Worried I may have put my unborn DD at risk due to my anxiety disorder?

[LadyStoneheart]

This might be long, so please bear with me.

I suffer with depression and anxiety, and after unsuccessfully weaning off my medication (citalopram) earlier in my pregnancy am now back on a low dose as was becoming unable to cope. TBH, the dose I'm on currently is not enough to completely manage my symptoms but it is enough to cope with day-to-day life, and most days are fine.

I'm now 37 weeks pregnant with my first child. I've felt like I've spent this pregnancy in and out of the labour and antenatal wards (first due to cysts, then hyperemesis requiring multiple admissions, then decreased fetal movement - thankfully a false alarm, then UTI, then threatened preterm labour at 35+4 requiring a three day stay with steroid injections for baby's lungs and nifidipine regime to relax uterus. I'm also being monitored for ?obstetric cholestasis - LFT's a week ago normal but waiting for bile acid results and still itching.

With all the visits in and out of the hospital Im frankly sick of being there, and my experience of the midwives there when in and when calling for advice has been very mixed - last time I called (and subsequently went in) the midwife I spoke to was very dismissive and made me feel like I was being a neurotic nuisance despite that I was calling on the express instructions given to me on my previous visit. She put me 'on hold' but failed to mute the phone so I overheard her discussing me with the senior midwife who also seemed baffled as to why I was troubling them. They ended up telling me to "come in anyway as we're not busy, so you may as well."

On to the current issue:

I've been having strong braxton hicks on and off since discharged following the pre-term labour scare. On Sunday afternoon, I noticed that I was very damp all down my thighs, and had a watery discharge that soaked through my knickers and pj bottoms. I changed and mentioned it to my mother who told me it was probably nothing or maybe the result of a weak pelvic floor. A few hours later when I got up (we had watched a film) I noticed I had soaked through my clean knickers and a little onto my leggings. I changed again and put a pad in. When I checked the pad later I found it hard to tell if I had any further watery discharge (being as it was clear) but did feel generally damp. Had a bath and went to bed.

I did consider phoning the labour ward that evening, but my anxiety is mainly focused around social interaction and the thought of making any phonecalls made me feel on verge of a panic attack. Before when I have asked DH to call them for me they have always insisted he put me on so they can talk to me.

Recently my anxiety has been heightening , ? due to the holiday season and also that last week was the first anniversary of a very painful bereavement. In addition my experience the last time I called the hospital put me off - I felt like my call would not be welcomed.

The next morning, there didn't seem to be much discharge. Have felt continously damp since but not enough to soak through underwear or a pad. Started having contractions last night at about 10pm which were every 15 minutes and definitely not BH. However these all stopped at about 3am when I fell asleep and have only had the occassional BH since then.

Saw my midwife today at 9am. Told her all of the above and she seemed very annoyed that I hadn't been into the hospital or called them. Said "You know you should call the hospital if your waters break." Tried to explain that I didn't know if it was my waters or not and that it seemed to have mostly stopped, also no one has said to me "call the hospital if your discharge turns watery", just mentioned bleeding and contractions increasing, decreased movement etc. Baby has been active, still feels like she's trying to kick her way out of me.

I asked her if it was my waters then, and she said there was no way of telling for sure without going to the hospital and being checked over there. She told me to put a pad in and if there is any more leaking in a couple of hours to call the hospital as it was bad for waters to have been broken for a long time. I felt very much like I'd been told off. She then spoke of how she would see me in a few days at my antenatal classes and for more blood tests.

Since she left I've been crying constantly, worried that my anxiety/fear over calling the hospital has endangered my baby. The anxiety is being compounded by the thought of going back into hospital and being examined, as when I was admitted with ?labour before I had a very traumatic internal and speculum exam which was extremely painful and brought on flashbacks to my rape and sexual abuse from ex-partner several years ago.

So basically I'm sitting here in hysterics because I feel like I've been massively irresponsible due to my anxieties and put my baby at risk. I really dislike myself at the best of times but right now I hate myself intensely and feel unfit to parent, as I apparently can't even put my baby first before she's born.

If you've made it through all that well done. It ended up even longer than I expected. Just need to get it all down and out, and maybe a bit of handholding?

I am sending you a massive unmumsnetty hug.

I really feel for you as I suffer from anxiety and depression myself and, oh, when I read your post it just took me back to feeling v similar. Poor you, its awful I know.

You absolutely are fit to parent, nobody is perfect, nobody knows what to do all the time and we are all just feeling our way. Midwives can sometimes seem either v dismissive or massively over react but they aren't always right. Anyway, if your dd is still happy in there then no harm is done & the midwife wasn't that concerned or she'd have sent you up to the hospital.

Please don't beat yourself up. You can't change the past, but perhaps make a plan for what you'll do when you do go into labour? Maybe write down what you'll say on the phone etc? I sometimes find it helps to try to step back and recognise that the anxiety isn't rational, have the anxious thought , and try to let it go?

Becoming a mum is scary and overwhelming at the best of times and you are coping with a crap illness on top of it all. We're ALL just doing the best we can, you ARE your daughters mum and always will be and you'll be the best mum you can be and she will love you.

Is your partner supportive? I found it really helped to be very open and honest about how I was feeling and talk through my fears.

Wishing you all the best

Ps. Are you at term yet? When my waters broke it was a huge rush - no mistaking it, but some do trickle. Sort of a sweet smell, rather than of urine?

If it keeps coming it's probably waters, so you might need to get it checked out. You can refuse internals and in your circumstances I'd totally understand you doing so!

Poor you - I have had similar mixed experiences at the hospital with this pregnancy, am very high risk for pre-term labour, history of poor mental health during pregnancy and PND, very high anxiety, but attitudes from midwives and doctors have varied from the few who genuinely seem to listen and sympathise and those how give the impression that I'm fussing for nothing. I know exactly what you mean about feeling like you've been told off, and how difficult it is to judge at what point to call the hospital. I can only imagine how much more difficult it must be when complicated by traumatic memories of past abuse.

It is normal to question whether you'll be a good enough parent, but your anxiety is clearly making you really really miserable. Do you have any professional mental health support available to you? Most areas have a perinatal mental health team, your GP should be able to refer you fairly quickly, and in the meantime may well be able to ask your Health Visitor to come out and see you - it sounds like you really need to speak to someone who is there to listen to your worries and anxiety and to focus a bit on you rather than on the pregnancy iykwim. If you find it difficult to talk about perhaps you could try writing everything down (or just print off what you've written here) and show it to the GP?

Thank you both for responding.

Yes, I'm 37+2, so term now. I think I'll give writing down what I'll say if I have to call the hospital again may help (I often have to do this for GP appts etc otherwise I just freeze up).

My DH is lovely and very supportive for the most part, but is currently dying of man flu and has a big exam coming up in a week so very stressed. Even so he is very supportive, and has just gone to Sainsbury's to get me my favourite apples (biggest craving of the pregnancy so far) after lots of cuddles and backrubs. I hate to make him worry even more about me and baby though when he's very stressed as he is - he doesn't cope well with stress or illness, bless him.

It definitely doesn't smell like urine, and is nothing like my "normal" discharge, but I'm not sure if I'd say it's sweet? Will have to go check my pad soon to see how it's going and try to determine if it's enough to call about.

I haven't ever seen any MH specialists about my anxiety or depression, just GP and community MW. GP wanted to refer me for counselling but only counsellors available were male and with my past that is just not doable. Have been given online CBT instead. They were reluctant to let me continue on the citalopram unless necessary as apparently can cause dependence & respiratory problems with baby, which is why I came of it initially (although with the hyperemesis I rarely kept it down anyway so wasn't able to 'wean off' properly). Am now back on it but GP wanted me to try and stay to the lowest possible dose with plan to increase again once baby is born.

Going to disappear for a bit a DH just walked in with my apples and also a comfort McDonald's.

Thank you again.

Enjoy your lunch :-)
I'm genuinely shocked that they couldn't find you a female counsellor. I had counselling for PND with a woman counsellor who specialised in maternity-related mental health and found it really really useful. I really would urge you to go back to the GP and get a referral to someone you can see face to face, even if it's only listening visits from the Health Visitor. Your local Children's Centre might also be able to refer you to some form of support.

I am in tears reading this you poor thing a difficult pregnancy combined with anxiety. You should have had better care, I have had depression since a teenager and got severe ante natal depression in my first pregnancy I was put on baby friendly anti depressants that are safe for pregnancy so safe for a high dose that was manageable - did you know some anti depressants if on the wrong dose can make you more anxious and even have nightmares! You should have had this more closely monitored and had counselling - I got post natal counselling and touch wood have not needed anti depressants this pregnancy.

I was upset in my first pregnancy with care I had received in hospital then had a big bleed at 38 weeks I didn't go in I assumed I would go into labour (very naive) and it was normal as had not been told otherwise. I spoke to my mum after another bleed a day later and she got me to call the hospital who then induced me.

I should have gone in sooner but my DS was fine and I learnt a lesson you should go in and get looked after you may need induced as waters breaking can have a risk of infection. I hope you are OK you need to try to put your anxiety to one side for this but they should also be supportive.

By the time I was 26 weeks with DS I was on antidepressants getting additional support from midwives and health visitor and doctor support.

I hope you are OK big big hugs x x x