Pregnancy is an exciting time for couples, and there are many things to think about, plan for, and do to get ready for the new arrival. But for a woman with mental illness, pregnancy also means extra special attention needs to be paid to her illness, as well as to the needs of the fetus. As a supportive partner, you play a major role in this.

According to the Stanford School of Medicine, “A common myth states that hormones released during pregnancy protect women from psychiatric disorders and foster a period of emotional well-being. Recent studies, however, have shown that up to 20% of women suffer from mood or anxiety disorders during the gestation and postpartum periods. Whether the symptoms develop at the onset of pregnancy or are a continuation of a previous history, women face a difficult decision about how to manage their illness during pregnancy.”

How do you ensure that the entire family gets through the pregnancy with everyone doing well at the end?

  • Understand the risks to the mother: Anxiety and depression are the most common issues pregnant women face. Treating these illnesses depends a lot on the severity of the illness and mental health history of the mother. If the symptoms develop during pregnancy, counseling and a support group may be all that is needed, but depending on how far into the pregnancy the mother is, an antidepressant may be prescribed as well. For women who have a history of anxiety and depression, working with their treatment team to determine whether their current treatment is appropriate or needs to be adjusted is essential. Encourage your partner to continue taking her meds (if she is on any) until she talks to her doctor. Ideally, if a woman is considering pregnancy, she will discuss her treatment with the team before getting pregnant so that any adjustments can be made ahead of time.
  • Understand the risks to the fetus: The FDA is updating its information to better indicate medication risks to a fetus. Collaborate with your partner’s psychiatrist (or whomever prescribes their medication) as well as your partner’s OB-GYN to determine what–if any–changes need to be made to protect the fetus. In some cases, the risk of not taking medication is greater to the mother’s well being than the potential risks to the fetus.
  • Understand the risks of not doing anything at all: Untreated major depression has serious potential risks for mother and fetus. Symptoms may develop and worsen into the postpartum period, and postpartum psychosis can be a real risk. Untreated depression may lead to poor nutrition, smoking, drinking, suicidal behavior, prolonged or premature labor, and low birth weight. In addition, babies born to depressed mothers have higher rates of infant admission to a special care nursery for conditions such as respiratory distress, hypoglycemia, and prematurity. Mothers who discontinue their meds during pregnancy have high relapse rates, and this can put both their lives and the lives of the fetuses at risk.
  • Understand your role in this situation: You may be feeling a mix of emotions–ranging from excitement and joy to fear and anxiety–about many things, not just your partner’s mental health. Your role as the healthy partner is to help your pregnant partner be as healthy as possible as well. Be alert for signs that your partner is struggling with her mental health. Have many discussions over the course of the pregnancy (and beyond!) about what you both need. Practice self-care and encourage your partner to engage in self-care (such as exercise) as well. If you are having concerns about anything, seek your own therapy.


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Managing Pregnancy and Bipolar Disorder

Pregnancy Pointers for Women with Psychiatric History

Pregnancy and Psychotropic Medications

Pregnancy and Medicines

Creative Commons License photo credit: Nina Matthews Photography