As I sat in the peach coloured examination room earlier this week, filled with medical paraphernalia and leaflets of every kind, talking to a midwife I had never seen before, I wondered how much to tell her. I promised myself I would be honest, no more hiding. I promised that in this second pregnancy I would actively seek help for my mental health, and I have. I answered the questions asked of me during assessment. I told them, I don’t cope well with hormonal changes and it feels hard. So hard. ‘But, I am not depressed.’
Then she asked me how I am coping with my physical health, and this was the unravelling. This was my undoing. Tears streaked my face before I was able to reply and a lump caught in my throat so tight I coughed feeling the spray hit me in the face as it bounced off of my mask.
‘I’m not depressed’ I said. I don’t need to go back onto antidepressant medication, not yet, because ‘I’m not depressed.’ I’ve been depressed and this isn’t depression. This is fear, this is worry, this is overwhelming guilt and I won’t take more medication, because I don’t need it. I won’t need it. If I could just function physically…..
‘What do you feel guilty about Steph?’ She asked. ‘I feel guilty because my physical health prevents me from doing things, and I am scared this will continue long after the baby is born, and how is anyone supposed to care for a newborn if they can’t get out of bed several days a week?’ I cried.
Do I have a good support network? Yes.
Do I have a helpful husband? Yes.
Am I getting enough rest? Probably not.
Is more rest achievable at this time? Probably not.
The doctor will see you now. I waited, tapping my foot, wiping away my tears, taking a deep breath and giving myself a hypothetical shake. I’m not depressed.
The doctor was young, with a straight face but kind eyes. She told me she knew about my history, she knows migraines are disabling me and causing a surge in my blood pressure. She knows I don’t want to take more medication. She knows I had a baby born to preeclampsia and then in withdrawal nearly five years ago. She knows I can’t go through that again. She knows all of this, but still there are very few alternate options. I told her I have read the leaflets, I have followed the Best Use of Medicine in Pregnancy website. I have done my homework. I want a healthy baby this time.
‘But what about your health?’ The doctor asked me. ‘If you don’t reduce your migraines, you will not be able to care for your child at home, you won’t be able to care for this baby, and your blood pressure will almost certainly develop into preeclampsia early, meaning the likelihood of a premature labour is high. Not to mention the clear link between physical health and mental health you are at risk or a deterioration in both’
‘But it’s still your decision….’
Of course, it’s my decision, but how do I choose? I can’t choose between my health and the health of my baby. If I increase my medication again, I increase the risk of having a baby born in withdrawal, I already have a 1 in 3 chance of this. So If I increase again I have a 2 in 3 chance. The sense of responsibility weighed so heavy on me that I got into my car and cried for a full thirty minutes before driving home. I wondered what to tell my husband, wishing he had chosen a better body to house his children in.
I’m ok, I told myself, I can do this without their help. I don’t need any more medication.
When I climbed into my bed later that night I had a shadow in my left eye, the TV too bright to focus on, nausea creeping up on me. I was getting another migraine. I pulled out my tool kit, I grabbed ice wraps and acupressure clips and I turned off all the lights. But as I lay there in the dark in intense pain, unresponsive to my tried methods, I remembered everything the doctor had said.
‘This isn’t your fault, we will look after your baby, you need to look after you.’
I realised that trying to do this without support is making me depressed. I can’t do this on my own. I can’t function at full capacity without medication and I can’t be a good mum if I am unwell and depressed. I have fought long battles before becoming pregnant, I’ve tried hard to improve my health and I have a barrage of people telling me, it’ll all be ok. Congratulations, this is amazing. It doesn’t feel amazing. It feels scary and I am scared. It feels like my choices are not really my own and my mother’s instinct is to protect my baby at all costs. I don’t drink or smoke, I am trying hard to maintain a healthy diet and move more, but the reality of those things are not a cure for my illnesses.
Sometimes my feelings are extreme opposites, occurring simultaneously. I feel unlucky yet grateful and never luckier. I feel excited but terrified. Happy but that happiness is tainted by trauma. In control but never have I felt more out of control in my life. I can do this, I will do this, but first I need to admit, I am in need of help. That appointment wasn’t a cure, it wasn’t even really a lifeline but it was arming me with facts, facts I need to make better informed decisions.
My story is quite unique, but not singular, your story might be the same, but different because it’s yours. This pregnancy feels harder because I know more, but also easier because I do. Do your best, make informed choices, but know that no matter how hard it feels, how devastating, the key to good maternal health starts with you.