I am trying for another baby having s... - Action on Postpar...

Action on Postpartum Psychosis

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I am trying for another baby having suffered two episodes in the year following my first child.

CatherineT profile image
15 Replies

What experiences have people had with subsequent pregnancies?

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CatherineT profile image
CatherineT
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15 Replies
hel212000 profile image
hel212000

I'm not sure how much help I will be as I am currently pregnant and well, have you spoken to your GP to ask to be referred back to your psychiatrist or have you had any pre-conception counselling to find out your approximate risk of being ill again? How long ago was your previous pregnancy? I have a care plan in place and will be medicated after the birth to try and minimise the chance of it reoccurring. I know of at least 2 other ladies that have gone on to have successful pregnancies and remain well, hopefully they will be able to comment on this too. Good luck.

CatherineT profile image
CatherineT in reply to hel212000

I've just been reading some of your other posts. Twins! Wow! Congratulations! Are you staying in hospital after the birth? Or your MBU? Or are you planning to go home? I know if I ever give birth again the first thing I'll do is knock back some sleeping pills (and some anti-psychotics).

CatherineT profile image
CatherineT

I have talked to my CPN and psychiatrist who referred me (at our request) to the psychiatrist at the MBU. The psychiatrist there was very positive about the pregnancy period, describing a 'safer' period. She asked a lot of questions about where I am now compared to where I was prior to my episodes and questioned why I would want to subject my family to an unwell mother when we've just reached a reasonable place. She said I could admit myself to the MBU if I gave birth again, self medicate and wait to see what happens. My little girl is 3yrs old now and my last episode was 2yrs and 4 months ago. I think it's wonderful that you're pregnant and I hope that everything works out as you'd like. It's not a decision to take lightly.

hel212000 profile image
hel212000

I have a very good support network with my husband and family so as soon as both the babies and I am well enough to leave we will be discharged. I am having an elective section so am expecting to be in a minimum of 3 days. I have been prescribed medicine to begin taking the night that I deliver and also tablets to help me sleep although I have been told that the antispychotic drugs should make me drowsy too. It isn't a decision that we have taken lightly but PP robbed me of my first experience of motherhood it sure as hell wasn't going to rob me of another chance to experience it, plus the benefit of having siblings for our son. I hope with the right medication and support in place that I will remain well and will be another success story and if unfortunately things do go a bit haywire at least it will be recognised quickly and I would hopefully never be as ill as I was the first time around. Good luck.

CatherineT profile image
CatherineT

Is there more to your cesearian than the fact it's twins? Is it to reduce the risk of a traumatic birth? My CPN mentioned the idea of having an epidural for pain relief.

KatieKrinklebum profile image
KatieKrinklebum

Hi, I've been reading up on this as I myself fill the criteria for at high risk of developing PP, even though I've not had it before as this will be my first baby.

I read that one of the things that can contribute to PP is C-sections and the use of pain relief in any of its various forms. I'm not saying it's the end of the world if you end up needing to use a bit of something to get you through, (especially you have twins like hel212000 was saying she's having!) as it's not the be all and end all, but it is amongst the contributing factors.

I'm going to a birthing center instead of hospital, to try and have as natural a birth as possible and am looking into self hypnosis techniques and birthing positions - I might even have a water birth as it's meant to be really soothing, and I'll be taking a tens machine to use in the car to calm me down on the way there. It's early days yet for you though if you're just trying, but you could start to think about these things. What was your little girl's birth like?

CatherineT profile image
CatherineT

I tried to have a home water birth and didn't start on the gas and air until I was transferred to hospital where I ended up having an epidural. I was quite fixated on how my birth was going to be and now wish I'd never had a birth plan. I was so dissappointed in myself for not having a natural birth.

Have you read anything about gas and air being a problem?

Hannah_at_APP profile image
Hannah_at_APPAdministrator

We're thinking of another baby before too long too. Son is just turning 3 now. I know my triggers really well and the whole birth wasn't good, so we're hoping for a bit more control next time- as much as that's ever possible! Hopefully an elective c-section (I had and emergency one before), meds that I know worked for me last time (and the ones that didn't and made things worse), possibilty of an MBU admission etc. I'm due my final consultant's appt in a few days - this about the 3rd final one, I think he's so terrified of me and it going wrong, as he sent me home with meds early days of my pp! Hoping to have a more specialist consultant involved (this one is from an early intervention team rather than perinatal). The MBU I was in has now closed so I'd be keen to make connections with people so I knew them before I would worse case need them. Not that I'd probably remember them if last time was anything to go by as I was apparently rude and horrible to everyone involved in helping me! I'm really encouraged by experiences of others here and care planning and benefit of experience will be important. As will letting go and believing that the professionals will hopefully know what they're doing, should we need them again. Good luck, hope it all turns out well for us all.

CatherineT profile image
CatherineT

I was rude and awful too -I was a difficult one. Why do you think your consultant is scared of you? I felt that about the psychiatrist who helped me to be admitted but I think -now- that it is just her general demeanor. She's very quiet and non-confrontational the complete opposite of myself in psychosis.

hel212000 profile image
hel212000

KatieKrinklebum, I have never heard of the link to C-section or pain relief with PP, I have decided to have a section for several reasons, predominantly the research I have carried out I believe it is best for the babies due to them being identical and sharing a placenta, secondly I would prefer a section as I feel it puts me in control, I have my date and know that I do not need to worry about being induced and the lack of sleep that may occur with that. I have agreed if I go into spontaneous labour and both babies are happy and in the right position I will consider a natural birth.

CatherineT profile image
CatherineT

I think you're doing the right thing. You've researched and considered what you're doing. Good luck.

Naomi_at_app profile image
Naomi_at_appVolunteer

Hi Catherine, hel212000 and KatieKrinklebum

First of all, really good luck with the pregnancies and TTC! I know personally what a big decision it is after PP or with a risk of PP - just sitting here with my youngest (18 mo) enjoying Night Garden and feeling so glad that we did have another baby, even though it wasn't as smooth as I would have liked.

I had a very swift onset of mania and delusions with pregnancy #1, but found that Olanzapine worked quickly and well for me - I was fortunate to only need admission for 3 weeks. However, it was the long lasting and deep depression afterwards that really took its toll on us as a family.

As we came to pregnancy #2 after a 5 year gap, I had an amazing perinatal team - however for me I think most of my planning was about avoiding psychosis again. I made the choice to wait and see if symptoms arose, rather than taking Olanzapine directly after the birth. However, after an emergency c-section and then baby getting seriously ill at 7 days old, I felt the beginnings of mania, talking a lot, needing to write things down and a brief 'flip' into some of my previous delusions in the middle of the night. Immediately started on Olanzapine which calmed things down within two days.

For four months things were great - I felt pleased that I'd managed to nip symptoms in the bud just as we'd decided in the perinatal plan. Sadly though, I did experience a really severe depression again - and despite good planning, my usual antidepressant did not touch the symptoms. It took around 9 months to find the right antidepressant, and during that time I had 3 short admissions to hospital. However, once the drugs were right symptoms resolved incredibly quickly and I could enjoy being a mum again.

It's hard for me to admit, but I think I'd brushed off the possibility of depression - assuming that if we caught the psychosis symptoms early it wouldn't happen. It was a tough year for my husband and five-year old, but fortunately she has had brilliant support from a school nurse who now do quite a lot of work with children experiencing illness at home. Now that we are through the storm, it is good to be a family of four and for me it was worth it - however now knowing my risks are so high we will not have any more children.

I'm glad now to be involved in helping our local perinatal team to develop training for midwives and other health professionals. For all of us with higher risks of PP it's good that we are personally aware of the warning signs and are beginning to have access to services that can help us to plan even before pregnancy.

KatieKrinklebum profile image
KatieKrinklebum

I've just logged in to apologise for being rather blunt or forward with my question about your previous birth, I am nothern, but that's no excuse. You don't seem to have taken offence though, phew! I must admit too, I think I asked out of curiosity really as it'll be my first, so I'm dying to know what it's like. I bet I'll get there and my plan will go out the window!

In answer to your question, I can't remember having read anything specifically about gas and air. I was rather thinking that's what I'd probably go for myself if needed, as I'm sure I'd feel more in control of the dosage there than with other drugs, although I imagine it must make one a bit groggy after. I'll try and find the article I read and get back to you.

In the meantime, don't feel bad about that delivery. The only thing that matters is that the baby was born healthy in the end. We do what we do only to try and ensure that outcome. And each delivery is different, nobody knows what you went through. Some lucky women have it easy and the baby just pops out.

While I'm here, hel212000 I must wish you all the best with your twins and your c-section, and please ignore what I said which was aimed at CatherineT and not relevant in your case. I think a well planned C-section, when it's necessary, like for twins, is the best thing. Where I am the doctors pretty much won't consider a natural birth for twins, so I have every faith you are doing the right thing for your babies and yourself, and the recovery needn't be a problem if it's well managed. I'm quite envious of you. My husband and I always said we wanted twins. We want loads of kids but time isn't on our side! We are of course delighted with our little bundle of joy, but if there could be two of her that'd be even better.

Hannah_at_APP profile image
Hannah_at_APPAdministrator

CatherineT in answer to your question- I think the consultant I am still under in the community is just very cautious, he did see me early days and sent me home with meds rather than acting on it sooner. He did kind of allude to it at one appt when he said something like "unfortunately things didn't work out last time", and the meds he first put me on were not great. The MBU consultant and staff weren't that complimentary about the treatment I'd had at the local general hospital before I got to them- I ended up in a bad way and they had a lot to do to turn it round. I'd stopped eating and drinking and had to be put on a drip for example, which the first hospital failed to do. Probably a bit of "we know best" from the specialists and perhaps a lack of pp experience from the general lot, although it's an early intervention team so they should be good on the psychosis bit! I think the caution is understandable but it does frustrate me. I want to be signed off as fully recovered and the appt didn't happen yesterday due to bad flooding round here so we're not quite there yet! It's a psychological thing, being discharged would somehow draw a line and on some level it feels like he doesn't believe I am recovered. But I am and that sign-off will happen soon I'm sure. In the meantime, I get my money's worth from the NHS!! Sorry if this is long and waffly, it frustrates me as you might be picking up!!!

Hey everyone, planning for a second pregnancy is a tricky one. I had an acute episode of PP after my first son followed by clinical depression. We did go onto to making the choice of having another baby. We were blessed and fell pregnant with twins, who are now 8 months old. We have a 4 year age gap.

I had an amazing perinatal team, and I managed to avoid a relapse of PP and depression. I started on meds straight after delivery.

@katiekrinklebum, can I ask why you are high risk, sorry if I've missed a post?

With regards to your question about pain relief being a trigger I have never heard of this, apart from if you have a GA. With my first I had a little gas and air, a quick natural birth and I developed PP within days. With my twins, I also had a natural birth but was sort of forced to have an epidural to reduce the risk of having a GA if something went wrong. As if I hadn't had an epidural and twin b turned, or needed to be delivered in an emergency they wouldn't have had time to sort out an epidural and I would have had to have a GA.

The risk with GA's is you can come round being quite hyper etc. Which isn't a good start if professional are looking out for triggers. If that makes sense.

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