If you have schizophrenia, you may wonder whether it’s possible for you to have a safe pregnancy and start a family.
The answer? Yes: Pregnancy and maternity in people with schizophrenia have tripled over the past few decades. The current maternity rate for people with the condition is 50 to 60 percent, which is similar for people without schizophrenia, research suggests.
That said, if you want to become pregnant, there are certain things you’ll need to know and do in advance to stay healthy while you're pregnant and ensure the best outcome for you and your baby. Here’s how to prepare yourself for a healthy pregnancy if you have schizophrenia.
Before getting pregnant, it’s important to talk to your treatment team about how pregnancy could affect your symptoms.
Schizophrenia relapse (a return or worsening of symptoms) is common during pregnancy, especially for people who stop taking their medication. That’s why it’s really important to stick to your treatment plan throughout pregnancy. Medication and psychotherapy (talk therapy) are common components of schizophrenia treatment.
Whether you’re pregnant or not, you may experience symptoms such as:
Hallucinations (seeing or hearing things that aren’t really there)
Delusions (unshakable false beliefs that are clearly untrue)
Disorganized thinking, speech, or movements
Lack of motivation
Flattened emotional expression
Social withdrawal
Lack of insight into your illness (meaning you may be unaware of your symptoms or illness)
Some of these symptoms could put your and your baby’s health at risk, so it’s important to tell your schizophrenia treatment team and your ob-gyn about any symptoms you’re experiencing. If needed, they may adjust your treatment to help you stay well.
For most people with schizophrenia, medication plays an important role in symptom management. Antipsychotic drugs are the most common medications for schizophrenia.
Experts don’t know for sure how safe antipsychotics are for use during pregnancy. That’s because research in this area is very limited. Available data suggest most antipsychotics, except clozapine (Clozaril), may be safe for use during pregnancy, but this doesn’t mean they’re completely without risk.
For instance, all medications tend to carry higher risks during the first trimester of pregnancy, when a developing fetus is more vulnerable. Antipsychotics also commonly cause weight gain as a side effect, which could lead to overweight or obesity and raise the risk of gestational diabetes (diabetes during pregnancy).
Gestational diabetes is linked to certain complications. It can cause you to have a larger baby, which can cause damage to the infant’s shoulders during birth. It’s also linked to breathing issues for a baby at birth, low blood sugar levels at birth, premature birth or stillbirth, or an increased risk of obesity or type 2 diabetes at some point in your baby’s life.
But it may be safer for many people to stay on medication than to stop. That’s especially true if you or your treatment team feels that stopping meds may cause your symptoms to come back. As mentioned, schizophrenia relapse is common among people who stop taking their medication during pregnancy. Untreated or insufficiently treated schizophrenia may pose a greater risk to your baby’s health and your own than any medication-related risks.
It’s important to talk to your psychiatrist — ideally before you get pregnant — about what medicines you’re taking before and during your pregnancy, as well as the risks and benefits of both continuing and stopping medication. The best approach will vary from person to person.
Some people with psychiatric conditions may skip their meds during pregnancy out of fear it will harm the baby. It’s important that you don’t make any changes to your treatment plan without talking to your doctor first. Doing so could cause your symptoms to return or worsen.
Women with psychiatric conditions, including schizophrenia, during pregnancy are less likely to get regular prenatal care. That means fewer pregnancy checkups with their prenatal care doctor.
It's very important to have your physical health monitored by a doctor during pregnancy. One reason is that pregnant women with schizophrenia have an increased risk of certain pregnancy and birth complications. These may include:
Women with psychiatric conditions like schizophrenia also are more likely to use alcohol, tobacco, and other substances during pregnancy. This could also lead to an increased risk of pregnancy complications, including preterm delivery and preeclampsia (dangerously high blood pressure in the mother).
Schizophrenia can run in families, but not everyone with a parent with schizophrenia will develop the condition. Kids who have one parent with schizophrenia have about a 10 to 15 percent higher risk of developing schizophrenia than kids who don’t have a parent with schizophrenia, research suggests. If both parents have schizophrenia, this risk increases to 35 to 46 percent.
Postpartum care with your treatment team is very important after you give birth to ensure you stay in good health.
One reason is that people with schizophrenia have an increased risk of postpartum psychosis. That’s a rare but very serious form of psychosis (detachment from reality) that can happen within several days to six weeks after giving birth. People with postpartum psychosis have an increased risk of harming themselves or their children or of death by suicide.
In addition, women with schizophrenia may be more likely to have rapid repeat pregnancies than women in general. In a study of more than 1,500 women, researchers found that 6.3 percent of women with schizophrenia had a rapid repeat pregnancy compared with 3.9 percent of women without schizophrenia.
A rapid repeat pregnancy means becoming pregnant again within 12 to 24 months of a previous pregnancy. Rapid repeat pregnancies are associated with an increased risk of pregnancy complications. The American College of Obstetricians and Gynecologists recommends waiting at least 6 to 18 months after the birth of one child before becoming pregnant again.
Like many new parents, people with schizophrenia may struggle with the early period after birth. Along with medical care from your treatment team, it helps to have support from your partner or family if possible, especially overnight so that you can sleep. A lack of sleep can trigger a schizophrenia relapse.
Planning for a pregnancy when you have schizophrenia involves special considerations to ensure that you and your baby stay healthy.
Prescribed medication may be necessary to manage your symptoms, but it’s important to discuss risks and alternatives with your healthcare team.
Be sure to maintain regular prenatal appointments to monitor your health, and try to keep a robust support system in place postpartum.
