Preparing for motherhood: I have a psychiatric illness; can I have a baby?

The decision to become a mother is one of the most important ones in a woman’s life. If the woman has a mental illness, or has had one in the past, this decision becomes even more significant. There are many more issues to consider if you have a psychiatric illness or have survived one. It is advisable to consult your psychiatrist before planning a baby. It also helps if a family member or your partner is involved in this discussion, as sometimes the amount of information can be overwhelming. Here are some of the issues you should discuss:

• If you have had a mental illness in the past, is it possible that you will become unwell again due to the pregnancy? What effect will the pregnancy have on your mental health? If you used medication in the past, will it affect the fetus?

• If you are still using medication, what effect will it have on the baby? If it has serious affects, is there any alternate medication or can you go off the medication?

• What effect will the medication have on breastfeeding? Will it affect the baby’s health?

• Will the baby develop the same or similar mental illness?

• Will there be any complications in the postpartum? What precautions need to be taken?

• What are the issues that you will need to discuss with your obstetrician?

If managed well, women with mental illness can go through a comfortable pregnancy. It is important for the psychiatrist to analyze the risks and benefits of your pregnancy. This is because mental illness is high risk even if you have been well for a while. Sometimes you may be advised to wait for a few months before you consider pregnancy, either because you have had a very recent episode, or because you are prone to frequent bouts of mental illness. Each mental illness, such as bipolar disorder, schizophrenia, and others, comes with its unique set of risk factors and it is important that you discuss these with psychiatrist before considering having a baby.

Care plan

If you have a history of mental illness and are considering pregnancy, a care plan is most essential. Ideally this should be drawn up together with your psychiatrist and obstetrician. The plan will help them monitor your health during pregnancy better by scheduling follow-ups. You and your partner, or family, will be informed about the signs to look out for, what to do if things go wrong, and a set plan for emergency situations. It also ensures that there is always an alternate point of contact in your family for such situations.

Complications aside, women with mental illness have had comfortable pregnancies and make great mothers. What matters most is to be prepared and well-informed so that there are no panic situations.