Mental Health

The Unspeakable Truth Of Having Suicidal Thoughts During Pregnancy

Pregnant women are transformed into vessels, which makes it all the harder to get help.

by Sarah Sahagian
Woman in pregnancy lying down on a couch

Content warning: suicidal ideation

“I want to die,” I told my doctor when I was six months pregnant. Following his perfunctory inspection of my belly, the obstetrician had asked if there was anything else I wanted to tell him. For some reason – a cry for help? Not having the energy to censor myself? I told him the truth: I didn’t want to live…

What happened next is fuzzy, like the memories from that high school party when you first tried Smirnoff Ice. What I do remember is my doctor purposefully marching to the perinatal psychiatry department, declaring I needed to be seen that day. I remember he was resolute, like an army officer ordering his men to retreat. But they couldn’t see me that day. Or the next day. They couldn’t see me for a month, which felt like them saying they’d never see me; I couldn’t imagine being alive thirty dates later.

My doctor and I considered whether I should be sent to a psych ward as an in-patient, but the idea of eating hospital food at 28 weeks pregnant was demoralizing. Food was the one thing I still looked forward to. After the debilitating morning sickness that had me vomiting 8 times a day for the first twenty weeks of my pregnancy, my newfound ability to swallow food – and keep it down – was my solace. I promised if he let me return home, I’d be okay. And I suppose I didn’t lie; “okay” is a relative state. And when you’re accustomed to low-level suicidality, not killing yourself can pass for fine. I left his office, stopped by Tim Horton’s for a breakfast sandwich, and called an Uber to take me home.

For the past few years, I’ve been comfortable talking about my mental illnesses (Yes, plural). My generalized anxiety disorder, persistent depressive disorder and complex post-traumatic stress disorder are a trio of health issues bequeathed me by a difficult youth that was heavy on sexual violence and eating disorders, light on therapy. However, I’d recently come to the realization that none of my illnesses was my fault. I truly believed that, until I got pregnant.

Pregnant women are transformed into vessels for their babies’ protection. We are cautioned against drinking green juice or eating sushi, lest we get food poisoning. There are days when your mother-in-law calls with a reminder to take “small steps” to avoid falling, because it’s icy outside; no one seemed to care about whether you tripped on the ice before you conceived. Suddenly, it’s a full-time job to take care of your tummy. So, if you’re like me, it’s hard to admit that you want to kill yourself. Nothing is more anathema to being a good vessel for your baby than sinking the damn ship…

My baby was a wanted child, but everything about my pregnancy was unwanted. I didn’t want the three threatened miscarriages that kept me running to the emergency room, my underwear stained with blood. I didn’t want constant nausea that had me sneaking out of work meetings to vomit on the side of the street. And I didn’t want to lose an organ, but my growing uterus pushed my right kidney out of its pelvic cavity anyway. We discovered the errant kidney at my baby’s 19-week anatomical scan. To this day, it’s floating throughout my body, unmoored and unsure where it belongs.

I wanted to kill myself not because I wanted to die, but because I couldn’t cope with the pressures of making a new life. I couldn’t cope with the stresses of my fetus almost dying, or of her development threatening my own welfare. I couldn’t cope with the unrelenting nature of pregnancy, the fact that there are no breaks. It’s a job no one can do for you, even for a day – even for an hour.

After I got help, there were still hurdles. A psychiatrist prescribed anti-anxiety meds to ease my suffering, but the local pharmacist refused to fill my Ativan prescription. “I just don’t feel comfortable giving this to a pregnant woman,” he said. And I walked home in tears, because I needed that medicine. I wasn’t sure how I would survive without it, and I didn’t need the mansplaining of a guy who’d never been pregnant, and had no expertise in psychiatry.

I couldn’t take the friends who ghosted me when I intimated I’d had thoughts – thoughts I was working hard to resist – about ending my life since I’d conceived. I couldn’t take the implicit judgment, the idea that suicide was unspeakably selfish for a pregnant woman to even contemplate, the judgment that made me feel as evil as a serial killer, like someone too deranged to deserve help.

I couldn’t take when my loved ones insisted they were sick of my suicidal thoughts, and so I called a suicide hotline at 39 weeks pregnant, desperate to live long enough to deliver my baby. Nor could I take being in labour six days later, when my epidural failed and everyone said, “You’re doing great!” But what the fuck did they know? Because I wasn’t succeeding; I was just trying to survive. None of the people assembled had given birth, from my husband to the nurses and doctors. None of them knew how powerless you feel in that liminal space when you’re desperately trying to turn one body into two.

When I saw my daughter for the first time, I was grateful. I was relieved I hadn’t given up on our lives, entwined as they were for nine months. But even her birth isn’t a purely happy memory, because I was so ashamed of myself. I was terrified of how close I’d come to abandoning her by jumping off my balcony or drowning myself in a polluted river. I felt like a terrible mother before I even held her for the first time.

When I subsequently spoke of my horrific pregnancy in mommy groups, I joked about morning sickness, and I never mentioned suicidal ideation. I was so afraid someone would decide I wasn’t worthy of my daughter, the perfect baby I knew deserved a mother better than me. For the first few months of her life, I had nightmares about her disappearing, suffocating under a heavy blanket or being stolen by a relative who thought I was unfit.

As I write these words, I’m still worried. I’m worried you, the reader, will decide I’m a monster who came close to killing a wanted baby. But what keeps me writing despite these apprehensions is the hope – however small – that perhaps someone will understand. That perhaps I’m not a monster for having thought about walking into oncoming traffic seven months after conceiving. That perhaps I’m not a bad person because I went through a bad time.

Being pregnant with my daughter was the best worst thing that ever happened to me. I hope there’s someone who can understand that.