I experienced PPP back in 2020 amidst covid lockdowns, overrun maternity wards and the rest of that chaos. We had no idea what happened until my husband had to call the ambulance about 5 days post birth when I became completely delirious and it was beyond obvious that something was really wrong. In short, it was put in general psych ward on strong meds, then transferred to mums & bubs unit, then went home and slowly weaned off the meds at about 4 months (after getting a second opinion on the strength of the medication and recommended duration). I am now 25 weeks pregnant with no 2. The psychiatrist recommends that I go on a small dose of Quetiepine (Seroquil) – 25 mg from about week 34 and continue on post birth for a couple of months. We also have plans B and C in place with follow-ups post birth, potential spot at the Mum & Baby unit, lots of support at home, etc.
I am a little bit apprehensive about going on the meds (even if it’s a small dose and even if it’s only for a few months) and specifically about how it would affect the delivery (I am hoping to have a natural birth without medical interventions). I understand that things don’t always go to plan when it comes to childbirth of course, but I also know that your hormonal balance plays a very important role in setting on and progressing the labour. And I also know that even though the medication is quite safe, there is still very little research (not even sure there is any tbh) about its effects on pregnancy, labour, etc.
I guess my main question is, has anyone else had a natural delivery while on the meds and did you feel any side-effects from it? I am also considering a “wait and see" approach or maybe only take the meds after the delivery. Has anyone else tried that successfully? I would simply like to gather as much information as possible about this before I see my psychiatrist again.
Thank you all xxx
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Climber-mum
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Congratulations on your pregnancy, hope you are feeling well.
I’m sorry to hear that you had such a difficult experience back in 2020. That must have been hard with all the restrictions back then.
I had ppp back in 2016 with the birth of my daughter. I went on to have another child in 2020 and did not get unwell.
I was given three options for taking medication (mine was olanzapine)
1. Take a small dose at the end of pregnancy and after giving birth.
2. Take a small dose after giving birth
3. Don’t take anything and ‘see what happens’
I opted for taking it after I’d given birth as my symptoms started after I’d had the baby.
I can’t help with the question about taking medication and it affecting delivery but hopefully someone else on here will be able to.
Good luck with everything, I found this forum and the 1:1 peer support service so helpful when planning and going through my second pregnancy. Gather the information you have and discuss it with your doctors, you have a say too as to what happens.
I really wanted a home birth and my doctor and care coordinator were recommending a hospital birth, but I explained my reasoning for having a home birth and they agreed to it. Ultimately it was the right choice for me.
Take care and I look forward to seeing updates as to how you are doing
Hello there, I am on antipsychotics now and the side effects have been horrendous for me. I have insomnia, really bad depression ,nausea and when I've tried to come off the worst withdrawl you can ever imagine. I would do things as naturally as possible. I have looked at the work of Dr joanna Moncrieff and the Critical psychiatry Network. This is just my opinion but I believe it strongly. Try and ask questions or get a second opinion on potential risk of harm to the baby from antipsychotics and whatever happened to you before take all the practical support, try not to have days on end alone at home with the baby as that's what causes My psychosis. I wasn't given early help but sounds like you've done everything right and your partner. Let us know how it goes and tell your partner everything, re how you feel etc and maybe even get talking therapy so that you're getting any feelings out. All my very best wishes, Jo
Congratulations on your pregnancy. I hope you'll get some replies here from people who have been there, and had second children.
I didn't have a second child, so I'm afraid I don't have much personal experience to share, but I wanted to make sure you had seen our guide to planning a pregnancy if you are at risk of PP:
It sounds like you are getting some support from a specialist perinatal mental health team. It's important that you are under a perinatal psychiatrist if possible, which it sounds like you are?
I know many people who have taken anti psychotics towards the end of the pregnancy, most anti psychotics are safe to take during pregnancy.
As I said, I hope you'll get some more replies here, don't hesitate to write again.
Hi thereMy name is Ailania I had PP after my first son was born in 2019. I'm 15 weeks after having my daughter. I was given the option to take meds in pregnancy or wait and see. I chose to wait and have now gone on 50mg Sertraline. I waited mainly due to how well I felt during pregnancy I felt medication wasn't needed at that point.
Congratulations on your second pregnancy. I had PP back in 2002 after the birth of my son. I went on to have another child in 2006 and was fortunate to be well following the second birth.
I went on prophylactic medication the day my second child was born. As I remember it, the option of going on meds before the birth was given but I think this was dependent on how I felt. They were more concerned about me getting enough sleep on the run up to giving birth and I had sleeping tablets which I could take if needed. I don't think I took any of those but they were there as an option.
I would be guided by your medical team and it might be worth asking if there is a reason they feel you need to take the medication before the birth.
Whatever you decide, look after yourself on the run up to the big day. Those of us who had another child have all been where you are now. Please use this forum to seek any reassurance or support you need. I really hope it all goes well for you.
I had pp also during covid lockdown. I know how traumatic it was for me so I’m so sorry to hear you went through that too 💜
I would love a third in the next year or two and I think I will have a meeting with the psychiatrist then get assigned a perinatal team during the pregnancy and come up with a plan. I am still medicated on aripiprazole and sertraline 3 and a half years post illness as I wasn’t well before the psychosis as well. I may stay on them both indefinitely and throughout a future pregnancy. Or the other option, come off ari but stay on sertraline. Then go back on Ari towards the end of the pregnancy where I would imagine any issues relating to the feutus would be minimal if there were any.
I do know ssris alone aren’t reccomenddd for women like us who have had mania, so it might not be a good idea for me to come off any. I’ve had a brief look on anti psychotics during pregnancy and doesn’t seem to be any concerns.
Perhaps talk with your perinatal team about a medication plan? Xx I think being on an antipsychotic for at least the end of pregnancy/ after birth would be wise for any of us going though another pregnancy rather than chancing it perhaps. It sounds like you were really poorly and I wouldn’t want you to go through that again 💜 plus if some symptoms returned, at least it wouldn’t be as severe if you would be already medicated and therefore less trauma to you xx
Oh and I had two planned homebirth that ended in emergency c sections. I totally get wanting that unmedicated natural birth. I think I would either try to have a natural birth if they let me or have an elective c section so it reduces the trauma and difficult recovery of an emergency section. I do think having some positives for the birth will mean more likely ness of a well postpartum period xx
Hello Climber Mum, just thought I would add my experience as you gather information.
My PP was in 1988. Total shock and quite a trauma. I did go on to have two more children but there were a lot of changes. In 1988 my marriage was very troubled and I had moved away from all my family. The birth was traumatic and like you, 5 days later I became extremely unwell and was sectioned in a general psychiatric ward. I recovered but my marriage didn’t survive.
For my second and third deliveries I opted for an epidural so that the birth was not a trauma. I had moved and remarried and my mum moved in just before I went into labour and stayed for two full weeks. All I had to do was sleep and feed the baby! I did take progesterone immediately after the birth and stayed well. It was a real joy to be well during the post natal period. I followed the same plan for baby number 3 and remained well throughout the post natal period. I gathered as much information as I could about the medication available at that time , 1996, and it was lithium or oestrogen or progesterone. I spoke to the specialists at that time. I will never truly know whether it was the hormone treatment, the total support and sleep made possible by my mum, the easy labour or just the complete change in my circumstances which made the difference. But certainly having had PP once I did prepare myself just in case it happened again.
Do hope all goes well and it would be lovely to hear how you get on.
Thank you all for the lovely and encouraging responses... Yes, I am proactively working with a perinatal psychiatrist at the moment and will bring up all of my concerns to her when I see her next. I had a natural first birth and I really enjoyed the intensity and the joy of it. The main trauma actually happened after the delivery when I experienced breast feeding difficulties and everything kind of snowballed from there.
This time around I am planning to deliver at a birthing centre, which is attached to a hospital. The birthing centre is an alternative to a home birth, where they don't use any medical intervention, but if there's an emergency I could be transferred to the actual birthing ward.
I suppose I consider myself one of the fortunate ones for whom having had PPP didn't define how positive I feel about motherhood and birth. I would very much like it to remain that way for my second child and having a go at a natural birth again would be in line with that.
Thank you again I really appreciate all the support and understanding. xx
Hello Climber-mum, so many lovely encouraging replies here already. Its so good that you are giving careful consideration to your birth options. When I went on to have a second baby I was able to discuss birth options with the matron at my hospital and I took out a lot from that conversation. Perhaps that's something you could ask from your midwifery team, if you haven't had a chat already.
I started anti psychotic medication from the last few weeks of pregnancy at the smallest dose which was increased after birth. It meant my boy and I stayed a few more days in hospital for his observations on any withdrawl signs. He passed his observations with no concerns and we went home after 3 days.
I had gestational diabetes during my second pregnancy, which meant I ended up opting for an induction at 37 weeks, and despite having needed intervention because of the diabetes I was very lucky to have had a very good second labour. Sometimes things don't go as planned as you wisely say, but as long as you feel informed and in control of the decisions you will be able to look back positively at your experience.
All the best on this pregnancy and do let us know how things go, take care
Congratulations on your pregnancy 😊 You’ve had some lovely replies, I just wanted to share my experience with you too.
I had PP after my first son was born in 2012 and had a second son in 2016. I was put on Quetiapine when I experienced PP (modified release version) and responded well to it. As part of planning during my second pregnancy I think my main choices with regard to medication were to take a ‘watch and wait’ approach or start taking medication after the birth. For me, I’d say my main symptoms of PP started about 3 weeks after the birth (in hindsight a lot of anxiety leading into it which I don’t think was ‘normal’, and a fixation on the breastfeeding and massive lack of sleep, but insomnia and rapid decline from the 3 week mark). I therefore didn’t feel medication during the pregnancy was necessary for me, but I know for a lot of women PP starts much sooner. I opted to start on a low dose of Quetiapine after the birth – I ended up staying in hospital for one night and then started the medication when I went home the following day. I personally decided that if I took the watch and wait approach, it would be a very anxious 3 weeks assuming things would follow a similar pattern. I stayed on the low dose for 6 months, fortunately I stayed well.
I had a natural birth both times, the second was a LOT quicker! The birthing centre sounds like a lovely option and good to be attached to the hospital should you need to be transferred. I’m sure it will be such a different experience for you – it must have been so difficult giving birth and becoming unwell during covid lockdown the first time around.
Sorry I don’t have any experience to share around taking medication during pregnancy and any potential effects on labour, but I hope other replies have been helpful 😊
Do take care and write here whenever it helps, I found APP information and support so helpful when planning for my second baby.
Thank you Maria. I appreciate your reaching out 💛💜❤️Yes, so far so good... I'm about to start my third trimester tomorrow. I have been feeling quite well, just feeling more and more tired as my belly is getting bigger 🤰. I haven't had a follow-up appointment with my psychiatrist as of yet, as it is meant to be at around 32-34 weeks, but I've been feeling pretty well all things considered. Crossing fingers it will continue to be ok into the last trimester. I still haven't made up my mind about preventative medication at the end of the pregnancy... I think I will wait for my follow up appointment with the psychiatrist and make sure that she can address all of my concerns before making that decision.
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Are these Olanzapine side effects? 
Baby number 2 due in a month
Unsure whether to try breastfeeding with no 2, given that I'll be taking olanzapine as a preventative. Advice on toxicity etc appreciated
