Even if you are not bipolar, deciding to have a baby is a
major life event. But at least bipolar women are not told categorically that
they must not become pregnant, which is what happened until a decade or so
ago.
When I got pregnant I didn't know I am bipolar. But I had a
trouble-free pregnancy with no morning sickness, and I felt terrific until I went
into labor. My natural delivery with no anesthetic was
naturally painful, and in retrospect, I wish I'd had a spinal. But all in all,
I was lucky.
If you are a bipolar woman who wants to have a baby, consult your psychiatrist and obstetrician about medication options.
Ideally, of course, years earlier you will have got medical advice on how being
bipolar factors into your contraception decisions.
If the prospective father is the one who is bipolar, he and his
wife would be wise to discuss with his psychiatrist how fatherhood may affect
him. If both people in a couple are bipolar, they should both consult their doctors, perhaps together.
Pregnancy has never been restricted to those who choose it. Bipolar
women who accidentally become pregnant had better continue to take their usual meds
and consult with their doctors and the prospective father about whether to continue
with the pregnancy.
If you are bipolar and pregnant or planning to become pregnant and you plan to take bipolar medications before
and during pregnancy, make certain the meds have not been shown to
cause birth defects. And if you do not want to continue taking meds
while pregnant, be alert to the risk of self-medicating with
alcohol and tobacco, which also can cause birth defects.
A further risk is that
if a bipolar woman takes no medication and becomes depressed during pregnancy,
her depression can have a negative impact on the baby. Yet another key factor
is that statistically, a bipolar woman who ceases taking her meds before and
during pregnancy is at risk for the return of symptoms.
There is no one answer that fits all bipolar expectant
mothers and their medications. Consultations with your psychiatrist and OB-GYN
can help with a decision about what, if any, meds to take while pregnant.
I was surprised to read that electroshock therapy may be
safer for a pregnant bipolar woman than drugs. Of course, electroshock should
only be administered by a doctor knowledgeable about bipolar disorder and pregnancy.
Given the emotional nature of pregnancy even for women who
are not bipolar, bipolar women can help themselves and their baby by having
talk therapy regularly with a professional they like and trust. If you are one
of these women, you might want to discuss with your therapist whether the
baby's father should join you in at least some of the sessions.
It is a good idea to arrange well in advance of the birth
to have someone who can take care of the baby if you are unable to do so until
your postpartum bipolar disorder stabilizes, because a bipolar woman who is
pregnant or has just given birth is at increased risk for a manic episode that
may require hospitalization, whether or not she has been taking her meds.
Another key consideration after giving birth is whether or
not to breast feed your baby, and if you do breast feed, whether to take
medications, and if you do take medications, which ones are safe for your child? Again, find a doctor well versed in answering such questions.
Whatever you decide about having a baby, I wish you all the
best. With the support of your partner, your families, and your doctors, you
and your baby, if you choose to give birth, can be off to the best possible start.
