Difficult Topic #1

Dear Baby,

Everytime I go to the clinic to get a refill for my medication, there's this one doctor that seems to judge me. Unfortunately, it seems he's almost always the one that's working there when I go in. Just my luck! Anyway, it makes me feel kind of uncomfortable that he always interrogates me about, not only the medicine, but the dosage too.

You see, Baby, I'm on a mood-stabilizing medicine called Paxil. I'm on 60mg a day, which is a rather high dosage. Paxil is a "Pregnancy Class D" medicine: This means that there's an increased risk of birth defects in babies whose mothers take Paxil during pregnancy; however in some cases it's healthier for the mother to continue the medication, rather than try to function without it. After thinking about it very hard, I decided that I truly believe you and I fall into the latter category. I really believe the benefits of continuing Paxil (at my current dosage) far outweigh the extra 2% increase in the possibility of you having a birth defect.

Now, if I chose wrong, and you are born with either holes in the heart, club foot, PPHN, omphalocele, or an abnormally shaped skull; then you can blame me, and I won't hold it against you. In fact, you can trust that I already blame myself.

That seems like a scary list, and you might already be mad at me for my decision, but allow me to clarify some things. I did extensive research on this; and although the risks for birth defects are increased when the mother continues Paxil, the actual percentage of risk is still very low. There's a 2% chance that, even without Paxil, you'd be born with a birth defect; Paxil doubles that percentage, but that means it's still only a 4% chance.

On top of that, if I did stop using Paxil, you would have had to try to grow and flourish while being carried by a mother who would have multiple panic attacks a day, every day. The panic attacks I get when I don't take Paxil are severe and last anywhere from 30 to 90 minutes. I have anywhere from two to five panic attacks each day. They include hyperventilating, heart palpitations, hysterics, etc. I truly believe the stress from the panic attacks would have majorly increased the chance of me miscarrying you. So far, I've had one, minor panic attack while pregnant with you. That's a vast improvement for our situation!

So, Baby, as I said, if you were born with a birth defect, I do apologize. I fully expect all the blame to fall on me, but I just want you to know that I absolutely had your best interests at heart when I made this decision. If, by some miracle, my panic attacks would have had no effect on you whatsoever, then I absolutely would have discontinued the Paxil and suffered through the panic attacks for you. I promise you were the only thing on my mind when I made my decision. I sincerely hope I made the right one! We'll find out in about 3 1/2 months.