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A 40-year-old G1P0 woman with bipolar disorder and a history of childhood sexual abuse and opioid use disorder (sober x 10 years) is diagnosed with severely diminished ovarian reserve and becomes pregnant through in vitro fertilization with a donor egg. At conception, she is stable on valproic acid and remains on it for her entire pregnancy. She later develops pre-eclampsia and requires a C-section for failure to progress in labor. Which of the following aspects of her history would most elevate her risk of postpartum psychosis?