Starting a family is an exciting and nerve-wracking time for anyone, but having a mental health problem can add an extra layer of planning and anxiety to getting pregnant. Is your medication safe for pregnancy and breastfeeding? How can you keep both yourself and your baby well? And what specialist support is available along the way?
First and foremost, the best advice is to have a conversation with your GP before you start trying to conceive. “Quite simply, the earlier you start thinking about it the better,” says Dr Trudi Seneviratne, Chair of the Perinatal Faculty at the Royal College of Psychiatry. “In England we’ve had a huge expansion of perinatal mental health services in the last three years, and our mother and baby outpatient services now offer specialist pre-conception counselling. Your GP can refer you for a conversation before you fall pregnant,” she explains.
“This will usually be for people who’ve already got a history of mental health problems – which might be depression, anxiety, bipolar disorder, schizophrenia, OCD, whatever it is – and are on medication,” Dr Seneviratne adds. “But it could also be for people who are not currently on medication, who just want to think about what support they might need if they do get ill.”
Having this conversation with the experts early on will help you make important decisions about your perinatal mental health care plan – which could include continuing, switching or coming off your medication, being referred for talking therapies, and seeing a specialist mental health midwife.