What No One Tells You About Mental Health and Pregnancy
Pregnancy comes with a range of emotions — highs and lows. While it’s a beautiful thing bringing life into this world, the toll it can take on a first-time mother isn’t something commonly discussed. I want to tell you about my personal experience — my first and second trimester of pregnancy and the mental, emotional, and physical difficulties I’ve felt. At 6 weeks pregnant, I laid on the couch in agony. Not only was I experiencing severe morning sickness, but I was going through prescription withdrawals. But, let’s start from the beginning…
In April 2019, I went to my primary care provider on the military base and told him we’d like to grow our family. I asked to have my blood type identified and if there was anything else he recommended. He put me on Prenatal vitamins and never addressed my medications – which I’ve been on for 3+ years.
Many months went by with no success of getting pregnant and I started to think something was wrong with me. When my period continued to come each month, it would send me into a full breakdown and I felt like I was letting my husband down. We were doing all the right things – tracking my ovulation, taking ovulation tests, avoiding alcohol at certain times of the month, etc. Finally, we stopped actively tracking and the next thing I knew – I was pregnant! We were overjoyed and thrilled.
Table of Contents
First Trimester
I was so anxious for my first ultrasound because things hadn’t felt real yet. The Army Base in Grafenwoehr, Germany doesn’t have OBGYN’s so I was assigned a German doctor, Dr. Pollak, in the local town of Eschenbach.
During my very first appointment at 6 weeks, he looked over my current medication list, said he wasn’t sure what they were but that I needed to stop taking them immediately. Panic set in and I tried to reason with him that I couldn’t do that. He simply just said I had to…
I talked it over with Stephen that night after doing research on my two medications – Zoloft and Topamax – and it was (we thought) a no brainer that I had to stop immediately because of the potential (high) risks to the baby.
Zoloft was being taken for anxiety and depression and the Topamax was for migraines. Zoloft is not as dangerous to the fetus, but it has been shown to cause withdrawals in the baby immediately after birth (like excessive crying). Topamax has up to a 3% chance of causing cleft lip and/or cleft palate if taken during the first trimester. (Source: FDA) This one scared us the most because I was more than halfway through the first trimester before I found this out.
Within 24 hours of stopping my medications, I already began to feel the effects of withdrawals. I felt weak and foggy-headed, like I wasn’t really there. Within 36 hours, the headaches, nausea, and vomiting began. I tried everything to settle my body from warm baths to saltine crackers and ginger ale. Nothing stopped the throwing up. I spent hours hugging the toilet and sucking on ice cubes because I couldn’t stand the thought of another sip of water, or especially Pedialyte.
A few days later, I was admitted into the hospital and diagnosed with Hyperemesis Gravidarum. I had to stay overnight and was given multiple IV bags. The worst part was how long it took them to draw my blood (and how many times they stuck me) because I hadn’t been able to keep any food or beverages down for the previous 3 days. That stay in the hospital, in a shared room with a new mother and her baby, was one of the worst experiences. The curfew times and no extra room meant Stephen had to leave me alone there overnight. The next morning, after an IV bag finally finished, I couldn’t get out fast enough (despite the nurse’s advice to stay longer).
But, every time I walked into our house, I headed straight for the toilet. The memories of being sick in every single room started to eat at me. I began to hate our house, where we lived, the disgusting shared back yard where people don’t pick up their dog’s poop (literally making me gag all the time). Every time I use the bathroom, I remember the times I laid on the floor, projectile vomiting and laying in the bathtub crying and wondering why this was happening to me.
I was able to eat here and there, but it never all stayed down. I could at least drink water. Weeks went by like this, I even visited home (North Carolina) for a few weeks and indulged on all my favorite foods – Chick Fil A, J. Peppers, and Doss’ hotdogs. (Which all tasted delicious, while it lasted!)
Getting Help
I decided at the beginning of November to see an actual psychiatrist and discuss my medication options. I hadn’t felt like myself for weeks and it was starting to show in the amount of weight I lost, the inability to do anything without breathing heavily, and just not being able to leave the house due to fear of getting sick. The psychiatrist I saw did more research and decided that I should start back on Zoloft, my antidepressant. The research seemed inconclusive as to the risks for the baby, but even more so, the risk of becoming severely depressed could be even more harmful to the baby.
He started me on 150 mg of Zoloft and in two weeks, I was to up the dosage to the maximum of 200 mg. I felt better, able to do more, but was still having a lot of social anxiety about being sick in public and I wasn’t enjoying the things I used to – blogging, photographing, reading, hiking.
Second Trimester Begins
November, and my birthday, came and went with no light at the end of the sickness tunnel I was living in. The week before Thanksgiving, I found myself dehydrated again, so I went to my OB to receive IVs as opposed to the hospital. This was when I knew things weren’t going to work out between the doctor and I. He administered TWO bags of IV in less than 30 minutes. I felt really unusual and my body started to go numb. I thought it was just another normal day of overheating, but later I realized that he put me into something similar to extremely high blood pressure. I don’t even remember driving, but as soon as I got home I blacked out and fell asleep for hours. I immediately threw up upon waking and I knew that what was happening to me wasn’t normal.
After hiring a Doula, I realized that I didn’t have to continue seeing the same OB if we weren’t a good fit. Thankfully, our Doula recommended a great new doctor and things have been much better!
Being sick hasn’t really stopped us from traveling, but it has made it much less appealing. In the beginning, I wore sea bands 24/7 and carried throw up bags in every pocket wherever we went. I made sure to always know where the closest bathroom was. Thanksgiving was spent on a 4-day road trip through Ireland and I spent the first week of December with my mom on an Avalon River Cruise through Switzerland, France, Germany, and Holland. Some days were great and I could participate in all the activities, and then some nights I had to be delivered dinner in bed because I was too sick to venture out.
It has been incredibly hard being so far away from family/friends and feeling like the only support system I have is my husband, who has to be away sometimes. We started rearranging some of the rooms, which has helped mentally, and we even switched our bedroom to a different room.
I couldn’t make it through without Stephen, who is there literally every possible moment to hold my hair, get me towels and clean up when I couldn’t. I ask him all the time why and how he does it, and he just responds with he “vowed to love me through sickness and in health”.
My Thoughts on Overseas Healthcare
The Military healthcare system has had a long reputation for not upholding normal healthcare standards. I’ve had my fair share of misdiagnoses – like when the doctor swore I didn’t have the flu (even though I had it for the previous 2 years and knew the exact symptoms). It was only after begging him to give me the flu test that confirmed I was positive for the flu. His unempathetic response didn’t go unnoticed or forgotten. I don’t blame the doctor who put me on Prenatal Vitamins and knew I was trying to get pregnant, and yet never told me about the risks of the medications I was taking… No wait, actually I do! I strongly feel that if I had not had to quickly stop taking my meds, Hyperemesis wouldn’t have set in. Or maybe it would have, but I’ll never know now. I blame the German OB who should’ve been more understanding but also should’ve never had me stop the medications that quickly. It was ultimately my decision, but I figured a doctor knows best and I wasn’t willing to risk that on the future life of my child.
Going Forward
I’m 24 weeks pregnant now and have (barely) survived 18 weeks of throwing up whenever and wherever. I still struggle with social anxiety and depression, but I’m doing routine things to help myself. For example, always getting out of bed by 8:30 and taking the dogs outside for long walks daily.
People always talk about not being able to drink during pregnancy, growing out of your clothes, not being able to touch your toes, etc. They never mentioned anything about being sick over half of your pregnancy and the toll it can take on your mental health.
The thing that keeps me going is knowing that that sweet little baby face I get to see in May will all be worth the struggle.
I write this post for myself mostly, to finally put pen to paper about how I’ve been feeling, but also for others – for my friends and family who wonder why I’ve been distant, why sometimes I don’t feel like FaceTiming or talking, why I’m absent on social media, and why I can’t get on a plane and visit even when that’s the only thing I want to do.
If you have been through HG and/or depression during pregnancy, I feel you. I know what you’re struggling with and how difficult it can be to see the light at the end of the tunnel. All I can suggest is to find people who love you and who will try to understand what you’re going through (because unless they’ve experienced it, they aren’t ever going to completely understand).
Now, enjoy my favorite meme about pregnancy:
xoxo, Summer
6 Comments
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Amy Wyscarver
Summer,
It is so good to hear from you in this post. I can only say how sorry I am to hear how difficult things have been to date- I say sorry, because of course while you are thrilled to be pregnant and will abide anything until the day you see this wonderful creature, it has been a rough road and not the stiff magazines or other people would have you think it is. Pregnancy is not easy for many women and it’s good to share that honesty instead of perpetuating a myth that’s it’s unicorns and rainbows from conception to adolescence 😂
I had HG 2x and it was absolutely miserable- At least with the second pregnancy it only went 13 weeks. It was the longest 13 weeks of my life. I endured infertility treatments through my first pregnancy and a birth that let me say- wasn’t an ideal experience the first time but I ended on a spectacular note with the second one.
I had 2 beautiful and wonderful children in the end and I made it through.
I am quite concerned as a nurse to read the blatant malpractice on the part of providers you have seen during this time though. Do not forget that- you don’t have to take legal action nor am I suggesting you do so but what you have experienced at the hands of some of these providers- military based, private practice or what have you is still the same- malpractice. It’s shameful our military families experience poor care no matter where they are in the US or abroad- it shouldn’t be. No woman should experience this period when pregnant.
There seem to be 2 distinct camps for pregnant women to make the decision to join- you are either “For” or “Against” your doctor because you suddenly feel you have to look out for everything that goes into your body. It shouldn’t be that way and I’m sorry it is. Unfortunately, the ethics of how clinical research is conducted (and it’s legitimate) doesn’t allow for “experimenting” on pregnant women and their unborn children- otherwise we might have better data about women who legitimately need to continue on certain medications for their own mental health and well being during pregnancy. You and your doctor have now made the best decision you know how to make with the best information available to preserve your mental health, physical health and pregnancy.
There are more women who need to speak up on this topic without fear. We also need to hold providers accountable and question them when we do not understand- understanding whether on our part or needing to understand their viewpoint as well. It should be a give and take without fear on either end. Most healthcare providers I know want that type of relationship with their patient- particularly a pregnant one. I am so sorry you haven’t had that experience but know that all is well, you are advocating soundly for yourself and your child and that’s what is most important. You don’t have to be the doctor- you just need to speak up- as you have for yourself and gain understanding. Sometimes we aren’t always right (google doesn’t make you right either but it can help you know what to ask and have better discussion during your visit) I also know there’s nothing like a mother’s intuition and that should always be heard, talked out and regarded with respect.
You are almost at the finish line and I can’t wait to see the pictures of your beautiful new baby.
Fran
Summer, I’m so happy that you’re feeling well enough to write and post. So many of us do not experience the ‘glow’ and maternal happiness that we are promised as pregnant women, it’s courageous and wonderful of you to post about your experience for others. I was another who was ill during pregnancy but they didn’t have a name for it, or remedies to make me feel better, so like you I lost weight, had to take leave from work, and was alone living with my in-laws as Tim was on the other side of the country going to school with no internet or cell phones to communicate with. Not many of our friends understood the loneliness or dreariness I felt on a daily basis. I understand your circumstances and hope as the weeks pass that you feel better and better. Thinking of you! ❤
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Ciera Dobson
So sorry to hear your experiences with different healthcare professionals! But I hear you with HG. I’m on my 3rd pregnancy now and have had it in all 3. This time it is 100 times worse, with hospitalisation becoming a norm. Even brushing my teeth causes vomiting! I have noticed you were taking Zoloft which has caught my attention. I take sertraline which is a generic form of Zoloft. Again not harmful to the baby but I do feel that not enough research has been conducted to see if there is any correlation between pregnant women taken this and the prevalence and intensity of HG. I have been left with no choice but to take Ondansetron (anti-emetic) that does increase risk to the baby as nothing else works and like you considered termination as it is so bad. Ondansetron works by suppressing serotonin in the body as serotonin works in your digestive system to cause nausea and vomiting to help rid the body of foods that cause stomach upset etc. But sertraline or Zoloft work by increasing serotonin levels in your body (especially the brain) to help with moods, anxiety etc. I’m no scientist or doctor but surely taken two medications that work against each other on the very thing that might be significantly increasing the intensity of my HG should be looked at. But no doctor has even raised an eyebrow anytime I have been asked what other medications I am on. I’m still in the depths of sickness but hopefully at some point I will emerge.