I’m a week away from entering the third trimester with my second child. All things considered, I’ve had a pretty straightforward pregnancy. It’s certainly helped that my day-to-day anxieties around pregnancy have been much less intrusive than they were the first time around. I’m still heating up my deli meat and avoiding raw-fish sushi, but with this pregnancy, I’m letting myself have a bit of caffeine in the mornings without guilt. As long as the soft cheese is pasteurized, I’m giving in to my cravings. I’m not fretting and ruminating before every doctor’s appointment, imagining all the worst-case scenarios so that I’ll “feel prepared.” Overall, I’ve found that I’ve been able to retire the dread of waiting for the other shoe to drop and instead spend more time appreciating the magic of the fact that I’m actively growing a human inside my own body.
I ultimately decided to proactively medicate because I realized that the closer I get to my due date, the more I’m starting to feel the worries creep in.
Nevertheless, I’ve decided to start taking Zoloft when I get a bit closer to the tail end of my pregnancy. I’ve gotten the OK from my doctor, and I feel confident that taking SSRIs during pregnancy is the right decision for me.
I ultimately decided to proactively medicate because I realized that the closer I get to my due date, the more I’m starting to feel the worries creep in. My first time around, I had the gift of naivete on my side when it came to mentally preparing for the labor and delivery experience. Sure, I was worried and wondered what it would be like, but in general, I had been cautiously optimistic, perhaps even a bit cocky, that I’d be a secret pro at pushing and the doctor and nurses would congratulate me on my stellar technique. But after living through a traumatic first birth, I’ve found that I have a lot of fear about history repeating itself. The PTSD is cropping up more and more in the quiet moments I have to myself, and I find myself getting lost in thoughts and fears: Will my baby again be stuck in breech for weeks and weeks, leaving me in limbo of whether vaginal birth will be in the cards for me? Will I fracture my tailbone a second time? Will I be nauseous and vomiting again through the early stages of labor, stuck sitting on the floor of the bathroom to remain close to the toilet while dealing with the rolling pain of contractions? Will my early labor stretch on for 30+ hours? Will I have to push for multiple hours? Will we have to resort to forceps to pull my baby out? Will my second baby have an even larger head, causing even more of an issue trying to clear the birth canal?
Another positive is that entering labor and delivery feeling more calm and collected often leads to better outcomes for both the mother and the baby.
For these reasons and many others, it feels like there are many benefits to going on SSRIs without a ton of downsides. There is a lot of evidence that taking Zoloft, and especially waiting to take it until near the end of the pregnancy, doesn’t cause issues for the baby. Zoloft is one of the most-recommended SSRIs for prenatal and breastfeeding mothers dealing with postpartum anxiety (PPA) and postpartum depression (PPD). Another positive is that entering labor and delivery feeling more calm and collected often leads to better outcomes for both the mother and the baby. And finally, it will let me proactively mitigate the hormonal shifts of baby blues, my milk coming in, and more serious and lingering conditions like PPA and PPD as I once again prepare to make the transition from prenatal to postpartum.
It’s also worth noting that this won’t be the first time I’m going on SSRIs for help with mood stabilization related to childbirth; I decided to go on Zoloft after my first child was born to combat the at-times crippling PPA I found myself facing. The first time around, I white-knuckled it for the first eight months postpartum, unable to distinguish between what were “normal” parenting struggles and what was, in fact, a hormonal imbalance that needed correcting. I’d have a bad few days of crippling anxiety and crying nonstop and feeling like the world was caving in, only for things to start to feel better and lead me to believe I’d “beaten” the bad feelings … only for the cycle to repeat itself, again and again and again. Finally, I admitted to myself that this wasn’t normal and that I was only depriving myself of being able to be present and more relaxed during these crucial months in my daughter’s life. I spoke with my doctor, voiced my concerns, and was prescribed a very low dose of Zoloft. Once I’d had a few weeks for the drugs to take effect, I felt immense relief. I was sleeping better. I wasn’t spiraling nearly as often. I was able to relinquish some of the control I’d felt like I’d had to have around things like nap windows and preparing to leave the house. But most importantly, I was starting to feel like myself again—and able to appreciate the moments I had with my daughter in a way I’d been sorely lacking in the first nine months of her life.
Medication was great, but it was for other people, not me, I thought. But when I got out of my own way and gave it a try, it really saved me.
I hadn’t realized how complex my own feelings about medication were until I was faced with the idea of going on SSRIs for the first time. I’d always thought I was open to medication, but when thinking seriously about going on it myself, I realized I felt quite a bit of shame around the idea that I “needed” help. Medication was great, but it was for other people, not me, I thought. But when I got out of my own way and gave it a try, it really saved me.
That’s why I’m so proud of how far I’ve come. The fact that I’ve made this decision to go on medication proactively the second time around feels like such a huge step in the right direction. While there are plenty of unknowns awaiting me as I transition from a mother of one to a mother of two, at least I know PPA and PPD won’t be holding me back this time. I feel confident I’ll be prepared to weather the storms ahead and come out on the other side.