Planning a pregnancy with a mental health condition

Pregnancy and having a baby can be an exciting and demanding time for women. If you have an existing or past mental health condition it brings extra challenges and you are at higher risk of relapse during this time than at others.

However, the good news is that with support and treatment you are likely to have a healthy pregnancy and baby.

The support you need while you’re pregnant depends on the type of illness you have (or have had in the past).

Planning a pregnancy

If you have or had a mental health problem in the past and you’re planning to have a baby, you should talk to your doctor before you become pregnant.

The doctor will discuss how pregnancy and birth might affect your mental health problem, and how any medication you might be taking could affect the baby. The doctor might refer you to a specialist service if you are on medication. They will advise you which medication needs to be avoided and what kind of safer treatments are available for your condition.

Pregnant already with a mental health condition

If you are pregnant already, and have had a mental health problem in the past, it’s very important to talk to your healthcare providers as soon as you realise you’re pregnant. They will discuss:

  • How pregnancy and birth might affect your condition
  • How your treatment can be made as safe as possible during pregnancy.

You should tell the team who look after your mental health that you’re pregnant, and also tell the midwife or doctor looking after your pregnancy that you have a mental health condition.

If you have or had a psychotic disorder (such as bipolar disorder or schizophrenia), the health professionals will work together to make a plan for your care during pregnancy, birth and afterwards.

If you’re already under the care of a community mental health team (CMHT), you should tell your care co-ordinator that you’re pregnant. They will be able to tell you about the treatment and support that are available for pregnant women and new mums in your area. If you are not under the care of a CMHT, but have been in the past, you should talk to your GP. You may need the support of the CMHT during pregnancy and for a few months after your baby is born.  

What about medication when I’m pregnant?

Some types of medication for mental health problems have risks for your baby if you take them when you are pregnant or when you are breastfeeding. It is important to tell your doctor as soon as possible that you are pregnant so that your treatment can be discussed and considered with you.

Although some medication may have risks for your baby, if you stop medication suddenly you may become unwell very quickly so it is important to talk to your healthcare team first.

Your doctor should talk to you about:

  • any risks the medication may pose to your baby
  • the benefits and risks of switching to another medication that’s safer for pregnancy
  • the benefits and risks of switching to a ‘talking treatment’ (psychological therapy)
  • the possible effects of stopping or switching  your medication suddenly.

The type of mental health condition and severity will be a factor in these decisions. 

If you decide to take medication when you are pregnant or when you are breastfeeding, you should be offered the type with the least risk for you and your baby. You should be offered the lowest amount that will still work and should usually not take more than one type.

If you would like to stop medication when you are pregnant, but medication is the best treatment for your mental health problem, your doctor should talk to you about your reasons for wanting to stop medication and about the risks, if any, to you and your baby.

What about medication when I’m breastfeeding ?

Breastfeeding has benefits for your baby, and health professionals will encourage you to do it if you can. They should talk to you about treatments that you could take if you decide to breastfeed. Many types of medication for mental health problems can pass through your breastmilk but in most cases it is in extremely small amounts, considerably less than the amount that passes through in pregnancy. A few medications may affect your baby so health professionals will discuss the risks of starting, stopping, continuing or changing medication with you.

If you need medication that means breastfeeding isn’t safe for your baby, or there are other reasons that breastfeeding is not for you (such as the impact of sleep deprivation on your mental health, you should be supported and not made to feel guilty about this. It is important to your baby that you are not unwell.

If you are breastfeeding and are taking medication for a mental health problem, your baby should be checked for any side effects.

Find out more about antidepressant medications and their side effects (NICE guidance)

Find out more about antipsychotic medications and their side effects (NICE guidance)

What can I do to help myself?

Other resources

Sources

  1. NICE (2014) Information for the public: Mental health in pregnancy and the year after giving birth.http://www.nice.org.uk/guidance/cg192/resources/information-for-the-public-mental-health-in-pregnancy-and-the-year-after-giving-birth-pdf
  2.  ibid 
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Last reviewed on February 1st, 2015. Next review date February 1st, 2018.

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