Pregnancy and Bipolar Disorder

I am getting a bit older in my life, and starting to feel the "itch" and pressure to hurry up and start a family before it's too late. I have begun conversations with my pdoc to explore this as well as my PCP. I'm very frustrated with my experiences so far and wanted to see if others have had similar experiences or to just gain other people's thoughts on the matter.

A quick bit of background. I was married previously, and during that time I got off medications and we tried to conceive. There were fertility issues, and I have known for awhile that It would make it more difficult/take more time for me to get pregnant, which is why I wanted to start these conversations early. I have subsequently divorced and am in a new long term relationship. We have not had protected sex in 3 years and said that we would be happy if I were ever to get pregnant, but we just didn't want to specifically try.

So back to the present. I spoke to my pdoc about planning on seriously trying to get pregnant and what we would need to do. We looked at my meds and basically I would need to come off all of them, though she said that I may be able to stay on a low dose of seroquel if my OB/GYN was comfortable with that as she has had some in the past who were and some who weren't. She said that there are a few medications which are OK to take during pregnancy ie. Latuda, trilafon, clozaril, and zyprexa (Don't ask me how those ones are all OK to take during pregnancy) so we could look at changing to those depending on what my OB/GYN wanted. She said she supported me in my choice to try to conceive but did state that I probably would be considered a high risk pregnancy due to my psych issues.

I went to my PCP to talk to her about it and get a referral to an OB/GYN. One of the first things my PCP said is, "Have you thought of a surrogate?" She didn't like the idea of me switching or getting off my medications at all and thought it would be better if I looked into a surrogate (without my eggs-due to genetic factors) or adoption. This really upset me.

On top of all that, after I talked to my boyfriend about the medication changes I would need to make and the fact that I would be considered high risk, he says that he thinks it would be a bad decision for me to try to get pregnant, and that I would be selfish in trying to do so as I could potentially be putting myself and/or my child at risk by not being on my current med regime. He is also stating that he thinks that we should no longer have unprotected sex. (Let's exclude the fact that he knew all of these risks before, and he was still fine with having unprotected sex, but that besides the point of this conversation)

Am I missing something here? Is it really all that terrible to want to carry a child if you have a psychiatric diagnosis? Is it so bad that it's not even worth trying? I sort of see it as, "it's my body, it's my choice and my responsibility." but apparently others don't see it that way.

Hi cheze I have three children and have had four pregnancies my first child was born when I was 17 and conceived on a manic episode. Three of my four pregnancies where before I was diagnosed but definetely experiencing symptoms. I found that while pregnant I experienced no symptoms before and from talking to other bipolar mothers this is quite common. Even though I was on a episode as soon as I conceived I stopped experiencing symptoms. My third child was after I was diagnosed and I choose to go med free owing to the risks associated with some of the medications. I went on episode a depressive while trying to conceive but as soon as I got pregnant my symptoms again stopped.

They returned after the baby was born each time. On my third I breast fed while on safe medication with no harm to my baby. I don't think you are being selfish at all and I'm sorry you are being greeted so negatively. My pdoc was supportive. I was classed as high risk on my third pregnancy but I was still able to have a home birth so I wasn't classed physical high risk. I had to have regular appointments with my cpn pdoc midwife and obstittrician in order to ascertain I was still healthy mentally. In my country they even have mum and baby units for mentally I'll new mothers who are struggling to go and stay at with the baby and receive extra pychiatric support.

I think you should research and make some decisions such as whether you wish to take meds whether you want to breast feed on meds and what support facilities you wi have and need. I think your partners reaction is a little knee jerk and maybe if he does some research he will feel better.

I did research before deciding to have my third and my research indicated most bipolar women are stable during pregnancy but usually have a episode within twenty four hours of giving birth unless they are fully breast feeding in which case they tend to get weaning psychosis if type 1 as you are. This means and was certainly true in my case that my baby was three months when my symptoms returned and feeding less so I was able to take my meds after her lasts feed at night and have a few hours before she fed.

I don't think you are selfish at all and having a baby with a psychotic mental illness doesn't have to be a negative experience feel free to show your partner my post to reassure him that things may be just fine.

However I don't advice trying to conceive the way you are because if you do conceive the meds you are on are most likely to cause birth defects if taken in the early stages of pregnancy. So I suggest you use contraception for now find a supportive doctor and research your options and then go for ivf. I wish you the best of luck and hope you will be able to have your longed for baby with as little problems as me.

In fact as Ive been depressed for nearly a year now and the meds are not working a part of me is tempted to have a fourth just for the fact that I'll get better but I know that's the wrong reason to have a baby so won't. I really hope my post has helped.

-- Thu Mar 13, 2014 11:40 am --

Hi cheze I have three children and have had four pregnancies my first child was born when I was 17 and conceived on a manic episode. Three of my four pregnancies where before I was diagnosed but definetely experiencing symptoms. I found that while pregnant I experienced no symptoms before and from talking to other bipolar mothers this is quite common. Even though I was on a episode as soon as I conceived I stopped experiencing symptoms. My third child was after I was diagnosed and I choose to go med free owing to the risks associated with some of the medications. I went on episode a depressive while trying to conceive but as soon as I got pregnant my symptoms again stopped.

They returned after the baby was born each time. On my third I breast fed while on safe medication with no harm to my baby. I don't think you are being selfish at all and I'm sorry you are being greeted so negatively. My pdoc was supportive. I was classed as high risk on my third pregnancy but I was still able to have a home birth so I wasn't classed physical high risk. I had to have regular appointments with my cpn pdoc midwife and obstittrician in order to ascertain I was still healthy mentally. In my country they even have mum and baby units for mentally I'll new mothers who are struggling to go and stay at with the baby and receive extra pychiatric support.

I think you should research and make some decisions such as whether you wish to take meds whether you want to breast feed on meds and what support facilities you wi have and need. I think your partners reaction is a little knee jerk and maybe if he does some research he will feel better.

I did research before deciding to have my third and my research indicated most bipolar women are stable during pregnancy but usually have a episode within twenty four hours of giving birth unless they are fully breast feeding in which case they tend to get weaning psychosis if type 1 as you are. This means and was certainly true in my case that my baby was three months when my symptoms returned and feeding less so I was able to take my meds after her lasts feed at night and have a few hours before she fed.

I don't think you are selfish at all and having a baby with a psychotic mental illness doesn't have to be a negative experience feel free to show your partner my post to reassure him that things may be just fine.

However I don't advice trying to conceive the way you are because if you do conceive the meds you are on are most likely to cause birth defects if taken in the early stages of pregnancy. So I suggest you use contraception for now find a supportive doctor and research your options and then go for ivf. I wish you the best of luck and hope you will be able to have your longed for baby with as little problems as me.

In fact as Ive been depressed for nearly a year now and the meds are not working a part of me is tempted to have a fourth just for the fact that I'll get better but I know that's the wrong reason to have a baby so won't. I really hope my post has helped.

-- Thu Mar 13, 2014 11:41 am --

Oops sorry for double posting and mammoth post .

In fact I'm angry at what your doctor said about adopting on your behalf there are many reasons that make a pregnancy high risk such as if you have twins are over 35 are overweight. And every pregnancy is a risk no one knows until they are pregnant if they are going to get anti natal or post natal depression. That's without those who get unexpected physical risks like in my last pregnancy I developed spd a condition that makes you unable to walk In extreme cases this honestly caused more problems than my bipolar.

I am at the stage where I am considering starting a family. My doctors so far have been all about risk management; risks of not medicating vs risks to the baby for medicating etc etc.

I would like to declare how thoroughly sick and tired I am of all this pathologize-ing over a natural process. Every single woman who gets pregnant and has a baby could be construed as having 'risks' to the baby or herself. Every woman who goes through childbirth and becomes a mother is built for it. She knows that things might go wrong, and these days there is help if she needs it. She doesn't constantly go "what if what if what if".

Don't let these doctors worry you about your pregnancy. Find someone who is supportive. It's up to you whether you want to stay on the medication or come off it. At the end of the day, it's you who knows what is best for you and the baby. And you need someone who is thinking positively, someone who will enable you to be the best you can be.

Hi Cheze2,
I don't know the details of your mental health and your doctors do. Based on that, I would say the doctors know best.

On the other hand, doctors have an obligation to tell you about the risks so that you can make an informed decision. The doctors are being objective while the issue is emotionally loaded for the would be parents.

What are the risks for any woman of having a child?
What are the risks for a woman with bipolar disorder having a child?
What are the probabilities of each risk occuring?
Can you live with the risk if it comes true or happens?

When my wife was pregnant with our first child, our doctor ordered an amniocentesis. Prior to the test, we talked to a genetics counsellor who informed us the risk of the amniocentesis causing a miscarriage was ten times greater than the risk of the chromasomal defect we were screening for.
We chose to not have the amniocentesis because we wanted the baby, normal, or not.
In the end, my son was normal.

So, you have to introduce objective thinking into an emotional decision.
I hope you find peace in your decision.

Take care,

Very tough situation

There is always the option of adopting a child. There are far too many abandoned children out there.

I can understand the emotional drives for having a child to carry on your family history, but every kid deserves a family and sometimes child bearing is not the best choice.

Just my 2 cents

Crawling wrote:I think you should research and make some decisions such as whether you wish to take meds whether you want to breast feed on meds and what support facilities you wi have and need. I think your partners reaction is a little knee jerk and maybe if he does some research he will feel better.

Thank you Crawling for sharing your experiences. I too have heard from many women who are diagnosed with bipolar disorder that the best they ever did mood wise was when they were pregnant. After making this post I actually did decide to do some more research and I made an appointment with a perinatal psychiatrist at a very prestigious hospital near me, so hopefully that will give me some better and more reliable information to help me weigh the risks/benefits. I hope that this reaction is more knee jerk and that talking to someone more professional about his concerns will be helpful.

Crawling wrote:I did research before deciding to have my third and my research indicated most bipolar women are stable during pregnancy but usually have a episode within twenty four hours of giving birth unless they are fully breast feeding in which case they tend to get weaning psychosis if type 1 as you are. This means and was certainly true in my case that my baby was three months when my symptoms returned and feeding less so I was able to take my meds after her lasts feed at night and have a few hours before she fed.

It is the "postpartum psychosis" that I have read about that I am most concerned about. I would feel terrible if 24 hours after giving birth to my child I wasn't well enough to enjoy it and to be there during those first few moments.

Crawling wrote:In fact I'm angry at what your doctor said about adopting on your behalf there are many reasons that make a pregnancy high risk such as if you have twins are over 35 are overweight. And every pregnancy is a risk no one knows until they are pregnant if they are going to get anti natal or post natal depression. That's without those who get unexpected physical risks like in my last pregnancy I developed spd a condition that makes you unable to walk In extreme cases this honestly caused more problems than my bipolar.

I'm right there with you on this one.

bipolarbirdie wrote:Find someone who is supportive. It's up to you whether you want to stay on the medication or come off it. At the end of the day, it's you who knows what is best for you and the baby. And you need someone who is thinking positively, someone who will enable you to be the best you can be.

I agree, it's important to find someone who is supportive. I think it's also good to be aware that there are risks to staying on medications while pregnant, and some medications are known to cause some very serious fetal defects.

skilsaw wrote:What are the risks for any woman of having a child?
What are the risks for a woman with bipolar disorder having a child?
What are the probabilities of each risk occuring?
Can you live with the risk if it comes true or happens?

These are very good questions that I think I will bring with me to my appointment with the perinatal psychiatrist. Thank you.

bipolarmusician wrote:There is always the option of adopting a child. There are far too many abandoned children out there.

I absolutely agree, and I plan to adopt a child at some point in my life. I would still like to experience childbirth as well though. It seems sort of like a "right of passage" or something for being a woman, and I'm physically capable of doing so, I would really like to have that.

Thank you everyone for your replies. it means a lot, and I've really needed to vent about all of this as it's been swirling in my head for awhile.

I absolutely agree, and I plan to adopt a child at some point in my life. I would still like to experience childbirth as well though. It seems sort of like a "right of passage" or something for being a woman, and I'm physically capable of doing so, I would really like to have that.

I understand, i was birthed in a series of variables that would have motivated many women to simply get an abortion. Im glad that wasn't the case. I am certain your child will fare well

I wish you the best of fortune |>

I think that I did not express myself well this time, because it seems that everyone missed the point of what I said.

I did not mean that knowing if a drug is dangerous or not is unimportant. I did not mean that knowing that postpartum depression is an issue for bipolar woman is unimportant. Clearly these things are important.

What I am trying to say is, for gods sake, treat the pregnant woman like a human being for once!

There is a difference between having an objective opinion, and objectifying someone.

So what my complaint is, is that if a doctor is talking like they are going to control the whole pregnancy via manipulation of risk factors, what effect will that have on the patient? Oh, you say, the emotional woman should grow up and listen to the smart, logical doctor who knows everything?
Well what I am saying is, the smart logical doctor doesn't know everything. He is not a mother. Motherhood is emotional. It is not hysterical, unthinking emotion. It is the most important emotional process for mankind. Where the mother gives of herself, for another. There is no way the doctor can 'manage the risks' without respecting the decisions of the mother.

Is a little respect for the mother and what she is about to do, too much to ask?

bipolarbirdie wrote:
So what my complaint is, is that if a doctor is talking like they are going to control the whole pregnancy via manipulation of risk factors, what effect will that have on the patient? Oh, you say, the emotional woman should grow up and listen to the smart, logical doctor who knows everything?
Well what I am saying is, the smart logical doctor doesn't know everything. He is not a mother. Motherhood is emotional. It is not hysterical, unthinking emotion. It is the most important emotional process for mankind. Where the mother gives of herself, for another. There is no way the doctor can 'manage the risks' without respecting the decisions of the mother.

Is a little respect for the mother and what she is about to do, too much to ask?

yeah, good point.

It doesn't help the bipolar people get discriminated upon too, many people terming the condition a "mental handicap".