For many years, bipolar women were told not to get pregnant, but in the last decade or so, medical progress has made pregnancy an option, which is particularly good news because the highest percent of bipolar women in the United States are in their childbearing years. There are nearly 4.5 million of them.
If you become pregnant by accident and are bipolar, don't drop or change the dosage of your bipolar medication without the advice of an ob-gyn and a psychiatrist. If, however, you plan your pregnancy, discuss with your docs whether you need to adjust your medications, and the medication dosage, perhaps beginning six months before getting pregnant and continuing for three months after giving birth. This is important in part because some bipolar meds can cause birth defects.
In addition, pregnancy may lower the effectiveness of bipolar medications and so increase the chances of bipolar episodes. Unfortunately, not a lot is known about optimal dosages of bipolar meds for pregnant women, but you can discuss the issue with a qualified doctor.
A bipolar pregnant woman whose doctor has adjusted her bipolar meds should, of course, eat healthily, and get enough rest and exercise. She should not smoke, drink alcohol, or take recreational drugs, even if tempted in order to manipulate her own sense of stability and well being. Talk therapy may provide especially welcome support. If she becomes depressed, she and her doctor need to address this issue immediately, because severe depression in a pregnant woman can have a negative impact on the child she is carrying.
If you find electroconvulsive therapy (ECT) works for you, your doctor can help you decide whether to continue it during pregnancy and what, if any, adjustments to make if you do.
There are many ways to be bipolar, and no formula fits every bipolar woman who wants to become pregnant or who has given birth. Almost everyone needs a support system of family, friends, colleagues, and medical professionals, but for a bipolar woman who is pregnant or has recently given birth, this is especially critical.
She may find that she can't cope and needs live-in help or needs to consult a psychiatrist, ideally a perinatal psychiatrist, and perhaps to enter a psychiatric facility, ideally a perinatal psychiatric unit. (Perinatal refers to a few weeks before and after giving birth.) Plans should be in place before she becomes pregnant not only for the pregnancy but also for her life as a new mom. Some areas now have perinatal psychiatrists and even perinatal psychiatric units.
As more and more is known about pregnancy and bipolar disorder, pregnancy should become an increasingly viable option for bipolar women.