I'm a 31 y/o bipolar II woman who is starting her journey into pregnancy.
I'm hoping to get information from other mamas with bipolar or other mental disorders that require medication.
How did your pregnancy and conception go? Did you stop your medication?
I very much want a homebirth with a midwife, but I've already been turned down by 4 because of my mental disorder. It's disheartening.
I guess I'm just looking for been-there-done-that stories, and tips on how to progress.
Anyone have any advice?
Bumping ... anyone?
I have no direct experience, but I think you're wise to be investigating the homebirth option. My husband's mental health was severely affected by the chaotic nature of the hospital setting during my first birth. For my second birth I hired a midwife and stayed home, and the fact that we had previously met all the health professionals that we dealt with, and that they knew us well, and that we were in a familiar environment, helped my husband preserve his mental health a lot better.
Hi there Mama, I also have Bipolar 2 but it hasn't been identified until more recently. I was depressed through my pregnancy with dd2 and started an antidepressant at that time (Prozac). After weaning from breastfeeding I started taking Wellbutrin as well. During my entire pregnancy with Ds (from conception to birth and breastfeeding) I took both Prozac and Wellbutrin. Now we've added on a little bit of Abilify and I don't know if it is something that can be taken during pregnancy/breastfeeding.
http://www.motherisk.org or 1-877-439-2744 Motherisk Helpline
To be honest, ds had a little bit of twitchiness in the first hours after he was born but that faded away pretty quickly. The midwives thought it was a side effect of the meds. I was able to have a homebirth with midwives even with my condition. There was a midwife who was experienced in and confident with serving mothers who had a history of mental health problems. Maybe you need to do some research to find one near you? If someone like that even exists near you?
I'm late to come back and say thank you, but I appreciate the feedback.
I'm currently on abilify, zoloft, lamictal, and lithium. I know I have to go off the lamictal and lithium for pregnancy/nursing. Not sure about the abilify, because my previous pdoc was kind of an idiot about reproductive effects of psych meds. I'm hoping to find someone more supportive.
(Side story: when I first started talking to him about getting pregnant, my FIRST sentence was "I WILL be breastfeeding." Three appointments later, when we're talking about switching meds, he says "oh, of course you won't be breastfeeding so you can go right back to your "normal" meds after."
I just kind of stared at him. I'm an LC. I know that there are a bunch of good meds that are safe while breastfeeding, and it frankly annoyed me that he automatically assumed I wouldn't even look into them.
Yet another reason he is my -prior- pdoc)
Anyway. I am very committed to a home birth. My experience in hospitals has been...bad...to say the least.
Plans are deferred for a while, but I'm, still hoping to get more input from mothers who are medicated, on how they managed.
Thank you again!
I have been thinking about this a lot too recently. I have bipolar type 2, diagnosed 7 years ago when I was pregnant with my son (he was very much a surprise). Before that I'd tried about a dozen medications for depression since I was about 13. At the time I waited the few months I had left of pregnancy before starting medication because I didn't think it was a good idea to be dealing with side effects while still carrying him. Despite starting medication after he was born I still breastfed him until he was almost 2, because the doctor said the benefits of that would outweigh any small risk of minor negative effects.
Anyway, about 4 years ago I started on lithium along side a much smaller dose of the anti-psychotic then eventually swapped to taking lamotrigine (Lamictal) with the lithium. I had another surprise pregnancy (seems I don't get on well with the contraceptive pill!) about 3 years ago and immediately cut down the lithium (after checking with the doctor, obviously) and intended to come off it completely but then had a very early miscarriage. I felt awful because I thought it might have been due to the lithium, but the doctor said it was very unlikely and probably just a chromosomal abnormality. I decided to still come slowly off the lithium after that anyway, because for a short time I intended to try soon for another baby, but then my relationship ended. I've been off it since but increased my Lamictal.
I now have a wonderful partner (who was my best friend first for a long time :) )and we are moving into our new house in a couple of weeks once the renovation is finally finished! We would like to try for a baby next year, so I have both talked to my GP and psychiatrist about the risks of various psych drugs in pregnancy and breastfeeding and done a lot of research including reading medical journals. Doctors almost always do not have up to date knowledge of such specific things, because they have a lot to keep up with!
It turns out that the risk to the baby is actually much lower than you are often led to believe and the high rates were from old and poorly conducted studies. I can quote lots of boring papers or just from a specialist organisation: "Studies have suggested the rate of any heart defect with lithium exposure is approximately 1-5%. This is only somewhat greater than the background rate for heart defects in the general population, 0.5%-1.0%. No other birth defects have been linked to lithium use in pregnancy.(http://www.mothertobaby.org/files/lithium.pdf.) Personally I wouldn't want to take it though, considering there are safer alternatives.
I think the best option for me is to stay on my Lamictal during pregnancy. More recent fairly large studies have shown only a slightly increased rate of cleft lip or palate in babies born to mothers who take it. Some studies suggest this might be because Lamictal alters folate levels in the body and is more likely to be avoided if it is made sure that high dose folic acid is taken before and during pregnancy. It is seen as a safe option for epileptic women to take during pregnancy, therefore also a sensible choice for bipolar women.
Really, one's decision has to be made on the basis of whether they feel the likelihood of relapse is high if they stop their medication (especially considering the way pregnancy affects the moods of "normal" people!) and whether the medication they take causes adverse affects or has a low risk. None of the psych meds have *no* risk, but a lot of doctors will tell you that there is a higher risk to the baby if you are ill during pregnancy than if you take the safer meds.
Staying on antidepressants but coming off mood stabilisers is a REALLY bad idea and no doctor should suggest it. Bipolar people should never take an antidepressant alone because it can trigger bad manic episodes. I had that happen a few times to varying extents during the years they were misdiagnosing bipolar as depression. Not fun at all. It is a particularly bad idea during pregnancy. The changing hormones already put you at risk of bad mood swings, and ending up really ill or having to suddenly take high doses of anti-psychotics or other meds to stabilise you is going to be much worse for the baby than staying on a mood stabiliser.
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