What It Means To Have An NHS Perinatal Psychiatry Planning Meeting.

May 26, 2022May 26, 2022 ~ Eleanor Segall ~ 3 Comments

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,

Eleanor x

PS shout out to my parents, Rob and family for their constant support.

Bipolar and Perinatal Mental Health: Part One by Eleanor

April 6, 2022April 6, 2022 ~ Eleanor Segall ~ 5 Comments

I havn’t been sure for many months whether I was ready or wanted to share about the many issues I have been grappling with for a number of years. However, writing for me is therapeutic and so I wanted to share about the reality of mood disorders and thinking about starting a family.

To begin with, this is such a personal and complex issue for anyone with what is termed ‘severe mental illness; ie bipolar disorder, schizophrenia, psychosis. Our illnesses mainly have to be managed on daily medication and for some people with severe mental illness, they may still live with daily symptoms which can cause difficulties for them.

So this article is my personal experience of living with Bipolar 1 disorder and anxiety. To note, I was started on Lithium in 2014 after my last hospitalisation- which has stabilised the bipolar episodes into remission (it does something to the seretonin in the brain). I still live with some anxiety, but the combination of Lithium, Quetaipine (an anti psychotic) and anti depressants has meant that I do not become manic or psychotic and nor do I suffer from severe depression or suicidal depression. I feel more stable and I have engaged in therapy for the trauma I went through, for 2 years. So, thankfully at the moment my illness is very much controlled well and I have support from Rob and my family.

One side effects of my medicines has been weight gain and I aim to lose weight over the next year. This is important to me because it can sometimes impact on fertility and also makes a pregnancy more high risk (physical side effects such as blood clots etc). I will also be 34 in July and so this has become more pressing for me in terms of wanting to try for a baby. However, there are many risks in choosing to do this and going ahead, without speaking to a perinatal psychiatrist or mental health team.

Today, I got my referral letter to the mental health team to discuss planning a pregnancy and am on an NHS waiting list til June. For me, because my type of bipolar can be dangerous with the mania and psychosis- and having had several psychotic episodes in my life to date that have ended me up in hospital- a pregnancy where I carry a baby myself, has to be carefully planned in terms of my medication. For many reasons, I want to stay on my medicines for the entire pregnancy- so that I don’t end up relapsing during or straight after pregnancy (with bipolar there is a greater risk of relapse and post partum depression/psychosis due to the hormonal changes straight after birth).

I have been terrified for a number of years over what to do in order to keep me and a potential baby safe. I have researched surrogacy so I don’t risk making myself unwell, but this comes with a whole host of legal challenges around who is the parent, high financial costs (of treatment and paying expenses for surrogate/agencies) etc and the wait for the right surrogate. Surrogates can also pull out before giving. birth, you have to put your trust in them if you don’t know them- and you are trusting them with something hugely important! We also thought about adoption but with my mental health history and the potential issues that a child in care may be facing, I just didn’t want to put myself through the stress of being scrutinised.

So, please God even if we are blessed with a healthy child- the pregnancy may be as a friend of mine has termed ‘high risk’. This scares me and it scares me about potentially ending up in hospital again, on a mother and baby unit. I want to stay on my mood stabiliser and anti psychotic so the bipolar doesn’t cause this- however, I have decided that as long as I can stay on my medication and have the support of an experienced perinatal psychiatrist and mental health team (as well as my therapist),- plus regular monitoring and scans… and of course a proper plan put in place in case of relapse, this is what I will do (again, no one knows until you start trying for a baby and there can be many hurdles but I am trying to think positively).

I have also been asked whether I am worried about passing bipolar on. This is a worry as it does run in my family- however, I believe the risk of this with one parent is only about 10% (I got unlucky). Sometimes, I sit and question- am I being selfish for wanting to be a mother? And I realise, no I am not selfish. I don’t want my potential child to get bipolar disorder but equally if they do, we will deal with it. We also both want to get tested by Jnetics as we are both Ashkenazi (East European) Jews so may be carriers for certain illnesses.

Some women don’t want to be mothers, but I always have done since I was a little girl and I can’t imagine never having a family with my husband. I want to be the best Mum I can be and reduce my illness risk as much as possible to remain stable and well.

Do I wish things were different and I didn’t have this illness? Yes. but the reality is that I do but that I have been stable for a long time. I know we will make good parents whatever way it happens and I just hope the road ahead won’t be paved with challenges… it is never easy. I write this because its not often talked about… and I know there will be more to come on this subject but I wanted to share- if you yourself are going through something similar, you aren’t alone.

It took a lot to share this because its so personal and I worry about sharing too much- but this blog has been years in the making really! There is never a right time to open up- but maybe now I can allow myself to a bit and release the burden.

People sometimes ask me if I have children (as im mid thirties and married) and my answer is always, I hope to one day soon but leave it in Gods hands.

With love,

Eleanor x

Window to the Womb partners with BlueSkeye AI to launch Avocado App to support Perinatal Mental Wellbeing in the UK.

January 6, 2022 ~ Eleanor Segall ~ Leave a comment

Window to the Womb, the UK leading provider of private Baby Scan Services for pregnant women, has partnered with BlueSkeye AI to launch Avocado.

Avocado is a brand new pregnancy App which uses cutting-edge AI technology to support effective mood management. Window to the Womb is rolling out the use of the Avocado App across all 44 clinics nationwide enabling women who attend for early and later pregnancy ultrasound services to access their scan images and scan reports digitally. In their drive to support women in early stages and throughout pregnancy, Window to the Womb has worked with BlueSkeye AI to provide a range of additional services within the App including the ability to log a pregnancy diary, access mindfulness or exercise material and order personalised baby scan photos.

Managing Emotional Wellbeing and Moods

Avocado provides women with the ability to understand and manage their mood and emotional wellbeing throughout pregnancy. Recognising that pregnancy and preparing to have a baby is such a big life event it is well understood that pregnancy can be an emotive time and a trigger for mental ill health. Pregnancy hormones can be a likely contributor to changes in mood, as well as other triggers including fatigue and sleep deprivation.

The Maternity Mental Health Alliance, a UK charity that is focussed on addressing the needs of women during pregnancy reported that 1 in 10 women experience perinatal mental problems and more needs to be done to support women during pregnancy. The lived experiences of women, as documented and made available to listen to by MIND, who have experienced perinatal mental illness indicate there is more to be done to help raise awareness in society about the prevalence of anxiety and depression (and other mental illness) during pregnancy.

Avocado enables women to track their mood alongside other key pregnancy metrics whilst managing their private scan appointments and much more. The app directs women to useful resources including the NHS’ Every Mind Matters mental health and wellbeing resource.

”At Window to the Womb, we are privileged to meet and provide services to thousands of women at different stages of their pregnancies. We are committed to ensuring that women are well supported as they access our services and we are keen to ensure that women are empowered to self-manage their mental and emotional wellbeing during this time” said Managing Director of Window to the Womb, Tony Harrison.

BlueSkeye AI is a fast growth tech company based in Nottingham creating AI you can trust, and is on a mission to improve wellbeing and patient health outcomes by delivering accessible and objective services and products that help patients understand and manage their mental health and wellbeing. The ethical AI company’s technology is underpinned by Behaviomedics, pioneered by BlueSkeye AI’s CEO, Professor Michel Valstar.

“Our core technology automatically analyses and synthesises the face and voice to monitor mood and other medically relevant expressed behaviour. We are delighted to work in partnership with Window to the Womb to apply our technology to help perinatal women understand and manage their mental wellbeing” said Professor Valstar, CEO of BlueSkeye.

The App is available to download on Apple and Android devices. A premium version is now available for subscription and includes additional features that promote wellbeing during pregnancy.

Please visit www.avocadoapp.co.uk for more information.

This article is unsponsored- I am sharing it because i believe greatly in the mission of the founders to support perinatal mental health.