Schizophrenia is a serious psychiatric disorder that causes hallucinations, delusions, and problems thinking. (1) If you do become pregnant with schizophrenia, there are certain things you’ll want to know to help ensure the best outcome for you and baby.

Schizophrenia Symptoms and Pregnancy

You may be wondering, “does schizophrenia get worse during pregnancy?” Some people find that their schizophrenia symptoms are minimal during pregnancy, while others may struggle with symptoms throughout pregnancy. (2) Common schizophrenia symptoms include: hearing, feeling or smelling things that aren’t there, thinking illogical or untrue beliefs, or having disorganized thoughts or speech. (1) Some of these symptoms could put you and your baby’s health at risk, so it’s important to tell your ob-gyn about any schizophrenia symptoms you may be experiencing. Your ob-gyn may recommend that you see a maternal-fetal medicine specialist. These are doctors that help take care of women with complicated and high-risk pregnancies. (3) It is possible to experience schizophrenia for the first time during pregnancy. The symptoms of schizophrenia typically appear in a person’s late teens through early thirties. (1)

What Are Risks to Mother and Child When Mom Has Schizophrenia?

Women who suffer from psychiatric illnesses, including schizophrenia, during pregnancy are less likely to get regular prenatal care. That means fewer pregnancy checkups with their prenatal care doctor. (2) Women with schizophrenia also are more likely to use alcohol, tobacco, and other substances during pregnancy. This may lead to an increased risk of pregnancy complications, including preterm delivery and preeclampsia (dangerously high blood pressure in the mother). (2)

Schizophrenia Medication and Pregnancy

For most people with schizophrenia, medication plays an important role in controlling schizophrenia symptoms. This is why it’s important to speak with your psychiatrist and doctor before stopping any psychiatric medicines. An estimated 15 to 20 percent of pregnant women suffer from any mental disorder. (2) That includes schizophrenia. Many may skip their meds during pregnancy out of fear it will harm the baby. Research shows, however, that skipping medicines may not always be the safest option. (2)

In one study, for instance, researchers found that pregnant women who discontinued using antidepressants were 5 times as likely to see their depression worsen than women who kept taking their meds during pregnancy. (4) Many antidepressants are considered safe for use in pregnancy. (5) The jury is still out on the safety of antipsychotic medicines in pregnancy. Some studies have suggested that taking antipsychotic medication during pregnancy can lead to birth defects, especially when taken during the first trimester. (5) However, a large 2016 study showed that the use of antipsychotic medicines during the first trimester did not meaningfully increase the risk of birth defects in kids. (6) Several studies also have shown that the drug haloperidol (Haldol) does not cause birth defects. (5) According to the National Institute of Mental Health, no medication is considered perfectly safe for all women at all stages of pregnancy. (5) And there are a few psychoactive drugs that most pregnant women should avoid due to their risk of birth defects. These drugs include mood stabilizers, and perhaps benzodiazepines. (The research on benzodiazepines is more controversial than the well-established literature on risks of mood stabilizers.) (5) Mood stabilizers are medicines to help even out the “highs” and “lows” of bipolar disorder. They also may be used by some people with schizophrenia or schizoaffective disorder. Benzodiazepines are commonly prescribed to treat anxiety. Some people with schizophrenia also experience anxiety, so may be prescribed benzodiazepines. Overall, whether or not a person should continue psychiatric medication during pregnancy is highly personal. This decision is best made with a provider, particularly one who knows the person and her history of illness well. The woman and her provider can weigh the risks and benefits of both stopping and continuing medication. Also, there is sometimes the possibility of reducing or stopping medication for a small period during the first trimester, when risk of many of the adverse effects of drugs is highest. Whether or not you remain on medication, continuing with your provider is essential as, in both cases, your provider will be able to monitor you closely throughout pregnancy for any issues that may arise.

Will the Child Have Schizophrenia?

Schizophrenia can run in families, though not everyone with a parent with schizophrenia will develop the disease. Kids who have a parent with schizophrenia have about a 6 times higher risk of developing schizophrenia in their lifetime than the general population. (7)

Schizophrenia Postpartum

Women with schizophrenia may be more likely to have rapid repeat pregnancies than women in general. In a 2019 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. (8) A rapid repeat pregnancy means becoming pregnant again within 12 months of a previous pregnancy. Rapid repeat pregnancies are associated with an increased risk of pregnancy complications, including severe bleeding and tears in the uterus. (9) The American College of Obstetricians and Gynecologists (ACOG) recommends waiting at least 18 months after the birth of one child before becoming pregnant again. (9) A major fear for mothers with schizophrenia is that they’ll lose custody of their children. Researchers estimate that about one-half of mothers with schizophrenia maintain custody of their children. (10) In cases where a mother loses custody of her child, it’s common that a family member will take custody of the child. (11) A combination of medication, psychotherapy, and social services can help women with schizophrenia care appropriately for their kids.