second baby after PPP

Hi has anyone had a second child after ppp? We are thinking of having another only the thought of having another episode is so frightening its unreal. We don't now what to do . Has anyone got any advise about how to without having a relapse or without taking the medication? Any help would be appreciated. Thanks

[BronSyd]

Hi Anamor,

There are a number of us on here who have ventured into the second child journey. I am 2.5yrs into having another child post PP. After an initial hiccup of low level mania and a few weeks on medication all has been well.

I guess there are a couple of things to consider. Firstly how traumatic your first episode was. Some people would not consider risking the possibility of going through that again. I was quite lucky the 1st time around. I responded to medication and recovered quite quickly so it never really occurred to me not to go on to have more children.

Secondly, ensuring you have plans in place. If you can work out what you are going to do it takes away some of the reasons we all ended up in the situations we did. Often it's the fact that we didn't know what was going on the 1st time that we weren't able to get treatment until we were already quite ill. Second time around we have the power of knowledge. We know what to look for and have the plans in place to hopefully avoid some of the more extreme symptoms of PP.

Some things to consider in your plan are ensuring you are connected in with your local mental health team (perinatal if possible). If you don't already have one, seeking out a perinatal psychiatrist will help as they should have the most up to date knowledge on medication and other techniques to help manage a possible episode.

Have plans in place to be able to go into a Mother and Baby Unit if required. Have your support network at home all on the same page. Hopefully you can have family and/or friends have some time off to help out if needed. (Luckily my husbands work was able to give him 16 weeks paid leave as he was considered the primary carer after a note from my psychiatrist).

Decide whether you want to take medication during your pregnancy (depends on the medication), straight after the baby is born or like me take a wait and see approach. Medication can also affect whether or not you are able to breastfeed if you want to consider that.

Try and reflect on what your early signs of not being well are. I knew once I started making big plans to change the health system 3 days after my second child was born that I was heading towards a manic episode so was able to get on top of it quite quickly.

Sleep tends to be a major focus of staying well so consider how you are going to manage that with a newborn.

These a just a few things to consider. It definitely is possible to go on to have subsequent children post PP. If I'd taken medication straight away I may not have even had any PP symptoms but I am actually glad with the decision I made as I felt I was then in control.

I know there are a few mums who have or are close to having their second babies so it might be worth seeking them out to see how they've planned things and follow along with their journeys.

Good Luck

[Lilybeth Volunteer in reply to BronSyd]

Hello anamor15

Welcome to the forum and thanks for your post. I can't really add much to the good advice above as it is so informative and current. How old is your first child? There's a gap of six years between my sons who were born in the mid-70's and early 80's mainly because we were worried I would be ill again.

I did have PP twice and was very ill. However, awareness and treatments have changed so much for the better that some mums here did not have PP a second time. There are quite a few posts from mums regarding second pregnancies if you search this site which might be helpful to read.

Take good care of yourself.

[Teresa_K_S Volunteer]

Hi Anamor15,

I totally understand your fears. They are justified too looking at the statistics. However, it's not all hopeless. There are lots of things you can do to prepare for a second birth. I must add it took us seven years to pluck up courage and to feel ready to have a second. I think the main thing is to give yourself time. It takes a long time to recover from PP and also time is needed to enjoy a relationship with your partner without the constant pressure that suffering from PP and the aftermath brought.

I didn't think I would ever be able to go through having anymore children as much as I yearned for it. I had to move all baby things to the loft so I didn't constantly have a reminder upsetting me. I now have 3 children and I didn't have PP with the 2nd or 3rd. I did however plan ahead. It took me many years to accept medication was a necessity for me. By the time I had my 2nd I had grown to think of medication as being a help rather than something I had to rid myself of to prove that I was well. For me a care plan with a consultant psychiatrist was put in place. I stayed on very low risk meds during pregnancy (this was amitriptyline which has been around years so they knew it to be the safest in pregnancy). I was also able to breastfed on the amitriptyline. I breast fed for 9weeks until my mood took a dive and I started to not sleep. Then I was put on the meds I needed and everything else just fell into place. The same care plan also worked for my third.

I don't really think I would recommend a wait and see approach. It's lovely that it has worked for others but as PP takes hold so suddenly it is quite a risk. Obviously it's a personal choice and everyone is different. Either way you have the benefit of being ready for it this time, just in case. Good luck x

[Ellie_at_APP Partner]

HI Anamor15

Thanks for your post. You are not alone, many women struggle with the decision of whether to have a second child. It’s good to see you’ve already received some great replies. I only have one child, who is five, so I know really well the really difficult decision of whether to have a child, and being terrified of becoming ill again. It’s such a hard decision isn’t it? I had a tough time with my PP as well, and suffered from depression afterwards, and so it is a really hard decision to risk going through that again.

However – there are so many positive stories of women who have had second children, and as the others have said, there are so many things you can do to prevent it happening again. What is crucial is that you have a care plan, as others have said, and support ideally from a perinatal mental health team.

I wanted to direct you to two things from APP that may help you, if you haven’t found them already. We have a guide for planning a pregnancy if you are at risk of PP. app-network.org/what-is-pp/...

This really tells you everything you need to know about planning a second pregnancy and what kind of things you need to think about and plan for.

In the guide APP recommend that you seek advice from a perinatal psychiatrist ideally even before you get pregnant (pre-conception). This may help take away some of your fears too?

If there is no perinatal psychiatrist in your area, APP do offer a free second opinion psychiatry service with Dr Ian Jones, a perinatal psychiatrist, which is free to your health authority (they don’t need to pay for it). You need to be referred by your psychiatrist or GP. Via the forum I have heard nothing but positive things from women who have seen Dr Ian Jones. From what I understand he will look at your notes from your previous PP, advice you on your particular risk, and will help you consider your options and will write a letter to your care team etc who are supporting you. Others who have seen him can give you more information of how it was for them and what he helped them with, I know that others have said it really helped them to get the support they needed, and the professionals all working together. Information about the second opinion psychiatry service is here: app-network.org/what-is-pp/...

There have been many posts on this forum from women seeking advice about second pregnancy, if you search in the search bar you should be able to find a lot of really good advice that was given to other women that you would find helpful too.

I really wish you well with your decision, I hope this information has been helpful.

Ellie