One of the first thoughts I had after I was diagnosed with bipolar disorder was, “Can I still have a baby?” It felt like all of the things I’d looked forward to as an adult just weren’t going to happen. At 25 years old, love, marriage, and a baby carriage—as I wanted it—seemed like a distant, unattainable wish. So many things I’d never experienced began to run through my mind. I felt cheated. But what about my baby? Could I have the daughter I’d always wanted while living with a mental illness? And would I pass it on to her? I prayed to God not! I wouldn’t want that for my worst enemy. The unknowns built my questions by the minute.
Is It Possible to Take Medication for Mental Illness While Pregnant?
Dawn Friedman, M.S.Ed., a therapist in Central Ohio who specializes in maternal mental health, says it’s absolutely possible.
“There are different medications for different people who are managing their bipolar disorder, and the discussion should be had with their prescribing physician to make decisions about what medications to continue or if any changes need to be made,” she told TheBody. She added that pregnant people should not make decisions about medication without talking to their doctor or whoever prescribes their medication, as it could be dangerous for the pregnant person and their baby.
Will the Medicine Affect the Baby?
According to Friedman, different medications have different levels of risk. However, she added, “Unmedicated bipolar also carries risk.”
“This is why it is so important to be working with a physician who is familiar with managing the medication needs of pregnant and postpartum women with bipolar disorder,” Friedman said. “These are complicated decisions of weighing risks, talking about risk factors, and creating support systems. If a pregnant woman does not feel confident about her physician’s ability to manage her care during her pregnancy and after, she can reach out to Postpartum Support International, which can help connect her to a doctor with expertise in these areas.”
I must admit that the medicine I take was a big worry for me. I take a lot of medicines, and some are used to offset symptoms caused by my psychiatric medicine, Latuda (lurasidone); therefore, it’s a big concern. When I think of the health of babies, there’s always caution involved for certain foods. I recall my cousin telling me she couldn’t even get dental work done because she was pregnant. A major concern of mine was mutilation, so I dug deeper.
Could the Medicine Hurt the Baby or Affect the Brain and Development?
Kim Langdon, M.D., an OB-GYN at the online health care service Medzino with over 20 years of experience, said that it all depends on the medication.
“Antiseizure medications that can be used as mood stabilizers have the most serious consequences,” she said. She pointed to valproate, one bipolar medication, which can lead to birth defects and cognitive impairment in babies.
“It is best avoided, where possible, in all women in their reproductive years,” she said. “Carbamazepine and lamotrigine may also pose some risks, but the studies are unclear. Lithium for bipolar has been associated with fetal malformations.”
Could the Mental Illness Be Passed Down to the Baby?
According to Langdon, mental illness tends to have a genetic component, but “it is not linked to one gene, and it depends on what mental illness it is.” When I asked if mental illness could be a dormant genetic trait, Langdon replied, “It’s possible that someone who gets pregnant with the genetic material but without the disease could pass it onto their baby.”
Being proactive has been a very beneficial element in my life. It’s helped me graduate college, write a memoir, and obtain other goals I’ve set for myself. Although I know you can’t always plan everything, I couldn’t help but wonder if thinking ahead would be beneficial in regard to preparing for a baby.
Should the Pregnancy Be Planned?
According to Dr. Howard Pratt, D.O., behavioral health medical director at Community Health of South Florida, Inc., he has patients discontinue or taper down psychotropic medications until they are no longer taking them before they even try to get pregnant.
“Now, getting to the point where there are no medications being taken is ideal,” he said. “We can’t always achieve this, given that we might encounter a situation when the mental health symptoms themselves may present dangers that outweigh not taking the medications, and we are into weighing risks and rewards.” He says that he prefers that all patients living with mental illness plan their pregnancy.
Receiving that information confirmed that being proactive would only aid in the greater good of the baby. Knowing that brought me relief and a sense of comfort. Yet being mentally ill is a struggle, a battle, that only those living with it fully understand. I still had to know, for my unborn baby’s sake, the absolute safest and healthiest route, from a professional’s expertise.
What Is the Safest and Healthiest Route to Having a Baby While Mentally Ill?
“If you are planning ahead of time, you are taking a lot of the risk away,” said Pratt. “Depending on what the medication is, the timeframe that you need to be off of that can vary, but the safest thing, if possible, is not to be taking any psychotropic medications, especially while trying to get pregnant, because those first few weeks are the most vulnerable time for the embryo.”
“One of the biggest issues encountered is when a person isn’t aware they are pregnant and are taking medications or doing other things that could negatively affect the embryo,” said Pratt. “And, relatedly, some psychotropic medications can make oral contraceptives less effective.”
Of course, all everyone ever wants is a healthy and happy baby. Getting these questions answered lessened my fears slightly but inevitably sprung about more questions. Though I’m not in a space currently to start attempting to conceive, I want to be as proactive and aware as possible when the time arrives. Still, I can’t help but be fearful of the possibilities that the medications I take may affect my unborn child, as they affect me daily. I take mood stabilizers, antidepressants, and an antipsychotic. These are hard drugs, and they seem awfully heavy to have in my system while carrying something so precious and delicate as a baby. This is where my hesitance of taking medicine while pregnant kicked in. However, Langdon’s final remarks really set me straight and put things into perspective.
“The main problem is the possibility that the disease progresses or a relapse occurs during the pregnancy or postpartum. Abrupt discontinuation of a medication can be more dangerous than continuing the medication. Example: severe depression or psychosis could lead to maternal harm (suicide) and hence fetal harm,” said Langdon.
Another tip that Pratt added is that continuing the medication after birth isn’t a good idea because it can be passed down to the baby through breast milk.
After getting all of my answers clarified and broken down, I feel relieved and encouraged. Having a baby while living with a mental illness is possible, although it comes with a few added challenges. I feel inspired by the possibility of conceiving and nurturing a healthy baby while monitoring and keeping my sanity—with the help of my doctor. I hope this article helps others who have wondered or know someone struggling with whether they want kids in fear that—because they have a mental illness, and might be afraid they’ll pass it down to them—it’s a definite ‘no.’ As for me, I have renewed hope that it’s possible. I’m possible!