Thinking of having another baby…

[KeiraMarie]

Good morning, has any of you gone on to have another baby after an episode of PP & if so what was the outcome? Did you have a care plan in place? Was you referred to the perinatal team during you’re pregnancy?

Did you manage to stay well after delivery? Or sadly did you suffer another episode & if so how was that handled?

I’m thinking of maybe trying for another, I think main reason are I would love to have a baby girl, that would be the dream & complete my family & I’m longing for hoping that if I was to make the decision to have another baby I would stay well & have the newborn bubble I so missed & lost out on after the birth of my son 16months ago..

I think I’m still grieving the time lost with my sons early days due to been so unwell & I long to experience this again in a much happier healthier state of mind.. or at least I’m hopeful I would..

Any advice/support would be much appreciated Thankyou 💕

[Naomi_at_app Volunteer]

Hi KeiraMarie

Thanks so much for posting, and well done for reaching out here for support. There are many women in the online community here who have made the decision to have another baby, and lots of positive stories of good support from specialist perinatal mental health teams, help with decision-making about medication and experiences of both staying well, and going on to have another episode of PP.

My personal experience was that I did go on to have a second episode of PP back in 2011, but I had excellent support all through pregnancy with a perinatal mental health team, and a clear plan in place for relapse including medication ready to take if I did notice any early warning signs. We nipped the beginning of psychosis in the bud, with advice on the phone from the Crisis Team, and had a really good first 6 months. Looking back, I feel I withdrew from medication more quickly than advisable, and sadly I did go on to have a period of severe depression. However, the joy of my two daughters now aged 15 and 10 makes the memories of that time bearable, and helps me to offer hope that even if a relapse does happen, you can get through it.

We have an information guide specifically written for mums considering pregnancy which you can download here app-network.org/wp-content/...

I'm sure lots of other mums will share their experiences and support here as you go through what we all know can be a tricky time of decision-making. APP is here to support you for as long as you need us.

Warm wishes

Naomi

[Maria_at_APP Moderator]

Hi KeiraMarie,

I am currently pregnant with my second baby after having pp in 2018.

So far I can say that the experience and level of care has been very different from the first time around.

Before even getting pregnant, when we were still debating if we were to have another baby or not I was able to have a chat with a perinatal psychiatrist through a referral from my gp. This is called a preconception counselling meeting and it was very useful for me to clarify questions I had around medication, risks and measures in place to reduce it.

After I got pregnant I was referred to the perinatal mental health midwives in the hospital where I would give birth and also the community perinatal mental health team, which can be from another trust depending on where you live.

I have regular appointments with the midwives and the community perinatal team. There is also support in terms of therapy available through the community team.

At week 30 something there is multidisciplinary meeting which includes all professionals that will be involved with your care, the hospital, the community team, etc. And a plan is put in place about your care specially around the weeks before and after the birth of your baby.

If you have any questions feel free to DM if you prefer.

Take very good care, it is a difficult decision when at risk of pp, but I hope that from some of the experiences of mums here you will be reassured that the level of care and support is very different.

[Rachel_at_APP Partner APP]

Hi KeiraMarie,

Your post very much resonated with me. And I'm sure it will with others too. Deciding whether to have further children is a very personal decision, which can be fraught with such emotion, anxiety and worry following PP. I had my second baby nearly eight months ago now, following PP with my first baby in 2016.

Before conceiving myself and my husband went for pre conception advice from the Specialist Perinatal Mental Health Team. Our GP referred us and we both found it really helpful. It was a space we could ask lots of questions and receive support. Following that appointment I accessed Counselling too.

Once we’d conceived, I was put under the care of the specialist perinatal mental health team once again. I was very fortunate; it was a straightforward referral to them, and I felt supported from the off. I was given, on the whole, a great team who supported us through the pregnancy.

A few significant things that I always like to share, I hope it might be helpful for you,

- Yes I had very robust care plan in place from the start, and this was continually updated

- I was very lucky to have an absolutely brilliant psychiatrist who honestly was phenomenal throughout, both my husband and I really rated her. Even though we never actually met face to face (COVID!), we really felt supported in her care

- A very supportive GP

- A brilliant specialist mental health midwife at the hospital, who went above and beyond to support me

- Taking antipsychotic medication from 35 weeks of pregnancy

- A planned five day stay in hospital on the postal natal ward in a side room (not on the open maternity ward) following the birth of the baby

- A strong link being made between the hospital and the psychiatrist who were different health trusts

- A very robust discharge plan to come home

- No overnight feeds of the baby to preserve my sleep. I was very lucky to have midwife and maternity support staff help me while I was still admitted in hospital, and then a husband who luckily is brilliant at night feeds and seemingly needs much less sleep than me for which I'm very thankful

- A lot of self-care and hunkering down at home once discharged from hospital. The pandemic helped with this; I didn’t want visitors anyway… So people actually not being allowed to come actually stopped that being awkward for everyone!

- Husband working from home has helped in terms of support being on hand (moral support and practical)

Thankfully I was extremely fortunate not to have a reoccurrence of PP this time. It hasn’t been easy and I did have a wobble / near miss during my planned five day stay in hospital. However, with family support quickly spotting the signs and linking with the doctors on my behalf my medication was changed which “nipped it in the bud”. The medication wouldn't have worked so quickly and effectively if I hadn't have already been on a low dose from 35 weeks. Being on the medication before birth, for me anyway, was definitely the right choice. Although I know it’s not an easy decision to make, and its very personal to each person.

In terms of the NHS they have been phenomenal, I have had to be pretty assertive at times and strong willed, put myself out there and advocate for the right care to be given. Covid certainly added unfortunate complexities at times. But nothing was insurmountable with the right support, I just had to keep communicating the whole way through.

I hope this might help in some way. Everyone’s experience is different, but I consider myself extremely lucky to have had this restorative experience with our second baby.

Take care, and write any time if you have any questions. I'm happy to share.

Rachel x

[KeiraMarie]

Hey ladies, thanks so much for taking the time to reply in depth to me & for the support, I’ve red every reply & as of yet we are in no ways of actively trying for another just yet..

we have spoken about the possibility of adding another but due to me been so unwell after the birth of Luke it’s left us both with some anxiety & questions..

my postpartum psychosis was classed as ‘boarderline’ & I wasn’t placed on antipsychotics I was put on lorazepam, zopliclone & sertraline which was upped every week, I was placed on 50mg, then 100mg & the therapeutic dose of 150mg so the physical side effects from the cocktail of medication I was on left me feeling very spaced out, drowsy & I was asking them repeatedly if I had dementia & if so I need to be placed on the dementia ward which was next door! (I was convinced at the time I was loosing my memory as I couldn’t remember any of the staffs names, or conversations that took place) I would also doze off mid conversation!

I think again that was down to the boarder line postpartum psychosis me thinking & been so convinced that I sadly had dementia! Plus if I remember correctly I had them check my sodium levels as I was convinced I was very low on them! Which they did & al came back fine..

& although a third & final child would be the happy ending I ain’t too sure if I can go through all I have done again if I was to sadly become unwell with PP again.. but like you ladies say the support & care is right there from day one.. & if I was to show signs of relapse they would nip it in the bud which is exactly what they did last time..

it’s just so hard to make such a risky decision & I know if I don’t take that chance I have a feeling I will forever regret it & look back on & so wish I had..

Im just absolutely terrified of possibly having to endure this living nightmare all over again but I also understand some women do & have managed to remain well after the birth of their babies so I too have to think of the positives outcomes too ☺️Xx

[mummy2beee]

Hi KeiraMarie,

I suffered PPP after the birth of my son and he is now 18 months old. I can completely relate to wanting to relive those first few months after missing out on so much, as I was in a mother and baby unit for a few months.

I am currently 23 weeks pregnant with a baby girl! I couldn’t believe it.

I am still under the perinatal team and we are currently having teams meeting every month, and the closer I get to delivering we will have more regular contact and a plan will be put in place.

My main concern is being in the hospital alone, I was in hospital for 9 days with my little boy due to it being covid and not allowing visitors.

My nurse has assured me things will be put in place this time to protect me from this.

I am a little nervous, but truly believe I am much stronger this time round and pray I don’t go through PPP again…

Lots of love xx

[annajames1]

Hi KeiraMarieI had post-partum psychosis after my first child and certainly didn’t want anymore children after such a terrible experience. However, the universe had other ideas and when I discovered I was pregnant with my second child, I was petrified. I went back to see the psychiatrist who had treated me and he suggested putting me on preventative medication while I was pregnant. I told him that I’d rather wait and see what happened after the birth, than take medication while I was pregnant. The amazing news was, I had my son and had absolutely no signs of anything, not even a day of the baby blues. I would say, go for it, just make sure that everyone keeps an eye on you after the birth and if there are any signs, they can be nipped in the bud. Good luck.