My Blog

Another Twinkle in the Eye

Historically, there are more unexpected pregnancies after the Christmas and New Year festivities than at any other time of the year. For example, read this BBC report here. It may be alcohol fuelled or due to more time off work and one cosy evening that results in a ‘surprise’ towards the end of January. For some couples it will have an additional layer of angst if a previous pregnancy has resulted in mental illness or trauma, e.g. a difficult birth, postnatal or antenatal depression. Due to fear, such women may feel that a termination is the only answer.

I’d like to think that in early 2017, we can help couples with this dilemma. In researching for my book ‘Another Twinkle in the Eye – contemplating another pregnancy after perinatal mental illness’ (CRC Press 2015)*, some couples admitted that by having an unplanned pregnancy, ‘nature’ had actually made the difficult decision for them and they went ahead with it. Others were so terrified and subsequently ended the pregnancy. I write this blog because several women have said to me that ‘if only’ my book had been around sooner, they may not have had the termination they now regret. Here are some of the ways that may be useful to know.

So what can be done to help?

1. The services and resources offered to women and their families may have improved since the previous pregnancy. The government have pledged £290 million into developing and improving services. Perinatal mental health is currently a hot topic (at last) and NHS Trusts are being encouraged to improve or provide the support that is needed. Check what now be available in your area by an internet search for local and national services available on-line,e.g https://www.england.nhs.uk/mentalhealth/perinatal/community-services/ . There may now be a specialist midwife for perinatal mental health in post who can help you. Peer support can be very usual too. Due to social media there are now many more ways to connect with mothers and fathers who have been unwell following the birth of a previous baby. e.g. #PND Hour. Finding out what helped them can be very encouraging.
2. Couples told me that they found the ‘next time’ easier because they knew that if they did become ill again, they knew what it was, what helped last time and that it would pass. They were able to make a plan to organise practical help and get a support network established ‘just in case’. Many of those who did have a plan in place found that it was not needed. Those with a ‘wait and see’ approach were more anxious and that led to further mental health issues. Knowledge of both their triggers and treatments also helped next time around.
3. It is possible to make the next pregnancy happier and healthier than previously. Each pregnancy is unique and any mental or physical challenges that happened before may not be repeated. Perhaps this time the pregnancy can be a enjoyed more, especially if a plan has been made to help make it so. Building in time for rest and ‘me time’ is very important. This time the 9 months may be savoured more – with a first pregnancy there is a tendency towards impatience!
4. Every birth is unique. Just because a previous one was difficult, it does not mean that a subsequent one will be so. If this is a big fear, talk through your concerns and wishes with a midwife and GP who take your concerns seriously. If they fob you off, ask to see others who are more appreciative of why you need additional reassurance. Having a birth library approach, as suggested by Debby Gould,  can be a more positive approach than a plan. Women tell me that if a birth did not go ‘to plan’ previously, they felt they had failed. If they feel there are a range of options they can have it doesn’t matter then about those that then are used to have a healthy baby delivered.
5. Some new mothers have difficulty in bonding with their new baby. With a subsequent pregnancy, there are ways to help with this both during both the antenatal and postnatal period.
6. Choice of feeding may be an issue to be determined ‘next time’. If previously this was a cause for concern, make your wishes and reasons for your choice made clear to those caring for you and the baby to help your confidence with a new baby.
7. If lack of sleep was an issue with an earlier baby, again discuss with loved ones and healthcare professionals how this can be managed better with another new baby. Remember that this next baby may actually sleep better than the first one! You may find the techniques used by The Cheshire Baby Whisperer, worth exploring.
8. With an additional pregnancy, there will be sibling(s) to consider. If there is a chance you may need to be hospitalised for psychiatric reasons again, make provision for your other child/children. If you think it out and have a solution ready, just knowing the option can be therapeutic in itself and may not be needed. If you ignore the risks, an underlying panic could build up and contribute to you being unwell again.
9. Enlist the support of your partner, family and friends. Their initial reaction may not be what you want! Do tell them what it is that you found helpful with a previous pregnancy and postnatal period, and what you would appreciate next time. Let them know that you value and appreciate their help. This might be babysitting and/or practical help.
10. There are a wide range of self-help treatments that can help your mental health. This may include exercise, massage, mindfulness, hypnotherapy. Create your tool-kit for both during and after pregnancy of ways that you know work for you.

Throughout all of the above considerations is the notion of positive thinking and communication. A plan for a subsequent pregnancy is likely to be more successful if approached in terms of what you want rather than don’t want. For example, it is best to be described in ways to stay well rather than avoid being ill. Visualise a healthy, happy pregnancy; a birth that meets your expectations and a mentally well early start to your increased family.

Every situation is different and there can never be any guarantees that a new baby will mean that everyone is well. What can be considered are ways to maximise your health for all concerned. I fully appreciate that this is a very serious decision that will require discussion and thought. These points of course need to be expanded upon fully. Please see my book for further details and resources on all the above. I also strongly recommend that the correct medical and psychiatric support is sought and given for you as an individual.

As one mum said to me ‘Although I have suffered this awful, cruel illness (postnatal depression) twice and been to the depths of despair, my children and partner are the light of my life. The year I suffered following their births is nothing compared to the life of happiness that these children give me every day’.

So if you do find yourself unexpectedly pregnant and are so worried about the repeat of a previous mental illness in the perinatal period, please seek advice and support. It might just be the best Christmas present you have ever had!

Elaine  🙂

*‘Another Twinkle in Eye – Contemplating another pregnancy after a perinatal mental illness’ was highly commended by the British Medical Association for outstanding contribution to medical literature, in their Popular Medicine Book of the Year 2016.

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