Action on Postpartum Psychosis
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A second child after post partum psychosis?

Hi... I had pp after my daughter was born in 2013. It was horrific and left my husband and I in a very delicate state for many years, especially as we previously lost a child to Edward's Syndrome. My daughter and I want me to have another baby but my husband isn't keen. It's been nearly 5 years and I'm medication free and have been since 2014, and I've had counselling for the past two years. I think I'll be fine and I'm fully prepared to put a care plan in place including stopping at the MBU for the first week or two. Every time I try to talk to my husband he's funny about it although he doesn't just say no now. I get so upset because this is supposed to be an exciting thing but yet again I feel that I shouldn't be getting excited and really I shouldn't even be considering another baby. Meanwhile my formally alcoholic sister who has had two children taken away from her is pregnant again and expecting in May. Is it me or is life just completely unfair?! Can someone reassure me that having another baby is okay and a natural thing to want?

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Hi Victoria, I had PPP after my first baby in 2016. Friday was the last day of medication for me and feels like a fresh start. I feel like I’m on the same journey as you just a bit behind. Just like you PPP hit myself and my family like a ton of bricks and we have been rebuilding ourselves ever since.

My husband and I seem to be in the same place with talking about a second child, so far we both feel like it’s a big risk to us as a family to take on the pressure that I might get Ill again.

That being said we both agree that a sibling for our daughter would be the best thing for her and as time goes on for me that is becoming more and more of a consideration for me.

I think it’s totally natural to want another baby and all the advice I have been given by my psychiatrist and GP is don’t let it put you off a second child.

You seem like you are in a sensible place about this when you talk about the care plan and going back to the mbu. For me that’s the only way I would face in to it.

You mentioned you have been going to counselling for two years. Has your husband seeked the same support?

Good luck, I’m rooting for you

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Thanks for your message Nicola. It's good to have some reassurance. Yes my husband has had some counselling too, but I think because he was the one dealing with me and seeing what I was like while I was pretty delirious, he has quite a different view on things to me. Also, he didn't really get the support he needed from our respective families, partly as he struggles to ask for it and partly because I don't think they wanted to believe the extent of my illness. I had ECT as part of my treatment and no one else supported us in that decision, which made me feel very alone as I was so frightened about it. My parents were useless in accepting that I wasn't coping in the first place. They thought my husband was mad as he went to the 24 hour Tesco to get all the formula stuff because I couldn't do the breast feeding and was wake crying all night with my screaming baby. That was before the hallucinations, nightmares and suicide attempts started. It all seemed like sort sort of horror story! I can understand his reluctance...

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I think a horror story is pretty accurate. When I think about opening the door to having another baby i often have flashbacks. Can you imagine what it’s like if you were the guy that lived everything stone cold sober.

I was offered ECT, I said no. My husband thought i should have it and because I was under section and he was my next of kin the psychiatrist felt it was his decision to make. My parents were with us in all my ward rounds and supported us most days it was only for the fact that my dad was on my side that I managed to convince them to give me a few more weeks to get better on my own. Which I did. I really feel for you both having to go through that on your own.

I’m so sorry that you didn’t get the support you needed from your family. Your experience sounds truly awful.

Would you be able to talk to your family now and ask for their commitment to support you second time round? Do they now understand your illness and the risks.

I have been thinking that i would have to enlist support ahead of time with my family and friends to support us through a second pregnancy. Including who’s looking after my husband whilst I’m being treated. They say it takes a village to raise a baby I think probably a town to tackle PPP.

I have also been thinking that perhaps I should start saving now for a night nanny to support the night feeds at the beginning and perhaps once a week to take the pressure off us as a family. I guess the other option is shared parental leave if your husband is working too.

Also with the pressure as women that we put ourselves under to breast feed do you not think that should be off the table too. I did it for the first two weeks despite my husband pleading with me to stop. I wish I had realised that formula was fine and let my husband buy the tommee tipee prep a lot earlier. Somethings gotta give.

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My husband wasn’t overly keen on having a second but we did as he eventually agreed. I felt completely broody and it was totally natural, I don’t now so nature is telling me to stop at 2!

It is risky for us having a second so it is understandable that your partner is reluctant.

They don’t get the medication and counselling that we do and can probably remember more of the experience, therefore it is equally as hard for them in my opinion.

He unfortunately has to be on board as I think the only reason I didn’t get pp second time was because I didn’t do night feeds

I sometimes think I was irrational to take the risk to have a second but that natural yearning for a child is overwhelming x

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Hi

I had PPP in 2013 with my daughter.

Me and my husband both wanted another baby but where worried about the risks. We asked the docters to refer me to the Parinatil Team for a consultation.

The doctor was a specialist in PPP

and spoak to both of us and answered all of our questions.

She reassured us that once I got pregnant, the Parinatil Team would be involved and support us every step of the way.

I had a care plan in place and I went on preventative medication three weeks before baby was due and I’m very pleased to say we where fine no PPP second time round.

Second baby experience was much better.

I would recommend going to talk to a doctor at the parinatil Team.

Good luck.

Jenny xxx

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Hi I had my first (my son) in 2006 and suffered ppp, 3 years and 3 months later I had my daughter, it was a big decision and I’m glad I took it! She was born at home and it was a wonderful experience full of love compared to my first experience full of fear. I had complete support throughout second time round from my wonderful midwife, husband and mental health team leading up to birth and beyond. The one thing my first experience taught me was the importance of self care, (before, during & after!) sleep is crucial so for my own health I made a Decision to bottle feed from the start, this I believe made a huge difference, I also made sure I ate regularly (helps with anxiety) every 3/4 hours, I used calming relaxation music and now meditate regularly (this is also a great tool) exercise regularly walking in nature helps too. It’s a big scary decision but with love and support you can do this xxx

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Hello Victoria 1982,

it is such a personal choice and obviously requires loads of family planning knowing that there is the risk of getting PPP once again. I must say you are all such brave ladies wanting to manage a second pregnancy or more. Sometimes I wonder what it would have been like having a brother or a sister for my son or just experienced a bigger family!?

Luckily provisions are given to prepare mums and families, if one decides for another baby. One just has to explore and do some thorough research about the facilities available such as professional care, MBU's etc. In my opinion the inclusion of partner/husband for decision making and family planning is vital, -in addition preparing a support network with family, friends and professional members of staff via partnerships and/or charities etc.

Even if I could, I would not put my partner through this traumatic experience again. We all have extreme stories to tell, sometimes due to lack of professionals' knowledge and inappropriate treatment and unreasonable behaviour by members of staff as it was in my case in Somerset. At the time we have had no access to an MBU and it was an ongoing "trial and error" to find appropriate medication and therefore I possibly was without sleep far too long and they could not do anything else , but seclude me on numerous occasions, because of ongoing episodes.

My recovery took much longer than expected and my partner was looking after me for 6 months full time once I came out of the Psychiatric Hospital. I was like "a vegetable" and only my partner and my home sanctuary with my baby brought me back to life. He slowly re-integrated into his work and after one year I managed to be weaned off completely. I still struggle with fear and anxiety issues.

Life is beautiful though, I feel enriched, because of having had the opportunity of having my son and thus, not being on my own, but always loved by my big and little man.

:-)

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Hi Victoria,

I suffered PPP in 1982, I'm guessing that's the year you were born. Everything you describe is so familiar, the fear and lack of understanding within the family, the debate over NCT, the pressure on your husband. Well done for getting through it.

I went on to have two more children. I did everything I could not to replicate the bad experiences of the first birth. Like Positiveminds, I had homebirths, and took good care to eat when I wanted (food in hospital can be a joke) and to sleep in my familiar bed. The stress was so much lower and I was fine.

All the precautions you suggest sound very sensible.

Bear in mind that a second birth where things go well will enable you to regain the experiences you missed out on in the early weeks during the chaos of PPP, and will lay the worst of the flashbacks to rest.

PPP has faded to an incident in my past which no longer upsets me. If it had remained the reason for stopping at one child I would have found it much harder to move on.

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Thank you.

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Hi Victoria

Thank you for sharing your story and your concerns with us here - we have all ‘been there’ before so can hopefully give you the support and guidance that you need at this time.

It can be a real dilemma making the decision to have another baby after an episode of PP; it took several years for me to feel ready and prepared to have a third baby having suffered PP 5 years previously. I researched how to reduce the chance of another episode and took Lithium after the birth of the baby, hormone injections and bottle fed..(I think now preventative/prophylactic measures may have changed i.e taking anti psychotics in late pregnancy- you may want to find out what the procedures are in your area) ... all went well until about day 10 when symptoms of PP started, but they were not as severe as previously and I had the right support on hand to quickly give me anti-psychotics .... I got well within about a week or so - I do consider myself extremely blessed that I did not have a full blown episode. Looking back I realise that sleep deprivation was the only major factor - my baby didn’t sleep at night and as I wanted to be looking after her all the time I stayed awake when she did and perhaps the midwife/family should have intervened before things started slipping away again.

Something that comes to mind often is that I could never ever regret taking the decision to have another baby - I wouldn’t have my precious girl if I hadn’t taken the brave step into the unknown.

I really hope that the support here can help you and your partner /family come to the right decision for you all. It can be very frightening for partners to think about taking the risk and having another baby but with the right care and medication it is possible to avoid a relapse or have a much milder episode than the one you had before.

Please do keep reaching out for the support that is out there-

With warmest wishes

Jas

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Care plans have improved a lot. There are no guarantees but with medication and good planning there is a good chance of staying well. I have epidural as pain is a big trigger for me. For some it may be hormonal. This time I'm considering lithium last few wks of pregnancy to reduce post partum risk . After to take quetiapine short term to rest and lithium. Will ur husband be able to help with night feeds or someone else. If you have just one child I think it is manageable. Explain to ur husband how things have changed. You shud see a perinatal specialist and stay extra in hospital with a side room if poss for delivery. Vitamins omega 3 help too. Organisation is vital to have time to rest lower stress. I was fine last time. I had pp about 9 yrs ago but I did refuse meds and basically have no care plan. Last time a lot different and stayed well despite dealing with a lot. Even if there was a relapse if you already starting meds and have a back up plans things shouldn't be that bad

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Have already had a stay in the MBU agreed for as a precaution and for night feeding or my husband would do. Will definitely be mixed feeding but I loved breast feeding in the end last time so will be doing in the day if have another baby. My husband is definitely coming round to the idea as my daughter won't let up about wanting a sibling, but I don't think my parents understand the risks so I'll need to talk to them if it happens. It would be do lovely to have a more normal experience that I can actually chat about without my eyes welling up.

Just wanted to say thank you for all your kind comments and advice. Had no idea there were so many of us! Thank you.

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You know what you want, you have made sensible plans which recognize the risks, now relax. You will be OK!

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It depends on you but I think the home environment is better than mother and baby unit. Do you mean before the baby is born? If it is not very high stress at home and you can rest prob better to be with your family. In unit you will see ppp unwell ect but everyone has their preferences. If you feel it is suitable for you then go ahead. Don't panic about what may happen. I have a severe episode and left a similar gap between kids. Even to have one more without a relapse was a big wish and everything was fine. And believe it or kit I am pregnant again( accident lol) and fine off meds even against all the odds at 28 wks now. I never would have imagined to think I wud be ok and cope and it's fine. Just keep praying to God . The care is so gd and info available too. Starting meds straight after birth v imp. Quetiapine good to relax get much needed sleep. Lithium safe after 26wks of preg. Lowers risk to take meds in 3rd trimester too

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An important reminder is to not focus on breastfeeding esp if it interferes with medication. I suppose you could do day time feeds. But for me I just breast fed for a day to give the colustum and then switched to bottle. It was lot easier and son is v healthy . It was not worth the risk to exhaust myself. Also midwife shud help at night with feeds in hospital. Discuss everything at delivery care meeting ie pain relief, side room, exact meds in all scenarios

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Highly recommend couple/family therapy. It saved my family.

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Dear Victoria

You have had some great support and replies on here, I hope they have been helpful and reassuring.

I just wanted to make sure that you have seen our guide for planning a pregnancy if you’re at risk of pp. it was written by families affected by pp and leading perinatal clinicians and should have all the information you would need. app-network.org/what-is-pp/...

I hope this is helpful

Take care

Ellie

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I'll take a look thank you.

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