Choosing not to have more children - Action on Postpar...

Action on Postpartum Psychosis

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Choosing not to have more children

bisketty profile image
18 Replies

Evening all,For context, I have a 21-month-old son, and after his birth I spent 6 weeks in a Mother and Baby Unit with him, as well as an initial week separated from him in an Acute Mental Health Ward, due to PP. I initially took Olanzapine and experienced lethargy, weight gain and a general zombie-like state where I was just going through the motions and craving food and sleep, and feeling very disassociated, for at least eight months. I have switched to Quietiapine, returned to work part-time, and have felt more myself and lost a significant amount of weight since. I am about to start tapering my dose, with my support team and I monitoring to see if I develop any signs of bipolar.

My husband and I had always planned on having two children, and I personally never wanted to raise an only child. However, my husband was extremely relieved when I told him last year that I don't want another pregnancy as I feel the risk for PP, and for longterm impacts such as bipolar or from treatments such as ongoing medication or ECT (which was recommended for my last episode but not administered), is too high. I am terrified of losing my sense of self and identity completely, and of not being able to be there for my son during immediate treatment or for the long term if I had a second episode of PP. My husband and I have since looked into adoption, but he is hesitant due to its possible negative impact on our son. I was just wondering if anyone is in the same boat as us at the moment, or made a different decision - and, if so, what informed it and what was the outcome?

Thanks , and take care.

18 Replies
Jocelyn_at_APP profile image

Hi Bisketty,

Thank you for reaching out to us on what is such a difficult and personal topic. Everyone is so different in their choices and you really have to do what is right for you and your family.

I only have one child and thought that I would have 2 but now do not plan on having any more. I am toying with the idea of fostering, but once my son is a lot older, potentially moving onto uni or out - He is currently 7! My reasons for not doing this at the moment are mainly practical really! Such as expensive of another children, lack of space, logistic of day to day life and work / life balance.

I think my son would love to have an other child in the house - most of the time! What are your worries about the negative impacts on your son?

I'm wondering if there is a forum like this for people considering adoption that might be helpful for you?

As I said it's such a personal decision and only you know what would work for your family.

Hopefully some others will have some more useful input than mine!


bisketty profile image
bisketty in reply to Jocelyn_at_APP

Thankyou, it's nice to know I'm not alone. My husband and I have attended an adoption information session and are both currently considering the ethics of adoption. Also, in our country (Australia), many children who are adopted often have complex health needs, so that type of adoption would involve us knowingly choosing for our existing child to likely have ongoing responsibility for their sibling in their adulthood (as opposed to unknowingly, if it occurred with our own pregnancy). Tricky stuff like that, mostly about the implications that informed choice brimngs. It's also so lovely to hear from you that your older child is very happy and not 'craving' a sibling - at the moment I am working through some guilt about my choice meaning that I can't 'give' my son a sibling.

hgallo profile image

Hi Bisketty,

Welcome to the forum. I'm volunteer with APP and I had pp after the birth of my twin girls in 2016. I also had a psychotic episode in 2018, non pregnancy related (not as extreme as the first one thankfully!)

I always wanted 2 kids as well, and so I was happy I don't have to think about another pregnancy after pp (having had twins.) I completely understand your apprehension though, it's not an illness anyone wants twice for sure!

So I guess there are things to weigh up. There is a guide which outlines the risks associated with a second pregnancy if you've had pp the first time so maybe have a read through:

Joycelyn's suggestion about looking at sites for potential adopters I'd look at too. Here's a starter for ten:

There's lots of things to consider, age, sex of the child that I would imagine could impact. They do also run courses for parents who adopt and I'm sure they'd be very thorough on looking for a child who would best fit your family and circumstances.

Thanks for being so open and honest. I wish the three of you all the luck in the world x

bisketty profile image
bisketty in reply to hgallo

Thanks for your thoughtful response. Congratulations on your twins. We've already attended an adoption information session in our country (Australia), and O've talked at length with my private PP specialist psychiatrist, as well as my original MBU care team, and I feel like there's no escaping the '50% chance' fact I keep hearing. I feel quite confident and relieved about my decision not to have one pregnancies - I'm thinking it as making a choice to be able to be present for my son and husband, and able to support them. However, I fully respect others' different choices as having children is such a life-changing decision.

EmiMum profile image

Hi bisketty,Such an important topic to raise and as both Jocelyn and Hannah have said such a personal decision. It is entirely different for everyone and so many factors come into play.

I had pp in 2018 after the birth of my daughter. I was in general psych for 10 days without her and then in an mbu for 2.5 months. It feels like it has happened to someone else at times, so extreme was it and so seemingly out of the blue. The long recovery process was also another mountain to climb. I have learned to look at the recovery as self maintenance nowadays, being on the lookout for my mood while learning to enjoy the good times and not worry too much about the bumps on the road (so much easier said than done). I am diagnosed bipolar 1 recently.

I went on to have a second baby in October 2021 and the decision for me depended on having support from my family, the perinatal team and friends around, good follow up during pregnancy and postpartum and good risk management if pp or depression were to present again. I did not develop pp but I did have some mild to moderate depression which was treated at home.

Extending the family is a big change for everyone and the children do feel it. That was as much of a worry for me as pp while pregnant, so if that is your concern I understand where you are coming from. I can't say what it was that brought it up but my daughter and my son have a great bond. She was never going to be a lonely child, she is very sociable and cousins and Sunday lunches at granny's, but being very close to my brother myself I was hoping for that for her. And they have their disagreements as it is normal, will fight and push as siblings do, but that is life.

Whatever you decide will end up being the best decision for you and your family.

Do take good care and let us know how you get on, sending you very best wishes

bisketty profile image
bisketty in reply to EmiMum

Thanks so much. Congratulations on expanding your family while also learning to look after yourself. I feel the same as you re. the value of sibling bonds, and I also recognise that they continue longer than parent-child bonds. Because of my personal experience of having siblings, I am very much struggling to accept the idea that my son may be an only child (while also knowing so many only children that are totally fine).

I personally don't feel like I can climb those mountains of illness and recovery again, though.

EmiMum profile image
EmiMumVolunteer in reply to bisketty

Hi bisketty,

I totally understand. And whatever you decide will be best for you and yours. Timing was also a factor. In our case we waited till I was feeling well in myself for quite some time and I think that is a good idea when you want to bring a new baby or child into the family. I wanted to have stability in my life at the time to, so we went for no house moves or job changes while I was expecting the second one and that environment of calmness certainly reduced the stress and allowed us to focus on what mattered.

Take really good care, wishing you all the best

Chesterjackson profile image

Hi, sorry to hear you have been struggling. I had an episode when I had my first child and the doctor assured me it probably wouldn't happen again. How wrong was he, it was identical to the first episode (not everyone goes through this). Luckily I wasn't admitted to hospital either time as my husband refused to let them take me and dealt with it on his own. Having had it happen again we made the decision for me to be sterilised. It wasn't fair to expect him to do anything as if anything happened to me he wouldn't be able to have more children. I think you are both very sensible talking this through and it is a very tricky thing to navigate. Be strong for each other and I am sure you will work out what is best for all of you. Take care and good luck for the future.

bisketty profile image

Yes, I've been told there's a 50% chance of reocurrence and a 75% chance of women who experience PP going on to develop bipolar at some point in their lives. I couldn't handle another episode as it would mean another 18 months of suffering and incapabilities. Thankyou for sharing amd so sorry you experienced it twice.

bisketty profile image
bisketty in reply to bisketty

Also, I can't believe your doctor's false assurance. That must have been particularly frustrating.

KatG profile image

Dear Bisketty

My husband and I have a ten year old son and we have looked into adoption (off and on and off and on again!) for many years.

We had always wanted our son to have a sibling and we have tried first the old fashioned way and then lots and lots of failed fertility treatments. I was always aware of the risks of having PP again (I have a bipolar diagnosis from when I got it first time around) but for me I was ok to accept that risk. But later on, when no baby ever came, I thought maybe it was my body’s way of telling me it wasn’t a good idea!

I’m also aware of how stressful the adoption process can be, and how that too will carry a risk of mental illness. It is very intrusive, particularly around health matters, and I’m aware that many children come into the care system due to parental mental illness. As you say, many children will have long term physical, mental and / or developmental health needs and that too could be a huge stressor.

I don’t write all this to put you off, not at all, just to be aware of it all before you embark.

There are lots of fantastic resources out there for people who are considering adoption - I had a book called “Ready to Adopt?” Which was useful, and I’ve also read a lot about child development and attachment. I particularly like the American academic Dan Seigl.

Happy to chat more or answer any specific questions. I’m in the UK so don’t know much about the Australian system I’m afraid. However the emotional and psychological process is I’m sure the same!

Take care,

Kat x

bisketty profile image
bisketty in reply to KatG

Thanks so much Kat, life is definitely a huge learning process of letting go and accepting things that are out of our control.

I realise I may not even meet the selection criteria for being an adoptive parent as the Australian system (and I bet the UK one too) involves assessing your health records and status, and I am still taking medication for a mental illness. I've spoken to my psychiatrist and she said adoption would not carry the risk of PP, but (like you) pointed out that it would have its own significant challenges. Our family's plan is to give it six months of stability re. work and home life, allow me to begin to taper my medication as per psych's advice, and check in again then.

Thankyou for your offer of support - I'll keep you in mind if I have any questions.

KatG profile image
KatGVolunteer in reply to bisketty

That all sounds incredibly sensible. And it’s great you have such a supportive psychiatrist. I’m also on long term medication for my bipolar which I would need to disclose, and I guess my GP would do a report on my overall mental and physical health. I didn’t mention above but we also had several years (!) of couples therapy. It started as a “ready to adopt?” type of service that is provided by the Tavistock Centre but morphed into more general psychotherapy for us as a couple. It was really helpful (I think!) but quite hard work. That might also be something for you to consider as and when you’ve got the headspace.

Best wishes

Kat x

Elmo1505 profile image

Hi Bisketty,

I have just read through your post and replies to and from others on the forum. I completely understand and relate to your concerns on becoming pregnant again but wanting another child, as I have had the same worries before. I thought I would share my story, in hope that it would bring you some comfort to know you are not alone.

I was diagnosed with Bipolar with acute psychosis in 2016, after being sectioned and admitted to hospital for 3 months in total. I was discharged on Lithium and an anti-psychotic medication and this helped to keep me well. In 2018, I fell pregnant with my daughter and was then under the care of the perinatal mental health team, as well as a mental health midwife during my pregnancy. I was informed of the 50% chance of relapse and given options of medication I could take during my pregnancy, but decided I didn't want to risk any complications to my daughters health even if the chance was little. After giving birth to my daughter in 2019, I relapsed and was separated from my daughter for a week like yourself due to PP. We then was admitted onto a mother and baby unit where we stayed for a couple of months.

My daughter is going to be 4 this year and when she was around 2 years old, I really wanted to plan for another child, I have always wanted more than one child and for her to grow up with a sibling. We spoke with psychiatrists at the time and weighed up the risks and decided in the end that as much we would love another child, the 50% chance of relapse was too much of a worry for myself. I am hoping in the future I can revisit my decision and hopefully have another child with the right support behind me and my family, but also know whatever happens is the best outcome for us all.

I think EmiMum gave some brilliant advice and I completely agree that a calm environment and eliminating as many stressors within your control, as well as the right support, plays a significant role in keeping well.

I think you are taking a brilliant approach by weighing up all your options and figuring out what is best for yourself and your family. Thank you for sharing, I hope you find what best works for you and your family and wish you all lots of happiness.

Apologies I couldn't be of more help, but I hope if anything, you found a little comfort in reading my experience.

Take care, wish you all the best xx

bisketty profile image
bisketty in reply to Elmo1505

Thankyou so much, it sounds like we have very similar perspectives. I agree that mine could change in the future, especially with the right support. That's also a good way of looking at it - that either outcome is positive.

Take care and thanks again.

Koala2021 profile image

Hi bisketty Just wanted to share with you my choices as I thought you might find it helpful.

I had my first child in 2004 and experienced PP with a 3 month admission and then a long time to come to terms with it. I later in life married a new partner and I was nervous about explaining to his family and him what could happen if I had a baby. I dont think they really understood, but they were supportive and we had a baby together. This was 17 years after my first and I was very worried about what could happen but didn't want that to take away the chance I had of growing my family. I didn't experience PP with my second but I was slightly manic and looked after well by the Perinatal team.

I've always been open and honest with my first son as well about where he was when he was born and have taken him to visit the MBU when he was abit older, to get an understanding of it.

I know its easy for me to say but I didn't want PP to take having another baby away from me. I wanted to fight it as I knew the outcome after being so unwell is worth it in the long run.

I hope you and your husband can come to a mutual agreement which you are both happy with and keep using this forum for advise and support 💗

Laneybug1710 profile image

Hi bisketty

This is something that my husband took a LONG time to make a decision on. I'm an only child and he has 3 younger siblings so we could see both sides.

I was told my risk of pp in a 2nd pregnancy was 50/50 and for a while I felt I could give more to just 1 child.

However we decided to see if we could extend our family and I'm 19 weeks pregnant with number 2. I'm receiving extra care from my perinatal mental health team and feeling good.

My son will be 4 when our new arrival comes.

All the best in whatever decision you make

EmiMum profile image
EmiMumVolunteer in reply to Laneybug1710

Hi Laneybug1710,

Sorry I am jumping on your thread reply to bisketty, but I just wanted to pass on my congratulations on your pregnancy. Such good news that you are feeling well and receiving extra care from the perinatal team. Here if you want to have a chat. Take good care, wishing you all the best

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