Motherhood, mental illness and beyond

Posts tagged ‘abortion’

First steps

DH and I have been together for 12 years now, and for all bar the first few weeks we’ve known that we both wanted children. At least 2, preferably 3 or 4 or even more. We decided on our favourite names in 2003 (our eldest wasn’t born until 2009!). For over a decade the prospect of having a large, chaotic, loving and happy family has always been a part of our plans. But not any more. Today, as a 33 year old mother of 2, I asked my GP to refer me to the local hospital to discuss sterilisation.

This is something I’ve discussed with my husband and my mother and I think it’s the right decision. I hope it is. The reason is very simple – as much as I yearn for more children I know that another pregnancy, another child, could endanger my life. My mental health has deteriorated over the last few years. I have suffered with post-natal depression after the birth of both my children, each time severe enough to make me suicidal. During my second pregnancy I had ante-natal depression which, while not as severe as the PND, still meant I was barely functioning. I wasn’t able to care for my daughter (then just 2) properly, I wasn’t able to care for myself and I certainly wasn’t able to care for the child I was carrying. As recently as March this year I was in crisis and suicidal; although I’ve recovered from that and feel stable again there’s always the possibility of a recurrence.

In addition to this, my physical health is poor. I suffered from awful PGP (pelvic girdle pain) in both pregnancies – the first time this meant I needed crutches to walk, the second time I was barely able to move by the third trimester. There’s also my spine to consider, as I have degenerative disc disease. I’d previously been told that if I wanted children I should have them before I was 30; the last consultant I saw was even more blunt and told me that if I wanted to retain the ability to walk I would limit my family to the 2 children I already have.

I know that sterilisation is a huge step to take, but to me it seems the logical one. For all the reasons listed above, if I should accidentally conceive I would have to abort the pregnancy. And I honestly don’t know if I could do that. But having conceived my son while correctly using contraception, I have very little trust in the usual methods of birth control. While I know that sterilisation isn’t a guarantee, it has far better odds of successfully avoiding pregnancy than anything else. My husband, lovely man that he is, has offered to have a vasectomy so that I don’t have to undergo a fairly major operation. But that seems unfair, to me. I’m the problem here, I’m the reason we can’t have more children. If DH and I ever split up or if I died, I would like him to find someone else and have the option of having more children if he wanted to. So I’ve said no.

I know that there will be people reading this who can’t have children, and who are probably screaming at the screen that I should be thankful for what I have. And I am, I really truly am. I realise that my pain is in no way comparable to that of someone unable to conceive or carry a pregnancy to term. But knowing that I will never have another child is very painful for me and I refuse to pretend otherwise.

DH and I have always been keen on fostering and that may be an option for us later on, if our mental illnesses aren’t a barrier. But I will never bear another child and I need to come to terms with that, somehow. Last week I took the first step and disposed of all the baby clothes and everything that DS has outgrown. Today I took the second. I’m not sure what the next step is but I hope it leads to not just acceptance, but peace.

On abortion

Today an anti-abortion group called Abort67 staged a demonstration in a town near me. They displayed placards with images of aborted foetuses and handed out leaflets containing similar images. So far, so normal for an anti-abortion group. But this demonstration wasn’t outside a family planning centre or a clinic where abortions are carried out. It was outside a college whose students are aged between 16-19. And those placards, with the images of aborted foetuses on? They weren’t the usual A4 or even A3 sized ones but were several feet high.

The Abort67 website states that their end goal is “…to make abortion unthinkable and to see the law give full protection to the unborn.” However it would appear that they care little for children once they’re born because the college also houses a nursery for children aged 5 years and under; these young children would also have had to pass the placards which were taller than them.

Abortion is a difficult thing to discuss. Most people are either strongly for or against it and all are convinced that their view is the correct one. It is an issue that excites people to passionate debate, and feelings often run high. But this demonstration displayed a remarkable callousness and lack of humanity. Can you imagine the effect that seeing those placards would have had on small children and impressionable teens? What about passing adults who had lost a much wanted infant?

I suppose I can understand the group’s reasons for wanting young people to think carefully about what abortion is and what it entails – it’s not something to be undertaken lightly and teens are stereotypically portrayed as being careless with contraception. But figures from the Department of Health show that in actual fact the abortion rate amongst under-18s is falling and has been for the last 5 years; in 2012 it was just 1.28% (or 12.8 per 1000 if you prefer). In fact the abortion rate is falling across the board – the statistics show that for females aged 15-44 it was just 1.65% (16.5 per 1000). That’s the lowest since 1997. 91% of these abortions were carried out before the 13th week of pregnancy.

I understand that for most people abortion is distasteful, but more distasteful to me is the idea of forcing a woman to carry and give birth to a child she does not want and is unable (perhaps financially, psychologically or emotionally) to care for. Abort67 boast on their website of persuading women attending clinics, women who are extremely vulnerable, to change their minds about seeking an end to their pregnancy. But will those activists be there for such a woman when she’s in labour? When she is struggling to care for a baby she was effectively blackmailed into having? When she can’t afford clothing or nappies for her child or food for herself, or when her mental health is suffering as a result of having a baby she didn’t want? No. Of course not. For this very reason I strongly believe that anti-abortion campaigners should not label themselves as “pro-life” but pro-birth; they generally care little for what happens to an unwanted child once it has been born.

The access to safe abortion is a right. It is not something that is lightly done, however much tabloid nonsense you read about some women using it as a method of contraception. People have a right to bodily autonomy, to have the final say in what happens to their own body. To remove this right from half the population, to force women to be nothing more than incubators, would be a monstrous wrong. I am fortunate and have never had to seek an abortion. But I have been in the situation where my husband and I had to consider it as an option and believe me, it was not easy. Yet I am grateful to have that option. So many women across the world are denied it.

If you started reading this as someone who is anti-abortion I doubt my words have changed your mind. That wasn’t my purpose though, I respect your right to have an opinion just as I hope you respect mine. But there is a difference between having an opinion, having an intelligent discussion on the matter, and forcing people (particularly children) to see distressing images of aborted foetuses in order to convince them of your humanity and compassion. That seems more than a little backward.

Depression, SSRIs and pregnancy

Today the BBC has reported that according to an adviser for NICE (the National Institute for Health and Care Excellence) women who are fertile should be discouraged from taking SSRIs, a class of anti-depressant. The rather aptly named Professor Stephen Pilling was quoted as saying:

“The available evidence suggests that there is a risk associated with the SSRIs. We make a quite a lot of effort really to discourage women from smoking or drinking even small amounts of alcohol in pregnancy, and yet we’re perhaps not yet saying the same about antidepressant medication, which is going to be carrying similar – if not greater – risks”.

Professor Pilling claims that there is evidence that taking SSRIs in early pregnancy increases the risk of a baby being born with a heart defect from 2 in 100 to 4 in 100. If this is true then of course new guidelines need to be considered. (Having said that, in my experience doctors are already extremely cautious when prescribing any kind of medication to a woman who is pregnant or breastfeeding.) However it is other quotes attributed to him that have infuriated me. According to the BBC article :

He says that women not suffering from the most severe depression who become pregnant whilst taking the drug are taking an unnecessary risk.

“You’ve got double the risk. And for women who are mild to moderately depressed, I don’t think that those risks, in most cases, are really worth taking” he said.

“It’s not just when a woman who’s pregnant is sitting in front of you. I think it needs to be thought about with a woman who could get pregnant. And, that’s the large majority of women aged between 15 and 45.”

First of all the diagnosis of depression is extremely subjective, often relying on the individual answering a multiple choice questionnaire that has points assigned to each answer. If you score above a certain number then bingo! You’re depressed. But what one person interprets as mild depression may be what another person feels is moderate depression. Someone who is severely depressed may not believe they are because they’re not considering suicide.

I’ve had episodes of depression since my early teens, including 2 bouts of post-natal depression (PND) and 1 bout of ante-natal depression (AND). The first time I had PND I refused to take any medication because DD was breastfed and I was scared that the anti-depressants would affect her through my milk. As a result I was severely depressed for a very long time despite various other therapies and I planned my suicide on multiple occasions. I am concerned that if Professor Pilling’s reported opinions become guidelines the same may happen to women who are pregnant.

If, through the media sensationalising this or through poorly worded new guidelines, a pregnant woman is made to feel the way I did it’s entirely possible that she may consider taking her own life (and therefore that of her unborn child). If a woman suffers from depression that requires a particular treatment then she should be given that treatment. At the end of the day, uncomfortable though it is for me to say, the life and wellbeing of the woman is more important than that of her foetus.

Any suggestion otherwise removes a woman’s bodily autonomy, her right to decide what happens to her body. This is dangerously close to a number of anti-abortion laws that have been proposed in the United States, where the supposed rights of the foetus (usually a non-viable foetus) would outweigh the rights of the mother, who is reduced to the status of a mere incubator.

As for Professor Pilling’s apparent suggestion that “pre-pregnant” women (so any woman who is capable of conceiving, and therefore presumably including pubescent girls) might be refused access to SSRIs, it’s ludicrous. Would a doctor refuse a diabetic woman her medication? Or an epileptic woman? Both of these conditions often require medications that can be risky for a foetus yet I doubt that many doctors would recommend their patients stop taking them merely because they might conceive a child.

What are your thoughts?

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