To be surprised at being called ‘selfish’ here?

[FatOldBitch]

I am newly pregnant and having a very anxious time due to a previous late loss.

I have a prescription for sertraline but have so far not taken it as, although things aren’t easy, I feel I am getting by OK without it at present.

My psychologist however has told me I am ‘selfish’ not to take it. I found this perspective surprising as my reasoning had been the exact opposite in that I was putting my unborn baby before myself. The doctor who prescribed it said that, although any risks are thought to be very minimal, she couldn’t promise they were actually zero. She left me the prescription and agreed I’d fill it if I felt it necessary.

Yet my psychologist is concerned about the effect of my anxiety on my 3.5 year-old. This wasn’t something I’d thought very significant if I’m honest. Said anxiety mainly manifests as frequent rushes to the bathroom with heart-racing to check for bleeding. I’m not sure that’s really affecting him?

It also feels quite belittling as an adult to be called ‘selfish’ to my face. ‘Have you considered the effect this may be having on your DS?’ would surely have been a better way to raise this and open a discussion about it. AIBU?

My reasoning would be the opposite too. You are doing the right thing not taking it during pregnancy.

Your psychiatrist should not have phrased it that way.

When I was offered Sertraline via the GP when I was TTC I also declined. The GP understood but also said that a mother’s mental health is just as important as the physical health during pregnancy. It is a risk Va Benefit.

Here is the link to the Sertraline page on Best Use of Medicine in Pregnancy (BUMPS), which my GP directed me to during my pregnancy. You can see some of the small risks of taking this in pregnancy.

3.5 year will be picking up on your mood and won’t be able to articulate it, he won’t really know what is wrong but it will be affecting him. It isn’t selfish. However, the GP has prescribed this for a reason. They thought it was necessary, they don’t prescribe things to pregnant women if there isn’t a need. By the time you realise it is necessary, that could be having a much bigger impact on you, your baby and your existing child. Anxiety isn’t going to be good for your pregnancy either.

I’m not saying take it because that isn’t my place. It isn’t a simple case of don’t take it as it carries small risks it’s damaging, as medical professionals feel not taking it could be damaging too. You need to balance all the available information and make an informed decision with your medical team. Your psychologist thinks you need it, they’ve phrased it poorly but it also got you thinking about it. Would “have you considered the effect this is having on DS?” got you thinking about it, as you said it can’t be having any impact on him?

I think if her medical professionals, with probably at least a decade of training, have recommended it, your reasoning isn't worth a great deal.

OP they shouldn't have phrased it that way. However rushing off, heart racing to check compulsively isn't nothing, and try to do an honest inventory of whether it is affecting your child. Also, I know a couple of people who took similar in pregnancy and in at least one case, the child is definitely more affected by her mum's MH than mum acknowledges.

I’m not sure selfish is the right thing to say but your child will pick up on your anxiety. They will be affected by it.

Hmmm. Observing a few situations like this from the outside, I think the anxious person often tells themselves

‘well I only do X real world thing’ in your case rushing to the bathroom

and aren’t aware of their emotional state most of the rest of the time (which leads to that behaviour) and can be very hard to be around.

OTOH my heart goes out to you, so sorry for your loss, it’s understandable that you are worried.

and there’s no right answer on whether to take the drugs or not.

Doesn’t sound like your therapist is the most compassionate and supportive. Can you see someone different?

could you explore some other ways to support your state of mind and deal
with you le anxiety?

alternative therapies like yoga, acupuncture, homeopathy can be great for this.

maybe a doula?

good luck

I’d say you’re definitely not selfish. Sertraline is not approved for under 18s and I wouldn’t risk taking it while pregnant. Obviously, your doctor thinks it’s ok but I think the psychologist is totally out of order calling you selfish.

Just to be clear, the doctor did not say to definitely take it. She left it up to me whether I felt I needed it and gave me a prescription to fill in case I do at any point. So I am not going against medical advice here.

I feel really torn and undecided what to do now. One of the risks is post-partum haemorrhage which I had last time.

I’m not saying you MUST take this medication. Of course it’s your decision. Do you have coping mechanisms for when you struggle? It’s no bad thing for children to see you using these to cope.

If that specific risk means you will be preoccupied about it - and I can see why you might be just because that's human nature - then surely that will counteract at least some of the benefits of taking it?

Sorry for your previous loss. Pregnancy can be random and cruel.

Sorry to hear of your previous loss and also your struggles with mental health as a result, it’s understandable.

I was on Sertraline during my second pregnancy, my DD is now nearly 3yrs old and all was fine. I didn’t want to be and had previously been on Venlafaxine but had the discussion with my GP who prescribed Sertraline due to being the safest SSRI during pregnancy. Obviously this is only based on anecdotal evidence as they can’t actually carry out clinical trials on pregnant women! I was on it for depression which was triggered by my first pregnancy 10yrs prior (PND but I’d always had episodes of anxiety and low mood). I tried to come off it for the safety of the baby but my mental health and my family suffered as a result. My GP said this was equally important and that heightened stress and anxiety during pregnancy can also be harmful to pregnancy and the baby. Some evidence suggests high levels of cortisone can affect the baby too, potentially causing behavioural and emotional disorders.

Only you can decide how much you and your anxiety is affecting you, your family and potentially your pregnancy and unborn baby. Clearly your therapist did not phrase it particularly well but maybe the point stands. If your GP has deemed it medically appropriate and your therapist too, then I might consider taking their advice. What does your DP think?

I agree that if there's a potential risk (even if it's minimal) to the baby with the medication and your anxiety is around a previous loss, then it does seem it may add to the anxiety in some ways. However, I think you and your medical professionals really need to weigh up the risks v the benefits. I'm not saying the psychologist was right to call you selfish but perhaps they were being very direct if they do in fact feel the benefits outweigh the risks? They didn't phrase it professionally, however it's given you a different perspective so I'd focus on that, maybe write down the pros and cons, and come to a decision based on what you know and feel. If you don't want to take them, what are the non medication alternatives?
Do you have a partner or close friend youve confided in - what do they think? Sometimes when you're in the thick of it you don't always realise the extent until afterwards. I've definitely been in situations where I thought I'm fine, then it's taken basically a mental breakdown to realise I'm not fine and should have accepted help earlier.
So sorry for your loss and I hope you can draw a positive from what was said. Xx

Depends on how much insight you have really. Did you have cause to take it previously and are discontinuing, or they want to initiate it now during pregnancy?

If you were meant to be on it/were on it pre-pregnancy due to general factors, it’s hard to imagine these have medically disappeared and you are likely having an impact on those around you including your child. If you had no cause to be on it pre-pregnancy and they want to initiate it now merely due to anxiety specifically related to the pregnancy only then you are not being at all unreasonable to refuse it. However, you will need another mechanism to address your health anxiety during this time as it’s taxing for yourself, your family and your healthcare providers.

• was meant to be magically not medically. Hate predictive text.

I am sorry to be blunt, but I agree. We all know that medical professionals tend to err obsessively on the side of caution when it comes to pregnancy so I think the fact that this is identified as a drug pregnant women can take and in your case has been specifically recommended means you should take it.

Let's also not.forget that high levels of stress are not recommended for pregnant women and there is some concern it can affect the baby.

Making decisions for your health that are against the recommendation of multiple professionals, potentially to the detriment of both of your children as well as yourself, seems.silly to me.

I just wanted to say you're not alone, I've been prescribed it too and decided not to take it yet as I'm still breastfeeding the doctor told me to just stop breastfeeding while the lady who was doing my cbt said as long as I had the option of it, the choice is mine.
The choice is yours, with anxiety you'll have good days and bad, are you able to push through the anxiety to meet your sons needs? If so I'd explain that to the psychologist.
You're seeking help for your anxiety and also thinking about the effects of the medication which shows you care about your children.

I also came off my anxiety/depression medication before getting pregnant because I was worried about any potential side effects. I asked my doctor what the risks were and she said infinitesimal but technically if theres a 0.01% chance of a problem in pregnancy without medication there is a 0.03% chance of problems with. I thought well its infinitesimal but I might also triple that tiny risk and that put me off.

Like you I didn't think my anxiety was a significant risk to my pregnancy and the medication risk (in my mind) outweighed that. My father had died 6 months before my pregnancy and the month before I had a very early miscarriage so I was a bit stressed a little worried about PND but it the end after the baby my mental health improved significantly (I think mat leave from my stressful job played a part in that) and I was glad I came off the meds on the run up.

You cannot make a wrong decision here OP you are not selfish with or without the medication, do what is best for you and the baby. Ignore peer pressure even from the doctors, if you need it then take it, the risks are very minimal (especially after the 1st trimester), if you think you can manage without that is 100% valid too. Xx Take care.

Hi @FatOldBitch, I hate your username BTW, even if you are a fat old bitch it sounds like you're being mean to yourself, if you're an anxious person that won't help.

I am really really sorry about your loss, the trauma must be horrific and you are likely still juggling the grief.
I hope your pregancy treats you kindly with a happy outcome for you. 💐

I understand you're reluctant to take medication during pregnancy, sadly I have to take quite a few and sertraline at 200mg is one of the many.
Without my sertraline I would be a nightmare for my family so I understand why the doctor said that, but you not taking them is because of trauma and fear.
Medication in pregancy is always a difficult situation to navigate with outweighing risks/horror stories/advice and ultimately the choice is yours alone to make.
I know sertraline is one of the safer medications, sadly one of my kiddos had withdrawl affects on some of the medications I've needed to have a safe pregnancy and even knowing it was the best for us both, the guilt is awful. But i know the guilt would have been far greater had I not had the medication and the out come far worse.
Constantly checking for blood, which I've also done after a loss may turn into a bit of OCD, which the sertraline may help you with because if you think logically, you're putting yourself through a lot of fear with checking excessively. It's understandable and not even an irrational thing to do, but each time you check you poor thing you're bracing yourself for hell.
If you don't want to relieve anxiety via medication which millions of people don't want to do, you'll need to put little steps in.
Maybe see if you can only go check when you need a wee. Or if you're peeing constantly set an alarm 3 times a day and only check then. Try to get out the habit of scaring yourself? Sounds silly but even trying to break the cycle may help ease the fears a bit more.

Best of luck with your decision and if you are anxious, be kind to yourself pal, I'm probably digging to deep into your username but you deserve to feel good things about yourself. X

I think it's wrong that these medical experts are making you more anxious. But if taking the medication causes you anxiety because of the possible side effects then it could be counter productive. I suppose you need to weigh up the pros and cons then come to a decision.

I think you are doing the right thing. If you really need it, you know that te risk is minimal but meanwhile better to safe than sorry

Can you get a second opinion OP?
I personally stopped my medication in my last and current pregnancy.
I have significant anxiety issues, and whilst i did receive some concern from some professionals, for the most part, I found people to understand my viewpoint and were actively supportive when they realised that I had good insight into my own condition, and that I had educated myself on the decision I was making and accepted myself that my decision could change in line with how well I was coping.

This second pregnancy, medication free, my consultant congratulated me on having a really well put together plan of how to navigate this pregnancy, but has also offered that if I need support to contact her.

I think if it seems that more people are concerned than not, it may be clear to them, but not you that your mental health is not in a very good place, and you may need to act accordingly.

Whilst I understand the want to avoid medication wherever necessary during your pregnancy, but it really isn't the end of the world if you do end up needing to have it.
You and the babies health is all that really matters.

So I am not going against medical advice here.

1. Unless you are sectioned, your doctors can't force you to take anything.
2. Your psychiatrist is also giving medical advice.

Being prescribed something for nothing being wrong is not the way forward. There is nothing wrong with you, it is completely normal to be worried in your situation. That is not abnormal.

Sounds like a shit psychologist. You would be better to be given some empathetic support and understanding and some take-home CBT to help you deal with the anxious thoughts - which are not irrational, given your past history.

No idea what you should take or not but why do people think anxiety won't effect children

I have great parents but I have memories of things about them as I presume we all do of our own parents, why would it be any different for our children?