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Women with Bipolar Disorder and Pregnancy

This project aims to investigate the views of women with bipolar disorder who are contemplating pregnancy or who are pregnant. Qualitative and quantitative methods will be used to discover what factors affect their decision to become pregnant and their choice of treatments to help them stay well.

Women with bipolar disorder are at very high risk of having a severe episode of illness in relation to pregnancy and childbirth, with 25-50% of births precipitating postpartum psychosis, a severe condition which usually requires hospitalisation. They face many difficult decisions, including whether to optimize their chance of remaining well by staying on their mood-stabilising medication and risking harm to the foetus, or to stop medication and risk becoming ill.

This study is designed to gather information on this hitherto neglected topic. Firstly, a systematic review and metasynthesis of the qualitative literature on the views of women with severe mental illness on having children, and the attitudes of the professionals who treat them, is being conducted.

This will be followed by qualitative interviews with women with bipolar disorder who are pregnant or contemplating becoming pregnant, to find out what they think about the decisions they have to make, and discover what factors they consider important. Each interview will be audio-taped, transcribed verbatim and examined through a form of thematic analysis.

The information thus gained will also be used to develop a questionnaire which, after piloting, will be administered to a larger group of women nationally. This will lead to a more thorough understanding of common themes and, ultimately, both data sets will inform the construction of a decision-making tool.

Who is involved?

This study is part of a PhD being carried out by Clare Dolman, under the supervision of Professor Louise Howard, Professor in Women’s Mental Health, Consultant Perinatal Psychiatrist and Head of the Section of Women’s Mental Health, and Dr Ian Jones, Reader in Perinatal Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine and Neurology, Cardiff University.

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