Diagnosed with OCD at 28 weeks pregnant - need to decide re: meds

[Onebirthplaneveryminute]

Hi

I had an urgent appointment with the Perinatal Mental Health team today as I broke down at midwife's on Wednesday and couldn't stop crying.

Basically I suffered OCD symptoms in last pregnancy (related to swine flu/death/decontamination) but I never sought help. PND/OCD continued until about 6 months post partum. I have tried to be proactive in seeking help this pregnancy, telling GP at 6 weeks, midwife at booking, getting referred to specialist midwife, then back to GP for meds x 2, then finally to see consultant psychiatrist today.

I don't have any compulsions in this pregnancy, but I have a lot of obsessions around the baby/my husband/me dying, including intrusive thoughts or "pictures in the mind" of very violent things happening to my boy or to me e.g. being flung through the window of the car, or being rolled over by a train. I knew it was getting out of control again because I started trying to covertly stop my husband from going out in the evenings because I was convinced he would be killed.

I function well at work although earlier in this pregnancy, I wasn't so good and psychiatrist said also mild/moderately depressed. There is a history of severe mental illness in my family - mood disorders, schizoaffective disorder, a grandaunt killed her baby after birth etc. I also come from an alcoholic background and suffered a lot of neglect which sort of overlays my OCD symptoms.

Anyway, psychiatrist prescribed sertraline 50mg but said it was up to me to make decision. No CBT likely to be available any time soon despite NICE recommendations to try this first in pregnancy. He will try to get me plucked out of waiting list and seen sooner.

I am not at all anti-meds, I work with mental health in children, feel no shame/stigma about it.. but I am concerned about taking any medication in pregnancy and about recent studies that have shown some incidence of pulmonary hypertension in newborn babies.

I forgot to ask, and wonder does anyone know, if taking meds would change the risk status of my pregnancy, as I am hoping to work towards having a low risk waterbirth... but maybe this would rule it out? Having a better birth than last time would be good for me, I think... I would be happy to take meds postnatally without a second's hesitation but more worried about this period of pregnancy.

Any thoughts welcome.

Hi, sorry to hear what you're going through. I don't know the answer to your question but I did find this thread from last summer...

www.mumsnet.com/Talk/feeling_depressed/678100-Anyone-had-a-baby-whilst-on-Sertraline/AllOnOnePage

Could you ask for a referral to an obstetrician to discuss the sertraline and whether you can still aim for a waterbirth?

link here

Poor you, you are obviously being very brave and proactive at a very difficult time for you. I would go for it with regards to taking the meds. Taking any meds in pregnancy is a balancing act between the good they will do and any possible harm, and it sounds like the OCD/depression is affecting your life a lot, and therefore your babies environment.
I personally took ADs throughout both my pregnancies, and my babies are fine; both times we spent a few days in SCBU for reasons probably not related to the meds. For my first pregnancy I had a home waterbirth, so it shouldn't affect your wish to have a water birth. (The second time I would have, but I was having twins!)
You will probably see an obstetrician during pregnancy - I don't know how it works in all areas but I had additional scans to check that my baby was growing properly, not because of the meds but because I was depressed and therefore less likely to care for myself properly.
I got my GP to get a report on my AD from the hospital pharmacist; it is so easy to see something on the internet and not know how good the research etc is, so I found this very valuable. It would be worth finding out about BF and sertraline at the same time.
Hope that helps, I will try to keep an eye on this thread.