Top tips for considering another pregnancy after perinatal mental illness

Elaine Hanzak - banner (2) I had post natal depression after Daisy was born, and I know it made me think twice about what would happen if I got pregnant again. The birth was much easier: I panicked a few days after the birth, but fortunately it was normal baby blues, and I went on to have a much easier time second time around. In this article, Elaine Hanzak, author of Another Twinkle in the Eye: Contemplating Another Pregnancy After Perinatal Mental Illness shares advice to help you if you are in the same position.

The decision to have another baby is often based on a wide range of considerations. If a previous pregnancy resulted in the detrimental mental health of the mother or father, it follows that this is very likely to cause additional concerns. Research indicates that if antenatal or postnatal (perinatal) mental illness occurred previously, there is an increased risk of it happening with a subsequent pregnancy. It is not definite and there are a range of conversations and actions that can be taken to reduce the risks and increase the chances of a healthy and happier start to an extended family.

  1. Pre-conception – ask for an appointment with your GP, midwife or health visitor so that you can discuss your hopes for a healthier outcome next time and have counselling if required. Speak to the team who were involved in your care previously and together make a plan for what is needed e.g. relevant medication, practical and emotional support. If you become pregnant unexpectedly, see your healthcare professionals as soon as you can so that a plan can be put into place.
  2. Acknowledge what happened previously and find out about the possible causes. Consider if there were factors that added to it that may not happen next time e.g. additional upset such as a bereavement. Be as candid and honest with yourself and others at each step of the way. The sooner that issues are identified, the sooner they can be dealt with. Identify any triggers and put plans in place to minimise them. If your choice of feeding was an issue, for example, find out what better support is now available.
  3. Discuss with your partner how you feel and what your respective concerns are. Share what helped previously and what could be more helpful next time. Also engage family and friends in asking for their support as opposed to any judgement they may have.
  4. If there were physical aspects that contributed to failing mental health, seek to minimise them next time e.g. a traumatic birth. Next time consider a ‘birth library’ of ideas to make it a better experience. If lack of sleep was an issue, make plans so that you are able to get more rest. Be kinder to yourself and allow a relaxation of ‘normal’ standards of housework, for example.
  5. Have your support ready, e.g. local peer or on-line support group; breast feeding counsellor; child care for existing child or children. Research the many ways of self-help activities that can improve mental health.
  6. Keep a positive attitude – plan for what you want to happen and be prepared to accept support and treatment if it becomes necessary. If anxieties do creep in, decide to take actions to ease them – if you hear yourself asking ‘what if’ questions, seek out the solution so that you can be at ease and enjoy the next pregnancy.
  7. Remember that each pregnancy, birth and child is unique. Next time round you can choose the differences that you may want e.g. in the time of year, place of birth. The advantage is that if you do become mentally unwell again you know what it is; that you can get treatment and help – you will get better.

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