You Pays Your Money, You Takes Your Chances

I hate doctors.

You scoff, thinking "but doctors are trained professionals and know far more than you do, O Litttle Panda."

What, you dont think that? You're all such cynical bitches.

My wonderful and superb GP decided to give up her practice (I guess she figured she knew what she was doing and didnt need to practice anymore) towards the end of last year. Since then I have been GP-less. So when I needed a new prescription for my Panda-Not-Be-Psycho pills (aka Lovan/Prozac) I figured I may as well just go to the local country-town doctor whom I havent seen for about 18 months.

I knew there was a reason I stopped going to him.

Doc: "Who put you on Lovan?"

Me: My GP.

Doc: "They know at the hospital you're still taking Lovan?"

Me: Yes.

Doc: "And they're okay with this."

Me: Yes.

Doc: "They were fine with you taking it all through the pregnancy?"

Me: Yes..

Doc: "Why didnt you stop taking it when you knew you were pregnant?"

Me: Because I have an anxiety disorder caused by hormonal fluctuations and when I am experienceing hormonal shifts I am quite capable of harming either myself or someone else."

Doc: "Well, during pregnancy hormones generally settle down"

Me: Not in my case they havent.

Doc: "You need to talk to someone at the hospital about this and see what they have to say about you breastfeeding while on it. You may have to either not breastfeed or stop taking the Lovan."

Me: Why?

GP looks up Lovan in the MIMS, where it says all sorts of nasty things that will happen to your baby should you breastfeed whilst taking the drug. Says breastfeeding should not be considered while taking Lovan.

End of consultation. I go home feeling now more anxious about the drug that is supposed to stop me feeling anxious, and start feeling the creeping guilt about what I may have done to Spudly for having taken it throughout the pregnancy, albeit under medical guidance.

Last night I consulted the Doctor Who Is Always In, and did a rather thorough search of research papers on the effects of Lovan during pregnancy and breastfeeding. Despite what the MIMS had to say, there is NO data that suggests that breastfeeding should not be attempted while taking Lovan. In fact, the conclusions drawn re Lovan in breastmilk all state that the amount in milk is so small as to make it a laughable idea that it could be worse than the mother taking it during pregnancy.

There is NO data that shows any teratogenesis in the fetus when taken during the first trimester. There is some data which suggests that in a small number of babies there may be withdrawal symptoms for the first week of life if Lovan is taken in the third trimester, but these are by no means dangerous - crying, diarrhea, general crabbiness, etc. There is the suggestion that infants should be monitored closely for the first 48 hours for any signs of withdrawal symptoms, mainly minor respiratory distress.

Furthermore, from a 7 year study there is NO data to show that there are any long term developmental issues such as neurological damage, lowered IQ etc from the mother having taken Lovan either during pregnancy or breastfeeding.

But look up the effects of a mother who needs medication during pregnancy or post-partum and stops taking the medication, and what you find is a higher incidence of miscarriage, long-term neurological and developmental problems in the child, low birthweight, intra-uterine growth retardation, suicidal tendencies, hypertension and pre-eclampsia, higher incidence of post-natal depression, inability to care for the infant and failure in the infant to reach developmental milestones.

My anxiety and guilt disappeared pretty quickly. It was replaced by anger.

We know that not all GPs can be up-to-speed with the latest research on the effects of every drug on the market. But if all that doctors are relying on is what is reported in the MIMS, how many women are badgered encouraged to either stop their medication or not breastfeed their babies on the basis of false information that is undoubtedly provided by the drug company who doesnt want to get their asses sued? To me it seems it's just another way in which women can be made to feel guilty about their needs and choices.

Monkey Boy and I made our decision last night. There will be none of this crazy "stop taking the medication that keeps you sane" bizzo going on around here. There will also be none of this "dont breastfeed your baby, it's too dangerous crap" either. I'll discuss the issue with the hospital at our next appointment and let them know that I have done my research, am aware of the possibility that there may be some withdrawal symptoms and am prepared for the potential need for monitoring of Spudly for a couple of days.

Personally, I think doing anything else would be grossly irresponsible on my part. Spud does not need a mother who cant look after him and who wants to harm anyone who gets in the way. Nor should he be denied the enormous benefits of breastfeeding because a bunch of drug company lawyers are a little nervous about the one woman in millions that wants to take them to the cleaners.