When I participated in an inpatient program, I met a woman whose family had a doctor perform a full hysterectomy on her when she was eighteen (she was now in her late fifties) because of her bipolar disorder. Her family and doctor both believed that she would be an unfit parent and they didn’t want to risk her having a child that could also develop the disorder. I was terrified by this story. This woman had not only endured a debilitating mental illness, but she had to endure it when compulsory sterilization was a reality for those in psychiatric hospitals.
Fast-forward to 2012, a Massachusetts woman with bipolar disorder and schizophrenia was forced to have an abortion and be sterilized. In 2013, an Italian-born woman had her baby forcibly removed by ceasarean and taken into child services by the UK government because of her mental illness.
As a woman who is married and still deciding whether or not I want to have children, the stigma toward pregnancy, motherhood, and mental health is concerning. But until two years ago, these were just stories I had heard or read about. Then I had my own, although much less traumatic, experience.
It was December (I remember because it was my birthday) and I had a consultation with a new psychiatrist. Like I said in a previous post, I’ve never met a psychiatrist I liked and I was certain this was going to be just another name on my list. I never thought it would probably be among the worst psychiatrist visits in my life.
As I sat in the waiting room, I knew who was waiting for me. It was undoubtedly going to be a man (they’re always men). He was going to have glasses (they always have glasses). He was going to be slightly disheveled (they’re always disheveled). He was going to ask me questions about my history that I feel guilty and embarrassed about. I was going to cry. He’d ask me why and I’d incoherently try and explain myself through my tears. It would be awful, but then it would be over.
You might be wondering, why is a psychiatric assessment so terrible? It’s because it’s not just just a doctor glancing at that mole on your shoulder. You’re sharing your most personal and more often your most shameful experiences.
Imagine the most embarrassing moment of your entire life. Maybe it was that time you farted during your sixth grade presentation or that day in tenth grade when you walked around with your skirt tucked into your tights ALL DAY. Whatever it is, imagine that moment and remember the fear of judgement, the embarrassment, and the shame you felt. Now imagine retelling every mortifying moment to a stranger on the bus.
And you’re not just retelling the story to a passive audience, your listener is asking questions. What did the fart smell like? What did you have for lunch that day? Have you ever farted in public before then? Does your family have a history of public farting?
These questions make you relive not only the embarrassing moment itself, but all of the moments that led up to the incident. Now you regret eating beans at lunch because you should have known better. Your family has always whispered about your Uncle Frank’s 1965 broccoli incident.
And as he asks the questions and you answer, he takes notes. Endless notes. You try and peer over his clipboard to see what he’s scratching, but you can’t see. He holds it close to his chest. And with those notes, he makes files – files that you are never privy to – even when you ask (trust me, I’ve asked).
That’s what makes the process of retelling your history to one psychiatrist excruciating.
When my name was finally called, I followed him into the office that now felt claustrophobic with the two of us inside. I quickly launched into the gory details of my illness. (It’s like ripping off a bandaid – do it quick and the pain lasts only a second).
We sit silently for a moment as I dig through my purse looking for a tissue (it’s not a psychiatrist visit without some tears!). Just as I find an errant tissue, he inhales and asks, “Are you thinking of becoming pregnant?”
I pause, momentarily stunned by the question. I’d seen a lot of psychiatrists, but none of them had ever asked this before. After a moment, I reply. “Not any time soon.”
“You know it’s dangerous to become pregnant while on these medications,” he replies, ignoring my response as he makes more notes on his clipboard.
“Yes, I know the risks involved.” My back is up, I’m feeling defensive. “But I’m not thinking of getting pregnant soon.”
“Good, because it’s dangerous and not just for you. We don’t know the risks of medication use on the foetus. It could cause birth defects and other issues. It’s not 100% but there’s still a risk. You need to know all of this before you become pregnant.”
“Yes, I’ve spoken to my doctor about it before. But since I’m not planning on getting pregnant any time soon, we figured we could revisit the issue when I’m making that decision. I don’t even know if I want kids anyway.”
He looks up at me, cocks his head to the side and adjusts his glasses before looking back down at his clipboard. “You know that your disorder is genetic.”
I nod, feeling my cheeks flush. He interprets my silence as misunderstanding. (I forgot to mention that psychiatrist’s are always condescending too).
“That means that it’s passed down,” he speaks slowly, emphasizing every syllable, “through the family…”
“I know what genetic means,” I spit through my teeth. There’s nothing worse than people thinking that you’re stupid.
“So you know that there’s a possibility that your child could turn out like you.”
I stare at him aghast, floored by the words coming out of his mouth. Apparently he thinks I’m some kind of monster that shouldn’t procreate! Would it be so terrible if I had a kid and they had bipolar disorder? I wouldn’t wish my disease on my kid, but my life isn’t horrible. And I imagine that if my child did have a mental illness, I’d have the tools to help them cope.
I suddenly tried to imagine my life without children. Where once it seemed like a choice, now it seemed like it was something being forcibly taken away from me. Anyone who knows me knows that I hate being told what to do and this doctor was suggesting that I shouldn’t have children.
For the first time in my life, I desperately wanted children. I wanted a hoard of them. I wanted to raise them to be healthy and happy and then I wanted to thrust their beautiful cherub faces at him as proof, see they’re fine! I can be a mother!
I was so angry, and hurt, and completely shocked by his implications that I don’t even remember how the appointment ended. All I can remember is leaving the hospital with tears streaming down my face, thinking, it’s my birthday. He ruined my birthday.
It’s been two years since that appointment and I have shared this story repeatedly to illustrate the pervading stigma and fear that exists towards those with a mental illness. My experience is no where near as traumatic as someone who was given a forced hysterectomy or a forced abortion through the collusion of families, friends, and doctors. But I tell this story to illustrate the point that medical professionals are still deeply uneducated when it comes to discussing mental health and parenthood. These comments came from a man who is supposedly educated in the field. This is a man treating a vulnerable population. This is a man who is using his authority to spread fear and misinformation.
Although my husband and I still haven’t decided if and/or when we’ll have children, the hurt and anger of this encounter linger. Some days, when I see my friends with their babies, I think “I could do that. I could be a mom one day.” And then I hear his voice, “but they could turn out like you…”