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Bipolar disorder - Pregnancy and Childbirth

Bipolar disorder is a diagnosed mental health illness. It affects your mood, with the person experiencing periods of feeling high or manic and feeling low or depressive. Some women may experience rapid cycles of high and low periods that occur several times in one day.

DO NOT stop your medication suddenly before getting specialist advice as this may increase your chances of becoming unwell.

Symptoms of depression may include:

Symptoms of mania may include:

Symptoms of psychosis may include:

Taken from NHS Choices NHS Choice - Bipolar disorder symptoms

Approximately 1 in every 4 to 5 women with bipolar may experience ‘postpartum’ or ‘puerperal’ psychosis

Please see postpartum psychosis section for more information

Women with bipolar disorder are at an even higher risk if their mother or sister has suffered with severe postpartum or puerperal psychosis

Preconception Planning

Before you decide to have a baby, talk with your mental health team or GP and depending on where you live they may refer you to the specialist Perinatal Mental Health team. Most pregnancies are not planned and in this situation it is important to let your mental health team or GP know as soon as possible. A team of professionals will provide your care in pregnancy and will work together with you to develop a care plan.

Things to discuss:

During pregnancy

DO NOT stop your medication suddenly before getting specialist advice as this may increase your chances of becoming unwell.

When you attend your booking appointment with the community midwife it is important to tell them you have bipolar disorder.

In Portsmouth we have a Specialist Perinatal Mental Health Midwife who will be able to support and advise your care. We also have a caseloading team of midwives AND A LEAD OBSTETRICIAN who MAY PROVIDE additional support to you during pregnancy, labour and the postnatal period. Referrals to these additional support teams will be made through your community midwife at booking or during your ongoing care IF APPROPRIATE.

Things to discuss:

Medication

The National Institute of Health and Care Excellence (NICE) guidance:

Some women prefer not to take medication whilst they are pregnant. However, for women with Bipolar disorder it is important that you maintain your own mental health during pregnancy. In collaboration with your GP and Perinatal Psychiatrist you can discuss balancing risks and benefits of medication and deciding whether to continue, change or stop taking them.

Early days with your new baby

 

During the first week to 10 days after birth a midwife or maternity support worker and your community mental health nurse will visit you regularly. When your baby is about 2 weeks old your Health Visitor will begin visiting you. We encourage you to share your care plan with health professionals and your family.

Ways to help yourself and treatment

Cognitive behavioural therapy (CBT)

This talking therapy aims to identify connections between thoughts, feelings and behaviour with the aim to help develop practical skills to help manage negative thought patterns or thinking and behaviour that might be causing you problems.

Talking therapy

This is an important part of your treatment as it provides a regular time for you to talk about your thoughts and troubles, enabling you to explore difficult feelings with a trained therapist.

Family therapy

This is a type of psychotherapy that focuses on family relationships and encourages everyone within the family or relationship to work together to improve mental health.

If you do become unwell do not feel guilty.  It is not your fault and can happen with the most careful planning. Make sure your action plan is started, as the symptoms can get worse quickly.

Tell your partner or friend and contact your GP, Perinatal Mental Health team or Crisis team as soon as possible

National resouces: