Pregnancy Risks With Bipolar
Pregnancy is a time full of excitement, hope and anticipation as you prepare to bring a child into the world. Chances are good that since you were little, you imagined what being a mother would entail. You thought of tiny clothes, stroller pushing, how many children you wanted, what their names would be about how you would parent. It feels like your whole life has been leading up to being a parent.
One thing that you did not account for as a child is your bipolar disorder. Bipolar disorder is marked by periods of fluctuation between depressed and manic episodes. With bipolar, a woman must take special caution when it comes to pregnancy. From medications, to hormones, and situational triggers, the risks of pregnancy to someone with bipolar disorder are real.
Deciding if the risks outweigh the benefits is up to you, but there are many pieces of the puzzle to consider. Severity and individual symptoms of bipolar disorder vary greatly so the material will not apply to all cases. The information included in this article is not intended to persuade or convince the reader of any stance or action. The information, which is sensitive and controversial at times, is only meant to give the reader the useful information and options in the decision making process of pregnancy with bipolar.
Pregnancies that are planned or intentional are more straightforward and an appropriate place to begin the conversation.
The decision to become pregnant is an important one. Many people look at factors such as age, financial stability, relationship status and others when making an informed decision. People with bipolar must include other factors in the decision including risk of pregnancy to symptoms. Woman with bipolar report more frequent fluctuations in their symptoms during and following pregnancy.
Because of this risk, you have to consider the consequences of your actions and risks associated with bipolar and pregnancy more so than other mothers-to-be. Being certain and building commitment will help make the process as successful and rewarding as possible.
- Be sure you want a child. People often talk about the benefits of having children and the ways they change your life for the better. The truth is children can create emotional, financial and relationship stress as well. The responsibility to care for another person, the lack of sleep and the lifestyle shift trigger emotional stress. Children need cribs, diapers, clothes and food, and this often causes increased financial pressures. Relationships change dramatically after children enter and the relationship must be stable and strong to endure the shifting. If your emotional state, financial life and relationships are all desirable, move ahead. If not, reconsider your motivations.
- Be sure you want to be pregnant. This may sound redundant, but pregnancy is not synonymous with a child. Just because you want a child does not mean that you want a pregnancy. There is no way to predict what symptoms may present during pregnancy. If you have been pregnant previously, your next pregnancy may follow a similar path or it could be much different than the one that came before. People with bipolar will face certain limitations and risks that the general population will not. This makes pregnancy tricky and overwhelming for women with bipolar. Surely, the reward exists, though.
- Be sure that you want to breastfeed. This is certainly not a deal breaker but woman that hope to breastfeed cannot return to their medication treatment until the breastfeeding has concluded. Pregnancy is extremely personal and the thought of including many people, especially professionals, may seem uncomfortable. This consultation becomes even more of a necessity for people that have bipolar
- Consult your OB/GYN. This professional is always a great starting point when it comes to decisions about pregnancy. Start early. Many recommend that you begin taking prenatal vitamins for months before you try to conceive. Discuss pros and cons as well as the risks and rewards of pregnancy for you. Be honest and open about your mental health. Work to understand what is expected of you. Your doctor will make recommendations and it is crucial that you follow.
- Consult your prescriber. You are likely in the majority of people with bipolar that use some type or some combination of medications to treat your symptoms. Like with your OB/GYN, talk to your prescriber about your intentions to become pregnant while they are still intentions. Certain medications used on people with bipolar have been linked to birth defects and complications. Do not stop your medications on your own. Your prescriber will work to wean you from potentially harmful medications. Be sure to do your own research as well. Different prescribers have different levels of comfort prescribing medications during pregnancy.
Working with a team and being clear with your hopes and expectations makes the situation more likely a success.
Among the general population, 50% of all pregnancies are unplanned. That rate is likely higher in those with bipolar disorder as the impulsivity, poor decision making and increased interest in sex during manic episodes increase the likelihood of pregnancy. An unplanned pregnancy forces you to react rather than be prepared. As always, if you are not looking to become pregnant, some form of contraceptive should be utilized.
The risks mentioned previously, grow exponentially with unplanned pregnancies because the prenatal care has not been in place and your medications may be harmful to the baby. With the increased danger, it is essential that you act quickly and decisively.
Unplanned pregnancies trigger many feelings as you work to process the substantial information and change your body will experience. Being honest and realistic with yourself will enable you to act decisively. Your choice is difficult and each option has a large significant emotional impact, but you must make one.
Option 1: Carrying the baby and giving birth to your child. Most people that get pregnant unexpectedly choose this option. If you feel that the benefit of a child outweighs the risks, this choice is for you.
Option 2: Adoption. In adoption, you are effectively saying that you are able to manage the risks of pregnancy but not the risks of parenthood. Adoption is a complex situation with psychological and legal implications. If you are considering this option, seek out knowledgeable sources in the field and strive to have a working understanding. All adoptions are not created equally so be sure to asked pointed questions.
Option 3: Abortion. This option carries the most moral and religious weight. The goal is to find the best answer for you. Some people would choose this if their symptoms were wildly out of control currently or they fear that their symptoms would be out of control without proper medication. Perhaps, people who are chronically suicidal with medication would view abortion as the best choice given the circumstances. Other people may choose abortion if they were not financially able, lacked housing or the functional ability to care for themselves or a child. For people in this situation, birth control is even more valuable as abortion carries a high emotional toll.
Whatever your choice, work fast. Contact your OB/GYN and prescriber immediately to follow the best course of action. Your OB/GYN can schedule testing and begin prenatal care. Your prescriber may choose to stop your medication quickly to avoid risk to the baby, wean you slowly or switch you to other medications. Discuss your prescriber’s comfort with medications that may cause defects to the child and work to keep yourself involved and informed in your treatment. Paying attention to your body and noting the pregnancy early will make the process easier.
Therapy: The Common Denominator
Whether the pregnancy is planned or not, you can benefit from therapy. Whether you decided on option 1, 2 or 3, you can benefit from therapy. Pregnancies, adoptions and abortions are some of the biggest decisions that any woman will face in her life. The emotions, societal pressures and need for quick action add to the complexity.
A therapist can act as a guide or a sounding board through your decision making process. Once the decision is made, a therapist can work with you to find ways to reduce the unwanted risks and address feelings of shame, doubt and guilt that often come with difficult decisions.
Your therapist can also coordinate communication between your OB/GYN, your prescriber and yourself to ensure accurate information throughout.
Being pregnant and bringing a child into the world can be scary, exciting, overwhelming and unnerving at the same time. For many with bipolar, pregnancy, delivery and postpartum are joyous times for them and those close to them. Following the information above will help you on the path to happiness and an expanding family. Remember, there is no shame in parenthood not being a good fit for you. As long as your decision is well thought out and informed, you can make the best of it.