Having a baby can be complicated under the best of circumstances—but for women with bipolar, it can come with a slew of additional challenges. While most women with bipolar have healthy pregnancies, there are some serious things to consider—like heritability. The chance of passing bipolar disorder to your child is 10% if one parent has bipolar disorder but goes up to 40% if it’s both parents.

We connected with Dr. Inua A. Momodu, MD, MPH, MBA, Chairman, Department of Psychiatry at AtlantiCare Regional Medical Center, who shared some key insights with us. “The decision to have children while suffering from bipolar disorder should not be taken lightly. Bipolar disorder comes with its own unique challenges that include mood swings as a result of hormonal fluctuations during pregnancy.”

Below, Dr. Momodu shares 5 tips and pro-active steps to take if you have bipolar and want to have a baby.

#1: Plan early.

You want to start planning for pregnancy before you stop contraception. Here’s why:

  • You want to build a pregnancy healthcare team.
  • You want to make sure you are as stable as possible before you begin.
  • You want to know what your early warning signs of having a manic or depressive episode are so that your partner, family, and friends can watch out for them.

It’s impossible to know exactly when you may become pregnant—in fact, 1 in 5 women get pregnant within a month of stopping birth control. So, keep using contraception until you have a real plan in place. If you are pregnant now—please talk to your doctor right away—don’t stop taking medication without speaking with your healthcare providers.

#2: Build a pregnancy healthcare team.

The professionals on your team should include a primary care provider, a psychiatrist, and a midwife or obstetrician. The good news is that the emerging field of reproductive psychiatry is helping make caring for women with mental health conditions better. A reproductive psychiatrist will see you through preconception, pregnancy, postpartum, and lactation, providing full-service mental health support, and can also care for women with infertility and those who experience a miscarriage.

#3: Get everyone’s buy-in.

Having the support of your family and friends—before, during, and after pregnancy—is crucial if you have bipolar disorder or another mental health condition. While you may become unwell during pregnancy—the risk is even higher after you give birth. As a result, women with bipolar are more likely to get postpartum depression and postpartum psychosis (especially true if other women in your family have had it).

You will need the extra support with things like jobs around the house, possible feelings of anxiety, but also help recognizing any signs or symptoms of your condition so that you can get the professional help you need if you have an episode of mania or depression. Dr. Momodu stressed that because of these considerations—”the decision to become pregnant should be jointly agreed upon with the support of your partner, family, friends and healthcare professionals.”

#4: Make a care plan.

Together, with your pregnancy healthcare team, make a care plan for treatment during pregnancy and postpartum. Your plan must have a treatment protocol for how you will be monitored for possible relapse after you have the baby. It’s a good idea to hand copies of this care plan out to your partner, family, and friends involved in your pregnancy care. All the members of your “village” must be in accord on how to help if you become unwell. After delivery, taking care of a newborn could be stressful and could increase the chance of a relapse. Even with medication, you have an increased risk of relapse during the postpartum period, according to the American Journal of Psychiatry.

#5: Make medication decisions.

“Bipolar disorder comes with its own unique challenges that include mood swings as a result of hormonal fluctuations during pregnancy,” shared Dr. Momodu. While medications help to improve mood stability, during pregnancy, these medications could also lead to potential birth defects and complications. As a result, some people choose not to take mood-stabilizing medications while pregnant. But here’s the downside: not taking medications during pregnancy could lead to a relapse of your condition. And even on medication, there is an increase in relapse during pregnancy and the postpartum period.

Whatever you decide to do—do it with the counsel of your full pregnancy healthcare team. Don’t stop taking your medication before consulting with your doctor—it could lead to withdrawal symptoms or make your condition come back, possibly worse than before.

Yes, there are additional things to consider when thinking about starting a family when you have bipolar, but know that with the right team in place, and the support of your family and friends, you can set yourself up for the best possible outcome.

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Last Updated: May 21, 2021