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Action on Postpartum Psychosis
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Danger zone timescales in subsequent pregnancies?

Can anyone tell me if you know how long the danger zone is for relapse in a subsequent pregnancy? I am on day 9 and feeling really well with no signs of a relapse and have been told that the first danger zones are day 3,5,7,10 and 14, but I don't know what happens after day 14. I know that 95% of women become ill in the first 14 days and looking back last time I was certainly ill by this point if not long before. I am taking quetipine as a preventative measure and fingers crossed it seems to be working. I am seeing the psychiatrist tomorrow so will ask then, but just wondered if anyone had any insight?

11 Replies

I was told that the danger period was 14 days. After a fortnight, I was deemed to be highly unlikely to develop PP (even tho' it was completely unexpected and had gone undetected for almost three weeks after my first child was born). The care workers backed off and I was given the all clear. I didn't take any prophylactic medication for the second pregnancy, and was lucky to not relapse. But I felt well post partum (tho' terribly cautious and aware of what might happen), and the second birth was quite unlike the experience I had with my firstborn.

All good wishes for your continued good health.


Hi Hel21200, I hope things went well with your psychiatrist yesterday & he/she gave you plenty of reassurance. Like Virginia says, I think the first 2 weeks are extremely fragile ones for us, but I feel the danger zone is much earlier & the first symptoms actually show in the 1st week from as early as day 3. I think if it was going to happen a 2nd time, it would start at a similar time as before, & probably in a similar way. I think it all sounds really positive for you & you're doing so well!

The extra worry at this time about what might/might not happen must be extremely difficult & something you just don't need with newborns! But I think that it's a really good thing to be so aware & informed & able to recognise the early signs should they appear. I guess it's just a case of carrying on with the meds & closely monitoring how you're feeling in those early days (which I'm sure you're more than doing!). Also make sure that when you're feeling well, that it's a calm & 'normal for you' well as oppose to 'too' well, ie, not hypomanic - Supermum coping too well, excited, too much energy, needing less sleep, busy mind etc.

You're doing all the right things & doing really well so try not to worry (easy to say, I know!). I'm SO pleased for you, well done! :-)


I suffered two episodes o f PP with both my children,although I have only recently realised this.

The psychiatrist I saw at the time knew it as PP but didn't tell me or my family,which has led to a lot of confusion and heartache. I nearly lost my daughter when she was nearly 1 year old,and lost custody of my son when he was 5 years old.I gave it 7 years between my children but I still got ill.

I went to prison twice because nobody realised I was psychotic.

The trauma I have suffered still gives me flashbacks and nightmares to this day,even thogh I had my daughter 23 years ago.

I am now married again to a wonderful man who knows all my history and he is very compassionate.

We were thinking of having children together,but i dare not even consider it now.

I am now on antipsychotic tablets after being diagnosed with Bipolar but it seems it is like shutting the stable door after the horse has bolted.

I will never get over what has happened to me and my family,but it is getting easier to cope with every day that goes by.

I hope you stay well and keep an eye on your symptoms before they get out of hand like mine did.

Best Wishes


So sorry to hear of your story. It sounds really traumatic. I hope life for you is a lot calmer now and that you find some peace. xx


Planning is v gd nowadays . There remains a risk but with medication etc it can often be prevented. I found epidural helped a lot


Just to update that I have been discharged from the psychiatrist and am now under a cpn who I will see regularly. I have been told I have passed the danger zone and can start to do might feeds etc from next week. I will be on medication for 6 months and will start to reduce this in 3 months. My aim is to be medication free by my sons 3rd birthday.


Congratulations hel212000, it sounds like everything is all going very well x I really hope you get to enjoy every minute this time round xxx best wishes to your family x so encouraging to hear how well ur doing x I had pp after the birthy son last June & my husband & I want to begin trying for a second child next summer


Well done for being 'out of the woods'. I can't offer any guidelines as I had two episodes of PP in the early 70's and 80's and have no memory of how many days it was before I became unwell, although my treatment in both involved ECT.

Best wishes for your continuing good health and happiness.


This is really reassuring to hear and I am so pleased that you have had such a positive experience this time round, thanks for sharing


Danger zone timescales in subsequent pregnancies? I agree the first few weeks after giving birth are to be closely monitored. I had my second daughter and was transferred from the maternity ward to the psychiatric ward 5 days later, at which I stayed a further 40 days. My Quetiapine was increased from 50mcg to 200mcg as I was not sleeping and was extrememly excited. I spent the nights rearranging all the the cards and baskets of flowers in my room. Definately, I became hypomanic. I was transferred to the psych ward by my psychiatrist to keep an eye on me as the anniversary of my first daughter's life (my firstborn died at 3 days old in 2004 and I suffered postpartum psychosis becoming suicidal within days of her loss) was approaching in a couple of weeks and I was particularly fragile. During my stay I had to stop breastfeeding as they adjusted my meds. I had an emergency stent put in my left kidney as there was a blockage and I was experiencing rapid heartbeats and intense sweating (I thought I was going to die and kept asking them to check my blood pressure)- I would look at my hands and beads of sweat would form at the tips and flow down my fingers into my palms like a river and in the morning I would wake up completely drenched in sweat (a most terrifying experience!) - showing them to the nurses, they just hoped my Zyprexa would relax me and calm my anxiety!? I had renal colic for 4 days and was given morphine intramuscularly until finally my psychiatrist was back and immediately realised I had serious health issues rather than it being all in my head, hence my emergency operation. I passed a 12mm kidney stone shortly afterwards!!

Gee, I think I should write a long blog or something, there's to much to write! To skip to my point....I was discharged in August and in January the following year I was hospitalised with PP when my daughter was 6 months old. I vividly remember breastfeeding my daughter until she fell asleep and then picking her up and placing her in her cot and watching her flop dead onto the mattress. I touched her forehead and she was stone cold. I believed I had killed her, that my breastmilk was actually water and lacking of nutrients. I had walked away in horror. A short while later I went back to check on her and touched her forehead again and she was warm and wiggled her lips and stretched - she was alive again. I was hallucinating!! I got my husband to drive to see my psychiatrist and ask for an admission and he took me straight away after I explained the above experience. I had been starting to introduce solids to my daughter and was getting conflicting advice from different sources - a nurse told me the baby's stomach was tiny so I shouldn't give her more than a couple of teaspoons a day, another told me at least a cupfull etc I was worrying I was going to overfeed her, then thought about my breastmilk not being good enough, that i wasn't eating properly and my breastmilk was v watery. I was told I wasn't producing enough breast milk when i was expressing etc etc. This time my stay was about 3 weeks. My baby did not come with my this time as the rules changed at the psych ward and they didnt have the support system set up. The experience was excruciating. After having los my firstborn, it felt like I had lost my second one too.

I think it is important that you have a support network in place at all times. I don't believe that there is a "safe" period after giving birth. There just has to be a way of limiting stress in your life during this important period of time.


Quetiapine is v good. If on low dose a mood stabiliser should be taken also like lithium


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