It can be very scary to think about having another baby after experiencing antenatal or postnatal depression. The fear of going through the same experience can make many parents hesitant to get pregnant again or to have another baby. Sometimes the risk is too high for some, especially if they have been severely unwell, and they choose not to have any more children.
While the risk of experiencing depression with subsequent children is higher if a woman has had postnatal depression, many women find that with plenty of support and preparation they are able to avoid another experience or they are able to get help much earlier and therefore they recover more quickly.
What Is The Chance Of a Re-occurance?
Following a complete recovery from a previous experience of PND there is a 50% chance of recurrence of postnatal depression with a subsequent pregnancy. If a woman becomes pregnant before recovering from PND the condition will usually continue through the pregnancy and may worsen.
Recurrence of Postnatal Psychosis is a 1 in 5 chance.
To reduce the chance of recurrence if the couple decides to try to have another baby it is ideal for them to wait until the woman has recovered from her depression. This would ideally mean that she has discontinued any medication and waited for 6-12 months before attempting to conceive.
This time gap also gives time for the couple to reconcile the experience for both the woman and her partner, sort of an emotional cleaning up of any cobwebs before contemplating another pregnancy. It also allows time for them to become more informed and to plan a strong network, e.g. Maternal & Child Health Nurse, GP, family and friends.
What Does Recovery Mean?
The definition of recovery is unique to every individual woman but the following statements indicate what it means to some women:
- "I feel much more like myself now than I have since my baby was born. When I was depressed I felt like I had gone somewhere else."
- "I still have a few tough days sometimes but nowhere near as often as I used to. From what other mothers say it's normal to have bad days as long as they don't last for too long and you can help yourself to feel better."
- "I know how to talk about my feelings and how to ask for help now and that helps me to feel supported and to look after myself. I share my worries with my partner now and we work out how to manage them together."
The following are stories by women who have had another baby after PND.
I got PND after my second child. In fact, I developed antenatal depression, but because I was suffering severe nausea and bronchitis I didn't realize then that there was a depression component to my low feelings.
After my baby was born things got worse. My husband was afraid of me seeking anti-depressant treatments so I struggled for 14 months.
I don't want to write about that time. Any PND sufferer could fill in the blanks.
Finally, I was directed to a doctor who had knowledge of PND. She counseled me and got me on to medication which suited me. Within a couple of months, I began to feel my symptoms ease. It was a long road to recovery, but once on medication, for me, it was a steady road.
After being on medication for quite a long time I discovered, to my horror that I was pregnant.
I was so afraid of pregnancy and getting sick again.
My doctor advised me to go off medication immediately, but as the weeks went by, the PND symptoms crept up on me. First there was sleeplessness and headaches, then irritability and libido was zero. My self esteem crashed and I had no energy.
I used PANDA for information and support and was told of the women who had needed carefully managed treatment during pregnancy. My doctor put me back on low dose medication and I kept in close contact.
Does this story ever get any better? Yes it does. The psychiatrists, obstetrician and I worked as a team managing my condition so my baby would be born to a mum in the best possible condition.
Their support, understanding and respect were essential to me getting through the pregnancy and looking forward to mothering a new baby and two older children.
My husband and family were also pillars of support and I learned to say "Yes" to all offers of assistance. My baby came and she is absolutely normal and beautiful. She is 5 months old now and we are all enjoying her so much. I am still on medication, at an increased dose, but am feeling well and I am delighted in every moment with the baby. How I wish I had gotten help earlier after baby number 2.
After having what was called at the time -mild PND' (which to me was probably the most frightening and difficult time of my whole life) the question of whether to have another baby was really problematic.
I had known for a long time that something was -not right' after my baby was born, but it took over a year before I saw anyone who could say "It is PND. You are going to recover and you will be your old self again".
During that year my husband and I coped as best we could but at the expense of our relationship. By the time we came to consider another child our relationship had been under great stress but managed to survive and things had improved.
I was keen to have another child, I loved my son immensely and I wanted him to have a brother or sister. But I was terrified -it' could happen again. My son was 4 years old when my husband and I finally decided (after butting the subject into the too hard basket) it would be -now or never'.
At last we began to think about the idea and talk about our feelings. We had both been separately traumatized by the PND experience in our own ways. After talking to PANDA and reading as much as I could, I felt I could make an informed choice. We realized that PND could happen again.
But this time, if it did recur, we could recognize it earlier and know where to get help.
PANDA had given me ideas of how to plan and think ahead and work out supports in advance. Throughout my pregnancy I felt scared but it never got out of proportion or spoilt the magic of the experience.
My second son was so beautiful. My first son loved him and by the time my baby was 6 weeks old we were all adjusted and quite enjoyed our new boy.
My anxiety about PND hung over me like a grey cloud but very lightly. However, I felt confident and felt I was coping. I didn't feel like I did the first time. With everyday, that cloud faded. I felt PND was not there. It was not going to happen but I wouldn't have said so out loud. I was quietly confident that I was well and would remain so. And I have.
After the birth of my first child I experienced a -living nightmare' which I later found out was called PND.
Our son was going to be an only child. As I began to recover the thought of another child/pregnancy was bearable. Further along the road to recovery, having another baby became an appealing thought. After I had recovered I was delighted to find myself pregnant.
This time it would be different… armed with knowledge from my friends in PANDA, I sailed through my pregnancy. Having PND was a real possibility yet I didn't feel afraid. Fore-warned is fore-armed. I chose my obstetrician carefully and spoke of my first experience for about 45 minutes and kept in contact with the psychiatrist. Of course, PANDA was there to form my safety net.
I would like to be able to say that this prevented me from getting PND again, but I can't.
While I was still in hospital, about day 5 or 6, I noticed signs of sleeplessness and losing my appetite, which could have explained by the different environment, but I knew it was more than that.
I asked for the psychiatrist to come up and see me. I knew my options and as I knew it was the same. I decided to start on low dose medication straight away. I organized lots of home support for myself and my husband understood too.
Over the months that followed I was able to function normally and my feelings for my baby and son were very positive, much to my relief.
I had a bit of a crash about 4-5 months after my baby was born, which involved 3-4 days of feeling terrified about everything. It was almost as bad as the first time and hospitalization with my baby was imminent.
Fortunately frequent visits to the psychiatrist, medication change, a very supportive husband who took over the domestics and talking to PANDA resulted in me regaining stability. I am not completely well, though friends wouldn't know. My mornings are the worst. Every problem is magnified but as the day progresses I pick up and the mountains seem like molehills by night.
Was it worth it? Yes without a doubt. I know my two beautiful sons are not marred by my illness and although it is hard for my husband at times, our marriage is happy. PANDA has been a great support throughout.