bipolar and pregnancy

What do I need to consider before falling pregnant?

Not all pregnancies are planned, however if you are planning a pregnancy it is best to discuss your options with your doctor or psychiatrist. If you are on medications they may need to be adjusted or stopped. You will also need to consider your own moods and their potential risk to a pregnancy. A manic episode while pregnant could lead to harm to both mother and child if you engage in reckless or dangerous behaviour. Another thing to consider is how you will cope after the birth when the risk of a post partum episode is high. Do you have the support you need for both the pregnancy and after the birth? Do you have issues looking after yourself or getting out of bed during a depressive episode? These are just a few of the things you need to consider before falling pregnant. The best thing to do is make out a list of all your questions and concerns (along with your partners questions and concerns) and then take this list to your doctor to discuss your options and how you can overcome things that may potentially be an issue.

How do my medications interact with pregnancy?

Mood stabilisers are a complicated class of medications to be used in pregnancy. There is a lack of sufficient data in regards to their risks in some medications while others are known for their teratogenic risks.

Epilim in particular can be incredibly harmful and can cause conditions that affect your foetuses face and head. Women who take this often swap to another mood stabiliser or cease taking medication all together. It has been found that a single daily dose of epilim can be more harmful than separate doses that are spread out throughout the day. Experts say that doses of less than 1000mg per day plus the addition of vitamin K is recommended for those who decide to continue with the drug.

What other factors do I need to be aware of?

As well as the risk of medication damaging the foetus, untreated mood disorders during pregnancy also pose a risk. A depressive or manic episode could harm both mother and child due to the impulsive and impaired judgement when manic as well as the lack of self care during depression. There is also a link between depression during pregnancy and low birth weight as well as preterm delivery.

What is a post partum episode and why is it a problem for me?

A post partum episode is a manic/depressive/psychotic episode that occurs after childbirth. It can be a problem because adjusting to motherhood is difficult and stressful to begin with, but with a post partum episode it can often seem unbearable. If the new mother is breastfeeding and unmedicated she may need to start on medications again and cease breastfeeding, which can be upsetting for some women.

What should I do if I want to fall pregnant unplanned?

The best thing to do is discuss it with your doctor, who may be able to come up with a plan that will allow you to safely cope with both pregnancy and your bipolar or schizoaffective diagnosis. It is important to see your doctor as soon as you suspect you may be pregnant, particularly if you are on medications. Some medications interact with the foetus and action needs to be taken straight away whether it be changing your dose or switching medications.

Can I breastfeed my child?

If you are medicated the chances are it will be secreted in your breast milk. It is best to talk to your doctor about this; they can advise you what medications you can take that are safe for your child.

Despite the risks with pregnancy, epilim has been deemed suitable for breastfeeding mothers while lithium which may be taken during pregnancy is generally unsuitable for breastfeeding.