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Finding Hope In Random Documentaries!

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Totally Married Podcast

Episode 321

Elizabeth and Andy discuss the recent doc that helped her feel that there is a god in this otherwise seemingly dumpster fire of an existence in Trumpland! An added bonus of discussion about sexual assault, and the recent scandals. Then they give their unqualified advice to listener questions about whether or not to take depression meds during pregnancy, how to heal hurt feelings over a pregnancy reveal, and how to find a therapist who is effective when you have no time and no money? Enjoy!

6 Comments!

Stephanie says:

Elizabeth gave great advice on the meds during pregnancy, but I wanted to add check out infant risk center at Texas Tech. Dr. Hale is the leading researcher on medications during pregnancy and breastfeeding. It’s great info to use when talking to your Dr about what meds are safe for you.

Jessie says:

Great episode! I just love listening to these first thing on my long drive in on Mondays. So… this is gunna be a long comment but bare with me b/c I think it’s important and for once in my life I can kinda/sorta say I’m a really qualified person to provide this answer:

I have a degree in Pharmacology and Toxicology and also happen to work for an “Institutional Review Board (IRB)” for a large academic institution AND I am pregnant with my third child and I’m on Wellbutrin and have been my entire pregnancy (I think that’s the trifecta for needing to leave a comment ;).

An IRB is essentially the ethics and regulatory review body for all human subjects research conducted under its purview. That includes research on pregnant women. And Elizabeth is sort of correct in that there are different (read: more) protections/requirements (i.e. federal regulations) to conduct research involving pregnant women (as there are for children and prisoners) but that does NOT mean research studies are not conducted on pregnant women.

On the contrary.. research is done all the time on pregnant women, what is RARELY done (if ever) is a randomized controlled trial involving pregnant women. Which is what people typically think of when they think of drug research (e.g. one group gets placebo, one gets active drug; confounding variables between the subject groups are controlled for as much as possible and the outcome data is compared). So Elizabeth is right in that there probably isn’t a study out there where one group of confounding variable controlled pregnant women is assigned placebo and the other similarly controlled pregnant women group is assigned to take Wellbutrin during their pregnancies and then the pregnancy outcomes are compared.

Having said that… what is done quite often are medical record review studies or even self-report questionnaire studies of women who chose (as part of their clinical care) to take Wellbutrin during their pregnancies and then their medical records are reviewed for the outcomes of their pregnancies and compared to the medical records of women who didn’t take any medications during pregnancy and things like… age/number of previous pregnancies/other confounding factors are controlled for as much as possible (so they don’t influence the results—SIDE NOTE: the study that originally linked alcohol to FAS… was not exactly pristine science… https://www.unc.edu/~fbaum/teaching/articles/Armstrong1998.pdf BUT I DIGRESS).

There is actually a great bit of data about the use of Bupropion (common name for Wellbutrin) during pregnancy as it is actually PRESCRIBED to women during pregnancy to help them quit smoking (Wellbutrin was actually originally marketed as smoking cessation drug when they discovered…hey people are reporting better moods while taking this drug!). Glaxo Smith Klein had a registry open for 10 years for prospectively reported pregnancy outcomes for women on Wellbutrin during pregnancy: http://pregnancyregistry.gsk.com/documents/bup_report_final_2008.pdf which contains LOTS of valuable information both on the registry study and other studies.

The BEST resource for aggregate information on drugs and breastfeeding is called LactMed and it’s run by the NIH: https://toxnet.nlm.nih.gov/newtoxnet/lactmed.htm

IN SUMMATION (if you’re still with me): There is not any statistically significant difference in fetal teratogenicity in mother’s taking Wellbutrin during pregnancy as compared to the rate of birth defects in women not taking any medication during pregnancy. THAT BEING SAID… if you wanted to be cautious (while still taking care of your mental health) you could avoid it during the first trimester and then go on it again after that time has passed. Most MDs will tell you Zoloft is a “the safest” anti-depressent/anti-anxiety drug to be on while pregnant so that is always an option as well.

My Experience: This has been my only pregnancy where I have taken a medication of any kind throughout the pregnancy. I’m on a relatively low dose of Wellbutrin and am approaching my 3rd trimester with everything proceeding normally (my anatomy scan showed no issues). I also plan to breastfeed while on the drug; as I feel comfortable doing so as I do not have a history of delivering prematurely and given the information on LactMed I feel safe doing so (even Zoloft gets into breastmilk so no matter what antidepressant you’re on during pregnancy they all get into the breast milk albeit at VERY low concentrations with minimal side effects if your baby is full term/healthy).

My OBGYN agreed and frankly didn’t bat an eyelash at any of my decisions and never once suggested I go off the drug.

IN SUMMATION: I am still just an N=1 so do what you feel is right. Consult with your doctor KEEPING IN MIND that every doctor will give you a different opinion of some kind for any number of reasons. And like Elizabeth said, MANY doctors will just blankly tell you (without any real individualized consideration) not to take ANYTHING while pregnant and for me that is both unnecessary and unrealistic.

Again, if it was men gestating the children and having the babies I suspect we’d know a lot more than we do about medications/pregnancy/child birth instead of just patting us pregnant ladies on the head, telling us to sit in the corner and worship our fetuses.

Kelli says:

To the writer inner with limited funds to find a therapist, I highly recommend the podcast Brooke Castillo’s The Life Coach School. There are nearly 200 episodes and her content is FANTASTIC. She has given me some amazing tools!

fruitypants says:

My reaction to the documentary is- think about all the times it didn’t work out for the person…why would God intervene in only some cases?

Erika says:

Exactly. Believe in God or don’t, but the idea that an incident like this proves the existence of God is flawed thinking. You’re (Elizabeth) looking at it as an isolated case, but in reality, the very reason there was film made about it is because of the crazy circumstances surrounding it. There are thousands upon thousands of cases in which the accused are not so fortunate to have a film crew around to support their alibis. It’s purely coincidence.

This is the same reason it bugs the crap out of me when people say they’re blessed to have this or that. “I have wonderful parents – I’m so blessed.” “I’ve never had a health issue – I’m so blessed.” etc. So why didn’t God bless the people who weren’t born into good families? Why didn’t God bless the people who are sick? If that’s our God, he’s kind of an ass for taking care of certain people and not others.

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