Amber:  Today, I invite you all to share with readers about your experience with pregnancy, adoption or trying to conceive or adopt after postpartum depression.Suzanne: With my second baby, I developed antenatal depression, which, believe it or not, surprised me. My first pregnancy was wonderful. My second one was awful. I was sick the entire time and became so depressed by the five month mark that I decided to get help. I started on a new medication that I was told was safe for pregnancy (I had stopped my other medication for the first trimester), and I was able to keep taking it — and safely breastfeed — during the postpartum period.

Grace: We were so terrified of having another baby. It took probably six months to convince my husband that we could do it. I know he agreed for my sake – we both knew that having another child was crucial to my full healing. I said to my husband the other day that our first son made us parents & our second son healed us.

We made the decision together that I would stay on my antidepressant throughout my pregnancy and postpartum period. My pregnancy was completely uneventful, which I am so very thankful for. I am a ceasarean mom, and we decided to go for a repeat cesarean so as not to trigger any anxiety. It was the right decision for us.

Yuz: Grace, that is such a lovely sentiment about your second baby healing you. We decided to have another baby once my daughter turned about 20 months and when I felt well enough to start the journey again. I knew that it wasn’t going to be easy, but I knew it was worth it and that if I slipped again, it would not be forever.

I’m not sure how far along in my pregnancy it was that I was on Twitter and saw a tweet from Amber about setting up a support group of mums that had survived postpartum depression and were pregnant or planning to have more children. I messaged her straight away and within a few weeks we were exchanging details and checking in with each other each week.

As it turns out, the 20-week scan revealed I had a serious condition with my placenta whereby the baby was in threat of not surviving. (I didn’t know the statistics at the time but there was an 80% chance of fetal demise). If I bled at any time, or my waters broke I had about 10-15 minutes to get my baby out alive, which was just not feasible as I lived at least 20 minutes away from the hospital. My anxiety levels increased dramatically and there were times as I got further towards the cut-off birth at 36 weeks that I got consumed with worry. Our closest friends, my #PPDChatArmy mamas and my survivor sisters all knew what was happening and how I was doing. I had ongoing scans to monitor the baby’s growth and amniotic fluid intake. (I’m so very grateful for the ultrasound technician that picked up this condition – he saved our baby’s life). I was admitted to hospital at 34.5 weeks and had our baby boy, on the scheduled c-section day at 36 weeks.

My son was placed in the special care nursery and stayed there throughout the duration of our hospital stay. Instead of being upset by this this time round, I was thankful for he extra sleep! I decided to take the tablet to dry up my milk following the birth, as my son was very small and I feared he would need time for his sucking reflex to develop and I wanted to avoid having to express for weeks. I advised the nurses of my history with postnatal depression and anxiety and they were extremely accommodating with my requests for rest and looking out for any signs I was slipping. (Given I had already been at the hospital a week and a half prior to giving birth I was able to ‘word up’ the midwives).

My son and I went home together on day five, however after a week being home and him only gaining 50g since discharge, we were re-admitted to hospital by his pediatrician so that he could be fed nasal-gastrically. We remained in hospital for a further nine weeks and finally came home when my son was nearly 12 weeks old (eight weeks corrected) and NGT free. I had some extremely low moments during our stay in hospital – it was a frustrating, overwhelming, confusing and disheartening time (x-rays, barium swallow, brain ultrasound, blood and urine tests, Echo, ECG, nine different formulas, various bottles and nipples tried, speech therapist reviews, pediatric dietitian consults) that finally led us to a diagnosis and discharge plan.

In the nine weeks of admission I was on the verge of slipping again – I was sad about us being in hospital. I was sad that I was away from my daughter for such a long time and I felt robbed that I didn’t have a ‘normal’ experience bringing a baby home (and never will) and I was angry, sad and scared that my baby was unwell. Despite all of this, I knew I loved my son and felt connected to him – so I rationalized this by saying that I was having a normal experience in an abnormal situation.

The amount of support I received was completely overwhelming and honestly life saving. My survivor sisters and the #PPDChat army were also there for me even though some had just given birth and their lives were hectic during their adjustment period. Knowing that there were people out there sending us their best wishes and thoughts got me through those days and real friendships were formed and remain to this day even if they are virtual ones and I’ll never meet these amazing souls in person.

Following our discharge, I kept a record of my son’s feed intake and had him weighed weekly to ensure his weight didn’t dip. This created some anxiety for me but I managed to ensure it didn’t become an obsession which I could not have done under the postnatal depression spell.

A few months following our second discharge I started struggling with the lack of sleep I was getting due to my son’s medical condition and breathing issues. I started getting intrusive thoughts and started getting angry about my lot – an anxiety ridden pregnancy, a premature delivery, a baby that was unwell and needed hospital admission and now a baby that doesn’t sleep! Luckily for us, there is the mother and baby unit (sleep school) and I immediately got a referral to be admitted and three weeks later were admitted for five nights. Packing up again and being away from my husband and daughter wasn’t easy, but was necessary. I left the unit after five nights with my little guy pretty much sleeping through the night and the biggest weight gain he had ever had in his short life!

Kate: I always knew I wanted to have more children, and as I recovered, it began to feel like I was reclaiming some original part of myself to do so. I was terrified.  It wasn’t like a totally happy feeling, but it was a feeling of determination. I tend to personify postpartum depression, and I felt like I was fighting back against someone who sucker punched me. That looked like preparing, counseling, planning and continuing to protect sleep as much as possible. I also rallied three critical people in my life, who I trust and who love me, and told them that after my first was born there were dark days which they didn’t know about. It was important to disclose that I had thought about, literally, stepping into traffic. It was important to let them know that even though I looked “ok,” I wasn’t. In doing that, I also invited them to sneak into my life and to check in with me – while also giving them lots of reading about trusting me if I was well. It also helped lift the burden from my dear husband a bit, so that he had some folks aware that we might need help. I never did, by the way. I stayed well.

Amy: Getting pregnant created much fear in my life over the last three years. Mutually, my husband Rick and I talked at great depth and we truly do not want to risk experiencing PPD again to have another child. We have chosen not to pursue another pregnancy and instead we are on the waiting list of adopting our next baby! That in itself was a hard decision to make – choosing not to become pregnant again and feeling like I was broken, no good, a failure and choosing second best. I will be honest – I am the only gal in this group that is adopting their next baby and it’s been hard reading all their answers and seeing how they all have had their second baby after PPD and are doing okay.

That said, I deeply desire to have another little one, and in all honesty, I am sad that I will not be pregnant again by choice. We decided to start pursuing adoption when Ella was 2.5 years old. We have now been on the waiting list for a domestic infant for 16 months. The wait has been hard and I am ready for our next little one.

Even with all the joy that will come, I am still hesitant and scared of what might happen once the baby comes. I know what my triggers are now for anxiety and depression. I know that PPD after adoption is possible. I know that I have the tools, but it still scares me. What I have had to come to peace with though, and this took me MONTHS, was to not think of my next baby as a time of “dealing with and being watchful” of PPD. Yes, I know we need to, but the fear of PPD has the potential to outweigh the joy that should come with the next baby. We will be watchful but not fearful.

Amber:  Amy, Thanks for sharing with such honesty.  I often wondered how it must feel to be the only one currently in the adoption process while others of us were pregnant or postpartum.  You are certainly not alone in considering adoption after postpartum depression, but you are the only one in our group pursuing that way to have your next baby.  I was always so amazed by and appreciative of your participation in discussions in which our griping over sleep deprivation might be the focus, even in the midst of your own yearning to have a baby to keep you awake.  You are such an empathetic soul.

Another question for the group… what do you want moms who are considering having another baby or are currently pregnant or in the adoption process to know most of all about how to prepare for the next experience and how much different it is/isn’t/can be?

Suzanne: If you’ve survived a perinatal mood disorder like postpartum depression and you’re ready to tackle bringing another child into your life, preparation is key. You can do it! I definitely felt more confident the second time around. I had my village in place, knew what symptoms to look for and which resources to use and I was on a medication that I believe helped stave off another experience with postpartum depression. Here are some of the things I did during the second go-round: set up sleep shifts with my husband to get consecutive hours of sleep, napped when the baby napped, took medication, bathed regularly (this really does help!), got outside as often as possible and leaned heavily on my family and friends (especially for meals). My second newborn experience blew me away, in a good way. I’m grateful.

Deborah: Know that you have a disease that needs treatment, just like gestational diabetes, to make sure that you and your baby thrive. Everyone I know who took their prescribed medication, with medical advice, had a much better postpartum experience with their second child, so please don’t underestimate these diseases or think that you can just “happy thought” or “exercise” yourself to feeling better. No one would tell a diabetic not to take medicine if their blood sugar levels were elevated and our brain chemistry levels are just as real and require medical attention at times as well.   And get help so you can get occasional nights of sleep!

Grace: Yes, Deborah, I do think knowing is half the battle. With the second baby you know what to expect, you know your triggers, you know what you need to be healthy. You know your support system, you know where to go for help, you know what your spouse needs. You have the confidence of being a second time mommy and that confidence is empowering! You can make more educated decisions about your birth, your postpartum period, and your health in general. You can do it and it can and WILL be different!

I still feel as though I’m “looking over my shoulder” for PPD. I hate that my bad days, which are normal with a newborn, make me afraid of crashing. I wish I could just have a bad day and think “dang, that was a bad day!” without fearing for my well-being. But, that is part of being a survivor mama. We keep fighting though, and staying in the present, focusing on one day at a time has been my saving grace!

Kate: Yes – – – prepare, prepare, prepare. Have a sick and and a wellness plan. Reach out to trusted people (but not too many, it could overwhelm). Have your doctors lined up, your care team lined up, your sleep plan ready. I also wrote a letter to myself when I was well outlining my plans … It was a compassionate, gentle note reminding my future self that this was my plan, and the real resistance to that I might feel is probably a symptom… because my “well self” really worked hard on making it a good one.

Yuz: For me, the difference between my first and second experience was that I had to be honest with myself and those around me. If there was something I could do to make things easier for myself I did it. I didn’t want to be a martyr. I wanted to be a mother.

It was all about planning from the moment the wee stick went positive. Once pregnant, I immediately started getting my ducks in a row. I told Lauren Hale (the creator and moderator of #PPDChat) straight away as I knew I would be needing the online support. I made notes of my triggers and thought through strategies to help alleviate them. Sleep deprivation was my number one trigger, so we considered getting a night nanny whenever I needed catch up sleep. Even though I knew my husband would be able to help at night, it wasn’t ideal having two exhausted parents! Another major trigger for me was breastfeeding, more specifically, the eight weeks of expressing I did following my son’s birth, and I wanted to avoid this happening again. I didn’t make the final decision on which method I would use to feed my baby until after the birth, and my decision was going be based on the baby’s gestation and birth weight. My considerations also took into account the practicalities of bottle feeding, allowing others to help with feeding if I needed a break or a rest. We also decided we would place my daughter into daycare an extra day each week so that I would only be looking after both kids together twice a week. To cover all bases I also advised my psychiatrist of my pregnancy, but would only make an appointment with him once I knew the pregnancy was viable following the 12 week scan.

Amy: For those adopting after postpartum depression, moms need to realize that there will be a grieving time and not to try and ignore that. We know what giving birth is like, we know what it’s like to feel our baby inside of us. And we are choosing to add to our family another way – a way that is new to us again! It’s important to deal with all the emotions that may come and not push them away. It’s normal and part of the process of healing, or at least it has been for me. The biggest thing that I would end with is this: every baby is a miracle, regardless of how it arrives. That is what I dwell on daily!

Amber: Wow. Thanks for sharing your amazing stories, ladies. I know that hearing about how different the second time is and can be will be helpful for other moms. I am grateful for your honesty because while the next time can (and probably will) be much better, it’s not always a bowl of cherries. Being prepared for that and focusing on “being a mother, not a martyr”, as Yuz so eloquently stated, really should be our primary goal.

Tomorrow, the readers will join us for our last post of this series. In it, you’ll get a sneak peak at a conversation that we all had right after the birth of Grace’s second baby. It’s an awesome testament to the power of support and awareness by those who really do know you and what you are going through.