See a specialist before you get pregnant

If you're thinking about having a baby and you're unsure about how you'll cope, Jenny has some wise advice: "See a specialist before you get pregnant."

Jenny was first treated for mental health problems at 28 and diagnosed with bipolar disorder three years later, by which time she and her husband Henry were already thinking about having a family and how best to approach it. She was stable on her medication and had successfully made a career change from lawyer to portrait artist, but it would be a further three years before they were able to try for a baby.

“It felt like a very long time because we didn’t know whether we’d ever have children, that was the hardest part,” she says.

Initially, the health professionals they consulted for information about the possible risks and the teratogenicity of different medications were not able to help them; getting information was “like banging my head up against a brick wall."

“The key turning point was getting to see the right person, which was the specialist perinatal psychiatrist, because the team I had been under locally didn’t have that expertise. They had told us you can’t get pregnant on lithium and you can’t stop the lithium because it’s not safe so we felt – are we ever going to be able to have kids?"

The perinatal specialist

In the preconception consultation, the perinatal specialist was able to say: "These are the options, these are the risks’ and to have that conversation with her was the most amazing thing and made us feel we were being given hope and empowered to make informed decisions.”

As a result of the advice they received, the couple decided Jenny should taper off the lithium whilst continuing with quetiapine, which is not teratogenic. Jenny also used a mood management programme called True Colours to help her to self-manage her mood and prepare for pregnancy.

“I also had a really brilliant care co-ordinator who helped us pull together a plan of how to cope during the pregnancy, birth and afterwards.  Part of it was a sheet with phone numbers which had on it all the different people who would be involved in my care: the GP, psychiatrist, care co-ordinator and the obstetrician, that was very helpful”. The plan also helped all the professionals involved co-ordinate her treatment more effectively.

Post partum psychosis

Jenny stayed well after the birth of her first child, a son but, when her daughter was born two years later following a lot of stressful events during the pregnancy, she suffered a postpartum psychosis.

“I was lucky enough to get into an MBU (Mother and Baby Unit) and keep my baby with me, but I didn’t get home for over 6 months and it was a long journey back to full health. But you do come out the other side and I’ve got two wonderful children and I wouldn’t be without them. I’m very well now and we both feel really blessed to have them”.

Jenny emphasises how important it is for women with serious mental health conditions like bipolar disorder to see a perinatal specialist.

“That hour we spent with her really changed my life and I don’t say that lightly. Having hope that we could have a family made such a massive difference.”

Sign up for the mood tracker True Colours

or email the team for information at: [email protected] 

Related:

Podcast  bipolar pregnancy and childbirth 

Becoming a parent with bipolar

Information on postpartum psychosis

Lithium and pregnancy study

My baby, psychosis and me