Before you know you're pregnant....

[risingsun]

To the OP - it has to be a personal choice. Lots of very smart women have expressed here their own beliefs and knowledge, now you have to decide for yourself.

One thing I do wish, is that people would stop saying things like, "I had a glass of wine every night and my baby was perfectly healthy!" (Not that anyone here said exactly that, but lots of examples were given of friends/family that did this.) Anecotes mean NOTHING for something like that, and I really don't get why anyone would even offer it like it helps.

I agree with MP. These are anecdotal accounts. In addition, many developmental disorders do not develop or are not evident at birth. Having a perfect baby does not assure that the child will develop normally. That is part of the risk factor.

 

[Pandora II]

To the OP - it has to be a personal choice. Lots of very smart women have expressed here their own beliefs and knowledge, now you have to decide for yourself.

One thing I do wish, is that people would stop saying things like, "I had a glass of wine every night and my baby was perfectly healthy!" (Not that anyone here said exactly that, but lots of examples were given of friends/family that did this.) Anecotes mean NOTHING for something like that, and I really don't get why anyone would even offer it like it helps.

I agree with MP. These are anecdotal accounts. In addition, many developmental disorders do not develop or are not evident at birth. Having a perfect baby does not assure that the child will develop normally. That is part of the risk factor.

Whenever I discuss my situation with taking opiates during pregnancy, I am invariably asked how Daisy was affected so I now tend to give the full story - yes she had to withdraw, no she doesn't seem to have any adverse effects - straight away.

My decisions were based on huge amounts of research on the part of myself and my medical team. I was in one of the most experienced hospitals in the world when it comes to drug-dependent babies and they said that Daisy reacted entirely as they would have expected and that the chance of any baby having long-term effects from the use of medically prescribed opiates in pregnancy was negligable. This was what made me go ahead with my decision to get pregnant at all.

I suppose my experience is anecdotal but I think it's slightly different from someone saying 'I had a glass of wine a night and little Johnny is just fine'.

I just know an awful lot of people with chronic pain who give up the idea of becoming parents because they think they'd have to come off meds they can't or that the baby would 100% be damaged. My take on it is that the blanket 'no meds in pregnancy' thing is great, but individual cases should be looked at more closely and evaluated as such.

Opiates are one of the safer meds to be taking - but your healthcare providers need to be aware and you need to look at the research on mothers on prescription opiates as opposed to drug addicts (where there can be a lot of comorbidity in terms of alcohol, nicotine and other substance abuse, plus potentially Hep. C infections, and often a complete blank when it comes to estimating exactly what dose of heroin etc the woman is actually taking). One thing that does need to be stressed is that opiates are often use in labour and if the baby is sleepy when it's born, they often give it a shot of naloxone - you don't want anyone giving an opiate-dependent baby naloxone as it can cause seizures.

I know when I was researching all of this and the information on breastfeeding on opiates and lamotrigine, I got a lot of personal accounts from people I contacted through places like the Epilepsy Society etc and whilst I know you can always be 'the one', I was very reassured by the overwhelmingly positive outcomes (in fact there wasn't a negative one I came across) and I still asked how their kids did with regards to milestones, birth weights etc

Ultimately everyone needs to do the research and make their minds up about what risks they are prepared to take. None of us live in a sterile bubble - and even if they did... well heck, I've got plenty of dodgy genes to mess things up if needs be!

 

[vintagelover229]

The one major benefit I have heard from mass recommendations to pregnant women is that taking folic acid when TTC and in early pregnancy has virtually eliminated spinal bifida, which is wonderful news indeed.

I have a very close friend whos wife can't take BC and is allegoric to all sorts of materials used for condoms. She got pregnant right away (unplanned) and they are very very poor. Her first son was born with his intestines outside of his body (not sure what it's called) however they were well aware prior and had a surgical team and fixed him up and he was in the hospital for quite some time (in fact he's now 3 and still refuses to eat solid foods, he has a stomach pump that uses special formula). Women are most fertile right after they have a baby and sure enough they got pregnant right away again (however this time she wasn't aware bc she was having health issues and she thought the signs were from that). She didn't take her prenatal vitamins and her baby girl was born wiht spinal bifida and will never walk.

They are a very loving family but now have 2 special needs children to care for. She told me had she known she was pregnant she would have taken the everything and she would have had a perfectly healthy baby girl. Both the kids are well cared for and well loved but I can't imagine how stressful and difficult it is for her to care for 2 kids that have special needs. My friend is an amazing husband and father but it's very important as soon as you find out to take care of everything you can for you and your kids health.

When my ex and I were TTC (only for about 3 weeks off BC thankfully) I started taking my vitamins a month before I got off the pill. I wasn't taking any chances (considering my very close friends and how close to home it hit).

I also have 2 siblings that have FAS and my mom drank with me. My younger sister has very difficult time comprehending things, reading, math and is also ADHD. Thankfully I never experienced any issues with learning or with school but I can't honestly say that it didn't have any affects on me at all (because I dont know what I would be like without my mom having drank with me).

I won't be drinking (and he won't either) when we are TTC. I love a nice glass of red wine every now and then but for me it's worth waiting the 9 months (or more if it takes a while to conceive) to not have a drink. I may feel differently when I'm sitting in front of everyone and they all have a glass in front of me but I doubt it.


This is a great thread!

 

[janinegirly]

I would be very curious to hear what the chances of spinal bfida are if you have a reasonable diet (let's say it's standard, not necessarily perfectly rounded) and do not take prenatal vitamins until you find out you're pregnant (let's say 5-6 weeks which is when you've missed AF). I imagine alot of women do not realize they are pregnant earlier on or weren't "trying" (most of Hollywood? and therefore aren't taking prenatals. I heard SB is still very very rare in these cases - but I'm not sure. Of course you should take every precaution you can, but I just wonder about this because I just find it hard to believe most women are as proactive during TTC as the ladies are here.

 

[amc80]

I would be very curious to hear what the chances of spinal bfida are if you have a reasonable diet (let's say it's standard, not necessarily perfectly rounded) and do not take prenatal vitamins until you find out you're pregnant (let's say 5-6 weeks which is when you've missed AF). I imagine alot of women do not realize they are pregnant earlier on or weren't "trying" (most of Hollywood? and therefore aren't taking prenatals. I heard SB is still very very rare in these cases - but I'm not sure. Of course you should take every precaution you can, but I just wonder about this because I just find it hard to believe most women are as proactive during TTC as the ladies are here.

Spina bifida occurs in 7/10,000 births.

"Research has shown that if all women who could possibly become pregnant were to take a multivitamin with folic acid, the risk of neural tube defects like Spina Bifida could be reduced by up to 70%." www.spinabifidaassociation.org

So even if you don't take prenatals, there's only a .07% chance of occurrence.

 

[Pandora II]

In many countries folic acid is added to bread and breakfast cereals - IIRC in the USA this began in the 1990's.

It's also worth checking whether you should be on larger doses. For example, anyone taking certain medications - for example anti-epileptics like lamotrigine, but also some antibiotics and other meds - should be taking a supplement anyway (normally 1-5mg a day) and especially when pregnant and TTC.

I was on 5mg a day - at one point I couldn't get the 5mg tablets and had to take 13 of the normal ones every day, I literally staggered out of the chemist weighed down with boxes!

 

[MonkeyPie]

I suppose my experience is anecdotal but I think it's slightly different from someone saying 'I had a glass of wine a night and little Johnny is just fine'.

Agreed, and I think your case was totally different! Not to mention you were monitored by doctors your entire pregnancy and Daisy was taken care of quickly. I think that is a far different case than knowing your pregnant and thinking, "I want wine and dammit, I'm going to have it!"

 

[Laila619]

Women are most fertile right after they have a baby

How sad for your friends, vintagelover. Just wanted to point out that the above isn't really true though, esp. if you're nursing.

 

[amc80]

Here's a question that is appropriate for this thread-
Is it necessary to go to the OBGYN for a pre-pregnancy consult? I've had some friends who have done this, but I can't imagine what the doctor would tell me other than to take prenatals. Especially I've you've had a clear PAP within a year...

 

[Dreamer_D]

Here's a question that is appropriate for this thread-
Is it necessary to go to the OBGYN for a pre-pregnancy consult? I've had some friends who have done this, but I can't imagine what the doctor would tell me other than to take prenatals. Especially I've you've had a clear PAP within a year...

It is not necessary as far as I know. I did not with either of my pregnancies and was not given heck when I started seeing my midwives at 8-10 weeks. So clearly they had not expected me to have done so.

 

[Laila619]

Here's a question that is appropriate for this thread-
Is it necessary to go to the OBGYN for a pre-pregnancy consult? I've had some friends who have done this, but I can't imagine what the doctor would tell me other than to take prenatals. Especially I've you've had a clear PAP within a year...

Yes, you should. The OBGYN can do a blood draw to see if you're immune to Rubella. If you're not, you really should get vaccinated because if you were to get Rubella when you're pregnant, you could miscarry or the baby could have serious birth defects. Scary stuff. If you get the Rubella vaccine, you have to wait 3 months until you can TTC.

Read more here: http://www.babycenter.com/0_rubella-german-measles-during-pregnancy_9527.bc

 

[lliang_chi]

Hm, my OB and GP (Genera Practiciner) did not draw blood. OB just did a normal pap, then talked "Take vitamins, have sex, call me when you missed a period." Granted it could be because my OB was a new appt, and I hadn't been going to him for-ever and ever. My GP I had, she had been doing my paps. She didn't say anything, just "How exciting, let me set you up with the OBs at the practice."

SO, I would be on Dreamer's side of the camp.

I also did ask my OB a lot of questions. I have a genetic amenia issue, and my MIL has MS ( I know nothing about the disease, but thought maybe I should mention it) and diabetes is highly prevalent in my family. He just said, "Take vitamins, have sex, call me when you miss your period." Gee thanks/

~LC

 

[shihtzulover]

I am not TTC, but I go to my general practitioner for my pap every year, and I had an interesting talk with him during my exam about a month ago.

I have been on SSRI antidepressants in the past, but I weaned off them about a year ago. A lot of my anxiety is back, but I hate the side effects of the medications, so I am trying to deal with it naturally. Anyway, he is encouraging me to get back on the meds (I agreed and took the samples home, but I just couldn't bring myself to take them yet, because I don't feel like I'm overwhelmed to the point of needing them).

I also mentioned that I am getting fed up with the side effects of birth control pills, too. I told him that I was questioning even being on them, and that my fiance and I were just considering using condoms and spermicides. He did not like that idea at all, and said that birth control pills are much more effective than condoms. He says that he doesn't think that spermicides are that effective at all (even when combined with condoms), that people don't consistently use them, and that they can cause irritation and such.

He was so worried because he said that SSRIs can cause birth defects, explaining that it would be much better to not risk it at all. I'm not sure how often those medicines do cause birth defects, and I also thought that condoms and spermicides are pretty effective, especially when combined - but he was totally against the idea.

Of course, now I'm scared to get off the pills, because we are not ready for children yet. I do want to have kids one day, and a small part of me wants them now (especially when I see my friends with their children), but I am not ready at this point. I would ideally like to be married for awhile first, and also be established in my career field.

 

[kama_s]

I am not TTC, but I go to my general practitioner for my pap every year, and I had an interesting talk with him during my exam about a month ago.

I have been on SSRI antidepressants in the past, but I weaned off them about a year ago. A lot of my anxiety is back, but I hate the side effects of the medications, so I am trying to deal with it naturally. Anyway, he is encouraging me to get back on the meds (I agreed and took the samples home, but I just couldn't bring myself to take them yet, because I don't feel like I'm overwhelmed to the point of needing them).

I also mentioned that I am getting fed up with the side effects of birth control pills, too. I told him that I was questioning even being on them, and that my fiance and I were just considering using condoms and spermicides. He did not like that idea at all, and said that birth control pills are much more effective than condoms. He says that he doesn't think that spermicides are that effective at all (even when combined with condoms), that people don't consistently use them, and that they can cause irritation and such.

He was so worried because he said that SSRIs can cause birth defects, explaining that it would be much better to not risk it at all. I'm not sure how often those medicines do cause birth defects, and I also thought that condoms and spermicides are pretty effective, especially when combined - but he was totally against the idea.

Of course, now I'm scared to get off the pills, because we are not ready for children yet. I do want to have kids one day, and a small part of me wants them now (especially when I see my friends with their children), but I am not ready at this point. I would ideally like to be married for awhile first, and also be established in my career field.

I'm sorry, but your Dr. is an idiot. What birth defects??? There have been many, and I mean MANY meta-analysis that showed NO correlation between SSRI exposure and birth defects in pregnancy. The whole fiasco began when one study claimed an increase in heart defects, BUT THIS STUDY DID NOT HAVE A ***** CONTROL GROUP!!! Any pregnancy has a risk for birth defects based just on CHANCE. You have to asses whether exposure to a drug causes an increase in risk OVER what the baseline risk is.

After that ill-designed study came out, lawyers went like a hunting pack with mass torts. Women stopped taking their anti-depressants and Drs began advising against them.

And the final thing you have to consider is the risk-benefit analysis (which you do with any drug exposure in pregnancy). In this case, the benefits FAR outweight the risks. Being born to a depressed mum has several negative effects on the baby. I strongly, strongly suggest you do some research on this before you blindly follow your Dr who is at least ten years behind on recent literature.

 

[kama_s]

I would be very curious to hear what the chances of spinal bfida are if you have a reasonable diet (let's say it's standard, not necessarily perfectly rounded) and do not take prenatal vitamins until you find out you're pregnant (let's say 5-6 weeks which is when you've missed AF). I imagine alot of women do not realize they are pregnant earlier on or weren't "trying" (most of Hollywood? and therefore aren't taking prenatals. I heard SB is still very very rare in these cases - but I'm not sure. Of course you should take every precaution you can, but I just wonder about this because I just find it hard to believe most women are as proactive during TTC as the ladies are here.

If you have a wholesome diet, you have nothing to worry about. Keep in mind the US has a fortification food program. Things like cereal, bread and pasta are all fortified with folic acid. So as long as you're eating well and don't have any reason for folate deprivation (disease or medication related), you should be just fine

Here in Canada we have increased the folic acid dose to 5mg/day, which is by prescription only. This increase was lobbied constantly by the group I was working with and I am glad to see it in place.

 

[Laila619]

Hm, my OB and GP (Genera Practiciner) did not draw blood.

Well, not every doctor does, but that doesn't mean it's not important. Do you know if you're immune to Rubella? If you got it while pregnant, it could cause severe birth defects. Now, the odds of getting Rubella are not super high, so maybe that's why not all doctors are worried. Still, it's serious stuff.

 

[amc80]

Well, not every doctor does, but that doesn't mean it's not important. Do you know if you're immune to Rubella? If you got it while pregnant, it could cause severe birth defects. Now, the odds of getting Rubella are not super high, so maybe that's why not all doctors are worried. Still, it's serious stuff.

Ugh. I guess I'll call my doc and see about getting the MMR Immunity test. I worked for a hospital in 2006 and part of the hiring processes was checking immunity. I know I was immune then, but I'm not sure if that means I am now.

 

[janinegirly]

Hm, my OB and GP (Genera Practiciner) did not draw blood.

Well, not every doctor does, but that doesn't mean it's not important. Do you know if you're immune to Rubella? If you got it while pregnant, it could cause severe birth defects. Now, the odds of getting Rubella are not super high, so maybe that's why not all doctors are worried. Still, it's serious stuff.

Aren't most people immune if they had the shot as a child? My dr also did not take blood - I honestly don't think it's necessary. I had my annual and asked a couple questions and she mentioned vitamins and that was about it.

 

[Tacori E-ring]

I did not go to the doctor before I TTC. While pregnant they did blood tests and my Rubella did come low. You cannot get it while pregnant but they did give me the shot before I was discharged from the hospital.

 

[shihtzulover]

Trust me, I totally know that he's a complete idiot. I honestly never usually even believe a word that he says, because he has said some ridiculous things over the years. I only go to him because it's convenient to get an appointment quickly, but I know that I should go somewhere else. I chose not to get back on the SSRI regardless, but only because I don't feel that I absolutely need it right now. I do still tend to have high anxiety levels (not so much depression unless it's caused by a bad bout of anxiety), but I am able to function pretty normally so far, and I don't want to deal with the side effects of the SSRIs (tending to make me really tired, sexual dysfunction, etc) if I don't need to be on them.

He only freaked me out about getting off the bcp because I'm always so paranoid about getting pregnant, anyway - and the things that he said just reinforced that worry. In any case, I am comfortable staying on the bcp right now, since the side effects aren't horrible, just a little bit annoying.

 

[hawaiianorangetree]

In many countries folic acid is added to bread and breakfast cereals - IIRC in the USA this began in the 1990s

This was made a legal requirement in Australia only last year.

 

[Pandora II]

I am not TTC, but I go to my general practitioner for my pap every year, and I had an interesting talk with him during my exam about a month ago.

I have been on SSRI antidepressants in the past, but I weaned off them about a year ago. A lot of my anxiety is back, but I hate the side effects of the medications, so I am trying to deal with it naturally. Anyway, he is encouraging me to get back on the meds (I agreed and took the samples home, but I just couldn't bring myself to take them yet, because I don't feel like I'm overwhelmed to the point of needing them).

I also mentioned that I am getting fed up with the side effects of birth control pills, too. I told him that I was questioning even being on them, and that my fiance and I were just considering using condoms and spermicides. He did not like that idea at all, and said that birth control pills are much more effective than condoms. He says that he doesn't think that spermicides are that effective at all (even when combined with condoms), that people don't consistently use them, and that they can cause irritation and such.

He was so worried because he said that SSRIs can cause birth defects, explaining that it would be much better to not risk it at all. I'm not sure how often those medicines do cause birth defects, and I also thought that condoms and spermicides are pretty effective, especially when combined - but he was totally against the idea.

Of course, now I'm scared to get off the pills, because we are not ready for children yet. I do want to have kids one day, and a small part of me wants them now (especially when I see my friends with their children), but I am not ready at this point. I would ideally like to be married for awhile first, and also be established in my career field.

**edited for language**

Trust me, I totally know that he's a complete idiot. I honestly never usually even believe a word that he says, because he has said some ridiculous things over the years. I only go to him because it's convenient to get an appointment quickly, but I know that I should go somewhere else. I chose not to get back on the SSRI regardless, but only because I don't feel that I absolutely need it right now. I do still tend to have high anxiety levels (not so much depression unless it's caused by a bad bout of anxiety), but I am able to function pretty normally so far, and I don't want to deal with the side effects of the SSRIs (tending to make me really tired, sexual dysfunction, etc) if I don't need to be on them.

He only freaked me out about getting off the bcp because I'm always so paranoid about getting pregnant, anyway - and the things that he said just reinforced that worry. In any case, I am comfortable staying on the bcp right now, since the side effects aren't horrible, just a little bit annoying.

My sister took Prozac during her last 2 pregnancies and while breastfeeding and my SIL is currently pregnant and on Lustral. SSRI's are very safe in pregnancy but unfortunately many, many GPs seem to give up learning anything new once they leave medical school.

It's like the Wakefield debacle - one flawed and badly carried out research project can have far-reaching consequences that multiple further properly conducted projects can struggle to overturn. I hold Wakefield personally responsible for a large number of the measles related deaths in the UK in recent years (10 in the district I live in alone in the last couple of years).

There is a base-line risk for naturally occuring birth defects anyway and you just look at how big an increase you add with whatever you take.

 

[Tacori E-ring]

shihtzulover, you are in Charlotte right? I have a great doctor if you are ever ready for a switch.

 

[MichelleCarmen]

I did not go to the doctor before I TTC. While pregnant they did blood tests and my Rubella did come low. You cannot get it while pregnant but they did give me the shot before I was discharged from the hospital.

Before TTC, I also went and tested to see if I am immune to Rubella and I am. I have to admit before becoming pregnant with my first child, I went nuts reading up on all kinds of stuff on the internet to make sure I did all perfectly to prepare for pregnancy. Began prenatals six months before trying and I wasn't taking any medications. Still, even with doing everything "right," I did have a pregnancy complication that was entirely unpredictable, so there is always a chance something can come up. Had the same complication w/my second son (and was told ahead of time this would happen - so no big deal) and both my kids seem normal. Or as normal as two boys two years apart can be.