I’d been lectured by my doctor that I must never get pregnant accidentally and that I must be very careful with contraception. It’s really best when you have bipolar to plan your pregnancy carefully if possible because of medication issues and the right support needs to be organised. So when me and my husband decided we wanted to have a baby I informed my doctor about our decision. My GP referred me to the perinatal Heath team and I was sent to see a psychiatrist, the whole process took 3 weeks.
At first I was really guarded about the psychiatrist because I felt like he might be judging me and thinking I shouldn’t become a parent, or I felt like the whole process of the peri mh team was to keep an eye on me in case social services got involved. I find psychiatric evaluations distressing as well because the psychiatrist asks you a lot of questions about your past and up bringing. I always feel like I need a stiff drink after an evaluation. I don’t like to talk about that stuff.
When I became pregnant, a special midwife called Sarah was sent to me for a home visit. Special midwives work with vulnerable women, whether they have severe mental health issues, learning difficulties, or are in a vulnerable situation (I imagine a history of drug use, domestic violence or maybe a refugee or something). Unlike ‘regular’ women all my midwife visits were at home, with Sarah. Sarah came to see me at unspecified times on certain days, and she could spend as much time with me as I needed, whether it be 5 minutes or 2 hours. She also asked me a lot of questions about my history and current environment, and at first I was defensive, but after a few visits I knew I could really trust her. The vulnerabilities team midwives have given me more than a few cuddles.
When my psychiatrist wasn’t seeing me for check ups on my general psychiatric health or medication, a psyc nurse came to see me. I didn’t feel judged by her at all and she put me right at ease. She helped me realise whether I was being a regular worried mother, or whether there was a more serious problem. She offered me a lot of encouragement and made sure my feet were on the ground. I could call my special midwife or psychiatric nurse anytime, night or day.
I was also referred to a support worker, who came to visit me several times. Her goal was to keep me from becoming isolated and to make sure I was getting out and socialising, but seeing as I was doing that just fine, I was discharged from the service. If I had needed her to, she would have accompanied me to baby groups or coffee mornings.
When I gave birth my midwife was a lady called Lucy, who I had not seen for many of my home midwife visits but was part of the vulnerabilities team Midwife’s (which consists of 3 women who work on the whole of sheffield). I already knew her and was familiar with her. It was so reassuring to arrive at hospital in the chaos of the jessops wing waiting room and know that Lucy was on her way to see me. I actually cried when after arriving at hospital, 30 minutes later Lucy had my labour room all prepared nicely for me with relaxing music and a bath readily prepared. The whole time I was in labour it was just me, my husband and Lucy. I felt relaxed and safe knowing that Lucy understood not only my mental health issues, but I didn’t need to feel paranoid about things like self harm scarring (from when I was 13 I might add, I dunno why people make a big deal about it) and I knew that she understood my history of sexual violence. She was incredibly sensitive and wonderful. I did find the birth incredibly traumatic, it sounds silly but I dissociated and wasn’t really aware that I was giving birth. I didn’t fully understand what was happening to me, and I was only in the hospital 4 hours before the baby came out!
After I had given birth, Lucy did a good job of keeping me nice and calm and I was allowed to sleep in the labour room overnight rather than being moved to a ward with other women. I feel like, even though the birth itself was difficult due to severe tearing, it was a dignified and empowering experience where I felt like I was fully in control of what happened to me and my body. I didn’t feel self conscious, or humiliated, or distressed. I have bit of shell shock from the birth, but I got over it in about a month.
After the birth, Sarah continued to visit me at home in my bedroom and she discharged me as soon as my mastitis has cleared up and I was confident looking after the baby. Getting discharged was more than a little emotional for me :’)
Now henry is 3 months old, I am still a patient at the perinatal health clinic. I go to a baby group with the other ‘service users’ every Thursday and it’s nice to be around other women who I know have had similar experiences to me. Sometimes the pressure to be a perfect mother is so much, and I feel ashamed to admit that I am a mother with a severe mental illness to people i meet at ‘normal’ baby groups. It’s nice to just be myself and talk about what’s ACTUALLY going on in my life rather than chit chat about issues that I think most mothers would identify with. The psych nurses run the baby group so I get to update them about how I am and see my psychiatrist right away if I need to.
My health visitor is a regular health visitor but she is aware of my condition, has given me her mobile for emergencies and is going to see me for 1 year, which is how long I am under the perinatal mh clinic. To be honest though, it shows that she hasn’t had much mental health training. She seems to be aware that I have mood issues, but not cognitive issues.
The odds of bipolar women getting post natal depression or post natal psychosis are quite high. I think there is a 25% chance of getting depression & 25% chance of getting psychosis. So I felt all along like the odds were good (50% chance I’ll be well) and I feel like the team of people who have helped me have kept me well and ensured that I am able to be a good mother and look after my baby. If I had not had this help, who knows where I’d be? I feel like this is such a valuable service for women and essentially, it prevents problems like suicide, infanticide and children having to be taken into care. To clarify – I was very much reassured the whole way through this process that the priority is my health and well being, not the babies (the baby is fine he’s built like a brick s*** house).
My grandma had bipolar, had no support and 3 out of 4 of her children were taken into care, I’m so gratefull I live in a time where I have this support and I am kept well. That I can say ‘yes I am here at this baby group for mentally ill people because of my history and because I am high risk, not because I am currently ill, I’m feeling very well, thankyou’.
For people who are thinking, that this might be a waste of their tax money, I think prevention is better than cure. It costs a lot of money to hospitalise people when they have a mental breakdown, it costs a lot of money to have social workers involved in children’s upbringing long term, it costs money to have intensive mental health treatment long term (which I now won’t need) it costs money to have police involved! I’m also well enough to work, if I hadn’t have been kept well I would have needed benefits, probably long term.
Amazingly though, if I had become severely ill there is a mother and baby unit on a mh ward, so I would not have had to be separated from my baby. In the old days I would have been and would have to have discontinued breast feeding because of it. although I would have to have travelled to Manchester or Nottingham to go there, so I really wanted to avoid that.
I’m really glad that I have had this support and I’m sharing my story because I want other women with mental health difficulties to know that there is support available and I want this service to be rolled out all over the country, not just in major cities.
When I was first diagnosed with bipolar, I was told that it was a momentous decision for my doctors to make because it would affect my life in big ways. I’d have to reconsider having children. I may not be able to work. I’d heard from bipolar women that they’d had their children taken away from them, that their kids don’t speak to them anymore or that they just hadn’t had any at all because it would have been too difficult. The perinatal mental health team is a gigantic leap forward in our society.