Mental health in pregnancy and after birth (SIGN)
Health care professionals working with mothers/birthing parents with borderline personality disorder should have access to support and/or training in managing the symptoms and behaviours associated with borderline personality disorder which may pose a risk to the mother, baby or pregnancy, or to the mother’s engagement with healthcare professionals and services offered.
Provide trauma-informed care for women/birthing parents with borderline personality disorder.
Advise women/birthing parents with borderline personality disorder who are planning a pregnancy, of the additional challenges of parenting associated with their emotional dysregulation and symptoms of borderline personality disorder, and the importance of ongoing support during and after pregnancy.
Where possible and appropriate, provide perinatal women/birthing parents with borderline personality disorder the opportunity to develop a shared formulation of the impact of pregnancy and parenthood on them, and their symptoms of borderline personality disorder. Where indicated this should facilitate access to individualised support and/or access to structured psychological therapies either specifically designed for borderline personality disorder, or for current comorbid mental health conditions such as substance misuse disorders, anxiety or depression.
Encourage pregnant or postnatal women/birthing parents with borderline personality disorder to develop and practice positive emotion regulation strategies. This could include access to psychoeducation, and/or training in emotion regulation techniques, such as relaxation, mindfulness exercises, or grounding practices.
When prescribing for a woman/ birthing parent with BPD consideration should be given to avoiding medications that may be lethal in overdose or are associated with substance dependence.