Thoughts on another baby after postnatal mental illness

“Just the one or are there more?”

 “Oh it’s not fair just to have one, when are you having your next?”

“Go on, have another baby now! A sibling is the greatest gift you can give your child.”

Dreaded questions and comments come unsolicited from other mums at the school gates, playgroups, from colleagues, at the supermarket, at the hairdressers…everywhere. When I respond I never say what I really think. The truth is that even with my content life, I wouldn’t choose to have an only child. And if I had my time again, things would be different.

The heart-wrenching and deeply personal questions bring the most harrowing time of my life straight back to my present, like a slap in my face and a punch in my gut. I’d always imagined having two children, maybe three. But after experiencing the severe postnatal mental illness, Postpartum Psychosis (PP), out of the blue after the birth of my first son, our plans and dreams for the future changed.

Big brother tshirt
Image via

The answer to those inappropriate questions is a painful one but over time the rawness has eased and I can now answer with confidence. So with my hackles up and an emotional step backwards, I answer the “Only the one?” question with, “Yes, just the one” with a calm smile. I’m usually then greeted with a pitying head-tilt and questioning look waiting for me to explain further. I’ve learnt to redirect the conversation, saying more only extends a painful topic and makes it a full-fledged discussion – my personal story isn’t gossip fodder, I choose who to tell and when I tell it.

And why do I have to justify my small and wonderful family anyway?

Spoiled child expiring
Image via ChalkingItUpBoards

Our culture perpetuates the idea that the perfect family includes at least two children and I’m seen as selfish to some and a failure to others. Society thinks my son will be spoiled and the change from only child to older sibling is celebrated as a status upgrade. There’s the notion that siblings make a happy family and keep us from experiencing loneliness, but sometimes it’s great having a sister or brother and sometimes it’s just not. My Mother-in-law feels the need to send my only son a Birthday card from ‘his sister’, her dog (!), to compensate….sweet but really, no need.

One is an odd number but having one child isn’t odd – it’s an equally valid and positive family option. I faced constant pressure and questions from family and friends; it would have been wonderful if they’d sensitively understood and accepted our reasons.

Image via Monderstarprint
Image via Monderstarprint

Decision Time

My sister phoned me up and excitedly announced, “I’m pregnant!” I was full of happiness and congratulations but I got off the phone and broke down in tears.

My experience of becoming a mum for the first time was far from idyllic, Postpartum Psychosis devastatingly hit me four days after my son was born, I was 35. It was an exceptionally tough start for our new family of three, but after two long and gruelling years, we got through it together. It took another fragile yet happy year to fully feel myself again and be discharged from the Early Intervention Team responsible for my care. At the final meeting with my Psychiatrist, who barely recognised me from the person he’d met three years prior, we touched on discussing the future. I was told the chance of recurrence for some was around 50%, although he thought my personal risk could be less. But he wasn’t a Specialist Perinatal Psychiatrist and at the time I didn’t know they existed or if there was one in my area I could be referred to, so the conversation was brief. Far too brief.

My biological clock was ticking abrothers-179375_1280-webnd we had a difficult and painful decision to make that would affect all our futures. Having been through hell and coming out the other side, not only with a beautiful boy but also with myself intact, could we risk that again? But how could we possibly stop at one?! Each time I saw a pregnant woman blossoming with toddler by her side or images of cute toddlers kissing a new-born baby’s head, I felt hurt, resentment, guilt, jealousy, sadness and pain…

I was overwhelmed with fear. I feared telling my family if we chose to have another, they’d be totally distraught. It was an extremely stressful and traumatic time for my husband and parents; they’d seen me at my worst. How could I put them through that nightmare again? I dreaded the thought of my son seeing me that way if I got ill again. How would he cope with me being ‘absent’ from him for a couple of years? This time he’d be old enough to notice and surely he’d be affected deeply?

I feared for the new baby. I realised I’d avoided babies for all that time; holding a crying baby instantly took me back to all the fear, sky high anxiety, feelings of hopelessness, inability and despair. How can I be a good mother to a baby when my only experience with babies was utterly terrifying? What if bonding with the new baby took a long, agonizing year like last time? I feared for myself. What if I didn’t have the strength and didn’t make it through a second time? Is it worth taking the ultimate risk?

I worried and felt crushing guilt for my beautiful boy and the questions were endless. Would be lonely without a partner in crime or a sibling to argue, fight, whinge about his parents with? Would he grieve for the brother or sister he’ll never have? Would he feel the odd one out as the only one in his class without a brother or sister? How do you cherish your only child but not smother them? Will he be shy and introvert? Would he feel pressure to be perfect? How do you prevent them from feeling the intense pressure of being your entire world? How would he feel with no-one to share grief in later life when we die and the responsibility becoming the grown-up in the family?

He’ll never have to share our love and attention with anyone; rationally I thought of the positives. We’ll always be there and have time for him; bedtime stories would be long and leisurely. We can sit by each other on a plane or bus or in a restaurant without any sibling rivalry. We’ll be more financially secure, can afford to do more with him and give him more life experiences than we ever could have with two. He’ll have new clothes or shoes and never the hand me downs. He’ll learn to be a good companion for himself and create a strong foundation of self-sufficiency and independence. He’ll be happy and comfortable with his own company and a sibling might not want play with the youngest child anyway. The list goes on…

After a great deal of thinking and reflecting we agreed that the experience was too awful to go through again and any risk, whatever the percentage of it happening again, was too high. Our little family was just too precious to jeopardise. It was a heartrending decision and it somehow felt more painful than if I’d felt I had a choice.

I grieved for never having the opportunity to experience how childbirth and a new baby should be and to never ‘doing it right’. I felt grief for the children I never had and guilt for my son and the things he’ll never experience. I felt broken, inadequate and blamed myself. The sadness is still there and I try not to dwell on it, but the thoughts bubble to the surface every now and then. I learnt to go easy on myself and accept things as they were. The day of my husband’s vasectomy was a poignant day in its finality but actually a positive one – from then on it was a definite and I could move on.

Specialist Advice, Information and Support

With more information I know we would have come to a different decision. I was ill nearly 10 years ago and back then when we were deciding whether to have another baby or not, there was little awareness and support around; even less for the brave women who had come before me. I felt alienated and isolated and had never met or spoken to another woman who’d had another baby after experiencing what I’d had.

It wasn’t until years later that I met someone who’d had another baby after PP and stayed well. At that time there were few people who were publicly open about their illness and no online forum or community existed specifically for PP families to connect and share experiences. Had there been I would have had the answers and support I needed and things would have been different. I would have had proof that it’s possible to go on and have more children without being ill again. I would have understood the illness far more and known that with the right advice from a Specialist Perinatal Psychiatrist and careful preparation I could have stayed well.

I would have known I’d be considered high risk and would be monitored closely and supported throughout pregnancy with a personalised care plan. I would have known that even if I was ill again it would be nothing like my first traumatic experience. I’d have been forearmed knowing what PP was, being prepared and recognising the first tell-tale signs would have made the world of difference. Overall I would have the most important thing…hope.

That isolation drove me, and still does, to establish and maintain a peer support community to play a vital part supporting future new families and making their journeys and decisions that much easier. I’m delighted and thankful to say that over the years as more connect via peer support and more awareness and information is available, I’ve seen increasing numbers of women choosing to have another baby after PP if they want to. Now I’m happy to be surrounded by numerous well supported and well informed pregnant women, excitedly, if not nervously, anticipating the birth of their second child. It’s heart-warming knowing that they’re now the majority not the minority.

Happy Ever After

I felt the fantasy of a larger family could have poisoned our happiness, but it didn’t. My gorgeous son never knew I longed for another child so he doesn’t pine for non-existent siblings – he’s confident in knowing he won’t have a sibling and we’re happy with that and think our family is wonderful just as it is.

Loneliness for my son was a groundless worry, he’s totally happy with his own company and will just take himself off for a day dream in his room or to play or invent something and appear once it’s completed. We have a fun but calm house and our son is happy and well behaved, I can take him anywhere without worry. He’s kind, thoughtful and certainly not spoiled in any way. He’s far from shy or introvert and because he’s used to being with adults he can confidently talk to anyone and is great with other children.

We’ve come to accept and delight in our only child family and have made peace with missing what was never there. We only have to focus on what we do have and celebrate that and our blissful relationships together. In the school playground surrounded by groups of children running and playing it’s easy to see that sibling or no sibling, they have happy lives.

Having an only child may be different from the ideals of others, but our family certainly isn’t strange or unfinished. For me I feel blessed, content and satisfied…and our little family of three feels totally complete and equally as perfect. There is a choice and whatever you choose will be right for