.

It's impossible - the only options are condoms which are not reliable, or like almost weekly blood test levels which just don't happen since covid (talking from experience here). It's really, really difficult, and there is literally nothing that can be done about it.

She sounded shell shocked on the phone to me and a bit giddy.
She had talked of wanting children but at the right time.

Someone suggested high dose folic acid - if she is 8 weeks then it is pointless as the neural tube closes by 6 weeks. The main issue is the effect of anti epileptic drugs on the NT but this won't be visible until the anomaly scan

I think there's a lot of people responding who have no knowledge of epileptic medication and contraception / pregnancy OP so try and take some comments with a pinch of salt.

@NC3435 It's not pointless - it can do some good for other things, it's not just about neural tube defects.

Those are the meds I can remember, hence why she needs to make a plan now and get the ball rolling with appointments with her consultants asap.
Thank you for your advice

I am proud of her and I tell her that often, she has turned her life around. Had some big bumps along the way.
The past year is the happiest I've seen her in a long time.

Yup, this. I am sure you will be a very supportive and loving granny, ie doing what you can and feel able to, around your work and life, but not doing the parenting for her. She and her partner are adults, he works, they should be able to access support from the various agencies out there - be there for her of course, but you have your own life and need to set expectations and boundaries now, don’t feel guilty about this.

Your not selfish OP, I would feel the same as you. I wouldn't be jumping for joy either.

I'm with you.
I've been epileptic since the age of 6
3 pregnancies with epilepsy , yes I know times have changed.
Then having 2 of my own children diagnosed with epilepsy.