Reducing Medication For a Home Birth - Where do I Start?
Q.
I am taking Citalopram 40mg for Depression and am 17 weeks pregnant. I tried to stop taking my medication but had a relapse.
I wanted to have a home birth, but my midwife says that because of the tablets they have to monitor the baby for 24hrs, so I'd have to go into the Birth Centre or Hospital. Is there anyway to get around this? I've read that you can taper off the medication and it will reduce the likelihood of symptoms in the baby, so could I do this then still have my home birth?
A.
Thanks for your question. You obviously feel passionately about having a home birth, but what your midwife has told you about needing to monitor the baby for 24 hours is correct.
The medication that you’re taking, Citalopram, is safe to be taken during pregnancy, but does mean that a few extra precautions need to be taken at birth. Tapering off the medication may reduce the likelihood of symptoms in the baby, but wouldn’t guarantee that you’ll be able to have a home birth.
You say that you’ve already tried to stop the medication and had a relapse, so it sounds like you obviously do need the medication. If you were going to try to reduce the dose, then you’d need to do so under guidance from your doctor and midwife and only if they advise you that it would be safe to give it a go.
However, reducing medication at any time can be tricky and you do need to think very carefully about doing so during pregnancy and how you might feel if you try. Your health is vitally important now, as you’re carrying a growing baby, so doing something that may make you feel unwell may not be the best approach.
As much as you may have always dreamt of having a home birth, you need to look carefully at the situation, weigh up the pros and cons and do what is best for both you and your baby. Although you may not be so keen on going to a birth centre of hospital, they are perfectly good options and will be able to ensure your baby is in the best hands.
In fact, if you’re looking for an environment that is second best to a home birth, then many birth centres are an excellent choice. You can give birth in a private room, relax in a similar way to how you would at home, use a birthing pool if you wish and generally have a relaxed and chilled out birth.
If you’re unsure of what facilities your local birth centres offers, then they’ll be happy to show you around and give you a taster of what it’s like. Either way, if you’re in any doubt about what to do, then please speak to your GP and midwife again and definitely get advice if you’re thinking of reducing your medication dose.
Good luck and hope the rest of your pregnancy goes well.
