If you had postpartum depression (PPD) after the birth of your first baby, you may be understandably worried about developing the condition again if you have another child. The fear of having PPD or postpartum anxiety can be enough to prevent some women — and their partners — from wanting or planning for a second baby.
But it doesn't have to. Understanding the signs of postpartum depression, setting up a plan to ease symptoms of anxiety and depression that might develop, and having a support team in place can help reduce some of the apprehension you feel about trying for another child.
What are your chances of getting postpartum depression twice?
It’s true that if you've had postpartum depression before, you’re more likely to get it again after a future pregnancy. But it’s also quite possible that with preparation and preventative action, you won’t.[1]
The risk of having PPD more than once varies from about 30 to 70%, depending on the severity of the symptoms you experienced after the birth of your first baby. Mothers who experienced very severe PPD have a higher risk of developing symptoms the second time around compared to moms who had milder PPD.[2]
But many women who struggle with PPD after the birth of their first child experience no symptoms with the next. Part of the reason is that every pregnancy and every child are different. Some of the factors that contribute to PPD are totally out of your control and may not happen with each baby you have.[3]
These include:
- Premature delivery
- Difficulty breastfeeding
- Colicky baby
- Traumatic labor and delivery
- Lack of support from partner or family
- Financial strain
Should you try for a second baby if you had postpartum depression with your first child?
Having a second (or third, or fourth) child is a personal decision that only you and your family can make.
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If the fear of having postpartum depression again is making you wonder if it’s worth trying for another baby, you may want to talk to a therapist before getting pregnant. They’ll help you work through your concerns and reassure you that whatever you chose to do is the right decision for you.
Some moms feel shame around having a recurrence of depression, but it’s important to remember that having PPD is never your fault. Perinatal mood and anxiety disorders are among the most common pregnancy complications. Getting support and treatment is the best thing you can do for yourself and your baby.
And be sure to take time to make your choice with your partner, if you have one. Don’t let anyone pressure you into making a decision before you're ready or doing something you're not comfortable with.
Can you prevent postpartum depression from happening again?
There’s no definite way to prevent PPD, but there are a few strategies that can help lower your risk. These tips can prepare you so that if symptoms do occur, you’ll be ready to address them right away.[4]
- Lean on your support system. Having a support system in place before baby arrives is key. That may consist of your partner, family and friends, your OB/GYN or midwife, a therapist, and your newborn’s pediatrician. In fact, your baby’s pediatrician should be considered a first line of defense in the fight against PPD. Your well-being affects your baby’s health in so many ways. Plus, your pediatrician will have a lot more chances to interact with you in the weeks and months after delivery than your OB/GYN, which is why many pediatricians now screen new moms for PPD.
- Make sure your friends and family are aware of the signs and symptoms of PPD too. Talk to them about what you experienced last time and explain the difference between PPD and the baby blues. Suggest that at the first sign of any change in your mood or behavior, they bring these symptoms to your attention so you can get help immediately.
- Set realistic expectations for yourself. Don’t pressure yourself to do everything. Lean on your partner if you have one, as well as friends and family members for help.
- Enlist a therapist. If you have a therapist, speak to them before you get pregnant about any anxieties you’re having. And if you don’t already have a therapist, consider finding one now so you have additional support in place during your pregnancy.
- Make healthy lifestyle changes. Eating a well-balanced diet (filled with lots of dark leafy greens and colorful fruits and veggies) and making sure you get enough exercise can help lower your risk of postpartum depression. Studies show that not getting enough of certain nutrients, including vitamins D and B, can up your chance of having PPD. Research also shows that women who don’t exercise during and after pregnancy are more prone to depression.[5] Try walking, swimming, Pilates or prenatal yoga. Check with your doctor about pregnancy-friendly ways to work out.
- Ask your doctor about medication options. If you were successfully treated for PPD with antidepressants after a previous pregnancy, some experts suggest going back on antidepressants either during pregnancy or just after delivery. Although some concerns have been raised about the use of antidepressants in women who are breastfeeding, many experts believe that in most cases, the risks of a depressive episode outweigh the risks of exposure. Speaking with a reproductive psychiatrist may be helpful to determine if this is the right course of action for you.
How can you and your partner cope with PPD if it happens again?
Postpartum depression can impact other members of the family too. Sometimes just the thought of you having another bout of PPD can be as scary for your partner as it is for you.
Having a line of open communication is so important. Talk to your partner about your fears and listen to theirs. Together you’ll better understand each other’s worries. Make a plan to move forward, whether that involves waiting until your firstborn is a little older or trying right away.
Your partner needs people to lean on too. Research support groups in your area that both of you can attend, like Postpartum Support Group International, which offers a list of health care providers searchable by zip code. Find ways that your partner can bond with the baby while giving you time to recover. Maybe your partner can take one of the night feedings so you can sleep, for instance.
The bottom line is that if you want another baby and you had postpartum depression after a previous pregnancy, there's a good chance you won't have it again with your next child. But if you do, there are ways to be ready ahead of time so that you can get the help and support you need.
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