Schizophrenic and pregnant

link: http://www.boston.com/Boston/metrod...2pdAOHXusTg8S6QzMrMO/index.html?p1=News_links

The short of it is the woman in question is bipolar and had a psychotic break while away at college. She is 32 now. She has been pregnant twice before. The first was aborted, the second, which was before her break, is in the care of her parents.

I tend to agree with the probate judge and the woman's family on this one. For her to remain stable requires medications that are not good for a developing fetus.
So which is the lesser of two evils, continue the meds and have possible serious birth defects or take mom off the meds and somehow carefully supervise her for the term?
If she delivers, who takes the baby from there?
What is to prevent her from getting pregnant again?
Thoughts?

 

It looks like a problem with no ideal solution.

I'd prefer to know more - such as how far advanced the pregnancy is, what level of risk is involved in the meds and more about the nature of her mental state without medication.

Without this knowledge I would hate to have to be the decision-maker. For the sake of internet discussion, I would lean toward a termination followed by proper medical care.

Sheesh! What a dilemma!

 

Is adoption not an option? To me, it should be considered in lieu of abortion or bringing another child into the world for her parents to take care of. Keep her on the medication (according to the article, if I understand the wording correctly, the fetus would be in less danger if she stayed on it than she would, if she were taken off) with close medical supervision during the term of her pregnancy? This, of course, would have to be ruled upon by a judge as criteria for allowing the pregnancy to continue.

Sterilization seems drastic in it's finality (though I understand that in some cases it is reversible). Mandatory birth control such as a coil perhaps?

Difficult call. No options serve to remedy the core problem which is her mental illness. On or off the medication, she appears delusional and is likely to continue making these sorts of unhealthy choices.

I do think the appeals court was correct in overturning this judge's ruling. On the face of it, it seems very draconian.

 

Where is the evidence that says she's unfit? There are a LOT of women out there who I would like to be sterilized because I see them as awful people and thus would be awful parents. They should also keep their awful DNA to themselves. Sadly, It's not my place to say anything.

She's already 5 months? By the time something actually happens in the courts, the kid will be in Kindergarten.

The female body is amazing when it's pregnant though. My cousin, who also suffers from mental illness, was taken off her meds when she was pregnant. She had NO problems and was in the best state of mind in years.

I've been too lazy to research, but have often wondered if any studies have been performed on the status of women with chronic disease who become pregnant. My mom, who also had MS, often said the best she ever felt was when she was pregnant. I kind of want to get pregnant just to see this for myself, but the idea of squeezing something as large as a baby out my vag does not sound appealing. Also, I don't think it would be wise to pass on my DNA. We don't need anymore people to randomly random on the internets.

 

Oh yes, good point Zombie. Can we please, please open this door? I drool imagining the number of mandatory sterilization judgments we can look forward to should the terms "unfit to be a parent" or "the presence of Hank Williams Jr. DNA" become the basis for the spay and neutering of those most likely to knock and get knocked up.

As Alistair mentioned, for purposes of this discussion, it would helpful to know more about this woman.

 

It's ironic that you have to take a test to drive a car but not to be a parent, but the alternative is pretty horrifying to consider. At the same time, it seems bizarre that the system can take away existing children, but cannot do anything to prevent those children from existing in the first place. I guess the notion is that we should not punish someone's predisposition to be a bad parent, only the fact that they have become a bad parent, which is probably reasonable.

I think the thought behind the original judgment requiring abortion and sterilization isn't a bad thought (and not nearly as "terrifying" as the headline might make it seem), but I think the legal ripples concerned the court of appeal enough to overturn it. And I can't rightly blame them for that at all.

It is true that a pregnant body can do some pretty amazing things, but I don't think that's really what is of concern in this case. She might have an amazing pregnancy and be completely in control, but that hormone balance doesn't last for very long, and the welfare of the child afterwards is almost certainly what they're trying to deal with.

 

I can't have an opinion without further information, but I am a proponent of "keep your laws off my body." I'd also like to know who the father is. By his absence in this article, I can only assume he's absent in her life and therefore isn't claiming any responsibility.

It's a slippery slope. If she is "forced" to have an abortion who knows who the next group of women will be deemed unfit.

Don't worry folks. I'm barren so you won't need to sign me up for sterilization. I am sad to know that having my uterus removed is "elective" surgery. I'm preventing myself from getting an inevitable lady cancer. Another thread though.

 

I've worked alongside a schizoid man, and I know what happens when they go off their meds. It's sad to see them spiral down into such an abyss. On the other hand, it's reversible.

In this case, if the medications are harmful to the fetus, then it is still up to HER to decide on them, however unfortunate that may be. We allow other women free reign over their bodies while pregnant, and her medical condition shouldn't somehow strip her of that right. If, as the original judge decided, we allow the law to decide what goes on inside her body (or not), then it is a very slippery slope to eugenics and state sanctioning of birth. Potential mental defect? Abort the child and sterilise the mother. That seems to be the message.

A less draconian solution would have been to eliminate/reduce her medication until the birth, and then restoring them. Again, it should be HER decision, but it's one that allows for the best outcome for both mother and child in the long term.

 

Good points grey, but, to stir the pot a bit, I don't think its about aborting potential birth defects. I think its more along the lines of the parents are concerned about this woman producing more children that can't be taken care of, birth defects or not.
They are already raising her son, who is probably around 8-12 now (she is 32, most first breaks happen very late teens, early 20's). How many of her children are they supposed to support and rear?
Adoption was brought up. I don't know the rules about adoption. Is there something in the rules that says potential medical conditions have to be disclosed or the parents medical histories if known?
The fact the parents brought this before the courts and they are raising her son leads me to believe the woman is not compliant with her medications. I know, that's speculation on my part but if she was compliant would this be happening if she was a happy, adjusted, medicated mom?

 

Somehow, I missed the statement that taking her off medication would harm her more than the fetus, so my last option is out.

A real Catch-22 of the original decision is that the woman would not choose to be delusional if competent (to decide her own fate). Of course not, as being delusional tends to make one by definition incompetent. Many schizoid/bi-polar sufferers do, however, even when competent, choose to ignore the medications that are keeping them competent, thus giving lie to the judge's presumption.

A sad case, with the potential for some serious, dangerous precedence.

 

This is what scares me most....

 

When we use terms like 'schizoid' or 'bi-polar' we are talking about a huge group of people with some overlap in symptoms but a vast spectrum of intensity of the symptoms.
A very close relative of mine is schizoid. Most people don't know it.
Not sure about the statement: 'Many schizoid/bi-polar sufferers do, however, even when competent, choose to ignore the medications that are keeping them competent.' Would like to see a few sources on that.

The mentally ill and what rights they have over their own bodies regarding procreation should be questions dealt with on a case-by-case basis. These questions are rarely easy. The best we can hope for is the least destructive outcome.

I'm pretty hardcore about the world not needing more kids in it (Zero Population Growth) though that would have no place in deciding this case. In my perfect world, it would.

 

I may have generalised a bit too much when I said "many". The one case of the gentleman I worked with was exactly that, however... he stopped taking his medications because he "didn't feel like himself" when he took them. He knew they were essential to keeping him functioning normally, but he chose to stop taking them. His descent into a world of hallucination and withdrawal from the rest of the world was sad to see.

I generalised that to the fairly large number of people who chose, while on their medication and therefore supposedly functioning and reasonably lucid, to stop taking those medications, even knowing the effect of that stoppage. I have no source for it.

 

I'm with Fangirl on this one. Abnormal psych is rarely a blanket theory, and individuals must be treated as such. While the theory places the thresholds and indicators for treatment options and diagnosis, put two bi-polar people in the same room and you'll often have two very different people, even if they are lumped under the same general diagnosis. Same with schizoid, chronic depression etc. This woman needs to be evaluated by a third-party psychiatrist that has never diagnosed or treated her nor working for defense or state in the case.

This case can certainly cause a dangerous pretense, but if the woman is seen to be unfit to herself and others, then it may be necessary to render a judgement that she is not allowed to care for children, run a daycare etc. While it sucks for the parents to have to possibly raise another grandchild from their mentally ill daughter, I'm sure they'd rather have the responsibility than have the child placed into state custody to disappear with little chance of seeing it grow etc.

It's a tough situation, and I'm not comfortable with the abortion/sterilization judgement. I wonder if the parents were asked to opinion in probate court. That would be the most damning/supporting in regards to the daughter.

 

While I support an individual's right to autonomy it's a little sad, how our society uses that to avoid caring for individuals that clearly would be better off with consistant supervision.

On the point of sterilization. Personally, I believe that every woman has the right to choose but if they choose to abort 3 times that they should be sterilized upon the 3rd abortion. I know this would be logistically a nightmare to enforce but I have met too many women who begin to view abortion as a birth control option when it should be a last resort. This woman had the right to refuse both the abortion and sterilization. I do believe that individuals such as this woman, who clearly have some difficulty with recognizing consequences of their actions (demonstrated by getting pregnant several times and stopping meds more than once) were cared for better by our society and restricted from making some poor choices such as stopping meds, we would have MANY fewer students for me to care for. I know of MANY students over the years who would never have been diagnosed and accepted into Special Education if they had not had a parent on drugs, medication, alcohol or with technically poor genetics and disorders such as this woman has. I sympathize with these individuals and understand how unfair it would be to deny them having children but I would definitely support the creation of a license for having children. We have to earn a driving license and can loose it easily but we can screw up our own children with little to no personal liability. Something is wrong with that.

 

There are all kinds of slippery slopes we are attempting to manoeuvre and I can see valid points in most everyone's opinions.
I do wish to note from a perspective of having been a clinical therapist and as someone who herself is being treated for anxiety issues, that the more serious the mental illness the dicier things are when it comes to successful treatment.
People don't always go off their meds. because they feel better and believe they are OK now (though obviously some do). The side effects in the treatment of schizophrenia for example, can be awful. Even simple depression medication can cause side effects that can make the depression almost seem like small potatoes. What I'm trying to say is that it is hard for me to say who is 100% wrong and who 100% right because I don't think there is an available solution that is going to fit perfectly. We have to do the best with what we are working with, we should be sincerely well-intentioned for the welfare of all effected parties, and then we cross our fingers and hope for the best.

 

From the article posted by the OP:

I failed to see anything in the article that claimed the fetus would be harmed if she were kept on the medication.

 

How many women have you met who actually consider it a birth control option rather than a backup if birth control fails and how many have actually used it as such?

 

Thank you.

Having had an abortion I can tell you, abstinence is preferable. And this was when the availability of abortion clinics was plentiful. More and more states are making it extremely difficult for clinics to operate. Doctors who set up shop are in some states are harassed and run out of town on a rail - some women need to travel all day and often out of state to have one performed. Some birth control measure.

 

Quite true and also true that 1 in 3 women have an abortion in their lifetime. Women from all walks of life and all kinds of circumstances. It just (selfishly) crossed my mind the other day after reading about how difficult it is in [PickAnyRedState] to get the procedure that I'm glad to be past the age of getting knocked up and will never again need one, as I did when I was 24 years old.
Sometimes, your only choice is to go out of state and book a room somewhere for a couple of nights due to the most fucked up thing I've ever heard of: mandatory 24-48 hour 'waiting' period after you set yourself up for an abortion appointment.