i suffered PP after my first born in January 2021, with admission to an MBU 10 days postpartum and a second time 2.5 months later. I have bounced back incredibly well and feel like my old self again, entirely weaned of meds and no longer requiring counseling either. My hubby ad I start talking about a number 2 more often and last weekend we wrote to my previous psychiatrist whether we can get some pre-conception counseling. I think I am up for it but obviously have many questions and concerns, possibly a bit of undealt trauma. I think women give up their physical body anyway when we decide to conceive but in my/our case we put both our physical and mental body on the line. It feels like a big sacrifice....
Then again, when I look at my son and also reflect back on my journey I feel like it was worth it even though it was a hell of a rollercoaster ride. I was wondering whether anyone is willing to share their experience with planning for a consecutive pregnancy and what helped etc. I know there are more post on this topic and have read back already, but it is also nice to get a few live response to this case.
Also, what further complicates the matter is that my husband and I moved on from the UK. We now live in Sri Lanka but do have an international healthcare insurance. So in addition to the general preventative care plan when it comes to PP we will have to make some big decisions around the place of birth. Here in Sri Lanka, which is home. Or my home country, the Netherlands. Or my hubbies home country, South Africa. Or the UK, which is not home for either of us but the MBU that I was in will feel like "home" should I be admitted again. All these thoughts haha (and that's me being sane...)
Have a lovely day! xxxx
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Wiwa21
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So nice to hear from you again. So glad you have bouce back so well and feel like your old self again.
I went on to have my second baby in 2021 after experiencing pp in 2018. It is great that you are already so well informed, and looking into preconception counselling, good quality information is really key. You are probably already aware, but there is a guide in the APP website about planning a second pregnancy.
My own experience of a second pregnancy after pp was positive in that I did not experience pp a second time around but I did get some depression 3 months post partum. I think it was not helped by the fact that I stopped breastfeeding around that time too. I think key for me when I experienced this depression, that wasn't severe at all but treated at home, was that I was already under the perinatal team. It only needed a call to my nurse to say, hi I have been feeling this way for the past week and I may need some further support, and the support was there. I cannot emphasize how lucky I was to be able to start some talking therapy just a month and a half after my symptoms of postnatal depression started showing.
You mention the possibility of deciding in which country to have your baby. There is a number of factors to consider and with decisions as complex as this it helps me to write down a list of pros and cons, and discuss it together with my husband after the kids are in bed and there are no other distractions.
If you have any questions with regards to preconception counselling I am happy to answer to the best of my memory.
Hi EmiMum, Thanks so much for your quick reply. It makes me think you are either a night owl or perhaps also in another time zone than the UK. I will look up the APP resource which i haven't read recently. So that is a good remier, thank you! I guess a follow up question on preconception counseling is what did you find useful to discuss and explore during these session? Thanks again xxx
I have a baby that just recently went back to waking up in the early hours of the morning. We take turns my partner and I, but we are light sleepers both of us now.
On the preconception counselling. I asked about the risk of a second episode of pp and what helps to reduce that risk, and what the perinatal team would also offer as the ideal avenue to reduce the risk. I asked also about birth options, even though this is not the area of perinatal mental health at all :), but as you I believe I had some birth trauma after my daughter, they were very nice and reassured me that they will back up whatever my preference would be, but that it is of course down to many factors we cannot predict fully. Still I felt they would have my back and ask for psychological as well as physical considerations to be taken into account by my birthing hospital.
I also had a few questions around medication, which is very usual.
And I also asked about my partner, he was with me every step of the way as well as my brother. Both of them remember more of my psychotic state than I did. They were both very incredible in dealing with their own fears (as many men have been raised to be the strong silent type), but it is something to perhaps consider, how can you and your partner work best as a team.
Take really good care, hope things go well as and when you have your meeting with the perinatal psychiatrist.
Thanks for the additional info EmiMum, I will take that on board. We will likely have the counseling session in Feb so it’s good to give it some thought ahead of that discussion. Good luck with the night shifts, I guess I am not looking forward to doing that again… Warm wishes! X
All the best Wiwa21, and thanks. It is all a phase with babies, at some point it stops :). Take really good care and feel free to message if you have any other questions or anything you would like to share
Good to hear you have come through so much and feel like yourself again. Such a relief isn’t it, for your partner too? Sri Lanka sounds idyllic 😊
I did have PP again, six years after my first episode. We missed an appointment with my psychiatrist about adding to our family which he later wrote to my GP about, as he thought it would not be the right decision for us. For some reason I went under the radar when I was pregnant with our second child and reviews with professionals were few according to medical notes. Also as mental health was in the shadows at that time, I didn’t realise how ill I had been.
I admit it was a very tough time all those years ago but thankfully I fully recovered under general psychiatric care and have been blessed with my sons. As you might consider having another baby abroad, there is also Postpartum Support International at postpartum.net with a list of international countries, with co-ordinators and links to helpful advice, which can be found under International Support there.
It is a lot to weigh up and I wish you well for the future. Take care 🌹
Hi Lilybeth, thanks for your response and sharing your story. I am sorry to read it though and it makes me sad to think about how scattered the care must have been many years ago. I mean it is still not optimal… Anyway, you are right you were blessed with your sons in the end and I guess that is a little bit of the mentality that I currently have. Even if I would have another PPP I think it would be worth it in my opinion. Or at least I am willing to take the risk. We are so happy with our son and I always wanted to kids. Your suggestion for the other platform/network is a real good one. Thanks, I will look into it if I have some time. Warm wishes xxx
Hi Wiwa21, Thanks for taking time to reply. I’m sorry I made you sad reading about the level of care years ago. Thankfully there are mums on the forum for whom PP did not return. So I think a good care plan is essential to cover all eventualities. These days it’s ok not to be ok ... being able to make a list of the pros and cons might be helpful before you make a decision with your hubby.
For now I hope you enjoy the delights of Sri Lanka with your family as you have come through so much 🌹
Hi, I had PP after the birth of my son in September 2020. We welcomed our daughter in November 2022 and I didn’t relapse.
Healthcare is a bit different in the United States. When I asked if there was prenatal team they said it was just my psychiatrist. My PP came with a bipolar diagnosis. I also did not get to breastfeed my son and I knew that this time that was really important to me. So my first goal was to find a medication that was safe to take while pregnant and breastfeeding, which was Olanzapine.
My husband got a new job which meant he wasnt going to get paternity leave. For me lack of sleep is a big trigger so we decided to hire nighttime help as well as daytime help.
Also every DR appointment I had I mentioned I was bipolar. When my daughter arrived I explained the importance of sleep and asked to not constantly have people knocking on the door, I asked if it could be in 3-4 hour intervals. The nurse called it “cluster care.” They put a sign on my door and they all respected my wishes. It was great.
Lastly education. I did a lot of research on what it means to be bipolar and breastfeeding. (I found a lot of great resources on YouTube).
Long story short, I remained well through out my pregnancy, so I never had to take the Olanzapine until my daughter arrived. We came home sick from the hospital with RVS (which really took so much out of me) and the help I hired was terrible so after one week I didn’t continue.
I was terrified to do my first night shift. My husband refused to use a syringe to help with the feedings. I didn’t want to introduce a bottle yet. And as my husband was storming out of the room because I also wanted to cosleep, he said you better pray. I was angry, scared, and so tired. So I prayed and I don’t remember what happened…aside from waking up 3 hours later. The longest stretch of sleep I had gotten in a week.
Thankfully I only took Olanzapine for the first two weeks of postpartum. I was sleeping well and felt great and I knew I could do this without the meds.
I’ll admit there were a few things that could have sent me down the rabbit hole but it’s hard to explain… everytime I told myself nope, it’s not what you think it is. Also being sick did a number on me mentally, but my husband kept reminding me it’s because your sick , it’s not the psychosis.
So make sure to understand your triggers! If sleep is one do what you have to do to get it. My daughter won’t sleep in the bassinet, even the professionals couldn’t get her too, so I cosleep. I never thought I would but my sleep is too important.
Having a care plan is also important.
And while I know not everyone is religious for me the power of prayer is very real and I know I had God looking out for me this time. I’ll be the first to admit I’ve had a difficult relationship with God, especially after the birth of my son, but due to other events after the birth of my daughter I was finally able to welcome him into my life and I’m so grateful to have that faith.
Good luck and know if you do relapse that’s also okay.
Thanks SKSharks for sharing your story in so much detail. Reading on women’s experiences can really be helpful. I think hiring a night nurse is def one of the options I would consider. That wouldn’t be too costly either here and sleep was certainly a trigger for me. I am not meds anymore and also not diagnosed bipolar, I wouldn’t be too keen to go back on Meds to be honest but if need be I will do it for a bit just as preventive measure. I don’t think I would want to give up BF for it though but last time I was on haloperidol and allowed to continue feeding my firstborn.
I am sorry to hear that your husband stormed out, that doesn’t sound nice and rather stressful at a time you were very vulnerable and in need of all the support you could get. Thankfully you stayed healthy and things are well now with a lovely family including 2 kids.
Thanks again for sharing your experience. Warm wishes xx
Yes. There are so many benefits to nighttime help. Just be clear to them what you want. I thought I was clear in that I wanted to skip one feeding and do all the rest, but they decided they only wanted to wake me for one feeding and not the others. Which was bothersome because I still had to wake up in the middle of the night to pump due to discomfort…so I’m like why can’t I just feed my daughter?
Anyways yes it was tough and it was terrible he walked out of the room, but it showed me I was capable and I could do this on my own. That confidence was something I needed, because there was so much fear due to what happened with my son.
Breastfeeding was too important to me. I still haven’t done a bottle with my daughter and honestly I don’t think I am. Haha
I think you summed it up so well there that we give up our physical self as well as our mental self. I had a 17 year gap before braving the baby plans again, so well done for not letting it hold you back and for making sensible planning.
I didn't experience PP again the second time round but I had alot of support from the Perinatal Community in the UK and looking back I think I was a little manic at times.
You have a lot of options to chose with pros and cons but I'm sure you will pick what is right for you and your family 💖 xx
Just thought I would post my experience of second and third pregnancy after having PP with my first back in 1988.
As you mention in your post, we had preconception counselling. Back then 1995 I liaised with the three specialists in the field for lithium, oestrogen or progesterone therapy. I had fabulous midwife support too.
Time moves on and treatments change and I truly believe my subsequent pregnancies were helped tremendously by the support plan I had in place. My mum was able to move in with us and she took over all duties other than breastfeeding! 😊 I had plenty of sleep having had the babies. I had no pressure to keep up with cooking, cleaning etc. my daughter from 1988 was now 8 and was a great help indeed.
I did follow a plan whereby I kept my blood sugars stable by eating carbohydrates every three hours. This could just be an oatcake or a piece of toast.
I opted for epidurals so as not to have the traumatic birth which I experienced in 1988.
I also asked for no pethedine.
I would be great to hear how you get on. PP comes so out of the blue, so forewarned is certainly forearmed.
I hope you’re well, it’s lovely to read your updates here and I hope things are going well in Sri Lanka.
Just to add my experience of having a second baby after PP, I had PP after my first baby was born in 2012 - it was out of the blue with no previous history of mental illness, like many others, and I’ve not had a diagnosis of bipolar disorder. I read lots of information and stories via APP, on the website and here on the forum, including the planning pregnancy insider guide, and had a consultation with Prof Ian Jones via APP’s second opinion service. This was incredibly helpful to talk through my experience and the likely risks and factors we could consider as part of our planning if we decided to go ahead. There wasn’t a perinatal mental health team in my area at the time so it was amazing to be able to access that specialist knowledge and advice. I was told the risk of having PP again with a second baby was around 50%.
For me, I think sleep deprivation was a massive factor in the lead up to my PP and I became totally fixated on the breastfeeding which hugely fed into that sleep deprivation. So these were factors we really tried to make sure I had support for. Once pregnant (which happened very quickly once we’d decided to try, which was a bit of a shock to start us off!) and booked in with the midwife, I was referred for consultant-led antenatal care which meant I had more appointments than if I’d been on the standard pathway, and saw an outreach mental health liaison nurse later in my pregnancy. She helped me to put together an advance directive, setting out my wishes and preferences if I became unwell again, which was shared with the other professionals involved in my care (GP, health visitor, midwife). The MBU where I was a patient when unwell were also informed of my due date and I had the option of going there after the birth if I wanted to which was reassuring, though I opted not to unless I became unwell. I visited the unit very late in my pregnancy to try and remove any anxieties about it, by seeing it when well, which was nerve-wracking but I’m glad I did it. I opted to go on a low dose of anti-psychotic medication after my baby was born, and to bottle-feed – a very personal choice which wasn’t easy but I decided to just remove breastfeeding from the equation as it had become such a fixation first time around. I did the initial feeds in hospital where I stayed overnight, then when we came home we switched to formula and I started taking the medication. I had lots of support from my husband and our families, my husband and my mum did the night feeds for the first few weeks which was amazing. I stayed on medication for 6 months, but fortunately stayed well and didn’t need to increase the dose at any point.
It's not an easy decision, and as others have said everyone has to come to the decision that is right for their family. I always wanted more than one child and the fact I’d responded to treatment well and knew I’d have lots of support around me really helped – we then planned for the worst and hoped for the best, as Helen has said forewarned is forearmed 😊 I’m so grateful I stayed well and had a completely different experience second time, I know others aren’t so lucky.
I hope all goes well with your preconception counselling session and if you have any questions please do ask – it’s great to be able to share experiences in this way.
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I have a baby that just recently went back to waking up in the early hours of the morning. We take turns my partner and I, but we are light sleepers both of us now. 
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