My little girl will be 6 when our second baby is born. I haven't ever spoken to our little girl about being ill after her being born. I suppose this is a bit of a longwinded post. But just hoping people might be able to give me some positive stories with second babies where they didn't have psychosis or it was managed quickly.
I feel guilty that if I am ill after this baby it will impact on my little girl.
Also have people taken Olanzapine in the last few weeks before delivery? An earlier post mentioned taking Quetapine immediately after delivery but I feel like my symptoms were very sudden and would post delivery be too late?
These are probably questions for the perinatal mental health team. I need to get in touch as they said they would see me after 13 weeks and I am 14 weeks today.
I found a leaflet that I was given when I had ppp all about ppp and it made me anxious because it clearly states the chances of developing ppp are 1 in 2 after a previous episode. Before making the decision to try for another baby I had firmly started to believe that there was almost a side note with this statistic because early medication would just prevent it happening. But in the leaflet there is no side note. So I have started to worry which isn't ideal and probably futile as I am having this baby and it will work out in the end.
Was hoping people might have success stories to spur me on where they had mild symptoms or no symptoms at all.
Thank you everyone 🙃
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Marshman
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Congratulations on your pregnancy 😊 I do hope you’re feeling ok.
On the emotional side of things, I completely understand how you’re feeling. I went on to have a second child and would definitely swing between feeling at peace with things and complete panic. I hope you will feel more reassured after you speak to the perinatal team, and also from shared experiences here. Worrying is to be expected but know you’re not on your own and can write here any time. And as you have said, whatever happens, it will work out in the end.
I had my second child in 2016. There wasn’t a perinatal mental health team in my area at the time so it’s good you have that specialist support. I did feel very supported by my GP, health visitor and midwife which all helped a lot. I was under consultant-led care antenatally which meant some extra appointments where they would ask me about my mood and birth plan. I then had outreach support from a mental health specialist nurse who was attached to the MBU I'd been admitted to with PP. That was a bit later in pregnancy - she helped me to put together an advanced directive document and think through my preferences and wishes should I become unwell again, advised around medication and all that side of things. It was very helpful to talk it all through and put plans in place, it helped to answer some questions and also raised some new ones to think about.
For me, I started taking medication after delivery but my PP didn’t happen immediately after the birth with my first and I think it’s quite usual to start taking meds in late pregnancy. This is definitely something to talk through with those supporting you clinically.
I did talk to my older son, and I did definitely worry about what it would mean for him if I became unwell again. He was 3 so I’m not sure how much he’d have understood, but I remember telling him we’d had to go to hospital together after he’d been born and it was possible I’d have to go to hospital with the new baby too if I was poorly again. I’d decided that being admitted to an MBU wouldn’t be my immediate preferred course of action if I showed early signs of developing PP (or going anyway after the birth just in case, which was an option for me) as I didn’t want to be away from my older son, but also that I was happy to be admitted if necessary and wouldn’t want him to see me very unwell… All those kinds of decisions can be thought through over the coming months.
I stayed well and it was a very different experience for me the second time around. I know the 50% statistic is scary – I tried to frame it as there being as much chance that it wouldn’t happen, but also that whatever the % statistic, it would either happen or it wouldn’t and we could just be as prepared as we could be. We planned for the worst, tried to reduce the risk where we maybe could (I think sleep deprivation was a major factor for me, so my plans included prioritising sleep and rest, taking a low dose of medication, opting not to breastfeed…), had support in place and then ultimately hoped for the best. I did feel reassured that if I did get PP again, we knew what to do and it would be picked up and treated early. But it took time to get to that point and to put those plans in a drawer – keep talking and I hope you’ll find reassurance from others’ experiences.
Take really good care and if you have any questions do please ask. Hopefully you've found APP's information on planning pregnancy helpful (app-network.org/postpartum-... I have a template plan you could look at if helpful too – drop me a DM if you’d like me to email you a copy 😊
Hi Jenny! Could I get a copy of that advanced directive in my email as well please? We are planning on a baby this year and I’d like to have this in place. Thank you in advance!
I took Olanzapine couple of weeks before delivery for my second baby. As you I felt my pp came very fast and I was showing some signs of being a bit more on the high side of mood just before delivery. I didn't have a recurrence of psychosis, some depression yes, but it was mild and I could manage it at home with medication and therapy.
I asked my perinatal psychiatrist the same question you have, what does the 1 in 2 really mean. He explained to me that that statistic refers to the outcome when there are no preventive measures in place. By putting measures in place that risk is reduced, he didn't give me a number when I asked by how much as that is difficult to measure and depends very much on personal circumstances. Of course, that is the answer I got, so I think it is a good idea to ask that same question to your perinatal team.
My personal belief is that knowledge and awareness are on their own great tools. And having a support network in place helps a great deal.
In terms of explaining to a child what was it to have pp, I think being open with age appropriate language could be a reassurance for you both. You could say something like you had to be in hospital for a while when he was a baby, without going into too much detail? Perhaps also something you can ask from your perinatal team is if you could have the opportunity to talk to a family therapist about this.
It is very normal to feel this uneasyness, specially as you are waiting on hearing from your perinatal team.
I remember having so many doubts while pregnant and trying to focus on the positive as much as I could and taking it one problem at a time.
I hope the perinatal team calls you soon and you can start the process that will hopefully give you more reassurance and make you feel well supported.
We are here also to share our own experience and answer possible questions you may have. If you are not currently under a peer supporter and would like to you can also check the APP site:
We had our second child in the time before APP's research. We were told that the chances of a re-occurrence were a million to one!
So, no planning, no advanced medication, and no discussion with our eldest who was 7 at the time. The nursing staff (without benefit of APP's education) were at a loss to know what to do when my wife had a second episode.
However, I was much better prepared, and the episode was a lot shorter than the first. You are in a much different position and your chances of a better outcome are a great deal higher than ours.
Our new daughter went on to read Mathematics at Trinity College, Cambridge and is also extremely sociable. She's a joy to us and everyone she meets. She's also given us a lovely granddaughter who seems as bright as her Mum.
So a bad experience at the time but, looking back, definitely worth it.
Firstly, congratulations on your pregnancy. I too had been told the same stat when I was being discharged from perinatal care after my psychosis. It definitely played in mind when planning to have a second child. I had a wonderful midwife and CPN who was attached to the MBU I'd been a patient in.
I chose not to take medication and scheduled a planned induction.
My son was 4 and I explained I'd had a "poorly brain" and might have it again.
My daughter was born in July 2023 and I remained well. I was monitored in the community for 6 months post birth.
Whatever you decide to do, wishing you all the best.
Fully understand all your concerns but want to share a little of my own positive experience.
I did have PP in 1988 with my first daughter but I went on to have two more girls 1996 and 1999 with no recurrence.
I did make plans and contact the key people at that time for advice with regard to PP, medication and breast feeding but my circumstances were very different and I had a strong support network. I had contacted a mother and baby unit just in case.
The main thing was that my mum moved in for two weeks and her goal was for me to Sleep as much as possible. I opted for epidurals and had a back up plan . I had to tick 12 days of well being to be clear . Back then the medication was progesterone which I took following delivery for about a week. Mum and I were just talking about how in her day mums stayed in hospital for 10 days and came home having slept and established feeding. It was wonderful to be well second and third time.
My daughter was 8 and was a great little helper when the babies arrived.
That is lovely to hear and very reassuring. My husband has said he will do all the night feeds for the first few nights so that will be very helpful. Also due to having had a traumatic birth with my first daughter and having complications during the delivery I have opted for an elective c-section. The consultant was supportive and kind which was reassuring.
Also my little girl loves playing baby dolls and is very excited because I have said she can pick the clothes for the new baby and help with them. I feel that although she still needs caring for being six she is able to entertain herself and dress herself so it won't be like having the pressure of 2 very small children to look after.
Hopefully I will hear from the perinatal team about an appointment soon. I might ring to check. Still suffering with nausea but I work part time and my husband works from home so it isn't too bad. Sometimes find that when I am resting my mind wanders to what could happen. But it is so nice to know that other people have had positive experiences with second and third children and it is a nice thought of having 2 little ones to take on holiday and to soft play and things like that. Will let you know any developments x
Marshman congratulations on your pregnancy! How exciting! (I know still nerve wrecking but nevertheless a blessing).
I plan on getting pregnant this year too. My daughter will be 2 when I’m pregnant and almost 3 when the second baby is born. That’s the plan anyway.
My PP happened early as well - I started exhibiting symptoms on day 3 and by day 5 have full blown PP and was taken to hospital by police. It was very scary. I did recover well and relatively quickly. Have been well for over a year now and we recently decided on baby number 2.
My doctors want to keep me on antidepressant as well as a mood stabilizer throughout my pregnancy and then around week 33 they plan on putting me on low dose Olanzapine (antipsychotic) and then up the dose after delivery. I have spoken to several women on here who were on these drugs not only after birth but their whole pregnancy. Their kids are healthy and well. And they remained well throughout the whole process.
I’m choosing to put my confidence in all these experiences and my doctors opinions. I am sure I’ll still worry but less so - since we would know exactly what to do should I start exhibiting any weird symptoms. But my understanding is that 50% risk is significantly reduced.
Congratulations on your pregnancy!! Do something nice for yourself. Prenatal massage or yoga. Try to relax as much as you can. Have a plan in place (advanced directive after birth, possible medications in late pregnancy and then meds after delivery, etc.) And make sure you have supports in place for several months after birth.
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