I’m not pre-pregnant. I just have a womb.

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November 12, 2013 | 11 Comments


  1. I have to thank Philippa for reminding us of something really important here: the question of what these drugs do to the potential child can never be separated from that other big question: what are they doing to, or for, the woman herself? If I’m taking a pill that I believe is essential to my health and well-being, but poses some risk of fetal harm, I have a right to keep taking it. Whether I decide to forego motherhood altogether, consider terminating the pregnancy if things go wrong, or simply live with the risk, no one should barge in to take the choice out of my hands.

    But I think the two docs quoted in the British press as warning women about the hazards of prenatal antidepressants have been hit with a bit of a frame-up on Mumsnet etc. Neither Louise Howard nor Steven Pilling advocated anything remotely like a ban on these drugs for women of child-bearing age. What they did propose was right in line with what every feminist wants: Our right to know the facts.

    Those facts include an elevated, although still small, risk of heart malformations and other catastrophic birth defects. They include a LOT of worrisome although not final data about a far greater risk of learning disabilities, autism-spectrum disorders and other cognitive problems in children exposed to SSRI’s in utero (http://rxisk.org/autism-awareness-day-antidepressants-in-pregnancy/ ).

    They also include the very real risk that once on these drugs you may not be able to stop them – or that stopping could trigger suffering even worse than your original depression. That’s as important for women who will never reproduce, as for the woman who does want to get pregnant someday, and assumes she’ll be able to stop any teratogenic food or drug when that day comes.

    Women also deserve the facts about these drugs’ impact on us, whether mums or not: their potential to trigger suicidal agitation in some people, the substantial risk that they will flatline your sex life and the well-founded fears that using them long-term may worsen your depression. Not to mention the close to 50-50 chance that they won’t help much in the first place. All these facts are routinely kept from patients male and female – but women are far more likely to be affected than men, with many justifying this silence as being “for our own good.” I wish just one major U.S. newspaper – just once! – would have the guts to interview Louise Howard or Steven Pilling about these concerns.

    But no such luck. Here in the land of the “Right to Lifers”, who are allegedly all about the babies, we don’t hear a peep about these drugs’ prenatal effects. Instead, drug companies actively promote them for pregnant women who may even be pressured to take them “for your child’s sake.” Right to Life groups are no more bothered about this than they are about the slashing of food-stamps and maternal nutrition grants to the poorest of the poor. While some of the rank & file are well meaning, these movements have very little to do with the welfare of either potential children or real ones. It’s more about controlling women and policing families.

    By the same token, people who work hard to bring us the facts about what our drugs, food or environment are doing to the developing fetus are generally NOT Right-To-Lifers. That may just be a rap hung on them by well-placed PR agencies, who have been known to sell us everything from boob-jobs to cigarettes as instruments of our “liberation” and who operate as freely online as in glossy magazines. Pharma has some of the best ones.

    They’ll gladly blindfold us, spin us around like tops … and then wax eloquent about our “right to choose our own direction.” What right? Maybe I’m being cynical … but it pays to be cynical these days.

    • Actually I am against abortion. And I think there is a lot of accusation thrown around that abortion opponents don’t care for children which is just unsubstantiated. There are literally thousands of non-profit organizations staffed by abortion opponents in the US that specifically work to help unwed mothers and pregnant women keep and care for their children. This has always been a Christian tradition (both evangelical and Catholic).

      As the son of a man who held a Doctorate in Pharmacy, I have been very disturbed about the adverse affects of psycho-tropic drugs in all stages of life–as was my father before me. We have in our own way advanced the dangers of these meds and have always encouraged people to intelligently look at the adverse side-effects and the misuse of studies to get these drugs approved through the FDA.

      You can disagree with my stance on abortion, but please don’t make a blanket statement suggesting that if you are against abortion that you only see a woman as a womb-in-waiting and that you have no concern about women as women or no concern about the horrendous side affects of a host of medications to every person regardless of sex.

      • Did you EVER had a clinical depression? Because it doesnt sounds like you had.
        What use is a pregnancy without ADs if i just kill myself? Yhe lethality of depression is known. I wouldn’t be the firstl. Other could kill their child postpartum-this is known and reported too(and its known that ppl like me who have/had depression are at a higher risks to get postpartal depression.
        Thats a reason why i wont have and dont want kids. Cant be as good as getting that shit again.

  2. Dear Lethe … don’t know if you were asking me, but yes, I write as someone who has struggled with major depression for thirty-plus years and has been on just about every drug in the book. And when it comes to the SSRI’s (Paxil, Prozac, Zoloft etc.) I’m a witness that they don’t work very well for severe depression. For many years I endured a situation where I felt lousy while taking these drugs, and really horrible every time I quit. I was told that proved I needed them for life. I was never told about withdrawal. I had to learn that myself, the hard way, in spite of the doctors. Thank god I did.

    Like you, and for similar reasons, I never had children. However I was on Effexor and Depakote during my “now-or-never” years (late 30’s) and very nearly made a different decision. No one ever told me that Effexor could result in birth defects and that Depakote, an anti-convulsant, was even more hazardous. That was unconscionable.

    As I said in the beginning, if someone really believes a drug is essential to her well-being she absolutely has a right to keep taking it. However, she also has a right to know the facts – both about fetal harm, and especially about withdrawal. My life could have been very different in many ways if these facts had not been kept from me. I can’t get those years back, but I still hope the next generation of women (or maybe the generation after that?) will finally win the right to know. That applies to those with severe depression, and even more so those who have these medications foisted on them for emotional distress that is due to very understandable (and not permanent) life stresses, and are told NOTHING about the risks. We all deserve better.

  3. Interesting you picked up on the userism of “pre-pregnant” but not the same for “cis” which is a pejorative. I am a Female, not a speciman under a microscope.

    Regaridng women being seen as “pre-pregnant”: If anti-depressants are harmful for the fetus, they are also harmful for women, with or without a fetus. I believe that has been established by our host and others.

    That’s the take home message here. Anti-depressants have huge potential to harm. It’s the nature of the chemical.

  4. “…I am a cis woman in her 30s, …”

    I am deeply offended by Females being referred to with a term used for a bit of tissue in a lab. It is appalling that this term should be allowed here, on this respected medical site and in particular in this article which is for and about women’s health and rights to be considered as full human beings. Further Gender has NO role in procreation, it is our SEX which becomes pregnant.

    I request that this term be removed.

  5. I see that the term “cis” has not been removed.

    This term is sexist and misogynistic. This may be an infringement of the rightys of Females under the Human Rights Act of various jurisdictions.

    It is a slur. Please apologize to Females for using this term and please remove it.

  6. Red who commented above sent this comment to Rxisk

    The term “cis”is a slur when used to describe Human Females. It is pejorative and sexist. I ask that it be removed from the essay on “pre-pregnancy”. I have made a complaint about it in the comments under that post.

    This term may infringe protection under the Human Rights acts of various jurisdictions. I believe it also may, contravene your Terms:

    I am offended and lessened by this slur being used here with impunity to refer to Females. I believe it is a contravention of my human rights to access this website and information without fear of being name-called and insulted in a way particular to my Female sex.

    From your Terms:

    6.3 Your user content must not be illegal or unlawful, must not infringe any third party’s legal rights, and must not be capable of giving rise to legal action whether against you or us or a third party (in each case under any applicable law).

    6.4 You must not submit any user content to the Website that is or has ever been the subject of any threatened or actual legal proceedings or other similar complaint.
    – See more at: http://rxisk.org/terms/#sthash.Rq1K1EwO.dpuf

  7. Hi Red,

    Cis really isn’t an offensive term, and it’s not one that is only applied to women. There is no sexism implied in the use of the term, it simply means ‘not trans’.

    It’s not a value judgement, it’s just a description.

    The fact that I used the term to describe myself indicates that it is in no way name calling, it’s just a word to describe a state of being. It does not imply goodness or badness, nor does it insult anybody.

    This post – http://eminism.org/blog/entry/399 – provides some interesting information about how the term originated… “the reason “cis” is preferable to all the others is that it treats “cis” and “trans” as linguistic equivalents, rather than treating one as more normal or natural or otherwise standard and the other abnormal, artificial or exceptional”.

  8. PS ‘cis’ doesn’t refer to ‘a piece of tissue in a lab’.

    “Cisgender has its origin in the Latin-derived prefix cis-, meaning “on this side of,” which is an antonym for the Latin-derived prefix trans-, meaning “across from” or “on the other side of”. This usage can be seen in the cis-trans distinction in chemistry, the cis-trans or complementation test in genetics, and in the ancient Roman term Cisalpine Gaul (i.e., “Gaul on this side of the Alps”). In the case of gender, cis- is used to refer to the alignment of gender identity with assigned sex.”

  9. Pre Pregnancy. I think your view of disliking the word, concept, association is selfish and ill informed.

    I have a 15yr old Son with FACS. Birth defects caused by Sodium Valproate. I should have had preconception counselling and women of childbearing age should receive appropriate advice.

    If I had received information about my life saving medication and its affects on the fetus during my teens I would have planned a life without giving birth. My Son has a happy life at the moment, his physical pain and suffering has not been extensive. Adulthood is just round the corner, residential care and vulnerability await and will not cease until he dies.

    It is time that the priorities of a child were put before the desire of a woman to have a child and before the desires of women who want everything to be written and phrased in non offensive ways.

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