Part four in our series of essays excerpted from The Good Mother Myth.
I held my husband Nathan's hand while we listened to the psychiatrist outline the risks we would face if we chose to have a baby together. The psychiatrist emphasized that no pregnancy was risk-free for any family, but that my generalized anxiety disorder, panic disorder, and major depressive disorder piled on some extra risks, during and after pregnancy. Of course, there was some more risk piled on top of that.
I had fought hard for the "natural," medication-free pregnancy I so desperately wanted, even after I learned that many women in my position safely deliver healthy babies after being on meds during their entire pregnancies. But I lost that fight.
I had spent 2011 trying to wean off of my medications, Effexor and Klonopin, and then trying to switch to lower-risk medications. I had told myself that with enough preparation, my anxiety disorders and depression would disappear just in time for pregnancy and motherhood. I had gotten expert opinions, had tried no meds, and then different meds. I'd even tried holistic treatments, alternative medicine, and huge shifts in my diet. Yes, all this planning had helped to alleviate my fears, but my guilt and sense of failure remained.
I wanted to make the last effort work so badly that I had lied to Nathan and my doctor. "Yes, Ativan is working out!" I told them. Then I began having panic attacks about going to work. I stopped showing up and lost my job as an assistant teacher at a childcare center.
That episode had done a lot of damage to my self-esteem and had planted more than a few doubts about my ability to "show up" as a mother. Here I was, without a job, back on the medication. It was cold comfort knowing that I had done my best to achieve minimal risk and arrived at Decision Time.
Even if everything seemed perfect for years after my child's birth, no one could promise me that any of my choices would ensure that child's health. I couldn't even promise that I would be all right: If I had a baby, I would face a much higher risk of postpartum mood and anxiety disorders.
I squeezed Nathan's warm hand tighter when the doctor said, "I can give you statistics and tell you that the odds are low, but you need to go and talk. What if you are the family facing the worst-case scenario?"
I wanted to be pregnant, even if I needed medication to win the battles I would face as a human being, a wife, a mother. I felt selfish for wanting to carry a child, knowing that I had lost so many battles against the chemical imbalance in my brain. But I wanted a baby with my entire being. I thought the guilt would swallow me up. Sitting in her office, I began to sob – with both pain and relief – while Nathan rubbed my back. I dabbed at my face with tissues, and we got up. I took a deep breath of crisp, fall air as we left the office and headed to lunch to have The Conversation.
We talked. While Nathan enumerated my successes, I countered with my failings. I pointed out that I needed to take medicine every day in order to just hold down a job or remember to eat three square meals. He reminded me that going to therapy, finding the right medication, taking it every day, and treating my illness were the acts of a strong, responsible woman.
Trying out new medications, trying to go off my meds, having this conversation, all before we were even trying to conceive a baby were responsible decisions. Any child we raised would see me modeling how to overcome the obstacles put in my path by genes, environment, and circumstances.
A good mother takes care of herself. She doesn't put herself (or her family) through daily panic attacks for the sake of a "natural" pregnancy. A good mother knows that there are risks in every choice and that she can never protect her child from every possible danger. I fought hard to rid my body of potentially dangerous chemicals, but I also understood that the poisoned thoughts my unmedicated brain releases make taking the drugs worth the risk.
No one, not even me, can say that I didn't try hard enough or that I don't deserve to bear children. Nathan was always confident about that. The day I held his hand in the doctor's office and in the cafe, I found that confidence too.
But even if we were willing to go forward, given my diagnoses and treatment, were we prepared for the worst that might happen? My psychiatrist had given us a summary of the studies that were available on Effexor during pregnancy and on Klonopin during pregnancy. The combination? We could only make an educated guess.
There seemed to be a slightly increased risk of miscarriage in the first trimester. A slightly increased risk of a cleft lip and/or palate birth defect. There was a definite risk that, after the umbilical cord that separated our bloodstreams was cut, the baby would feel symptoms of withdrawal from my medication, including irritability, seizures, sleep problems, slow weight gain, tremors, fever, and more. But there was also the chance that my baby would experience none of it. The most likely scenario involved milder, temporary symptoms.
I already knew that I would give up the home birth I had always wanted. I would give birth in a hospital, even though hospitals terrified me, so that experts would be on hand to deal with any birth defects or withdrawal symptoms. In other words, instead of a peaceful arrival into our family and our home, my baby's first days outside my body could be filled with pain, and we might need specialists to help mitigate that pain.
If the baby was born with a cleft lip, a cleft palate and withdrawal symptoms, we would grieve. Talented doctors would step in immediately, however, and make sure that he or she made a full recovery with no more than a scar to show for it and certainly no memories of any pain. We hated the idea, of course. Was it enough to stop us from taking the chance and having a baby? No. Was the risk of miscarriage enough to stop us? No.
The incredible lesson we learned that day was that no one would ever be able to point to anything during a pregnancy, birth, or new life and say "that happened because Anne-Marie took Effexor and Klonopin." All of it – even the symptoms associated with withdrawal – can happen to anyone, even a mother with a clean bill of health and no illness or medication before or during her pregnancy.
In my quest for perfection, I had never stopped to consider that healthy families experience loss and illness with no explanation. It had never occurred to me that deciding to expand a family could set any couple down a path to pain and suffering. If the Good Mother in my imagination couldn't even promise her family a perfect baby, maybe it was time to reevaluate what being a good mother would mean to my family.
Just a few months later, in early 2012, I became pregnant. My pregnancy was blessedly free from complications. The ultrasounds pointed to a healthy, active fetus. We made it through. And before long, we saw a healthy, active baby boy.
His birth was the single most empowering event in my life. I felt calm and strong, and I had so much faith in my body and my baby. He was born in perfect health. He didn't cry, but he was a healthy pink. His eyes opened. He gripped our fingers. His muscle tone was a bit higher than normal, and while he was too sleepy to nurse at first, there were no signs of withdrawal or pain. I asked if my medications were causing any problems. The doctors and nurses said that he wasn't in any pain and that we could feed him from a syringe. He roused so quickly that my midwife nicknamed him "the little monkey" because he never seemed to stop moving.
To this day, our son, Walter James Lindsey, has never experienced a single health problem. And though my anxiety and depression have not disappeared, I am managing them.
The happy family I fought so hard to have is here.
“Down the Rabbit Hole,” by Anne-Marie Lindsey, is excerpted from The Good Mother Myth: Redefining Motherhood to Fit Reality, edited by Avital Norman Nathman. With permission from Seal Press, a member of the Perseus Books Group. Copyright © 2014.
Read other essays excerpted from The Good Mother Myth.