Yesterday was the first NHS meeting with the Perinatal (pre conception/birth) Psychiatrist. I didn’t know what to expect from it, though a few weeks ago I had the non NHS meeting with a very good consultant psychiatrist. They were both lovely women who are very good at their jobs- I had had to initially try for a private referral due to NHS waiting lists, but then managed to get an NHS appointment.
I was a bit nervous to see how the NHS would handle it, as they will be who I have care with going forward, so I was pleasantly surprised to be treated with respect and insight and kindness. I know that sounds weird, but those of you who know what my hospital admission in 2014 was like, will know that it wasn’t all plain sailing. Due to lack of insight, decisions happened about me and not always with me and so to feel empowered for me and my husband is very important.
Essentially these meetings now I have been well for a long time, are to plan ahead and discuss psychiatric history, what medications are needed, how it can be managed and what this would mean for a foetus and baby too. Birth carries a strong risk of relapse with the bipolar disorder, including the risk of psychosis and depression and so medication particularly for me needs to be planned carefully. I will need to be monitored once pregnant.
I am on 3 different types of psychiatric medication and also a contraceptive pill. Before we start trying to have children, I will need to have a time of withdrawal from the pill, which could send my hormones all over the place (i used to have PMDD symptoms where I felt very depressed and suicidal on periods so this is a slight concern). Then I may need to taper down one of my medicines (possibly sertraline) with the assistance of the mental health team, to reduce the effect on a baby. As baby will have a time of withdrawal from medications after birth while in hospital- which scares me too that they will be affected temporarily so want to make sure any baby is safe, as do the team I will work with.
The Dr also mentioned I would need to be in hospital for 5 days after birth so my Lithium level can be monitored (too high it can be toxic to humans) and I will need regular blood tests also- which are a source of anxiety, I hate hospitals due to past trauma. There was also a mention of needing to stop Lithium pre Labour and my Lithium levels as a result being quite high from birth too. So this information is good, knowledge is power but its also a bit terrifying to factor this all in.
I am scared but its also…. exciting in a weird way. Despite not yet trying to fall pregnant for a number of reasons so far- (which include possible bipolar relapse and changing meds/ time frames and starting a new job role), I have wanted to be a mother my whole life and I have more challenges than most due to the psychiatric and hormonal changes and how the baby would be. I question whether I am doing the right thing too by trying for a natural pregnancy in future and thats really hard. But egg harvesting and surrogacy is not easy either.. and its like going between a rock and a hard place at times with the best thing to do.
The doctors also mentioned I should visit a mother and baby hospital unit during my pregnancy to see what its like and what support is given- as my worries about it being like a severe psychiatric ward are high. Apparently, its a much calmer, supportive and therapeutic environment. I don’t want to be in hospital but these are the types of things one has to factor in with the bipolar being biological with mood changes.
Rob is endlessly supportive – we are embarking on a somewhat unknown journey – but are now armed with way more information from both psychiatrists and are very thankful to live in the UK.
So, this will be the last update from me on this for a while but knowledge truly is power and I know that with the help of our healthcare system- mental health teams and perinatal psychiatry/ obstetrics, my family, medication, self care etc I should be safeguarded and cared for well.
When the time is right, we pray our miracle will manifest.
Thanks for reading,
PS shout out to my parents, Rob and family for their constant support.