The tragic death of new mother Charlotte Bevan and her four day old baby daughter, Zaani Tiana made headlines across the country earlier this month. Charlotte, who allegedly had a history of depression and schizophrenia, walked out of her local maternity hospital with her baby daughter, and committed suicide. The press has reported that Charlotte may have been frightened that her baby would be taken away from her. It has also been reported that Charlotte stopped taking her antidepressant medication so that she would be able to breastfeed her daughter.
Quite rightly, the NHS is now launching an investigation to look into how the new mother was allowed to leave her maternity ward. The press are being particularly vocal in their call for new mothers, particularly those with a history of mental health illness, to be more closely monitored in hospital.
Yet there is one aspect to this story that is not being discussed, despite it being an aspect that I believe may have substantially reduced the risk of Charlotte and her daughter coming to harm.
And it's this:
"Charlotte stopped taking her antidepressant medication so that she would be able to breastfeed her daughter."
The media alleges that Charlotte Bevan stopped taking her antidepressants because she thought that there would be risks to the baby if she took them when she was breastfeeding.
We don't know if this is true in Charlotte's case. But it is certainly true that many women are reluctant to take any kind of medication when they are breastfeeding.
Yet here's the rub. In fact, here is the part that makes me want to climb inside the internet and destroy all those pages of ill-advised advice about the dangers of taking antidepressants if you are breastfeeding:
YOU CAN TAKE ANTIDEPRESSANTS WHEN YOU ARE BREASTFEEDING.
I know, because I recently did it.
And guess what? It turns out me and my baby are fine.
A bit of a back story about me. I had severe post natal depression and trauma following the birth of my first baby. During pregnancy number two, I suffered from acute anxiety from the eighth week of pregnancy. I started taking antidepressants at 20 weeks because I had to. I was incredibly unwell, and I had a job to go to. A house to run. And a young son to look after. The medication didn't cure me, but it certainly made me more able to function on a daily basis.
And, when I gave birth and decided to breastfeed, my psychiatrist put me on ANOTHER antidepressant. So I was (and still am) taking TWO antidepressants. I breastfed my baby boy until he was six months old. He recently turned one, is walking, getting in to mischief and is quite evidently undamaged by my choice to take medication.
But here's the uncomfortable truth - I can't say for sure that we would have remained undamaged if I hadn't taken antidepressants.
Because I know why Charlotte Bevan did what she did. I understand what she was feeling, because I've had the same thoughts battling this wretched illness. I had my suicide plan well thought out. The difference is, I didn't go through with it. And I know that the reason was that my medication enabled enough of my true self to break through to challenge those thoughts, which allowed me to cling on to life by my fingertips - even though every fibre of my being was willing me to let go so that it could all be over with.
I'm not a doctor, but here is what I do know:
- My psychiatrist, who is a specialist in perinatal mental health, prescribes antidepressants to pregnant women and new mothers all the time.
- No one wants to test medication on pregnant or breastfeeding women, so the tendency is to err on the side of caution, even if the medication would actually be safe.
- I stayed in the mother and baby unit of a psychiatric hospital when my baby was born. Almost all of the new mothers there were on medication and breastfeeding. And all of the babies have turned out fine.
When I read about Charlotte Bevan, I want to know who told her to stop taking her medication. I want to know, because it was irresponsible advice that may have contributed to her tragic death.
Of course, there are risks to taking medication. I get that. But, when it comes to this issue, we're often talking about rumours and unsubstantiated risks versus a mother, or, in Charlotte's case, a mother and child, no longer being here.
Which is why, somewhere on the internet, this post needs to exist. If just one mother reads this, and, as a result, changes her mind about stopping her medication, it has been worth writing.
Finally, if you are reading this post and are worried about taking antidepressants during pregnancy or when breastfeeding, PLEASE talk to your doctor. Your baby needs you to be well. And you need you to be well too.
Current guidelines for antidepressant use when breastfeeding can be found here - http://www.breastfeedingnetwork.org.uk/wp-content/dibm/anti-depressants-oct14.pdf