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Action on Postpartum Psychosis
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Considering baby no.3

Hi everyone. I suffered with PP with both my children. I'm currently doing fine and off medication. Does anyone know if I was to consider baby no 3 whst can they do to prevent PP from coming back. ?

15 Replies

Hello Hayleynevin

I also had PP twice, six years apart, with both sons. I think there has been more awareness about PP since my episodes years ago and treatment has changed. I don't know if it's the same today but as I had two C-sections I was told I would be unable to have more children.

I was very lucky to recover after my second PP as my family worried at the time if I would ever be well enough to return home. So although I wasn't aware of my diagnoses until years later, we took steps so that we didn't have a third child.

There was a post here where the mum had three children, was fine with the first two and had PP after her third pregnancy. Other mums here have had subsequent pregnancies without PP returning. I think it's all about having a good care plan, good medication and support in place if the unthinkable happens.

I can see how you might consider baby no 3 if you have been through the trauma of PP twice. I have said before that when we get our mental health back we really need to look after it. So as you are free of medication and doing fine you need to weigh everything up carefully. If you did have a third child and were unlucky for PP to strike again, you need to consider the affect this would also have on the children you have now. I have spoken about my PP episodes to my sons as they are now grown men and I felt so awful when I realized that my first son, who was six at the time, witnessed some of my psychotic moods. They are both very loving and understanding.

Take good care ...... enjoy the freedom that good health brings :)


I agree. I think you could definitely take steps to prevent it. Or lessen the severity, but it would be taxing and hard for you and your other kids too. I had a third and didn't have ppp with my first two just bad ppd with the second but I had ppp with the third and it was really hard for my other kids. I had to be separated from them to get treatment and while the baby was unaware of what was happening they were not at all. I think it could go either way. If you really want it, find a good doctor well versed in ppd and ppp and have a solid plan should it strike, that would include care for your other children

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I had no pnd or pp after my first 2 children but i had pp after my 3rd, we are pretty sure that it was caused by a large variety of very difficult things going on in my life at the time.

I am now fully recovered and my youngest is 5 and a half I've been off meds for quite some time now and I'm currently in the last few weeks of my 4th pregnancy, crazy i know but these things happen.

I have however this time equiped myself with as much knowledge and support as possible and put a good plan in place to support me after baby is born regardless of what happens. I have also been having counselling throughout pregnancy from the hospital. I'm aware that it may strike again but also i know this time we will nip it in the bud very quickly and that there are a number of people who will be keeping a close eye on me so that makes me feel reassured.

Elaine Hanzaks book another twinkle in the eye was very helpful for me to get some ideas of what support i should ask for and where i can go for advise and support.



Thank you for all your replies. Gives me things to think about. PP really does suck! I feel angry that I have to consider this! Why can't it just be straight forward. If that makes sense. I hate PP! Life is cruel sometimes. A very good point raised about how it will effect my two children should PP strike. It effected my first child, she was 4 and witnessed everything I went through. It upsets me ALOT . I feel it's something I'll have to talk to her about when she's older. It's made the relationship between me and my second child quite distant. I was worried I was going to hurt my daughter in some way so I hardly picked her up and bonded with her. I feel I have a lot of making up to do there. Am I just creating more problems for myself considering baby no 3! X

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Hi. I had PP with my first and not my second. Although I went for a preventative approach with my 2nd with support from my perinatal psychiatrist and took Olanzapine for 3 months after the birth. Had a night nanny for the first 10 days- costly but worth every penny and didn't breast feed because for me it was a trigger (but that's not the case or right decision for all). Have not used contraception for couple yrs but nothing has happened. Am 42. Am fine either away as it is prob a selfish decision and my kids mean the world so I won't feel incomplete. I agree with the others you should only go for it if you put a strong plan in place and have loads of support and counselling. My oldest has no idea he spent the first 2 months of his life in hospital and I have a fab relationship with both. I was v ill with the first but recovered quickly. Personally before adding another to the equation I would think about building on the relationship with the 2 you have, as that will prove even harder if you have a small baby and potentially fall ill. It is great you are well now. Our mental health is so precious, as are our children.


Hello Hayleynevin,

no anger, no hate-just appreciative that I am a survivor like all of us on this forum.

One year (2010-2011) of vague memories and loads of flash backs till now, at the time being affected by extreme sleep deprivation and horrific side effects of traditional meds, nightmarish experiences in a mixed gender psychiatric unit with negligence and physical abuse and being locked up in an isolation cell, because of continues episodes for 4 weeks...

...despite a traumatic experience the light is back ...however, I do not forget and recovery has been a path of challenges, obstacles and 'enlightening moments'...

I have been able to focus on my son, I am grateful for my family and know my limitations...

I do not compare nor do I judge....in my case I want to give my son stability and support his emotional and social needs in all aspects. Happiness and health is of vital importance and thus, I also make sure that I use therapeutic alternative tools (meditation, exercising, painting etc.) in order to balance my mental, emotional and physical well-being.

In a Buddhist sense you have to be well in order to pass on love and kindness. When I am poorly, I have a support structure in place. We all need to draw back on some new energy in order to give...Thus, taking on too much, would put me pretty much off balance...

Wishing you and your two lovely children health and happiness...

Sabine :-)

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I had ppp with my first and then not with my second, I was involved with the Parinatil Team from the beginning and went on to preventative meds a month before baby was due, Olanzapine. Baby now 7 months and I am off all meds. And doing well.

It took a lot of consideration about having our second child, especially after I relapsed a year after having my first child. Medical staff told me that I always run the risk of relapse whether I had a child or not. So then We thought We may as well take the risk as it could still happen any way.

I was also worried about my other chiled and did not want her to see me un well. I found most medical staff pretty good about ppp and I told them all from the start so they where aware. My parinatil team where very good they had a care plan in place and it all went to plan.

It is a hard decision you have to take a lot into consideration but it is possible, good luck. X


Thank you Hannah. I guess my psychiatrist always says to me bdber to rule it out as she would take great care of me. I just worry so much of how its going to effect my husband and my kids if this happens again. But I guess if in on the right medication it shouldn't happen. Ohhhhhh I just don't know. The other thing is I have trouble conceiving naturally so will need fertility treatment again so there's the stress and worry of that too xx


Hi Hayleynevin,

Yes, PP is rubbish and it is so annoying to have this thrown into the mix when deciding about expanding our families, I completely agree with you on that! You've already had some great shared experiences and as you probably know, I had PP after my 1st child but not my 2nd, after a 4 year gap. We always knew we wanted to have 2 kids so whilst it is a very personal decision, it was right for us (and luckily turned out well) although after a longer gap than we thought. It was right to be fully recovered and off meds and in the right place as far as possible physically and mentally.

Having plans in place were really key for me too. If you haven't seen the link, here it is for the 2nd Opinion Service offered by APP app-network.org/what-is-pp/...

It was absolutely fantastic in my experience as I have no perinatal service near me. Just talking to someone who really understood and could then give his expert opinion to other professioals locally really pulled things together for me, and was very reassuring. I also took a low dose of meds after delivery and my care plan included things for my eldest to do, who he could go and stay with, who would take care of him etc if I had become ill (and also for the practical things like him seeing friends and having time away, which was important for us whatever happened). It was certainly one of my fears that he would see me ill and I would also have preferred an MBU admission if I had needed it rather than staying at home, so that was again in my care plan.

Whatever decision you take has to be right for you and your family, and with the risk of PP it is something that only you and your husband will know if you want to take. The APP Guides were also helpful for those around me, both family/ friends and professionals, as more than 1 midwife didn't really see what the issue was (scary isn't it?!) Here is the link: app-network.org/what-is-pp/...

Good luck with your decision, I hope the shared experiences here have been helpful to you. Take care, xx




Are you in UK? See Ian Jones for 2nd opinion pre-pregnancy planning.

I have had it twice, and would think third time can only have equipped to learn how best to manage it a third time.

I often get told "you couldn't do that to your other children, or to your husband"..... But I look at how our family of 4 loves each other now, and it is only stronger because of what we have been through together, and kids are more resilient than anyone gives them credit.

What's greater, the pain of PP, or the pain of a family cut-short too small??

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Very well said. I often think I'll be angry with myself if when I'm older I regret not trying to extend our family xx


Whatever your decision. Wishing you the best of luck and a happy new year ! Sabine :-)


Have a good care plan. You need help at night while you rest. Epidural v helpful for me to cut pain/ stress. Hospital should keep you longer than normal after delivery. Ask nurses to help at night. Re start meds immediately after birth if not b4. Quetiapine helped me relax and sleep short term. I recently had a baby and this helped to keep me well and I was v high risk. It can be done


I think it depends on your circumstances. For me having a second baby I have 100% risk of having pp apparently.but my husbands totally supportive of me going to hospital if I feel I need a rest, and I'm closer to my family (though some have mental health which doesn't always help). So I know my children will be well looked after. My mum was told by her mum after her episode of pp never to have children again, and so did the doctors, and mum hated that, so I know I will get lots of support to have kids.

Talked to hubby re food expectations. He wanted me to cook a lasange at four weeks of age. We r getting Takeaway if family don't give enough food this time.

Also talked to hubby re sleep.

There is also some reseArch out there on cosleeping for mothers sleep and protective factor for baby's psychiatric well being. It took a while for hubby to let me cosleep last time but I found that worked best. Depends on your meds though and a few.other things eg smoker etc.

And I wish we could employ a cleaner for the first twelve weeks!!


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