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It was with great excitement that I informed my case manager of my pregnancy. It would be safe to say that the news was not received with enthusiasm.She promptly picked the phone up and informed me that she was booking me in for a termination of pregnancy at the first available appointment. I was at first flabbergasted. There was no discussion about it.She said that it was her duty of care to make sure that I terminate the pregnancy. I did not handle this well at all and became very cross and agitated. I yelled at her that she could not force me to have an abortion. Her reply to that was that she would have me committed as an involuntary patient and then I would not have a say in the matter. At that point in time I did not know what my legal rights where. I told her that I would rather kill myself than have a termination and I ran out of the clinic in tears. I walked the streets for some time to try to clear my mind and take stock of the situation.

When I did return home, there were three members of the crisis assessment team waiting for me. I wanted to run away for fear that they were there to take me away to hospital and strip me of my personal right to decide what happened with my own body and my life. However, I physically could not run any longer. They reassured me that they were not there to take me away, just to make sure that I was okay and safe. They offered me some Valium™, which I didn’t take for I was unsure how it would affect the foetus. They asked me if I could guarantee my safety. I told them that I was not suicidal— far from it— I was just disillusioned by my case manager and bone tired, as you can only get in the first trimester of pregnancy. They came back the next morning to see how I was going and to tell me that I had an appointment with my psychiatrist that afternoon.

I was fearful of going to the clinic as I did not wish to see my case manager. They told me that it was within my rights to ask for a change of case manager. When I arrived at my appointment my doctor suggested that I think of having a termination as a responsible option. I told him that it was not an option and that it was better if we discussed other options.We discussed the medication I was taking at that time and it was decided that I talk about this with the  psychiatrist from the Mother–Baby Unit (MBU), as she specialised in this area. I was allocated to a new case manager who was very proactive in  supporting me throughout the pregnancy. She linked me in to the MBU in the area as well as to the Mother’s Support Program (MSP), an  outreach program for mothers with a mental illness.

I had regular appointments with the psychiatrist from the MBU.It was decided that I would come off all my medication except the antidepressants, as the other medications I was takinghad not been tested on pregnant women. I didn’t want to take any risks and,after much deliberation,I decided to come off my antidepressant as well. In hindsight that was not a good idea.It made things even harder, and I didn’t have the emotional buffer that an  antidepressant gives you,and having them on board during the postnatal period may have helped me. Towards the end of my second trimester my partner and I moved into a lovely little flat, made available by the Mother’s Support Program.I should have been elated that I had a place to call my own and to welcome my child into, but it seemed to heighten my feelings of isolation, loneliness and sadness.

Cognitively, I knew that I was meant to be feeling excited and preparing for the arrival of my child, but in reality I felt lethargic and down most days. I slept most of the time, the house went unkempt most of the time, and so did I. My doctors suggested that I return to taking antidepressants, but I would not have a bar of it.I didn’t want anything having a detrimental effect on the baby. I wasn’t thinking clearly and this was having a negative impact on the whole situation.So there were many unsettling factors even before I had given birth:

•I had no emotional or social supports.

•My relationship with the father of my unborn child was unstable.

•My financial situation was questionable.

•Although I had housing for the next 6 months, where I would go after that was playing greatly on my mind.

 •I felt that the health professionals around me doubted my ability to be a good mother, and that made me question myself as well. However, being linked into the MBU was a very positive aspect. It enabled me to be hospitalised when I needed to be, with the minimum of difficulty. Looking back on my pregnancy I’d say that I was depressed the majority of the 9 months.All these things had a great impact on my state of mind and my ability to cope as a new parent, when the time came.

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