Second baby due July 5th: Hi all... - Action on Postpar...

Action on Postpartum Psychosis

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Second baby due July 5th

Mims2014 profile image
13 Replies

Hi all.

Second baby due in July. Conceived quicker than ideal but it's a gift to get pregnant.

I had pp 5 days after birth of son in March 14. As with the rest of you, experience was horrendous!

I live in a very rural area (South Cumbria) about 2,000 births in the hospital per year but I'm only one of two to have pp in 15 years.

The services try but their lack of experience and knowledge is obvious.

How do I get a referral to Dr Ian Jones??

I had an easy home birth last time, wanting that again but all professionals against it. Want to keep me in hospital for obs but I think this would cause pp as I know I won't sleep in hospital if kept in a week.

Did anyone take Haliperadol? They are recommending I take it in pregnancy but I'm not sure. I took Aripriprizole last time and would be up for taking strong dose of that post delivery.

Any comments welcome!

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Mims2014 profile image
Mims2014
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13 Replies
jessieh profile image
jessiehAPP

Hi Sally,

Congratulations on your pregnancy! That is such wonderful news.

There are many women that post on here that are pregnant or have had multiple babies that should be able to help answer your questions so I'll leave to those with more experience.

I do hope you come back to the forum to keep us updated. We're all here for you.

Wishing you all the best,

xxx

Lilybeth profile image
LilybethVolunteer in reply to jessieh

Hello Sally

Congratulations ..... it really is a gift and a lot of mums here have had second pregnancies without PP returning ....

I think you have to be referred by your G.P to Prof Jones' second opinion service which has been invaluable to many here. I'm not too good with links but if you try app-network-what-is-pp/gett........... it might work. If not, one of the other mums will point you in the right direction! I'm sorry I'm not sure about medication as my PP episodes were some years ago.

Rest as much as you can and take good care of yourself.

Ellie_at_APP profile image
Ellie_at_APPPartner

HI Sally

Congratulations, great news!

Yes - planning ahead is key. You've probably seen a few threads on here about second pregnancies recently - have a look at the news feed - loads of good advice and information there.

I don't have personal experience of a second pregnancy but did just want to give you the link to the second opinion service with Dr Ian Jones. Others will say more, but it is highly recommended - he will be able to advise you (and the professionals supporting you) on things like whether you should take medication while pregnant etc. app-network.org/what-is-pp/...

I really hope it goes well, and that you get some women on here sharing their stories...

Just a thought instead of being in general hospital would they put you in a MBU for a week or so? I imagine you would sleep much better in that setting? X

Hannah_at_APP profile image
Hannah_at_APPAdministrator

Hi Sally,

Congratulations on your pregnancy and thanks for coming back to the forum. I too am in a northern rural area, with very little info and support for PP, so APP has been a great resource for me.

I had my 2nd child in 2013, and had a consultation with Dr Ian Jones (via Skype) which was completely invaluable. I can't stress it enough! Partly because I was discharged from MH services and didn't see a psychiatrist locally until 8 months pregnant. The advice he gave was really helpful and he also wrote to my midwife, hospital etc which really helped pull things together - and they actually listened to what I had to say as well, whereas their previous outlook had been a little more relaxed. If you need to (as I did!) take a printout of the APP web page to your GP and ask to be referred.

With the birth, I chose an elective c-section (as I'd had an awful emergency one with my 1st child) and also to go into a private room in the hospital after the first night. This really worked for me, as I could sleep - even in an unfamiliar environment - and get rest, and have visitors yet still be monitored. The idea Ellie mentioned around an MBU bed might also be possible, but knowing how scarce these can be, I don't know if you would want to travel.

I can't advise on the meds you mention, as I took Olanzapine. I also had a low dose of it when I gave birth, although not whilst pregnanc. Although it's not something we can know for sure, it hopefully was something which did help towards me staying well after my 2nd child.

Please come back and ask any more questions, I know what a scary yet exciting time this can be, and am wishing you all the best, xx

JonesieB profile image
JonesieBVolunteer

Hi Sallyhudson,

Great to hear from you and wonderful news on your pregnancy!

I understand all your fears and worries, I had my first child in 2005 and had PP but I did then go on to have a baby boy in 2008 with no sign of PP at all. I had a great perinatal psychiatrist watching over me (not Dr Ian Jones, as I didn't know about him then) and we made lots of plans to help me rest well after the birth.

The best laid plans sometimes, sadly, make no difference but I was one of the lucky ones. I didn't take any preventative medication during pregnancy but again you will hear differing advice on this depending on who you see etc.

Very best of luck and if you want to ask any other questions about second time around, feel free.

Warmest wishes to you,

JonesieB

Sarah2015 profile image
Sarah2015

My husband and I were very scared of having a second child after PP with the first. It took us three years to start thinking about number two seriously. I didn't want my baby exposed to medication while I was pregnant or through breast feeding. I took no medication while I was pregnant and then a very large dose of Abilify immediately after giving birth (I bottle fed).

I was lucky and did not suffer from PP with my second. I took Haliperidol when I was in hospital (with my first) and suffering from PP. I got the impression that, although very effective, Haliperidol is a bit of a 'sledgehammer' in terms of medication.

I'm sure I read a post on here recently where someone had been advised that PP generally follows the same pattern with an individual. I was advised by a psychiatrist with a LOT of experience in PP that pregnancy is a safer period, though she emphasised quite heavily that it is not a 'safe' period. She said the body naturally tries to remain as healthy as possible during pregnancy. I would -personally- question the idea of medication in pregnancy when previously you were well in pregnancy, unless you are particularly fearful of PP happening during pregnancy. I am a bit opinionated though.

All the best and good luck.

Mims2014 profile image
Mims2014 in reply to Sarah2015

Thanks so much. Like you, I hate the thought of exposing my baby to medication in pregnancy and I want to take Aripriprizole afterwards. Tbh, I wanted to see if I got it before any meds but I would compromise with CMHT and take it on delivery. It's just so hard to go against advice and I worry about being seen as non compliant. Haliperadol is old style and in my opinion, it can't be that great if they brought out new meds! I just know how much Aripriprizole effected me as an adult and I will always wonder if my baby has any issues and blame myself for taking meds in pregnancy. Anyway, not due until July so lots of thinking time! I'll feel better taking to Dr Jones too and getting an opinion of someone who knows pp xx

Sarah2015 profile image
Sarah2015 in reply to Mims2014

I'm so sorry, I am bit over opinionated. I know a baby is a lot more resilient in its third trimester and you're right to listen to professional advice. Talking to Dr Jones is an excellent idea.

I breast fed my second child once, straight after delivery, then I took a large dose of Abilify and continued until my local psychiatrist decided it was reasonable for me to reduce my meds.

I'd be useless as a volunteer on here!

Mims2014 profile image
Mims2014 in reply to Sarah2015

Don't apologise! I'm opinionated too. I also blame myself a lot so if the baby has any issues, even little ones, I'll always wonder and blame myself. What research there is says the risk is low to the baby but I'm not that bothered if i get it again as I know it'll never be as bad, it took ages for mental health team to see me and treatment was therefore delayed X

Mims2014 profile image
Mims2014 in reply to Sarah2015

Ps. They want me to take a low dose of haloperidol in third trimester to build up so that I'll have enough in my system to fight pp, it's about preventing post delivery rather than risk of being ill in pregnancy I think

TraceyR72 profile image
TraceyR72Volunteer

Hi Sally, congratulations on your pregnancy. I had PP in 2004 after my first baby. I went on to have a second child on 2008 with no psychosis/mania in the early weeks but an episode of depression when the baby was 9 weeks old. I know how daunting the 2nd pregnancy can be after PP, but in my experience having a good preventative/support plan in place was invaluable. Mine was developed with a perinatal psychiatrist, but as you have no such experts in your area I think that a consultation with Dr Ian Jones, as recommended by others, would be really helpful. He's helped so many women through this situation and can share his recommendations with your local health professionals, which will help them feel more confident about how best to support you.

I understand your concern about the hospital sleep situation, as lack of sleep those first few nights in a noisy ward was a huge issue for me after my first birth. However the second time was very different as my support plan included having a single room on the ward, getting good 1-1 support with breastfeeding, and the staff also looked after my baby for long periods during the night. I limited my visitors too. With a demanding 4 year old at home it was a good opportunity to focus solely on recovering from the birth and bonding with my new baby. I experienced those 3 nights in the ward as very restful, so it doesn't have to be a sleepless experience if the staff understand your situation and prioritise rest for you.

I took no medication during 2nd pregnancy but started olanzapine preventatively after the birth, which was recommended to me as safe for breastfeeding. I think I may have taken haloperidol with my PP first time around but can't remember for sure as it's all a bit of a blur so I can't comment on that.

I hope hearing some of our experiences is useful and reassuring to you. Let us know if you have any other specific questions or concerns as we're all happy to share the things that helped us.

Best wishes

Tracey

Teresa_K_S profile image
Teresa_K_SVolunteer

Hi Sally,

Big Congratulations! A second pregnancy is probably one of the most discussed topics on here. Do you have either a CPN or a consultant psychiatrist? I ask as it sounds like you need a care plan put in place and once in place that will give you some confidence in itself.

My psychiatrist was able to do a lot of research and speak to right people to find all the answers to the questions I had. Although a mother and baby unit wasn't going to be an option in the area I lived, my psychiatrist was able to find out where the nearest unit was and we still had a care plan in place.

I totally understand your concern regarding meds in pregnancy. I was told there was a need to balance any risks of medicating in pregnancy with risk of another PP. You also have your first child to consider if you become ill and I was very concerned I didn't want my older child to experience my being ill or my being absent if admitted to hospital. Doctors only prescribe if they feel necessary. In my case I took Amitryptalline (cant remember sp) whilst pregnant. As an older drug they have a lot of evidence to prove there its a low or no risk drug. I breastfed for a number of weeks before I needed a more effective drug.

All the best for your birth. I hope you get the lovely birth you had last time x

Bramble7 profile image
Bramble7

Hi Sally,

Congratulations on your pregnancy.

I had PP in June 2012 and went on to have my second baby in October 2014, so the same age gap as you are going to have.

I was lucky not to have PP second time round, I had a care plan in place, I took olanzapine post delivery (I was treated with this first time round; I did not take it during pregnancy as my Psychiatrist did not see that there would be any benefit from doing so given that, as we are all personally so well aware, PP presents itself post delivery, I was on a 5mg dose and, to my surprise, my psychiatrist said given the dose of 5mg it was safe to breastfeed, should I wish to do so, and he pulled up a recent report to support this)

It was planned for me to stay in hospital in my own room (if available) for 3 days post delivery, I didn't necessarily want to do this and had it on record that if I wanted to go home prior to this, I was free to do so. As it happened my baby was jaundiced and I wound up staying in 4 days and, I've got to be honest, I'm glad I did. I didn't have to do or think of anything or anyone else but me and my baby and look forward to my visits from my Darling Husband and elder son, food was brought, cups of tea and I felt in a safe environment and, surprisingly, I'd no associations from first time round.

I would say at this point that it was my choice and I was happy to deliver my baby in hospital and whilst it is so important to have a care plan in place I think that it's important to feel you have control over it (feels so important to us doesn't it, when we've been through an experience that we had no control over whatsoever) so, by all means, listen to the advice, but by the same token, don't feel pressured into doing anything.

Further to that, we told all friends and family that we wouldn't be having any visitors, aside for grandparents, in the first two weeks and that visits were to be kept to 30 mins (for them and for when we started to receive visitors post this period) I think on reflection, this was me attempting to have some control over a situation that we really didn't have any control over, but again, on reflection, I'm so glad that we did this because it meant we could relax, rest, eat and most importantly of all, get to know and enjoy our lovely new bundle and enjoy the lovely bigger bundle that we already had.

I was very lucky to have a wonderful perinatal psychiatrist in my area and I would also say at this point, and I've said it before but I'll say it again, without the information I received via APP and this forum we wouldn't have had the information that we needed to make the decision to have another baby, and they supported me tremendously throughout and just after my pregnancy (via their APP peer support service, which along with your refer all to Dr Ian Jones, is also something you may wish to consider)

All the very best to you - exciting times ahead!

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