A Medicated Pregnancy

By Brittany Welch

Darkness in Pregnancy

I felt so much despair six months into my first pregnancy. Nothing was going right, or at least that’s what I thought. I spent every non-busy moment crying and stuck on my couch, when I finally reached out to my obstetrician. 

Sitting in her office, I sobbed as I explained the hopelessness and darkness I felt all the time, the overwhelming loss of control over my own body. She listened intently as I outlined all the ways I was failing as a mom before my son was even born. After listening to me, she put me on mental health leave from my teaching position for three weeks and prescribed 17 mg of sertraline.

Finding Hope in Medication

The doctor explained how sertraline, or Zoloft, was the safest and most effective medication for depression during pregnancy, and that 17 mg was a very safe, low dose. Medication felt shameful, and at first, I rebelled against taking it because I thought I could do this myself. At the time, I didn’t know about PSI, nor were there any support groups near me. I was just getting settled with a new therapist who wasn’t trained in perinatal mental health, nor was he understanding of my situation. The closest appointment for a local nurse practitioner who specialized in perinatal mental health was six months out, but I wasn’t going to last that long.

After one week on mental health leave, I started taking the medication. It made me feel weird and zoned out, but my mood began to shift. It wasn’t enough, and my obstetrician upped my dose to 30 mg when I went back to work. Negotiating taking medication every day was a new experience for me. I learned to take my sertraline at night to avoid feeling zoned out at work and to help me sleep. Evenings became my most difficult moments when the medication began tapering off. I was tearful and emotional about everything during that time, but I was much better equipped to handle any difficulties that came throughout the day.

Birth Trauma, Depression, and Self-Acceptance 

My birth came and was filled with trauma, both physical and mental, and that continued affecting my mood during my postpartum period. Thankfully, I already had my SSRI on board to help tame the severe PTSD symptoms that came my way. 

I’ve come to accept myself as I am. I have always struggled with depression and anxiety, at some times more than others. I spent most of my twenties in a gray cloud with a heavy weight on my chest. Over the past seven years, my dose has gone up and down based on my situation, my hormones, my ability to cope, and more. During my second pregnancy, I needed to add in secondary medication to manage my severe depression and PTSD. 

The battles of shame and guilt over taking SSRIs during my pregnancies have been intense and ongoing. Each step of the way, my psychiatrists and obstetricians were up-to-date on the most recent studies into the subject and kept me well-informed. 

Unfortunately, the risks of not taking medication were higher than taking medication for me. Without sertraline and later mirtazapine, I would not be here today.

Medication Resources and Specialized Care

One resource I used was MotherToBaby, which offers unbiased, peer-reviewed research into medications and supplements taken by pregnant people and the effects on the fetus. Their fact sheets helped me feel confident in my decision to continue taking sertraline. 

I also saw a board-certified reproductive psychiatrist during my second pregnancy who helped me understand the risks and benefits of SSRIs. PSI offers chats with an expert for parents and a psychiatric consultation program for providers on a monthly basis to discuss the risks and benefits for each individual patient. PSI also offers a provider directory of providers certified in perinatal mental health who can prescribe medication if it is needed.

Finding the Care That’s Right For You

Over the years, I have also included multiple modalities of therapy, an inpatient stay, an outpatient intensive program, support groups, and twelve-step recovery groups into my care program. I’ve changed my diet and used supplements to support my mental health. Through it all, I’ve learned to stay consistent with my SSRI, and that even though I have severe ongoing depression, I am still a wonderful mother to my children. 

Talk to your provider to see if medication is right for you. There are medications that are safe to use during and after pregnancy and during breastfeeding. There is no shame in a body and brain that need medication to survive. You are not alone. You are not to blame. With help, you will be better.

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Medication Resources
Peer Support Groups
Specialized Support
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