Postnatal management with prenatal depression - Mothering Forums
I'm Pregnant > Postnatal management with prenatal depression
Triniity's Avatar Triniity 12:43 AM 01-15-2014

Hi everybody. 


I suffer from prenatal depression, and it was/is pretty bad, and I have to take medication for it. Yesterday I had an ultrasound at the hospital, and the obs doc said that in his experience the peds will take the baby onto icu for seven days for observation after birth. 


Our ped hospital is pretty quick with taking the baby to icu, and I am not sure if there really is a valid reason for this - but then - I am biased ...:)


I don't really want this (obviously) and am worried about the early bonding and the risk of postnatal depression. 


The medication I take is omipramol and clorazepat. 


I have an appointment with the head of the peds hospital to discuss the plan, does anybody here have any experience that she can share, or data? Thank you so much! 


I looked around a bit but could not find anything like a "protocol", the risk for postnatal symptoms appear to be quite small for the baby...but I might be wrong...

pokeyac's Avatar pokeyac 03:06 PM 01-16-2014
Bumping this up for more attention as I don't have experience to share. I really hope they don't plan on keeping the baby in the NICU for that long. That sounds unnecessary and difficult and expensive.
MeepyCat's Avatar MeepyCat 03:58 PM 01-16-2014
Is there a particular clinical concern that leads to the NICU time, or is it just because you're on anti-depressants?

Our NICU stay was quite long, because of prematurity, and my experience was that the NICU was a machine for causing PPD. There were good reasons for my baby to be there, but it sucks.

If the NICU admission is entirely due to your medication, it's best to strategize pretty carefully about the meeting with the pediatrician, IMO. You want this conversation to be all about the baby. Why would they need to admit the baby, and what signs of concern would they be looking for? Will the baby be able to stay with you if you're doing well? What arrangements need to be made so that you can stay with the baby as much as possible while he is in the NICU, so that you can nurse, hold the baby, and be involved in his care? Who will the baby's primary doctor be? Will your baby be assigned a primary nurse? If you have concerns about the baby's condition or care, who would you speak to? What test and treatments is your baby likely to need?

If you are asked about your own mental health, the answer is that you are taking medication under the care of a doctor (psychiatrist or OB) and that person is your preferred resource for mental health issues. You understood that this meeting was set up to discuss care for the baby. Your own care would be best discussed with your own doctor.

NICU stays are tough, but they are finite. Good NICU staff will help uou out a ton.

Also - I'm talking a big game about staying with the baby, because NICU visiting is a known struggle for a lot of families. Getting as much access as you want can be a struggle. But if your mental health would be improved by leaving the unit, it is okay. Completely. They will take good care of your babe, and be there when you get back. I will never be able state how grateful I am to the nurses who told me that it was okay for me to go take a walk when I was too jittery to sit still. DD was well looked after, and I felt so much better.
Triniity's Avatar Triniity 11:45 PM 01-16-2014

Thank you for your reply. 


The discussion with the ped was very positive and reassuring. He told me, that there "normal" policy is, to not separate mothers from their kids with a history of prenatal or postnatal depression. He thinks that the risk that the baby shows any signs of withdrawel or side effects would be around 1%, and the clinical observation if anything accurs can and will be done while rooming in. 


There will be a peds doctor at the birth so that they have a good look at our son after the birth, and if there is no sign of problems he will stay with me. The postnatal ward and the ICU are literally 25 m apart, so if anything happens, they can be there quickly, and there are pediatric nurses on the postnatal ward as well. 


He advised me to see a psychiatrist who is very experienced in prenatal depression and the adjustment of the medication for maximal safety for the baby, and I got an appointment in just 10 days. 


So I am quite relieved, and hope that everything will be fine. Obviously there is no chance of an ambulatory birth or going home the next day, but I am happy with this now. 


Now it's in my chart that the head of pediatrics allows the baby to stay with me as long as everything is fine. That makes me really happy! 

MeepyCat's Avatar MeepyCat 07:26 AM 01-17-2014
That is the best possible news! I'm so glad. Those sound like sensible policies and good plans.
Triniity's Avatar Triniity 12:17 PM 01-29-2014

I had the appointment with the psychiatrist who is kind of specialised into prenatal and postnatal depression, and he thinks he can improve the medication. He believes the benzos are not such a good idea, esp. since he thinks it's kind of unreasonable to expect me to stop them around 35 weeks. He asked me if I expect my life to be calmer than, and I just had to laugh...


So, we are getting there...