Planning pregnancy with BP is definitely a challenge. There might be a baby in my future, and my psychiatrist wants me to start preparing 6 months before conception.
I have stayed stable off meds with a strict self-care program that is hard to maintain. I have a 3 yr old son - before I was diagnosed - and I did just fine during that pregnancy (which was complicated). So what my Dr. alluded to was weaning down my dose and being strict about self-care. IF I have a problem, they can bump up my dose. My medication take 6 - 8 weeks of slowly increasing the dose to get to an effective level. It's not appropriate for crisis. So staying on a low dose would protect baby from the potential of becoming unstable and having to use more risky medication.
I tend toward depression rather than mania anyways, and knowing that it is not a permanent condition, I think I would be "fine" to suffer through it.
So the big problem with pregnancy and BP is actually post-partum. Giving birth changes how the body processes medication and can lead to concentrations that are too high or too low. If mom is trying to breastfeed, to high is and issue. If she is trying to maintain sanity, to low is a problem. In addition, if mom is going back on meds, there is the whole issue of side effects and geting up to an effective dose. Many women have bad cycling after giving birth that is hard to control.
I had a terrible experience postpartum - peaking 7 - 8 months postpartum and continuing until getting divorced triggered mania. My Dr.'s could not control mood swings with medication. My mood swings had a SIGNIFICANT effect on my son's wellbeing. But also keep in mind that I had been on anti-depressants the last 2 months of my pregnancy - a HUGE no-no for Bipolars! (Remember I was not yet diagnosed.) I can't say how much of the problem was due to the medication or giving birth. In addition I didn't know how to do self-care and WAS NOT taking care of myself. I was under tremendous stress with slow healing from childbirth, my marriage falling apart and my son being sick. I feel like I know the worst-case scenario and have information and support to get through a possible next time.
There is a young woman on here pregnant and off meds and having a hell of a time. I'm sure she will have some insight to share.
Borderline Personality Disorder
Post Traumatic Stress Disorder
"It's never too late to become what you might have been."