Pregnancy and mental health

As it is International Women’s day I thought I would write something relevant to women and mental health. Both men and women suffer with a variety of mental health problems. However, it is often argued that their experience of certain disorders may vary between the sexes or the proportion of men to women affected is variable. For example, I have read from certain sources that women are more likely to be treated with depression but men are more likely to commit suicide. I have also read that women with bipolar are more likely to suffer with mixed and rapid-cycling forms of bipolar compared to men.

I don’t feel like I know enough about the accuracy of these sources of information or have had enough experience with this topic to focus a blog post on these issues. However, one issue which I can be sure affects men and women differently is the experience of pregnancy and mental health. So that is what I will briefly discuss. This is particularly relevant to me as I hope to get pregnant sometime in the next few years.

The decision to have a baby when you are mentally ill is an issue for both men and women. Having one parent or both parents with a mental health difficulty makes raising children challenging. My father was raised by two parents, one of whom had bipolar disorder or manic depression as it was known then. My grandfather was in and out of hospital throughout my Dad’s childhood and seeing him ill affected my Dad a lot. His mother wasn’t there for him either as she hadn’t bonded to her children for some reason (possibly due to post-natal depression?). As a young teenager my Dad was forced to take control of the bills, the food and the chores.

Having a mental illness affects your ability to function. It affects your mood, your energy levels, your social skills and your general ability to cope with everyday situations. Having a child throws a whole load more situations for you to cope with. You become responsible not just for your own life but for another’s too. This will present unique challenges for parents with mental health problems who may find it hard enough to take care of themselves.

Although the decision to have a child is difficult for all parents with mental health difficulties, it is a woman who has to carry the baby to term. Her mental health is therefore affected in a unique way. She has to undergo all sorts of hormonal changes whilst pregnant and watch her body change. Instead of being exciting this may trigger a mental health problem. The anxiety of carrying a child and giving birth may cause a lot of stress. In addition women that suffer with mental health problems may be more likely to suffer from post-natal depression after giving birth. This risk has to be taken in to consideration by a woman who wishes to become pregnant. For me this is a particularly strong risk. As I have bipolar disorder type 1, I have been told that I have at least a 50% chance of developing a severe post-natal episode. This could be a depressive or manic episode and there is a significant chance of the episode being psychotic as well.

Another challenge for a woman with mental health difficulties who wants to get pregnant surrounds medication. If you are taking medication for your mental illness you have to decide whether to stay on it to keep well or to come off it to reduce risk to the foetus. Obviously if you are well and your body is healthy then all the better for both you and your baby. If the medications are helping to maintain your health then it may be important to stay on the medication. However, all medications carry risks to the foetus so it is a case of trying to balance up these issues to come to the right solution.

I have been told that because my bipolar is quite severe, I should remain on my medication during pregnancy. No doubt people will have different opinions on this and it is a personal decision but I am inclined to agree with my psychiatrist. If I suffer manic and depressive episodes during pregnancy because I am not on medication this would harm the baby even more than the effects of the medications themselves. However this does lead me to ask myself occasionally: should I have a baby at all? 

These are the kinds of worries that affect women when considering whether or not to get pregnant. They may lead some people to question whether or not to have children at all. Only you as an individual can work out what the risks are and what is the right thing to do for you and your body.Just remember that lots of mentally ill people have managed to raise children just fine. Mental illness doesn't have to be a barrier to you having a family.