‘Am I crazy to want a baby when I’m schizophrenic?’ After a decade-long struggle, one woman tells of her fears as she contemplates starting a family
There are babies everywhere – or at least, it feels like that.
Many of my girlfriends are new mothers or pregnant. Even my younger sister had a baby earlier this year.
I’m 33 and in a loving, stable relationship. In many ways it would be the most natural thing in the world for me to have a child.
But there is a rather significant snag – I have a serious long-term mental health condition. Ten years ago, I was diagnosed with paranoid schizophrenia.
When I was unwell, I locked myself away in my flat, convinced I was a fugitive, someone who had done something unspeakably awful – although I wasn’t sure what. I was constantly terrified and, at times, suicidal with guilt.
Of course, this was due to my illness. I hadn’t done anything wrong, and doctors think these horrible thoughts stem from problems in the brain, combined with difficult life experiences.
Now I take medication every day, have therapy, and generally feel fine, bar a little tiredness.
To meet me, you’d never know I have this condition. My boyfriend, a criminologist, was aware of my diagnosis before we got together as we were initially friends, but it’s never really been an issue.
But now, 16 months on, we are facing the first real challenge of my health problems.
It’s still early days in our relationship and we’ve only recently moved into a rented flat together, so children are still a distant thought.
But as I said, at my age many women are having babies. And I couldn’t help thinking it would be utterly irresponsible of me to follow suit.
Would I need to come off my medication while pregnant? All the information leaflets that accompany my drugs say you shouldn’t take them if you are expecting, and I have read that medication can damage a growing foetus.
But I’ve stopped taking the tablets before to see what happened and my symptoms, including those suicidal thoughts, came flooding back.
And what if I pass on my psychosis to my child? Even worse, if I began to struggle with my own daily maintenance, how would I care for a newborn baby?
I’ve had first-hand experience of how patchy NHS support can be for mental health patients. For instance, I have only recently been offered psychotherapy, which is seen as a gold standard treatment.
So I was pleased to learn there is actually support in place on the NHS for people like me who would like to start a family in the future.
Psychiatrist Paola Dazzan, a specialist in this area at the Bethlem Royal Hospital in London, says: ‘Having a history of psychosis does not in itself prevent a woman from having a child.
THE RISKS OF PREGNANCY
Most women develop mental health problems in their reproductive years, and are particularly likely to become ill during pregnancy or the first year of motherhood. They are also at increased risk of suffering problems such as stillbirth, so it is absolutely vital that the correct care is sought.
The first step is to assess your reproductive health, say Kathryn Abel, professor of psychological medicine at the University of Manchester. ‘Women with a mental illness have reduced fertility due to their lifestyles and the impact of stress.’
Next is assessing medication. ‘Your doctor can help weigh up risks to the foetus from medication and the risks to the patient if they stop,’ says Prof Abel. ‘If a pregnant woman has a relapse she may need to be treated with far higher doses than those who stayed on it, which will be more damaging.’ Medications such as lithium are less risky than once thought.
Ask to be referred to a specialist perinatal mental health service and a specialist midwife for medical support and also lifestyle advice.
If there is no such service in your area you will need to ensure that your midwife, mental health team, GP and gynaecologist all work together.
‘However, it is extremely important that any woman in this situation discusses her plan to have a baby with her psychiatrist and seeks specialist advice.
‘Some women will need to take medication during pregnancy, or will need admission to hospital after the baby arrives.
In the most severe cases, the mother may not able to be the sole primary carer for her baby, and will need additional support.’
Consultant psychiatrist Dr Lucinda Green, at St Thomas’ Hospital, London agrees: ‘Women with a diagnosis of a serious mental illness, such as bipolar disorder or schizophrenia, must seek specialist advice before trying to get pregnant, even if they are currently well.’
Clinical psychologist Dr Tamara Russell urges couples to seek specialist advice rather than simply visit their GP.
‘I know a few very distressing cases where women ended up having terminations after getting poor advice – doctors telling them it’s fine to stay on medication and then all too late seeing a specialist who flagged up the high risk of severe damage to the baby.’
She also advises against anyone giving up medication without having a careful medical plan in place. She knows of women who have done so and suffered a serious relapse, which ended in them becoming unable to look after their newborn.
When planning a pregnancy, psychiatrists can help women make decisions about medication. During pregnancy it is essential that mental health services work closely with the woman, her family and all the other professionals involved such as midwives, health visitors and GPs.
‘Assumptions should not be made about a woman’s ability to be a parent, or the treatment she needs, based on a diagnosis,’ says Dr Green. ‘Instead each woman needs individual advice based on how her illness has affected her. Decisions about medication in pregnancy are complex. For many women who have had episodes of psychotic illness, the benefits of continuing medication will outweigh the risks.’
And me? After a decade of being ‘mad’, I finally feel like my treatment is working. In fact, I have never been so stable and secure as I am now. My boyfriend and I aren’t quite ready for parenthood yet. But knowing that there will be support and care in place should we want to start a family, I am positive it can happen when we decide to take that important step.
Read more: http://www.dailymail.co.uk/health/article-2516044/Am-I-crazy-want-baby-Im-schizophrenic-After-decade-long-struggle-woman-tells-fears-contemplates-starting-family.html#ixzz2mG9kjUFp
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