Can I Have a Baby if I Have Schizophrenia?

Schizophrenia is a mental health disorder characterized by hallucinations, delusions, and difficulties in thinking, perceiving, and behaving. Many people, if willing, can manage their schizophrenic symptoms with medications, lifestyle choices, and guidance from qualified healthcare providers.

Key takeaways:
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    Schizophrenia is a complex psychiatric disorder with many co-morbid conditions.
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    There are many health risks for you and your baby if you are pregnant and have schizophrenia.
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    Taking antipsychotic medications while pregnant is an important consideration and may be in the best interest of you and your baby.
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    Support from a qualified medical team and in your personal life can be incredibly vital and helpful in the pregnancy and parenthood journey.

Pregnancy and parenthood are also achievable for someone with schizophrenia but there are many considerations.

Schizophrenia – symptoms and causes:

Schizophrenic symptoms can be wide and varying but are generally separated into two categories — positive and negative symptoms. Positive symptoms include hallucinations, delusions, and thought disorders. Negative symptoms include the inability to feel pleasure, lack of ability to converse, and lack of motivation.

The causes of schizophrenia are not completely understood. Many studies have shown that schizophrenia results from abnormal neurotransmitters (chemical messages in the brain). Strong genetic connections exist, with a 40% risk of developing the disorder if both parents suffer from schizophrenia.

Other risk factors for the development of schizophrenia include:

  • Abnormal fetal development;
  • Gestational diabetes and preeclampsia;
  • Maternal malnutrition and vitamin D deficiency;
  • Birth complications;
  • Childhood trauma;
  • Hostile living environment;
  • Cannabis use.

Co-morbid conditions of schizophrenia

Many with schizophrenia have other co-morbidities that can greatly impact their lives, relationships, and lifestyle choices. It is important to consider these in the context of pregnancy and parenthood.

Conditions that might appear together with schizophrenia include the following:

  • Substance use disorders;
  • Depression;
  • Post-traumatic stress disorder (PTSD);
  • Obsessive-compulsive disorder (OCD).

Schizophrenia and pregnancy – risks:

If you have schizophrenia and have become or desire to become pregnant, it is incredibly important to consider the impact that pregnancy and parenthood will have on you and your child. Many times, pregnancies of schizophrenic patients are unplanned.

Considerations and risks should be discussed with your healthcare providers and support system. Consider any co-occurring conditions of your schizophrenia and their potential impact on your pregnancy and parenthood.

Below we compiled a list from a systematic review of previous studies of over 40,000 deliveries of women with schizophrenia to evaluate the outcomes and risks of these pregnancies.

Risks for the pregnant parent

Risks for the baby

  • Birth defects;
  • Low APGAR scores (assessment of fetal well-being at birth);
  • Small for gestational age and low birth weight infants;
  • Preterm delivery;
  • Stillbirth and infant death.

There are many social and physical needs of parents with schizophrenia and their newborns. It is important to have to support of professionals throughout your prenatal care, delivery, and postpartum.

Schizophrenia medications and pregnancy

The most common form of treatment for schizophrenia is antipsychotic medication and therapy, commonly in the form of cognitive behavioral therapy (CBT). Medications may be combined for desired results. Additionally, as control is gained over schizophrenia, medications may be altered or reduced with the help of healthcare providers.

Can I take medication while pregnant?

Yes, there are antipsychotic medications that can be used in pregnancy. Approximately 500,000 pregnancies in the United States involve patients with a psychiatric illness, with one-third of those patients taking medication. Information regarding the risk of birth defects with the use of antipsychotic medication is limited. However, a large meta-analysis study of over one million pregnancies found there to be no significant risk of birth defects with the use of antipsychotics for schizophrenia during pregnancy.

There are two types of antipsychotic medications:

  • Atypical. This type of medications are better tolerated and include olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), and clozapine (Clozaril).
  • Typical. This type of medications include chlorpromazine (Thorazine), haloperidol (Haldol), and perphenazine (Trilafon).

All of these medications are considered FDA category C, meaning that risk in pregnancy cannot be ruled out. It is recommended that the smallest effective dose and number of medications be used during pregnancy.

Stopping medication while pregnant

If left untreated, schizophrenic symptoms and the risk for co-morbid conditions can be detrimental to the parent and the child. Medication compliance is a frequent issue in schizophrenic patients. A parent may choose to stop their medication while pregnant over safety concerns for the unborn child. Medications should not be stopped abruptly. If you desire to stop or change your medication regimen, it is important to speak with your care providers.

Can I take medication while breastfeeding?

Safety data on antipsychotics during lactation is very limited. The most common medications have safety ratings from L2 (safer) to L4 (potentially hazardous). It is important to coordinate your care and medications with your obstetrician or midwife and therapist. Input from a lactation consultant may also be useful.

Tips for pregnancy and parenthood with schizophrenia

  • Establish a healthcare team. Whether you have your psychiatric illness under control or need help with treatment, you must seek help from an obstetrician or midwife and psychiatrist to manage your care;
  • Find your support system. This can be your partner, family, friends, and/or a support group. Psychiatric illness can feel isolating. Pregnancy, birth, and parenthood are the most fruitful when surrounded by support and care. Accept help where it can be safely found;
  • Look after yourself. Taking care of your body and mind is important, especially while creating new life. Find some activities that you enjoy and coping mechanisms that you truly connect with. This will help relieve stress and anxiety. Healthy nutrition is beneficial for you and your unborn child. Ensure quality sleep and hydration.

Considerations if your partner has schizophrenia

If your partner has schizophrenia and is about to become a parent, the greatest contribution you can offer is support. Understanding your partner’s disorder process and individual symptoms will help you both to support one another through the pregnancy and parenthood journey. It is important to note that pregnancy, and especially parenthood, can be a time of stress and anxiety. These feelings have the potential to worsen schizophrenic symptoms or co-occurring conditions if present. Support and encouragement will be your greatest assets as a partner.

Schizophrenia is a complex disorder. Pregnancy and parenthood are life-changing experiences. Sometimes, schizophrenia, pregnancy, and parenthood may not seem congruent. With the correct care, support and motivation, you can create and raise a child while successfully managing schizophrenia.

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