I believe my depression drug killed my baby
When things go wrong in childbirth, every mother wants to know the truth, writes Carol Hunt, whose personal experience helps her to understand the long legal battle of Lisa McGillin
MATERNAL guilt can be a horrifying thing. It's a rare mother who can live with the belief that her actions during pregnancy caused serious and irreparable damage to her child.
Lisa McGillin, mother of eight-year-old Rebecca, who suffered injuries at birth consistent with Foetal Valproate Syndrome, understandably could not live with this guilt and fought to prove her innocence in the courts.
Last week a settlement of €500,000 was reached in her favour against two doctors involved in her care during pregnancy. It was a strange case, with neither defendant (Professor Patricia Casey and Dr Mary Holohan) admitting liability yet agreeing to cough up a hefty settlement.
Ms McGillin's medication for her bipolar condition was required for her depression, and there was an issue of balancing the risks to herself and the foetus. Fair enough. A mother's health, both mental and physical, should be paramount during pregnancy. But Ms McGillin claimed she hadn't been made aware of the dangers that her medication may have posed to her baby.
She contended that she had only been advised by Professor Casey to come off lithium for the first trimester and that she was also told that the Epilim she took was safe during pregnancy as long as she took folic acid in adequate amounts.
A quick trawl through Google would have informed Ms McGillin that neither drug was 100 per cent safe for a developing foetus. But she became pregnant in 2001, when many of us were not as au fait with the wonders of the internet as we are now.
I know this to my cost because in the mid-Nineties, like Ms McGillin, I was diagnosed with bipolar disorder and was prescribed lithium and Seroxat -- both drugs that I now believe cause complications during pregnancy. At the time I was in my late 20s, engaged to my present husband, and at no time was I ever advised not to become pregnant while on these drugs. Nor was I instructed to use contraception.
Some months later we were both thrilled and a little concerned to discover that we were expecting our first child. As I was feeling extremely well mentally I decided to stop taking all medication, as well as quitting alcohol and cigarettes. But I had unwittingly been taking these prescription drugs before I realised I was pregnant. It had not been planned.
Fearing complication, we waited until just before the end of my first trimester before telling our families the good news. Soon afterwards I had a scan, which -- as the doctor informed me -- showed nothing to worry about, and was admitted to hospital with a tedious, recurring back problem.
So there I was, lying in ignorant bliss and dreaming about my unborn baby, until a doctor unwittingly informed me that he could not prescribe the usual traction for my back because of the "problems with my pregnancy".
Problems? What problems? Bless them. Because of my seemingly dodgy mental state, it had been agreed to keep from me the fact that no baby's heartbeat had been found during my last scan.
When I was returned for another check, I was briskly informed that the baby was dead and I would need a D&C to clear it out. No sympathy, no information, and no explanation.
Distraught, I went on an information trawl and discovered that lithium, which I had been taking, could increase the risk of congenital heart defects in a foetus by as much as 400 per cent. (Newer studies, however, cite the risk as lower.) Armed with this knowledge, I asked the psychiatrist who had been treating me if the lithium could have caused my baby's heart defect. The psychiatrist emphatically denied that the lithium could have been in any way responsible.
Perhaps they were trying to protect me from the knowledge that I had, through total ignorance, contributed to the death of my baby. But what every mother wants is the truth. I now have two beautiful children, but I firmly believe that the loss of my first was due to the medication I had been prescribed. I remember discussing this with one consultant on one occasion when we met.
"Do you believe it was the lithium?" they asked me.
"I do," I answered.
They made no comment.
But Professor Casey and other doctors who work in the mental health area are in a double bind. They truly wish to do the best for their patients, and have seen the dangers to health and life which can occur when seriously ill patients come off their medication.
It is known that both lithium and valproate (both of which Ms McGillin was prescribed) can increase the risk of congenital defects in a foetus.
But it is also known that bipolar disorder can be fatal when untreated. So it becomes a guessing game, with doctors trying to do their best for both mother and child with the least harm to either.
I could be wrong, but I strongly suspect that perhaps part of the reason I was not instructed to use contraception while taking a drug that could be harmful to a foetus during pregnancy, was due to the religious ethos of the hospital where I was diagnosed. And I will never forgive them for keeping from me the knowledge that my baby was dead within my womb.
At that time, I did not seek a second, even a third, opinion. I trusted them implicitly. Today, most of us have no such excuse. We have a great deal of information available to us at the touch of a button.
If we are confused or worried we should insist that the experts go through all options with us, honestly and without sparing our feelings. Doctors and other experts are not infallible. Like the rest of us, they just do the best they can.
Originally published in
