Hi there, and welcome.

I have a Bipolar dx of unspecified type but can have prolonged manic episodes. I have not had children but I have been on and off mood stabilizers, for different reasons.

Typically, when i went off meds i was doing well. Perhaps the first most obvious thing i would suggest is, that you don't "try for this" until you have successfully tapered your meds, and are stable. You can help yourself stay stable by making sure you get enough SLEEP.

The very next thing would be to reduce the stress in your life to a minimum. For instance, depending on your lifestyle this might mean taking an early leave from work once you become pregnant. I say this thinking of a stressful work environment. However, some people get fidgety and feel more stressed if they are at home with nothing to do. If you enjoy work and it does not fatigue you, then, it might be positive for you to keep working while you can - in this case staying connected helps us keep from getting depressed. The point is to make choices (and changes if necessary) to reduce STRESS.

Plan A will be for you to be medication free during pregnancy, and if you want to breastfeed, possibly during that time too. You will need to work closely with your doctors - maybe see your pdoc more frequenly for monitoring. I would suggest having your obstetrician and pdoc work together from the outset to discuss your overall medical status as well as possible medications that can be used in the event you need to be medicated during pregnancy. Then, should you become depressed or hypomanic, you will all have to decide, based on the severity, whether it it is more important to medicate the episode and if so which meds to use depending on the gestational stage, or whether you might be "ok" enough to remain unmedicated until after delivery.

I would also suggest seeing a counselor before, during and afterwards even just for supportive therapy.

If you have family-history of postpartum depression it may be advisable to pre-emptively choose a strategy that will allow you to go back on medication right after you deliver, because as you know antidepressants take a while to "kick-in."

With regard to post-partum depression, there are a few solutions. one can be to use formula so that you can actually get back on medication right after having the baby. There are some meds (get docs advice) which don't pass into breast milk. Another thing you will need to do is make sure you get enough SLEEP and general REST after you have the baby... this means someone else gets up and feeds the child at night. If you are using breast milk, there are pumps that you can use to draw and store breast milk which someone else can then give the child during the night hours.

It just so happens i ran across an article lately about this recently. i will look for it and post it for you.

From my own personal experience, unpregnant but keeping mood charts and being OFF meds, i can say that a HUGE factor, perhaps even the BIGGEST, in retaining stability, is getting regular and sufficient SLEEP, every single night. Sleep goes off, mood goes off. (it happens to regular people too, but they just get cranky for a day, whereas we end up on major medications! ) So, if nothing else, go to the ends of the earth to ensure that you will be able to get the FULL amount of rest that you need during pregnancy and after delivery - and "FULL amount" means however many hours YOU need to feel rested. no "oughtta's" and "should's" about it.

wishing you well, and i'll be back with that article if i can find it again.

~ waves ~