On the other side of the coin, my girlfriend had a tubal after she found out she was bipolar. For awhile she went without meds and tried to get pregnant, but it was too destabilizing, and she felt she couldn't handle it. My husband and I decided we didn't want kids long ago, so he finally got a vasectomy last year.

After my first suicide attempt, I decided that I didn't ever want kids because I didn't want them to have to struggle with MI the way I did. And that was long before I had bipolar on my mind - that was just with the depression and ADHD symptoms! I had such a hard time that I wouldn't wish that on anyone - not my worst enemy, and certainly not someone I'd love. Plus I had never really wanted kids, just assumed that it was my "duty" to have them, so it's not like I felt that I was sacrificing anything.

But good news! Statistically, the likelihood that your kids would be bipolar is actually not as frighteningly high as you might think. "If you have bipolar disorder, your chances of passing it on to your kids average about 9% (14% for major depression.)" - The Bipolar Disorder Survival Guide, p. 85.

However, risk goes up with more MI family members - on average, 25% of your immediate family will have a mood disorder. In my case, it was 100%, so the genetic vulnerability is much higher and the odds that I'd pass on some kind of MI would be several times higher than the average 9%, even though my hubby's family seems completely sane.