Sat on the side of bath, clutching a positive pregnancy test and hearing the ringing in my ears that means I'm about to faint I had a single coherent thought. It broke free from the whirlpool of shock, disbelief and panic swirling around inside me head, forcing its way to the forefront of my mind which was currently scrabbling to find a foothold in this new reality in which I found myself.
What am I going to do if my GP refuses to prescribe my antidepressants?
The thought of trying to cope with life without them was even more frightening than having discovered that I was unexpectedly pregnant.
I was about six weeks pregnant when I tried to reduce my current dose of antidepressants, when my GP suggested that I tried but that if I couldn't cope she would still be happy to prescribe my original dose and then a higher one if necessary.
A week later I was sat in the office of a very senior community mental health nurse in floods of tears due to the attempted dose reduction and the fact that I just wasn't coping with the pregnancy physically and mentally.
I also ended up vomiting copiously into her waste paper bin, partly due to 'morning' sickness but mostly because we were at our local psychiatric unit and I was convinced that now that they had me inside the building they weren't going to let me out.
Clearly the NHS doesn't make a habit of kidnapping patients but even at that early stage I was so ill that I honestly thought my delusion was true.
Continuing to take the antidepressants during pregnancy wasn't a decision that I made lightly. One the one hand I was wracked with guilt at the thought of the potential harm that I could be causing to my unborn baby and I tortured myself by reading medical publications investigating the effects of maternal use of antidepressants on foetal development.
At the same time I was angry at anyone who claimed that the risks of taking antidepressants far outweighed the benefits to the mother and that any woman who chose to take any medications during pregnancy was putting their needs above the life of their baby.
I was struggling to adjust and quickly grew to resent Squidge (my son) for putting me in this position of having to choose between my wellbeing and his before he'd even been born.
Before I became pregnant the nightly ritual of popping the tablet out of the blister pack to take before I went to bed was (to me) as benign and normal as brushing my teeth. Now that I was responsible for bringing a new life safely into the world I developed a love-hate relationship with these little white tablets that lasted for the entire pregnancy.
I was very fortunate to have a (mostly) supportive healthcare team who were (with a few exceptions) united in their goal to get me to delivery in the best possible mental state by any means possible. This meant that for the majority of my pregnancy I was on the maximum dose of antidepressant, I took sleeping tablets on several occasions and I was prescribed a short course of sedatives to get me through a particularly bad week.
But even with the unwavering support of my two midwives, my GP and the psychiatrist at my local Mother and Baby Unit (MBU) I still had times where I was convinced that I wasn't fit to be a mum because I couldn't stop taking my medication.
After several months of mental self flagellation I rationalised my decision to take medications that could potentially harm Squidge by accepting that, without them I was unlikely to live long enough to deliver him. Looking back I believe even more strongly that without the antidepressants I would probably have committed suicide before my baby reached the age of viability.
It was this knowledge, as horrific as it was to face, that helped me to keep my nerve when I attended my first (and only) appointment with a second psychiatrist who began the session by saying he assumed that I'd stopped all and any medication when I found out I was pregnant.
If this had been the attitude of my GP or midwife and I hadn't had the benefit mine and my husband's medical knowledge (I'm a neonatal nurse and he's a doctor) then I may well have felt pressured into making a different decision. Particularly when you consider the strength of the opinion of the media.
Parenting websites, magazines, radio, television and social media; all these sources claiming to be reputable, reliable and being rooted firmly in science tell women that, from the moment they become pregnant their role is to place their child's needs above her own regardless of the consequences. I read stories about women who refused life-saving chemotherapy and women who were demonised for trying to order a small glass of wine, all because they were pregnant.
More than a year on I look at my beautiful, healthy little boy and I tell myself I made the right decision. But still I wonder, what if?
What if he'd been born with a congenital heart condition (studies claim use of certain antidepressants increase the risk)?
What if I'd had a miscarriage or a still birth or something else that could never have been definitely linked to my use of antidepressants?
Would I still have made the right decision then?
I don't know.
(Post originally published by http://23weeksocks.com)