Pregnant with 2nd baby after experiencing postpartum psychosis with my first child

[Neleyxo]

I just wanted some advice please I had postpartum psychosis with my first child back in 2020 when she was just a week old. I ended up being admitted to a mother and baby unit for a month and have been on a recovery journey from then. I have just find out that I am 6 weeks pregnant with my 2nd baby and I am really anxious and worried of becoming unwell again.No longer any symptoms, not on any medication just sometimes I suffer from anxiety. Please can someone advise who I need to speak to and get support from regarding care plan during this second pregnancy? Also for those who went on to have another baby after postpartum psychosis did you have to take any medication during pregnancy? Thanks in advance

[Naomi_at_app Volunteer]

Hi Neleyxo

Welcome! Congratulations on your pregnancy, and I’m glad you are part of the online community here as there will be so much support for you from lots of other mums who have had another baby after an episode of PP.

I thought it would be helpful if I copied you a response to another expectant mum from Rachel, one of our peer support team who had another baby in 2021. This reply has loads of information and shares her experience:

I had PP back in 2016 with my first baby, and have gone on to have a second baby who is now one. I had no reoccurrence of PP with my second with support of medication.

It’s such early days and natural to be worried - I know felt quite unsure and anxious about what the pregnancy and early days with two children would bring. But I’d like to say that in my experience there is lots of support available to you. Here for a start, lots of women will be able to share and be here for you.

The APP leaflet on planning pregnancy has some useful insights which you can take a look at. [link below]

app-network.org/wp-content/...

If you are in the UK there should be a Specialist Perinatal Mental Health team who your GP or midwife will be able to refer you to after your booking appointment.

I was very fortunate to have an excellent psychiatrist, specialist midwives, consultant care and was offered preventive medication during pregnancy. I had a planned extended hospital stay after birth so I had support during the period of highest risk for me. Gosh, there is lots I could add, but rather than bombard you feel free to ask any questions of the forum if that’s helpful as you go along and things crop up.

[Neleyxo in reply to Naomi_at_app]

This is really helpful thanks so much Naomi

[Lilly53 Volunteer]

Hi Neleyxo. Congratulations on your second pregnancy and great to hear you are mostly no longer experiencing any symptoms. It is understandable you are worried though.

My first episode of psychosis was 10 years ago when awareness was much poorer than now and despite having many classic symptoms (hallucinations, strange thoughts, anxiety etc) my illness was never picked up. It was like a living nightmare at times. But I recovered well as symptoms thankfully gradually eased up over time by themselves.

When I became ill again with my second pregnancy it was a totally different experience. I’d done lots of my own research online by then about my symptoms. I also found the APP website which was such a lifeline…..I genuinely thought I was the only person to experience such things until that point!

The second time around my family all recognised what was going on in my head and I got help from health professionals straight away.

So in my case I think knowledge / awareness of symptoms or signs of becoming ill among myself and my family members was key to my getting better sooner. For example the second time around I talked to so many people about how I was feeling that it became obvious I was unwell again. That was a massive relief as the first time I had suffered in my own head in silence for months. I also got access to a CPN each week. I think I also felt an underlying sense of strength knowing I’d got through this illness before and had hope I would again.

I hope all the info Naomi forwarded will be useful and I wish you lots of love and luck with your second pregnancy.

[Neleyxo in reply to Lilly53]

Hi Lilly, thank you for your reply and sharing your story. I’m glad that you were more supported and got better sooner in your second time round. Thanks for your well wishes I really appreciate

[Rkmummy Volunteer]

Hello neleyxo and congratulations on your pregnancy.

I had post partum psychosis with my first child in 2016 and went onto have another child in 2020. (Didn’t get ill second time round)

I saw a gp early in my pregnancy and got referred to the local perinatal team. I saw them at the beginning of my pregnancy then it all ended up on virtual support due to the pandemic.

However at the end of my pregnancy I did have a care coordinator and between her and the midwives they visited every day I the first two weeks.

I had options for medication

1. Choose not to take any and see what happens.

2. Take medication in pregnancy and after giving birth

3. Take medication after giving birth.

I went for option 3- late in my pregnancy I got the prescription and then a few hours after he was born I took my first olanzapine.

Good luck with everything

Rachel

[Rkmummy Volunteer in reply to Rkmummy]

And I also meant to say- make sure you make use of the peer support service on here. I did. Jenny_at_APP was fantastic and I still email her now!

[Maria_at_APP Moderator]

Hi Neleyxo,

Congratulations on your pregnancy! This must be an exciting but also anxious time for you as pp mums we have so many things to weigh in subsequent pregnancies.

I had pp with my first baby in 2018 and went on to have another pregnancy in 2021 for which pp did not repeat. I did have a wobble and experienced low mood and anxiety in December 2021 for which I started taking anti depressants and went on to have CBT, but did not need admission to hospital. Being under the perinatal mental health team already meant that things were caught up very quickly second time around and my recovery was so much faster for it.

Something that weighed on my mind during the whole of my second pregnancy was what would be the effect of me becoming unwell again on my eldest child. What helped me reduce that anxiety was to do a plan for with whom my daughter will stay if I needed to go to hospital for pp and have some practice sleep overs at grandparents. Those practices were useful regardless as me and baby stayed for 4 nights at the hospital when he was born. Of course, a long term stay at hospital for pp is different to less than a week away from each other, but trying to keep her routine as close to normal as possible and mercilessly indulging her felt like the way to go for us if I needed to go to an MBU.

Self awareness as has been mentioned before is also hugely helpful. Discuss your early warning signs with your partner and close family so they can keep an eye out too. Knowledge is a really powerful tool. It is also helps that everyone who would be caring for you is aware of your history. My hospital was really fantastic working with the perinatal mental health team (they were not from the same trust in my case), and all health care professionals I got in contact with had had a look at my notes where pp figured out prominently. If they were not aware of the illness they did ask me and I was more than happy to share my experience with them. I do remember having a long chat with one of the midwives in the postnatal ward whose daughter was in hospital being treated for psychosis at the time and we hugged and talked and cried together.

I wish you all the best in your pregnancy, please feel free to ask any questions here, many mums in the forum will be happy to share their experience with you.

[Jenny_at_APP Partner]

Hello Neleyxo,

Congratulations on your pregnancy 😊 Thank you for reaching out here, where you’ll find lots of support and shared experiences.

I had PP after my first son was born in 2012 and had another son in 2016. I had a lot of support the second time and it was a very different experience. There wasn’t a perinatal mental health team in my area at the time but there was an outreach service that I was referred to when I was booked in with the midwife – I was under consultant-led care just for the mental health element, and saw a mental health nurse who helped me to plan and prepare.

It really did make such a difference knowing the risk of PP was there, when first time around it was completely out of the blue and we had no idea what was happening. I had excellent support from my GP, midwife and health visitor. I ‘planned for the worst and hoped for the best’ and although it was an anxious time, I knew what I watch out for and that if I did show any early symptoms we knew what to do. I was told there was a 50% chance of me having PP again. I know no one can plan for every eventuality, and I’ll never know if what we put in place to try and reduce the risk of me getting unwell helped keep me well, or if I’d always have been in that 50%, but it really was a different experience just knowing that awareness and support was there. And putting those plans in place helped me a lot with my own anxieties.

I opted to take a low dose of medication after the birth. I became unwell with PP 3 weeks after my first son was born and was told if I became unwell again it would likely follow a similar pattern so I didn’t want to ‘watch and wait’ for 3 weeks worrying about it so started taking medication when I was discharged from the maternity unit. I stayed on that low dose for 6 months. You will be able to discuss all of this and put together a plan that is appropriate to your own experiences and preferences, this is just what felt right for me 😊

The planning pregnancy guide Naomi shared contains a lot of really helpful information. Do ask any questions, and you can use the search facility to find other posts about subsequent pregnancies after PP too, there is a lot of helpful shared experience here.

Sending you very best wishes,

Jenny x

[HelenMW Volunteer]

Hello Neleyxo, for some reason I can’t see the whole of your message but I thought I would just share my experience of PP.

I had PP in 1988 after my first child. I had moved, no family near by and quite a stressful time. I was unwell for 3 months and Back then I was in a general psychiatric hospital not a MBU

I had two more babies one in 1996 and one 1999. All girls. Second and third time I made as many plans as possible. I even contacted the nearest mbu just in case. I had epidurals as my first labour was a trauma. My mum moved in once I got home and all I had to do was sleep and feed the baby. I had no experience of PP . I think support and sleep made all the difference.

Congratulations on your second pregnancy, hope all goes well for you. Do keep us posted. This is such a wonderful forum and no doubt you will receive encouragement and support .

Sending warm wishes, Helen x

[SammySeal]

Hi Neleyxo

You've already had so many helpful replies, but I just wanted to say hello, congratulations and that APP is a great place to find support.

Myself, I had postnatal depression and PP after my first child, but was fine after my second child. Completely different experience, and a very positive one. It can be a worrying time though, if you were poorly first time round.

I was mostly very anxious after my second, mainly that the PP symptoms would return, but they didn't I'm pleased to say.

First time round I had very little help, this was back in 2009. Second time, in 2013, my assigned midwife had in my notes that I had PP previously and the Perinatal Mental Health team had a specialist community mental health nurse keep a good eye on me before, during and after the pregnancy. I didn't take an medication during the second pregnancy as I had come off it by then, but it was discussed and as I was being kept an eye on I felt satisfied that if I needed any medication I'd be well advised.

So I would say to make sure everyone involved in your care knows about your first pregnancy experiences. I would think at your midwife booking in appointment would be a good time to talk about it and ask what can be put in place.

All the best and keep in touch. x

[hope2929]

I am five weeks pregnant with my second after experiencing pp with my first and I am planning to stay on Olanzapine throughout my pregnancy and after. I hope we don’t have any repeat psychosis!

[Jenny_at_APP Partner in reply to hope2929]

Hi hope2929, congratulations on your pregnancy I hope you also find the information, resources and experiences shared here helpful and that you are keeping well.

Best wishes,

Jenny x

[Maria_at_APP Moderator in reply to hope2929]

Hi hope2929,

Congratulations on your pregnancy! I took olanzapine towards the end of my pregnancy and upped the dose after giving birth. I don't know if it was the antipsychotic effect or the drowsiness or the combination of the 2 plus all the other risk reducing measures we had in place, that kept pp at bay the second time around. All the best for the future. Take good care

[JackBruce]

Hi, I hope all the wise and wonderful comments reassure you. I'd just like to add that our experience was that my wife did have psychosis the second time, but people are right to say that may well not be the case for you. I don't say this to be unsettling just that when we've talked about it we both feel it was avoidable the second time, she feels she should have gone straight onto olanzipine after the birth, that we should have insisted on support and help and sticking to the aftercare plan we made ( it was the weekend and we didn't see anyone to assess her before discharge). Just a few simple things like that would have made all the difference, so I wanted to say, like some of the others, talk to the specialist take make a really good plan and insist they stick to it! This was ten years ago, it's much better now in terms of awareness and services etc. All of which being said I should add that the second time was much shorter/ easier to manage and we've both said that we can't imagine life without both our lovely kids! I really hope for you that you won't get up again, but please go in with your eyes open and be a proactive and planned as you can be, watch for any signs etc. Love to you

[Cheryl-2021 Volunteer]

Hi Neleyxo

Congratulations! Great to see so many replies and hope they are giving you encouragement and a clear picture of what's to come with your planning.

I had PP in 2004 and in 2021 went on to have another baby PP free. I opted to take medication just before birth and then increased it with Lithium the night he was born. Lithium had proven to be the effective one for me first time round.

I had a white board in my kitchen with all my support numbers, CPN and consultant numbers with names and all the signs to look out for. I found this to be a peace of mind that everything was covered incase it did come back. I also wrote a plan for what I wanted if I was to be admitted which my CPN uploaded to my medical records.

I found this forum very helpful and encouraging 🥰

Best wishes

Koala 🐨

[Neleyxo]

Thank you so much to all of you for taking the time to respond and sharing your stories. It really is such a comfort to actually finally receive some constructive answers and to be able to relate to your experiences. PP is such a frightening, isolating illness that it is wonderful to have this forum as a resource for help.

All your wise comments have been reassuring.I have been referred to the perinatal team by the community midwife. Thank you so much again for all of your valuable input so far which really means a lot. Love to you all

[Maria_at_APP Moderator]

Hi Neleyxo,

So glad to read that you have been referred to the perinatal team by the community midwife. I am glad you have found this place helpful. Take good care, let us know how you are getting on, all the best in the future