Planning a pregnancy with a mental health condition

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. Most women with mental health problems have healthy babies with the right treatment and care, but it is important to talk to your doctor or specialist early.

This information is for you if you are currently on medication for non-severe depression or anxiety.

If you have a severe mental health condition, for example  bipolar disorder, schizophrenia, severe depression and psychosis, we have information for you here. 

Mental health medication and conceiving

Some medicines used to treat mental health conditions can also make it harder to get pregnant or may not be suitable to take during pregnancy. 

It’s natural to worry about the effects of medicine on a baby but it’s important not to stop taking any medication you are taking without speaking to your doctor first, because stopping taking medicine could make your symptoms come back or get worse.

The doctor will talk to you about medicine that is safest for pregnancy and your health. Talking to the doctor will also help you find out how pregnancy may affect your mental health, which may help you feel more prepared and in control. This includes knowing how the medicines used to treat mental problems may affect you and your baby.

Pregnancy, giving birth and caring for a baby can affect women with mental health problems in different ways. Your symptoms could come back or get worse during pregnancy or in the weeks after birth.

This can sometimes happen quickly after childbirth and can become more serious. However, with the right support and treatment before you get pregnant as well as during pregnancy the risk of this will be much less.

Should I stop taking my medication now?

Do not stop taking medicine for mental health problems before talking to a doctor. This can lead to withdrawal symptoms, particularly if stopped abruptly, or it could make your symptoms come back or get worse.

Because it’s impossible to know when you will become pregnant, the best thing to do is keep using contraception until you’ve spoken to your doctor about your treatment.

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. 

You can read more about different types of medication and pregnancy here.

What should I ask my doctor about?

Talk to your GP about your plans for pregnancy and your experience of mental health problems.

Remember, your doctor is there to help you, not judge you in any way. You could try asking the following questions: 

• How might pregnancy and childbirth affect me?
• What is the risk of my mental health condition I have had before coming back or getting worse?
• How might my condition and its treatment affect me and my pregnancy and afterwards?
• How might my condition and its treatment affect parenting?
• Are there any risks associated with not treating my condition?
• If my condition isn’t treated with medication how will my symptoms be controlled?
• What mental health services are available for pregnant women in my area?
• What kind of support is available after my baby is born?

Will I get specialist support?

You may be referred to a specialist perinatal mental health service if there is one in your area. These are community-based teams of mental health professionals who care for pregnant women and women after childbirth with mental health problems, and their families.

If you are referred for specialist support before pregnancy, you should continue using contraception and any other medicine until you have had an assessment.

Find out more about specific mental health conditions and how they are managed in pregnancy. 

What kind of treatment will I get?

Your healthcare team will talk to you about any prescription medications you are taking and your options. These may include:

• taking prescribed medications if you are not already taking any
• carrying on with your current medication
• changing your medication to something with a lower risk of side effects for you and baby
• stopping your medication gradually
• using other treatments instead of medication e.g. talking therapy

To help you decide the best course of action, your healthcare professional will talk to you about:

• how unwell you have been in the past
• how quickly you have become unwell if you have stopped medication
• what medications have helped you the most
• if any medications have caused side effects.

The treatment you have will be your decision. Your doctor can help you by discussing what your preferences are with you and explaining the risks and benefits of all options.

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.

Talking treatments

Your doctor may also suggest talking treatments. These are also known as psychological therapies. This may include visits from a health visitor, cognitive behavioural therapy or counselling.

Find out more about treatment and support for mental health.

Support from family and friends

Having a supportive partner and/or a network of supportive people around you can help you if you have mental health issues during pregnancy or afterwards. Your support network may include a partner, family or friends. You may find it helpful to tell people you trust about your mental health condition. They can help you by:

• coming with you to any medical appointments
• understanding what symptoms to look out for if you are at risk of becoming unwell
• knowing who to contact for help if they are worried about you
• help you find ways to relax and reduce stress

They can also help you during the decision-making process about any investigations, treatment or care options as you plan your pregnancy.

Alcohol and drug use

Some people may use alcohol or illegal drugs as a way of coping with their mental health problems. It is important to stop because using alcohol or drugs can damage your ability to get pregnant and are harmful to both women and babies in pregnancy. There is support available in these circumstances.

Find out more about alcohol and drug use when planning to have a baby. 

Cigarette smoking

People with mental health conditions are more likely to smoke and find it harder to give up, but getting support can make a big difference.

Find out more about support to quit smoking here.

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)

What can I do to help myself?

• Use our top tips for looking after your emotional wellbeing.
• Make a birth plan that includes support after you give birth.
• Read about planning ahead for emotional wellbeing after birth.
• Use our tool to find out if you are ready to conceive.