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Pregnant Again!!

TwoUnderTwo profile image
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Hey everyone, I haven't been around in maybe...a year and a half or more. I have had a lot happen to me; my medications have been switched around like crazy, I came off all of them but one, and I dove into alcoholism and benzo addiction. I have been clean for over 70 days now! I feel like ever since my PP episode I just fell apart and did not deal with it at all. I am just now starting to settle, and then WOW I got a positive test four days ago.

My son whom the episode occured after his birth will be turning two November 8th, and my PP two year anniversary is November 13th. Frightening to know it has been almost two years and I am just now almost finished processing what happened in 2013.

I am fearful for the aftermath of this baby. My psychiatrist knows and so does my Ob/gyn, and I am considered a high risk pregnancy due to being on lamitrogine and the risk of another PP episode. I will get my first ultrasound on the 12th!! Hoping for a girl this time around; I am in a house full of boys!!

Did anyone have a pregnancy be considered high risk after a PP episode? How often were you seen? What was your preventative plan for after the birth?

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TwoUnderTwo
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Lilybeth profile image
LilybethVolunteer

Hello Twoundertwo

Welcome back and thanks for being so honest about how you have been. I'm really sorry to hear you have had so much to deal with in the wake of PP. It's good that things have now settled ...... though it must have been a shock as well as a lovely surprise to find you are expecting another bundle of joy.

Try not to worry ... easier said than done but at least your care team are well aware so they will be able to step in at any time if need be.

I did have a second son and suppose I was considered a high risk due to my worrying first PP six years earlier. Some mums here though have had second babies without PP returning ......

Hope your scan is amazing!! Stay safe and take good care of yourself.

Jenny_at_APP profile image
Jenny_at_APPPartner

Hi TwoUnderTwo,

I'm so sorry to read what a tough time you've had following PP. Well done on getting through what must have been a very dark and difficult time for you.

I'm sure you'll have a lot of support through this pregnancy. I'm 24 weeks pregnant and under consultant care for the pregnancy because of PP but not for the birth (my birth first time was fine so no reason to be under consultant care for that), so I have additional check ups with the consultant team on top of being seen more often by the midwife than if it was a straightforward second pregnancy. I'm also seeing a mental health specialist nurse. I've only had one appointment with the consultant team and mental health nurse so far, the next appointments are in a couple of weeks and I don't know how many appointments I'll be having beyond that. I've also only seen my midwife once so far, everything kind of gets more regular from now onwards so I'm not exactly sure what to expect - I think they'll just be checking on my mood and helping me plan for after the birth.

My plan for after the birth is to take a low dose of medication (I don't know what the dose will be yet), bottle feed after the first feed and get as much sleep / rest as I can (hubby will be doing the night feeds). I didn't get ill until 3 weeks after birth last time so I think it'll be a very anxious first month but I'll have a lot of support from family and am hoping I can enjoy those early days and weeks. At least we are aware of the risk this time and will know what to do if I start having symptoms.

Sorry that's not hugely helpful as my appointments haven't really started properly yet and my 'plan' needs more thought but there are a lot of others who have been through a subsequent pregnancy and will be able to share their experiences.

Take very good care and I hope the scan goes well.

Best wishes xx

Ellie_at_APP profile image
Ellie_at_APPPartner

Hi TwounderTwo

Phew, it sounds like you've had a rough ride since your PP episode. But it is good to hear you are clean now. I hope you are feeling OK, especially with this new big news of a second pregnancy.

I only have my son so don't have any experience of a second child. But I did just want to direct you, in case you don't know about it, to the APP insider guides. There is a guide for second pregnancies if you're at risk of PP app-network.org/what-is-pp/...

It has some really good advice in it, including what things you should consider, and what you might want to put in your birth/care plan etc.

Take care, do keep seeking support whenever you need to on here X

Hannah_at_APP profile image
Hannah_at_APPAdministrator

Hi Twoundertwo,

Congratulations on your pregnancy and for coming out of the other side of the PP and all the other difficulties you've been having. You're a pretty strong woman and we are all here to offer any support, so feel free to ask away on questions.

I had PP after my first child in 2009 and then had another baby in 2013 with no recurrence of the illness. I wasn't on meds by the time I was pregnant again so bizarre as it might sound, having some input already and being seen a high risk is a good step for you I would think. I found that because I'd stopped meds, been discharged from MH services etc, a lot of professionals thought I'd just been unlucky and I would be fine. But there is quite a risk of PP in subsequent pregnancies (as you'll know) and in the absence of a perinatal service where I live, I had a consultation with Dr Ian Jones through APP. I don't know if you're in the UK, but here's the link: app-network.org/what-is-pp/...

I don't know what services there are where you live, but I had to go to my GP and ask to be referred to the Community MH team, which was a huge delay and I didn't see a psychiatrist (other than Ian Jones) until 7 or 8 months pregnant. I found that the hospital I was giving birth in were concerned with just that - the birth. Although it is fairly recently, I hope that things are a bit more joined up now as it was quite hard going and we had to do a lot of things ourselves. For example, I wrote a care plan - like an extension of the traditional birth plan a lot of ladies do, and wrote bullet point info about when I'd had PP, what meds I'd taken, what had worked and not worked and also mine and my partners preferences on treatment if I became ill. I also had an elective caesarean, not a choice taken lightly but after an emergency one, I felt any kind of risk minimisation we could do was needed. I also took a low dose of meds after giving birth and bottle fed my baby after an initial breastfeed. It was quite helpful for us (and also for the professionals when they started paying attention!) to have everything written down. I lost count of the times I repeated myself to different midwives, Drs etc in ante-natal appointments. I was eventually allocated a social worker who helped put my home-written care plan into the hospital and NHS systems. He was a great support in getting everything tied up and making sure things went as we wanted, as far as possible.

I had the usual midwife booking in, then 12 week scan, 16 wk appt, 20 wk scan and appointment and 24 wk appointments at the hospital. This was only because I'd had a caesarean that I was under a consultant though, and I had midwife appointments in between I think, then every other week near the end (not sure, it feels like ages ago!) plus the odd trip to the GP to ask for a referral to Ian Jones and to chase up the CMHT referral too. I don't think i had more appointments than I would have had really, but towards the end it was good to know that everything was in place.

My advice would be to try and do as much planning as you can and minimise stress and other risks as far as possible. We were very much of the opinion that it was an awful scary time in many ways when it should have been exciting, but we did what we could. And if I'd have got ill again, it couldn't be as bad as before, as people would know and it'd be picked up. I also had it in my care plan that I would have preferred a Mother & Baby Unit admission if at all possible to minimise the impact on my eldest child if I was ill at home. But we'll never knew if that would have been possible as luckily I stayed well. You will know what is best for you and your family and what services you have available to you.

I wish you all the very best with it too, and please come back and ask questions and give us updates if you'd like. Take care, xx

TwoUnderTwo profile image
TwoUnderTwo

Sorry I didn't reply earlier! Had a nasty bout of the flu. I had an ultrasound yesterday and saw the bean! I have another on Monday. I have a corpus leutium cyst on my right ovary and it HURTS!

But anyway, thank you EVERYONE for the input so far. My husband's parents know, but we don't plan on telling anyone until about 16 weeks, just to make sure the baby is going to stick. I fear telling my family. They will be very upset that we let this happen and that they will have to go through all the mess again (yeah...because it was so much harder for them than me) but I plan on standing for myself whatever they say to me. I will not allow negativity affect me this pregnancy.

How did you tell your families about a subsequent pregnancy after an episode of PP?

Hannah_at_APP profile image
Hannah_at_APPAdministrator

Hello again TwoUnderTwo

Great news that the ultrasound went well, although the cyst does sound painful, will they do anything about it? Hopefully it won't be too painful as things progress.

It can be difficult telling family about another pregnancy after PP. We too waited until I was about 13 weeks (and had had a scan) and steeled ourselves for a little bit of negativity if I'm honest... But family (and friends) were really supportive. I also have some difficult family dynamics and things were pretty strained when I was ill. Funny how people can make things all about them isn't it?! I agree, you have to put yourself and your partner and other children first and try not to get too worried about the reactions of others. I was quite surprised that no-one was too selfish about it really, the main obstacles I came across were when we were trying to minimise visitors after I gave birth. We told people in good time so they could get used to it, and said how important it was to have quiet time, but some people were still sulky about it. You do have to be prepared to make the best decisions for you and those close to you, and stand by them. My partner was my great champion in this too.

It also helped us to tell people as a couple so that if there were any negative or difficult reactions, I didn't have to deal with them on my own. And I kept most of my pre-natal appointments to myself and my partner and didn't feel the need to share too much with others. I just told them that things were fine and plans were being put in place. It avoided too much prying and didn't allow others to interfere or make us worry unneccessarily.

It's also something to bear in mind that you won't necessarily get ill again; I know the risk is there, but it is possible to stay well after another baby (which I did). Try and keep positive but also try and minimise stressful situations where you can, and take it easy if possible. Easier said than done I know with other children in the house too!

Have your care team said anything about the frequency of your appointments or other support they can put in place for you? I hope the next ultrasound goes well too and you are feeling positive about things. Take care, xx

Lilybeth profile image
LilybethVolunteer

Hello TwounderTwo

Good to hear your update although I'm sorry about your painful cyst.

My sons were born six years apart, mainly due to my husband and myself wanting to add to our family but wondering if I would be ill again. However, I wasn't aware that I had PP after my first son was born. My mum thought it best to shield me from being judged so my illness was not discussed inside or out of the home. I thought I must have had PND and felt ashamed for years.

We were also worried about telling my parents about my second pregnancy but after my 'bump' was twelve weeks we told them and they were not pleased. To be fair my parents (and husband) had seen me at my worst and it was a very stressful time for them. I did have PP again in the early 80's and still didn't know it was PP. However, as spannerb mentioned, although there is a risk, it doesn't mean that you will have PP a second time. You seem to have a good plan in place with professionals monitoring you regularly. Treatment and interventions have changed so much for the better so try and stay positive.

Make sure to rest when you can and take good care of yourself.

Lilybeth profile image
LilybethVolunteer

Hello TwounderTwo

I hope your second scan was ok on Monday and that you feel supported by the medical team who are monitoring you.

We are all here for you.

Take good care of yourself.

TwoUnderTwo profile image
TwoUnderTwo

Oh I know it will NOT go well when I tell my family. They have had to deal with a lot when it comes to me, and I have a hard time not putting myself down because of it. I harbor a lot of guilt from my PP episode, and probably will never let it go. My family, especially my sister never lets me forget how hard it was on them.

I am getting another ultrasound on Monday; the one last monday went well and I am measuring 4 days ahead. The cyst burst, thank goodness so all is well.

Lilybeth profile image
LilybethVolunteer

Hello TwounderTwo

I know it's a big deal worrying what your family will think but try not to let it get to you. I felt very guilty too about what my parents went through the first time (although they never speak about it) which in a way made me feel even worse the second time. My sister would drop a hint here and there over the years about my dark days in the grip of PP and how badly I behaved........but PP is not our fault is it?

I know you have had to battle other things too but it's just 'life' and you have had the courage to come through the tough times. In an ideal world you might not get PP a second time! I think you can reassure your family that this time you are being closely monitored by the professionals who will be able to spot any problems.

My second PP was so long ago and I do regret putting my family through the trauma again. In time the guilt does fade into the background and our family has been blessed by all those special times my sons have been part of over the years.

Glad to hear the cyst burst .... what a relief that must have been. Try to rest when you can, if you can. All the best with your scan on Monday ......

Lilybeth profile image
LilybethVolunteer

Hello TwoUnderTwo

I hope you are ok and that your scan went well.

Take good care of yourself ........ we are always here to listen.

Hannah_at_APP profile image
Hannah_at_APPAdministrator

Hi Twoundertwo,

How was your scan on Monday? I hope you doing OK and not letting things worry you too much, I know when I was pregnant again I did worry a little about my family's reaction but at the end of the day, you do need to concentrate on you and the pregnancy plus your partner and children. I know it can be hard, but if your family are putting you through any kind of stress, you should not have that in your life at the moment and it's perhaps best to minimise contact a little, just to look out for yourself. I know parents and siblings can be the best support, but they can also be hard work (in my experience anyway!)

Please don't feel guilty; without knowing the full situation, it's more than likely not your fault and if they can't see that, then I would say it's their issue and you shouldn't be feeling bad. You can only do what you can do would be my take on it.

I hope this doesn't sound too heavy, but I think we have enough to deal with having had PP and the aftermath and the recovery, that we shouldn't have to take the whole world's feelings into account too. Yes, you had some other difficulties after the PP, but you got through it and are likely a stronger person because of it. Sometimes a little bit of focussing on ourselves can be beneficial, it's not being selfish, but doing what you need to do. I hope this helps and your week has been a good one, take care, xx

violetx profile image
violetx

Hi twoundertwo

Congratulations on your pregnancy. I too am pregnant with my 2nd child due 14th march 2016 and so makes me 23 weeks. My episode of PP and mania after having my son was december 2013. My sons birthday is on the 8th december and even though im excited he will be 2, i cant help but feel sad as its the anniversary of my illness. I cant believe its been two years. I dont think a day has gone by without thinking of the awful experience. Its hard to believe i was in a mental hospital. I dont understand but i often feel embarassed and i shouldnt be. I think its because of what my close ones witnessed from my out of character behaviour.

Yesterday i had an appointment with a mental health midwife and my care co ordinator cane with me. I told her what happened to me in my own words and the order of what hospitals i was admitted to. She told me her role and what i would like her to do for me. We put pen to paper ideas of what will go into my 'plan'. I have expressed that i wish to stay in hospital after giving birth so i can be closely monitored, have plenty of sleep and concentrate on baby whilst my son will be well looked after. So i may be able to stay 2-3 days and am assured if needs be i will stay longer. Im currently taking quietipin. And will be taking sodium valporate after birth. I dont wish to breastfeed as i want to concentrate on sleep and rest. Although il have a newborn to contend with i just feel that is best for me. I have been told and understand myself that my mental health is the upmost importance and to remain well will mean i will be able to care for my children. Ideally a room for myself would make sense. Im told i will be allowed someone to stay with me overnight throughout my stay. So my mum or partner will stay with me and they will both co ordinate care for my 2 year old. Before i will be discharged proffesionals will see me to say its ok for me to go home. Once im discharged i will be going to my mums. I know there after i will ha e midwives, health visitors and my cpn along with other carers to check on me but all organised and not everyday as i need to rest. This midwife then explained a proffesionals meeting. This will be a date made in february before baby is born. Everyone on board from my cpn, health visitor, midwife, phychiatrist, myself and family will attend to discuss my plan for after the baby is born. I left yesterdays appointment with a great weight lifted off my shoulders. As you can imagine im petrfied of becoming unwell again. But its comforting having some preperation and control this time round.

I wish you well for the rest of your pregnancy and remain well there after. Stay in touch, perhaps we could keep each other updated and exchange our care plan ideas. Also, if you read mh recent post you may find other comments from women who are also pregnant and other experiences of women going on to having more children after pp.

Take care

Violet x

Lilybeth profile image
LilybethVolunteer

Hello TwounderTwo

How have you been coping since your last post? Have you had more scans since the one you were going to have about a month ago? I wondered if you had told your family, and if so, how they reacted. It's a shame that such a precious moment can be overshadowed by the opinions of family.

I hope you are well and resting when you can. Take good care.

Hannah_at_APP profile image
Hannah_at_APPAdministrator

Hello twoundertwo, I've been wondering how you are too, hope you are keeping well, take care, xx

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