Epidural yes or no?
This is my second child after 16 years. With my first I had no pain relief and suffered with psychosis with a 3 month admission.
I'm now planning my second birth and my consultant seems to think if we plan it well we can prevent psychosis. Im not convinced and will be of course taking medication straight after.
The question I have at the moment is do I try an epidural this time?
Hello Koala2021
Congratulations on your pregnancy. I’m sorry you suffered psychosis with your first child.
I had PP twice many years ago, both with epidural pain relief. That said, from reading my notes there is a chance that if I had been monitored closely during my second pregnancy, six years later, PP might not have occurred. At the time, mental heath was very much in the shadows so my first PP was a family secret and I wasn’t aware how ill I had been.
It’s good that you have talked about a plan for your pregnancy ... was it a pre-birth planning meeting with everyone involved in your care? I’m not sure if you have seen the Insider Guide “Planning Pregnancy : A guide for women at high risk of Postpartum Psychosis” at app-network.org/what-is-pp/... which might be helpful.
If you are in the UK your Consultant could refer you to APP’s Second Opinion Psychiatry Service for specialist advice, based at Cardiff University. The link being app-network.org/what-is-pp/....
There are mums here for whom PP did not return, so I’m sure they will be able to offer their more up to date advice and reassurance.
Wishing the best of times for you and your family .... we are all here to lean on. Take care.
Thank you for your reply 
I have had a meeting with a consultant at Perinatal Psychiatry who is helping me plan what medication to start after birth and then I had a meeting with the consultant obstetrician that starting coming out with having a less stressful birth and it helping towards the Psychosis. Mine was also hidden family history which is why my chances are at 60 percent. Im just struggling with the worry of it coming back and scaring my 16 year old son if he sees me like that. I have a CPN sorted who is going to keep a close eye, just wanted to make sure I was doing everything I could to prevent it. I also have a constant worry of offending people if I do become unwell. Thank you for the links I will have a look at them x
Hello Koala2021
Good to hear from you. It seems as if you have a lot of good support in place. It must be reassuring to have a CPN to closely monitor how you are.
I should say that when my first son was born I was induced and had an emergency c-section as he was in distress, so I didn’t see him until the next morning. So with my second son I had an elective c-section which was much calmer and I was sedated, so I saw him within minutes of his birth.
I don’t know about you but as my illness was hidden, I carried a lot of unfounded guilt and shame for years, until finding APP. From all the support and shared experiences I realised I had no control at that time and it wasn’t my fault.
I can understand how you want to protect your son and it is a worry. I didn’t tell my sons about my episodes until they were in their early to mid 20’s. I only told them the basics as my psychosis turned me into a completely different person. Perhaps your CPN could guide you if you felt being aware might be helpful to your son?
Hopefully with all the measures you have in place, you will be well and as I mentioned, there are mums here for whom PP did not return in subsequent pregnancies. I hope the links will be helpful. Take care x
So frustrating when families keep it hidden. I feel your pain. I'm still waiting for my parents to ask me about my mental health in this pregnancy. Seems like they are playing the ignore it game again. My son is aware of the psychosis I was fortunate enough to take him to the unit I stayed on and meet the staff that cared for him when he was about 9 years old. Im just worried that telling him and seeing it first hand is quite worrying when he will be getting through his GCSES. Been kicking myself for the bad timing with that one.
My husband is the same its not my first child's father so he will be seeing it for the first time as well if it was to happen.
Its nice to hear there are mums that didn't experience it second time so thank you for sharing that with me. Gives me a bit more peace of mind xx
Hello Koala2021
I’m glad that hearing from mums who didn’t experience PP a second time has given you a bit more peace of mind.
I think it would have been better if I had ben aware of how ill I had been. I’m sorry your parents haven’t asked yet about your mental health. My parents were far from pleased when we announced we were expecting our second child. Looking back I think it was fear of the unknown. Hopefully, with all your planning and advice from professionals PP will not return.
I notice that your appointment with the nurse is in March. I wonder if before this date you could email your wishes in your care plan? Just in case it’s over the telephone and you can then be sure that you can go through it together in the time allowed.
Take care and be kind to yourself. We are all here for you .... stay safe
I know that feeling. My sister looked at my pregnancy like here we go again.
Im going to write an advanced statement and I now have a meds plan in place.
Unfortunately for me past few weeks have been really hard. Try and plan stress free pregnancy and then you find upsetting unfaithful things from your husband.
Looking at going on the medication earlier now. Regular contact with CPN. Just shows you can make all the plans in the world and someone can easily throw a spanner in the works x
Hello Koala2021
I’m sorry the past few weeks have been really hard for you. It’s good that you have regular contact with your CPN and I hope she been supportive in listening to things which have been upsetting.
Try to rest as much as you can. Hopefully your family will be more helpful as you pregnancy progresses. Take care and stay safe x
Hi Koala2021,
Welcomed to the forum and congratulations on your pregnancy. I am sorry to hear you had pp after your first baby 16 years ago.
It sounds like you have great support in place and that's lovely to hear. I just wanted to add, that it is perhaps a good idea to have a list of your preferred options for your birth. Discuss and agree on these with your ob gyn and psychiatrist and any other professional involved in your care, during a birth planning meeting.
Also in the birth plan you can include things like having access to a private room and additional help with the night feed from nurses to protect your sleep, as well of course as medication.
I had pp in 2018 and have been giving some thought about a second baby. I know that the delivery room could be a bit of a trigger for me, so I would like to consider another option next time. It is such a personal decision, what's important is that you feel comfortable with whichever measures are put in place to reduce your risk.
Take good care and keep well and safe during these strange times
Hi and thank you! That's such a good thing to point out I didnt even think about the delivery room and night feed support whilst in hospital. I think requesting a private room is a good shout. Wishing you all the best with the second baby planning. Sounds like you have a good age gap there. Im feeling the difference after waiting 16 years, as in trying to carry the heavy load lol xx
Congratulations on your pregnancy.I think it's definitely worth considering if you feel you need it. I think having the correct medication in place and having the network around you this time will make the difference. Wishing you luck x
Hi koala2021I had PP with my first child, which I opted for an epidural, which I did feel helped towards me becoming unwell as found it quite an ordeal, I feel it slowed the delivery as struggle to push, ending with a vontouse being used to help her out, though baby was presented spine to my spine so must have helped with the pain. My second child I opted for pethidine and felt this suited me. As you say you had no pain relief the first time, so this time with what ever pain relief you choose won't be as bad as your first time around, you know what to expect this time around. My second child I had no PP. If your have labour and delivery overnight see if they can put you on a quiet ward so you can recover and rest without lots of noise around you. Look in to all the pain relief there is available. Good luck and take care xx
Hi, this is exactly my worry with the epidural. I dont like the idea of not feeling my legs or having complete control. My son was also spine to spine but they have claimed this is unlikely a second time round. I also got told 16 years ago that epidurals can cause you to be paralysed but my obstetrician is saying that's a wife's tale. Once I hear these things I cant ignore them. I will look into this pethidine 👍 xx
This is going back 25years ago , and the person doing the procedure kept saying to me to wiggle my toes as I could become paralysed, I was in a panic.. and in my psychosis at the early stages believed at one point I had been paralysed......if you already have concerns about this procedure, then think carefully find all the information out how it is done ... I was able to walk around with help .Remember you went through the most painful birth there is, with no pain relief the first time, I admire you for that, as I know I would not have been able to have coped with that at all. Look into all pain relief that is available for you.
My second birth with my son, I went in to labour but wasn't properly dilated so they sent me home, so sat in the bath for the next 4 hours l think with my husband showering my belly with warm water, I then said I wanted to push, so off to hospital... had pethidine which to me took the edge of everything and was able to push, he was born a few hours later. this birth was so different and calm.. baby was presented better, his spine towards my belly..sure there is a professional word for that lol, so an easier quicker labour in all. This time around I had no PPP and didn't feel that feeling of shock I experienced with the first birth. So there is hope. I wish you the very best this time around. Xx
I knew it couldn't be a wife's tale and must of come from somewhere. This Obstetrician told me the name for it is sunny side up lol sounds more like a nickname and not an actual official name. I think the worry of an epidural might be too much for me as I have a bad habit of thinking I will be that one percent in a wheel chair after having one 🤦♀️
Being in water is something I havent tried I quite like the sound of your experience in a bath with warm water....
Thanks again been very insightful. Not due to see her for the plan until March 5th so got some time to look into things x x
I am glad I have been able to help you, hopefully without frightening you too much. They told be it was face to pubis..I like you one better lolIf you are worrying I think there will be a good chance this isn't for you. The water was lovely and better than being in the hospital for hours, I think they sent me home deliberately, so I spent as least time in hospital, as back 23yrs we didn't have the perinatal care they have in place now... so was practically on my own.
It was the showering over the tummy that was nice and helped through the contractions and just me and husband so lovely.
Yes plenty of time to do a little research. I have happy to answer any other questions etc... therapy for me helping others xx
It’s completely up to you. If you like the idea of no pain relief, fine, if you want an epidural, also fine. I know birth trauma is a factor in PP for some people. It wasn’t for me ... two ‘normal’ births, two PPs. The second time I had a delusion at about 16 weeks before due date and was prescribed 2.5mg of olanzapine which suited me and I was fine. They then increased the meds after the birth but soon agreed I didn’t need it, dropped it back down and stopped it - can’t remember exactly when.
I think the answer is to do what is most comfortable and least stressful for you. Second time round you will know all the signs and have treatment options in place and so it shouldn’t be a big drama, even if you do get it again.
And the nice thing is that the second baby experience somehow helped with healing the first.
Take care.
Hi thank you for you reply. I have discussed Lithium or Olanzapine. If one fails on its own then both. Lithium I can only begin after birth and previous PP came on 10 days PP which I feel is a short window to get Lithium working but we will see... I think I need to focus on your words its not a big drama and stop focusing on the dramas of the previous PP xx
So different the second time - effective prescription - no drama - lovely baby.
They can increase the olanzapine straight after birth. You will already have the pills so I'm sure you can start taking an increased dose the moment the baby is out! You will have a plan, everyone knows you are at risk and so your treatment will be ready.
Take care
What plan does your consultant have,?
Lithium and Olanzapine and an admission if needed. She says im high risk x
Hello Koala2021
Congratulations on your pregnancy! I just wanted to let you know that my episode of pp followed a very traumatic induced natural delivery in 1988. I did go on to have two more pregnancies and had an epidural each time. I did not suffer pp on these two occasions. I did have full support from professionals and family, and a place booked at a MBU just in case. I hope this is of some encouragement to you and I wish you all the very best. Kind regards, Helen
Hi Koala2021,
How are you doing? Good to hear you started on olanzapine and have a plan for after the birth. All my best wishes on this last trimester of your pregnancy, try and rest as much as you can and pamper yourself.
Hello Koala2021
A few weeks on and just wondering how you are? I hope the medication is working for you. Try to find time to rest as much as you can. Thinking of you .... take care. xx
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Hi koala2021
I’m not a professional so I can’t say for sure.
But I had an epidural and a c section and I still got pp. I was on an anti psychotic straight away.
Good luck with your pregnancy. I hope things work out for you.
Was this second case of PP or first?
First
Thank you for your insight and well wishes. I've been given 60% chance of it again so fingers crossed x
Got my fingers crossed for you x