My Fertility Story
Is it irresponsible of me to have a child? How can I nurture their wellbeing alongside my own?
Written by Caroline N
01 Caroline has a Bipolar II diagnosis. Her and her husband have been planning for a child, while simultaneously, trying to keep Caroline's wellbeing top-of-mind.
02 Certain anti-psychotic medications are not recommended during early pregnancy. Caroline shares her experience going off Lithium in preparation for pregnancy.
03 There is no one way to plan for a family. We are all on our own journeys, trying our best to do right by ourselves and those we love.
I always thought that my mood instability and anxiety were somehow character flaws or past traumas, and not mental health related. I have some baggage (waiting to be claimed) and I know I’m not alone in that — but mental health isn’t linear.
When I was eventually faced with a Bipolar Disorder II diagnosis, I realized that there were things happening in my mind beyond my control. I’ve battled anxiety since high school, and was diagnosed with BPII three years ago. I’ve also dealt with periods of PTSD.
I’ve always had a reluctance when talking about having children. Every time I was asked, I’d skirt the question with an indifference and change of topic. Sometimes I would say, “I’m just not sure.” I don’t have a very maternal demeanour so it didn’t seem out of the ordinary. Truthfully, I was harbouring fear.
There have been periods of time when I’m less able to function and need help — not being able to leave my bed, or, on the opposite end, appearing high functioning but struggling to concentrate or retain information. With that in mind, I can’t help but wonder how that will impact my ability to care for a human being.
I’m at the stage where the clock has ticked to an audible volume.
My husband wants kids, but for him, my wellness has always taken precedence. About two years ago, I went to my doctor to find out what our options were. Immediately, I was referred to the perinatal mental health ward at Mount Sinai hospital in Toronto. I’d been taking the antipsychotic drug Lithium which can be harmful if taken while pregnant, as it runs the risk of the baby developing a heart defect if taken within the first trimester.
I wasn’t willing to risk it, so I made the decision to go off my meds and start thinking about trying to get pregnant. I had learned so much about my triggers and how to manage and maintain a balanced life. I figured I was ready. And so, over the course of a few months, I went off my medication, slowly tapering down until I wasn’t taking anything at all.
At first I felt good — better prepared and more educated about what was going on with my mind. I was working out, meditating, eating healthy and not taking on too much. That was, until it all went downhill.
After eight months of being free of meds, my symptoms took on a whole new spectrum, starting with physical cues like extreme fatigue and memory trouble. These new symptoms blinded me from recognizing a looming depression that soon took over my life and made any attempts at the conception process impossible. It was the first time I had experienced depression symptoms in that order (i.e. memory trouble before mood swings).
I needed help again.
I’m now on a medication that has fewer health risks to a baby in the first trimester. It was also suggested that I could pause meds during the first trimester, when the baby’s organs are being formed, and re-start later on. I have protocols in case I want to decrease dosage to further reduce risks which could pose a threat to my own health, such as trigger depression or mania.
I’m told that I’m at greater odds for postpartum depression or that the additional hormones can trigger an episode. I would need to be monitored regularly for my mental well being before, during and after pregnancy. This level of preventative strategy feels so alien to my personality - to be so monitored and seemingly fragile doesn't feel like me.
All the while, I’m plagued not only with mental health stigma, but fertility stigma in combination.
How can I be accountable for a child’s development if I happen to not be well? Is it irresponsible to have a child when I have a disorder that can be passed down? How can I ensure I nurture their wellbeing and my own?
Not to mention, maintain my marriage in addition to this huge life change.
These questions have undoubtedly prolonged this decision for me and I still harbour feelings of guilt, fear and worry. I know that I will not always be well, but how I handle my awareness and humility counts for something. I have the support to get help. I know that when I’m well, I have so much to give. I have the tools to teach this potential person about tolerance, accountability and advocacy. Just like with the stigmas I face, I have a roaring strength to counteract. Against the odds, I’m high functioning and pretty fucking amazing.
For those with a mental illness considering procreation, I hope that my account helps you feel less alone. I hope it prepares you for the tough questions that will arise when facing this decision. I hope that as a society we can learn early-on about symptoms and mental health in ways that don't stigmatize parents, employees, bosses and human beings, as being lesser than or weak. Let’s change the narrative by sharing our stories so that future generations feel supported in being authentically open.