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Schizophrenia, Schizo-affective disorder and pregnancy

 

Schizophrenia

Schizophrenia is a mental health diagnosis given that is uncommon and there is usually a family history. Sufferers will generally have their first episode in their late teens or early twenties.

The two major symptoms are:

Other symptoms include:

The symptoms are not the same for everyone but they can be disruptive and impact on your ability to continue with normal daily activities like going to work, maintaining relationship and caring for yourself or for others.

Some guidance information for you to read:

Schizo-affective disorder

This word describes two parts

Specialists give this diagnosis if you have experienced periods of mental ill-health which shows signs of psychotic symptoms that are similar to schizophrenia and have mood symptoms of bipolar disorder and you have both these at the same time or within a two-week time frame.

Diagnosing schizo-affective disorder is difficult as it might be confused with other conditions.

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 to develop a care plan.

Things to discuss:

During Pregnancy

 

When you attend your booking appointment with the community midwife it is important to tell them you have Schizophrenia or Schizoaffective 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:
 Many types of medication for mental health problems may affect your baby if you take them when you are pregnant or when you are breastfeeding. But there is also a risk for your baby if you become seriously unwell because you are not taking medication. Whether you take medication will depend on the particular type of medication and how likely you are to become unwell without it”.

Some women prefer not to take medication whilst they are pregnant. However, for women with schizophrenia 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.

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

 

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.

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.

Family intervention therapy

This type of therapy is to help family members develop their communication, problem solving, information sharing and coping skills.

Art therapies

Music, painting, dance, voice or drama are ways to express and understand yourself in a therapeutic environment with a trained therapist. Women also report that simple interventions such as ‘adult colouring’ can help to focus their minds away from symptoms of their schizophrenia.

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.

Recovery

Where possible and safe, treatments will continue in the community, however sometimes you may need to be admitted to a mental health unit.

Admission to a Mother and baby unit

A Mother and Baby unit is a specialist mental health unit that treats women who are severely mentally unwell, who are admitted with their baby. Women are admitted to this unit if it is of no longer safe to be treated at home. For the majority of women this is an unlikely eventuality, however if it does occur then a referral to Children and Families Social Services will be made.

For more information on our local Mother and baby unit in Winchester:
Mother and Baby Unit - Melbury Lodge

National links to further reading and support: