5 top things to think about

These are the 5 most important things you can do before you get pregnant if you’re managing a severe mental illness.

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Planning a pregnancy

1. Keep taking your medication until you’ve talked to a health professional

2. Give up substances that could harm you and your baby

3. Be as physically and mentally healthy as possible

4. Think about what support you might need

5. Know your early warning signs of relapse and share them with those around you

More information and support

Planning a pregnancy

Planning a pregnancy takes a lot of thought. If you manage a severe mental illness, you will have the same things to think about as anyone else, like money and childcare. Plus, you might need more time to make sure you’re as healthy as you can be, and that you have the support in place that you need.  

These are the top 5 things to think about before you get pregnant. Even if you’re already pregnant, these things still apply. Speak to your GP as soon as you can, to talk through your options.

1. Keep taking your medication until you’ve talked to a health professional

Sometimes, people think they should stop taking medication when they start trying for a baby. The thing is, if you stop your medication all of a sudden, your mental illness symptoms could come back, or they might get worse. This may not be safe for you or your baby if you do conceive.

Always speak to your doctor before stopping contraception if you’re taking anything, even herbal remedies. They will help you find a treatment that is right for you during pregnancy.

If you need to change what you’re taking, or how much, you may need time to do this a little bit at a time before you start trying to get pregnant.

It may feel strange to keep using contraception when you know you want to get pregnant. But it’s vital to take the time to work out the right medication with health professionals before you get pregnant.

If you’re already pregnant, tell your doctor as soon as you can. They will explain the risks and benefits of your medication, and help you decide on the best treatment for you.  

Read more about medication during and after pregnancy.  

2. Give up substances that could harm you and your baby

Taking drugs, smoking, and drinking alcohol can make it harder to get pregnant. They also contain chemicals that can harm your baby if you do conceive. You should stop before you get pregnant.

If you’re already pregnant, you can still increase the chances of a healthy pregnancy if you stop smoking, drinking or taking drugs at this point.

For some people though, it’s harder to stop. There’s a lot of support out there – and it really helps. People who get support are 3 times more likely to quit smoking, for example.  

Check out this great free personalised quit plan from the NHS.

Your GP can tell you what support there is near you. If you have children, you could speak to your health visitor, family nurse or parenting support worker, too.

You can also contact some services yourself. There are links to support services at the bottom of this page.

If you have a close family member, friend or partner, they can help you by going with you to your appointments. Your doctor can also suggest ways that they might support you.

The main thing is to give up safely and with help from your doctor.  

3. Be as physically and mentally healthy as possible

Looking after your health will give you the best chance of getting pregnant and having a healthy pregnancy. You can do this by:

• getting closer to a healthy weight if you’re underweight or overweight
• taking folic acid and vitamin D supplements  
• eating a healthy, balanced diet  
• cutting down on caffeine if you drink a lot
• being active, such as doing brisk walking or swimming
• having a cervical screening test if you haven’t had one in the last year 
• checking that you’re up to date with your vaccinations, such as the MMR vaccine  
• getting tested for sexually transmitted infections (STIs) if you think there’s a chance you may have one.

Make sure you have talked to a health professional if you have any other health problems, such as diabetes or epilepsy. Your GP can refer you to a specialist who can give you advice on treatment before, during and after pregnancy.  

4. Think about what support you might need

Everyone needs support during and after pregnancy, but if you have a mental illness you may need extra support. Your psychiatrist or perinatal mental health team can help you plan what emotional and physical support might look like.

At 30-32 weeks of pregnancy, you may have a pre-birth planning meeting with the health professionals who will be looking after you.

At this meeting, you will agree a care plan for the rest of your pregnancy, the birth, and after your baby is born. You will be given a copy of your care plan to keep. The care plan is different from your birth plan.  

As well as support from the medics think about who you could ask if you need someone to talk to. Do you have a partner, family member or close friend you can turn to if you’re struggling to cope?

You can speak to your GP, perinatal mental health professional, midwife, health visitor or family nurse at any time. Don’t hesitate to reach out if you’re worried your mental health symptoms may be getting worse.  

There are also organisations and online communities where you can find support.

5. Know your early warning signs of relapse and share them with those around you

If you have a mental health condition, your symptoms may be more likely to get worse during and after pregnancy than at other times in your life.

No one knows your warning signs of relapse better than you and those you are closest to. If you do notice signs of a relapse, try to get help as soon as you can. It can and will be treated, just like any other illness.  

Your midwife and perinatal mental health team will ask you about your mental health at each antenatal appointment. They’ll also watch closely for any symptoms in the first few days and weeks after the birth, and treat them quickly if they come back.

You may want to write an advance decision, or advance statement. This lets others know your wishes if you’re not well enough to make decisions during a relapse. You could say who you would like to look after your baby and other children, what care you would like to receive, and which treatments you don’t want to have.

The charity Rethink Mental Illness has information about making an advance decision or advance statement.

More information and support

If you’re thinking of trying for a baby, use our Planning for Pregnancy tool to get personalised tips on how to have as healthy a pregnancy as you can.

Or check out these services, for more support:

• Mind offers advice and support for those living with a mental health condition, or who are helping someone who does.
• Get help quitting smoking from NHS Better Health.
• See advice on giving up alcohol at Drinkaware.
• Find services that can help with drug addiction through the NHS.