Planning a pregnancy with bipolar disorder

[Kokoraki]

Hi all,

My partner and I have decided to start trying for a baby towards the end of this year (as I need to come off of sodium valproate before trying). I've had a diagnosis of bipolar 1 since I was seventeen, and am now twenty-five. I've had some very general discussions with my psychiatrist about pregnancy and already know that I will remain on my antipsychotic medication if I do fall pregnant, and will have a pretty low threshold for ECT both during pregnancy and in the postpartum period. But I was really hoping to hear what kinds of more specific plans people with BPAD have had during and after their pregnancies so I can go in to my next appointment with my psych a bit more informed. Thanks in advance!

[Sally_at_APP Administrator]

Dear Kokoraki,

Welcome to the forum. I hope you will be able to find some answers and supportive replies to your post. It is great that you are trying to find out more information so you can be informed when you next meet your psychiatrist.

I had PP in 2015 after the birth of my daughter. I do not have personal experience of ongoing bipolar, but hopefully some ladies on here will be able to share their experiences about planning a pregnancy with you. I wonder if you have also been referred or if your psychiatrist is in contact with a perinatal mental health team? I only ask, as although you might stay under the care of your current team, it would be good to know if they can link with a perinatal specialist if possible. You should be able to go through a detailed birth and aftercare plan either with a perinatal specialist or with your current team.

If you haven't found it already, there is some information on our website about bipolar and pregnancy. We have a guide for those planning a pregnancy, some frequently asked questions and links to other resources which may help (app-network.org/what-is-pp/....

Please do have a read and if there are any questions you may have, we can try to help.

Take care and we are here if you need,

Sally x

[Teresa_K_S Volunteer]

Hi Kokoraki

How lovely that you are planning a pregnancy. How nerve wracking also, I know.

I have bipolar. Diagnosed (or more like informed of it) 6 years after suffering Postpartum Psychosis with my first.

When planning my next pregnancy it brought to the forefront my health and how my care could be planned. My children were born in 1997, 2004 and 2007.

In one sense you are fortunate as these days perinatal health care is improving all the time.

Though for myself my psychiatrist and cpn were the ones to oversee my care. I was taking Sodium Valporate when I fell pregnant with my third and had to quickly change medications! Both my second and third

pregnancies had the same care plan. I think if you can build a care plan personal to yourself then it is reassuring. In my care plan I knew which meds were preffered options. I had my own warning signs of becoming unwell and what to do at each stage. ie reduce work load/stress, family support, contact CPN. I asked for my husband to be involved in making my care plan too. Mother and baby units weren't available in my area back then but thankfully I stayed relatively well and didn't suffer PP again. My mood did drop though after 1 to 2 months both times. That is when my care plan proved invaluable and everyone knew their part to play in getting me stabilised and avoiding my mood spiraling further. Medications, my cpn, family and friends support were all key to keeping me well.

I hope you can make a care plan that you will feel safe with so that you and your partner can then enjoy planning starting your family

Good Luck and All the Best

Teresa x