For anyone who has survived postpartum depression, you know how painful and unsettling life felt after your baby arrived. During that first year, you are overwhelmed with feelings of irritability, helplessness, anger, rage, sadness, and anxiety (just to name a few). The fear of ever facing this experience again causes many parents to hesitate about having another child. There is nothing that they want to avoid more than those intrusive thoughts, hours of sobbing, or crippling anxiety. I hope this post will offer you some support and guidance in considering your next steps.
You have the right to say no

Pressures for nuclear families are constantly pushed at parents. I hear many well-intentioned family members asking when moms will be pregnant again, and expressing concerns that their children will be lonely if they do not have siblings. Firstly, let’s all agree that these folks need to chill out. No one should tell you what your family should look like. There are many, many single-child families who have wonderful, happy lives. If you have decided that one is enough, please rest assured that you are making the right decision. After all, it is your body, your lifestyle, your family, your income, and all of your resources. While loved ones may comment, at the end of the day, you have to take care of this little person. You are absolutely entitled to decide that you don’t want this option.
Many factors will influence your mental health

There are a lot of vulnerabilities that influence mental health. When it comes to postpartum depression, the list can include: poor sleep, stress, hormonal changes, physical wellness, relationship struggles, financial worries, history of mental health, multiple children, and complicated pregnancies/deliveries. This is not an all-encompassing list; however, it does address some important influencers during the perinatal period.
History of mental health struggles (including postpartum depression with your first child) is only one contributing factor. Postpartum depression symptoms typically decrease between one postpartum period to the next, showing that we have the capacity for healing. Research has found that there is high variability of whether parents’ symptoms of postpartum depression increase or decrease in future deliveries.
What does this all mean for you? Just because you had postpartum once does not guarantee you will have it again. If you had experienced significant distress in your first experience, err on the side of caution and seek support as soon you are pregnant. Postpartum depression is treatable. Your recovery experience improves when you do not prolong suffering.
You know more today than you did during your first pregnancy
Many first time parents feel nervous and uncertain about taking care of their babies. I mean, why wouldn’t we? If we are not surrounded by babies all the time, or if it’s not within our line of work, it makes sense that we are not experts on this topic. Since there are many unknowns during the first year with our child, we can feel inundated with worries about the baby’s well-being and our own capacity to parent.

As cliché as this may sound, practice makes perfect. Consider how vulnerable you felt when you first took your little one home versus how you felt six months or even 2 years in to parenting. You’ve gone from feeling incompetent to suddenly having a knack for diaper changes, effortless feedings, and confidence in bedtime routines. That level of skill and knowledge took you weeks of trials and errors before you could confidently move forward. This is the beauty of having a second child. That level of uncertainty and worry still exists; however, it is significantly more muted than the first time experience. You are much faster at handling all of those questions from your first time simply because you have the experience in your tool belt.
Understand your vulnerabilities

As painful as it may seem, I encourage you to sit down and reflect on your first-time experiences of pregnancy and postpartum months. What was hardest for you? When did you struggle the most? Did you have support available, and was your support team actually helpful? Were you able to rely on your partner? What kept you down on your hardest days? When did circumstances improve? Did you use medication, or were you able to manage without? What resources did you bring in the last time?
Knowing what was hard the first time can give us a working plan of how to handle the situation differently this time around. Some moms are so clear that they do not want to have another child while COVID-19 is still a concern. Other moms are aware that sleep training is what they needed in order to feel more stable. Many moms know that attending counselling and couples counselling helped them work through anxieties as they surfaced. It sucks to have to learn from our hardships. Knowing what did and did not work can help you decide what to do differently this time around. When you have the awareness, you have a lot more control and influence over the situation.
Find a community
The stats are very clear. About one in seven mothers and one in ten fathers experience postpartum depression. Yet, we live in a world where we suffer silently. Joining a support group, or connecting with other safe parents is one of the best things that you can do for your system. Let go of the pinterest-moms in your world. Don’t try and find validation from your next door neighbour who always looks well-presented and has the most well-tempered baby. These people will (hopefully, unintentionally) make you feel lousy. FInd parents who help you feel less alone. Your worries are similar to the stressors that others have also experienced. Find those who have survived postpartum mental health, and hear about their experiences. Learn what worked for them to not only have this level of encouragement, but to also find strategies that you want to employ.

If you experienced postpartum depression with your first child, it’s highly likely that you felt overwhelmed or frustrated with parenting. The circumstances are much more complicated if you are a single parent, or if your partner works long hours. While this is no one’s fault, feeling isolated in your parenting is an important factor to keep in mind. Gather your support team and come up with a plan that will support your needs. This may involve asking your mother to stay with you for the first week, or asking a friend to check in daily. You might contact resources like a lactation consultant, a postpartum doula, or a sleep-training specialist earlier into your postpartum experience. Your support team can be informal like friends or family, or professionals. Irrespective, these folks are helping you to fill in the gaps. There is a reason for the saying “it takes a village to raise a child.” No one should be expected to do it all alone.
Move your body
When we struggle with depression, our body wants to shut down, isolate, hide, or retreat. This makes a lot of sense when the world feels too much. Of course, you want to escape and disengage. It’s far safer in your home than to socialize, take the baby out, or pretend that everything is normal. When we stay hidden away, we can get caught in this safety net for a long time. Sure the world may feel safer when you’ve stayed away, but it’s also felt bleak and painful everyday that you’ve been hidden. If you are ambivalent to have another child because of this shut down experience, there are strategies that can help. There are many coping strategies that can be employed to use address anxiety and depression. The key is to find the right set of skills that fit for you.

One effective distress tolerance skill is to increase our activity level. I get that exercise is not everyone’s cup of tea, but I want to emphasize how quickly it can help you in getting out of a funk. When it comes to a crisis situation, getting even 2-5 minutes of intense exercise will force your physiology to change. Your shut down system is forced to be more alert with this sudden intensity. After this burst of working out, we have about 15-20 minutes of reprieve. We feel more regulated and think more clearly. This gives you a chance to look at your current setup and schedule. You may find you have more capacity to get out of your room, go for a walk, or call a friend. Things that felt unmanageable, suddenly feel more accessible.
Seek treatment

Postpartum mental health is not based on will power. Crying everyday, or stressing about spending time alone with the baby is not a normal part of parenthood. If this is your experience, I want you to know that it does not have to be like this. Postpartum myths can prevent us from seeking out help, and I can appreciate that these are genuine barriers. Whether it’s due to internal shame, external pressures, cultural expectations of motherhood, or any other factors, it can be hard to shift away from this perspective. However, the best part of working in perinatal mental health is that I know it gets better. I see mothers improving within a year or two of delivery. This may involve regular therapy, a community of support, various coping strategies, use of medication, or a combination of interventions. With support, postpartum mental health can improve.
Postpartum depression does not have to define your experience
If you are feeling scared of having postpartum depression again, please reach out. Just because you struggled with your mental health the first time does not mean it will happen again, or that it has to get as bad. There are numerous preventative and reactive interventions that we can incorporate to help you feel more resilient. Reach out when you feel ready.
Take care,
Kasi