Preparing for baby number 2

Hi,

I haven't posted here before but I have read lots of your messages and gained reassurance. I had pp in Jan 2012, 7 days after the birth of my daughter. The psychosis lasted about 2 weeks but was followed by cycles of extreme low mood/anxiety which lasted 9months. After lots of different meds I went onto lithium and an antidepressant. I stayed on lithium for 2 years after being well and reduced gradually and I've not had any relapses or periods of low mood since. I'm now pregnant with baby number 2 and have been asking for support from GP and consultant and not really getting any answers. I feel I need a good plan in place for when baby arrives for meds and support. My GP has eventually referred me to the local mental health service but I'm not due to be seen by a psychiatrist until I'm 36 weeks. I have heard via this forum about the second opinion service by Dr Ian Jones at Cardiff so I've been back to my GP and requested to be referred here. Initially he refused as he said the referral needs to come From psychiatrist. If I wait for psychiatrist appt it will obviously be too late. When I got upset during the consultation he then changed his mind and said he would refer me! Does anyone know if Dr Ian Jones accepts GP referrals and if so what the wait is to be seen? Any other advice for second pregnancy following pp would be much appreciated too.

Thank you

13 Replies

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  • Hello Elizabeth

    Congratulations on your second pregnancy and welcome to the forum. I'm pleased you have been reassured by the messages here.

    I'm sorry that your GP and consultant have not been supportive in giving you answers but you did well to persevere to be referred to Dr Jones' second opinion service. I'm not sure about the criteria for referral or the waiting time but I'm sure the team here will be able to answer this for you. I had the good fortune to meet Dr Jones some years ago regarding confirmation of my diagnoses and he was very helpful and caring. You might have read that other mums here have benefited from his input. Also some mums here did not have PP after a second pregnancy so there is always hope. I think a good care plan is essential and we are all here to support you.

    Take good care and rest as much as you can.

  • Hi Elizabeth32 and welcome to the forum.

    It sounds like you've already got some good info from here, I too found it an invaluable source of information. To answer your question, yes your GP can refer, as mine did for me.

    I had the 2nd opinion consultation with Dr Jones when I was expecting my 2nd (I had pp after my first child "out of the blue" with no other mh diagnosis). Like you, I struggled to access mh services and support as I'd been discharged from them and was off meds, with no specialist services locally. Luckily my gp was very supportive, so as long as you are referred by them or other professional, this should be fine. I believe there is no charge to your local trust either, which might be helpful for them to know!

    I can't remember the exact timescale but it was certainly weeks, or maybe a month or so we waited from initial letter to having the consultation. It was held when I was 6/7 months pregnant and had tried for some time to see someone locally with no success. What was really helpful was the write up which Dr Jones sent to my midwives, gp and hospital. It was like they finally listened and things fell into place. I really can't recommend it enough. Having a care plan was also really key for us,to have things in place and everything written down so I didn't have to repeat myself or rely on (non-existent) information sharing between professionals. It might seem onerous but is a really helpful tool and professionals also found it so in the end too.

    I stayed well after my 2nd and I think the main benefit of having plans and support in place was as a good reassurance, including for my husband. It was something we felt we could do to try and minimize the risk of getting ill again. And the consultation was really key in this. Please feel free to ask any more questions, I hope you are keeping well and managing to enjoy the pregnancy despite the additional worries I know it can bring. Take care, xx

  • I had a Skype app with Prof Jones on Tues. I'm 23 weeks pregnant. It was very beneficial.

    My plan is to take aripriprizole on delivery and not breast feed and to avoid daily night feeds (husband and grandparents to help). Dr Jones said that sleep is the most important thing and not being stressed - don't worry about upsetting people if you don't want visitors.

    My GP referred to Prof Jones, not consultant. I have my full planning meeting with consultant and all professionals next week - I think you should demand your consultant app sooner and demand an MDT with health visitor and midwife and GP and consultant and you should have a CPN. we have the most serious perinatal MH problems, it's a medical emergency so should be prevented as much as possible.

    Take care and if you get nowhere, I'll send you my plan and you can use it (with different meds - I think we should use what worked last time).

    Xx

  • Ps. Waiting time from GP regerring to Prof Jones app wasn't long - approx 4 weeks xx

  • Hi Elizabeth,

    Congratulations on your pregnancy.

    I don't have experience of second pregnancy, but I just wanted to say well done you for insisting you get a referral to Ian Jones. You were right to do that, the sooner you see Ian the better. Also it is never too early to see him, he accepts referrals for women who are planning a pregnancy even (so pre-conception).

    As you've heard from the great replies and advice you've had above, every feedback I hear about the consultation with Ian Jones has been positive, and has made a real difference to the support they received. I am sure you will feel much more reassured after meeting with him, and you have a clear plan of what you will do in regards to medication, sleep, support etc, and I hope that it will make a difference to the support you'll receive from the professionals supporting you.

    I would echo what Sallyhudson suggested - I do think you should demand better support - It's important your care is coordinated so everyone knows how they will be supporting you (health visitor, midwife, psychiatrist, mental health team). Just a meeting at 36 weeks with the psychiatrist does sound late, and not enough, to me. How many weeks pregnant are you?

    I just wanted to also check if you have seen the APP second pregnancy guide, which you probably have. Perhaps you could give your GP a copy of the guide as it does clearly say what support you should receive. app-network.org/what-is-pp/...

    Do keep writing here whenever you need to

    Ellie

  • Hi

    I couldn't agree more with others on here. It's imperative that you have a care plan in place and that you are placed under a consultant psychiatrist now and not at 36 weeks. We all now that babies have their own ideas about when to arrive!

    I get the impression that Prof Jones, as well as giving advice directly, will liase with psychiatrists who have little experience of PP so that you can have the best care possible. It's good to have expert advice but you also need to get to know your consultant early as they will be the one you see should you become ill again. Hopefully not this time.

    I avoided PP with my second and third. I was still terrified at the prospect of being ill and every little blip you can't help feeling is this it?! Having a support network of consultant, CPN, midwife and GP who all talked to each other to make sure I had the right meds and a plan in place is essential. I am convinced this extra support and health professionals acting quickly saved me from suffering another episode of PP with subsequent births. Take your husband with you on your next visit to the doc and go armed with as much facts and figures as possible. Maybe there is a NICE guide for patients who have previously suffered PP

    Good luck

  • Hi Elizabeth,

    I just wanted to say congrats on your second pregnancy. How many weeks along are you?

    I had pp in Feb 09, 10 days after my son was born. I had no history of mental health problems. I went on to have another baby in Apr 14 and I stayed healthy second time round.

    I had been discharged from my psychiatrist but I got referred back under her care again as soon as I became pregnant. I remember having a care plan meeting with everyone involved in my care when I was 30 weeks, even my husband came along.

    I felt like I was really involved in my care plan and that everyone knew my wishes, I had asked for my own room in the maternity hospital and my hubby was to stay with me at night. We decided to bottle feed so that I could get a good nights sleep and I had agreed to take a low dose of a anti-psychotic medication for 6 months.

    I wish you luck second time round, try to get as much rest before and immediately after as possible. I think you should go back to your GP and demand an urgent referral to see a psychiatrist and preferably the same one you had before as they will know you personally and will be able to notice if there are any changes in your behaviour, after what you have been thru you deserve any help you can get.

    Take care

    M

  • Hi sorry I forgot to mention APP 1 to 1 email service. I also availed of that during my second pregnancy and I was paired with a lovely person who had pp (with no history) after her first and she remained healthy after her second.

    Take care

  • Thanks for your replies and support. I'm 30 weeks, so now feeling that I need a plan in place. My G.P is sadly unsupportive, his reply to my request to be referred to Dr Jones was 'the thing is you're well at the moment!' So clearly not on the ball when it comes to preventative mental health care. I plan to change my G.P but he is the only G.P at that surgery and I live in quite a rural area so would need to travel a fair way to get to another surgery, hence why I'm still registered there.

    Just pleased I now have an appointment through with Dr Jones and hopefully this will inform my local mental health services.

    Xx

  • Hello Elizabeth

    I'm glad all the support here has been helpful to you.

    I think spannerb's reply must have been reassuring when she mentioned that after Dr Jones sent his write up of their meeting to midwives, GP and hospital everything fell into place. I'm sorry that your GP has not been supportive but I hope you will have peace of mind when you meet Dr Jones.

    Please keep in touch if we can help.

  • Hello Elizabeth

    Just checking how you are. Do you have your appointment date with Dr Jones yet? I'm sure he will be able to put your mind at rest.

    Please keep in touch if you can. Take care.

  • Hi,

    I'm doing well thank you. Yes I have an appointment on 5th April so feeling more reassured about getting some good advice and a plan in place. I will keep you posted. 

    Xx

  • Hello Elizabeth

    Lovely to hear you're well.  I'm glad your appointment with Dr Jones is not too far away now.  Try and rest as much as you can and have a happy Easter break.

    Take good care ....... we're all here for you.

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