To Have or Have Not: Should You Stop Having Children If You’ve Had Postpartum Depression?

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After my bout with postpartum OCD, I decided I would never have another baby. NEVER. NOT. ONE. MORE. EVER. I’m not the only person who has been through postpartum depression who feels this way.

I am reminded of the choice I made, a choice that would later be reversed out of necessity, by a story on ParentsConnect called “Postpartum Depression: Why I Won’t Have Another Baby.” This mom writes about how she had always planned to have more than one child, primarily because she so disliked being an only child herself, but has now decided not to after having PPD:

“I am still plagued by anxiety. I am still on medication and in therapy. And one of the most painful things of all is that I am left with no desire to do this again. I fear starting over. Not just fear of possible PPD, but of having another newborn. Worrying about milestones and growth charts. Almost two years later with my son now, I’m still worrying about growth charts. So I can’t bear to start over with another child. I fear the fear. I truly feel that if I have another child, I will have two kids with only half of a mother. That seems ludicrous to me. I’d rather focus all my love and attention on the one I have than risk his happiness just so I can say I have two children. Would I be doing it for him or trying to fill my own void?

So this leaves my child an only child. The thing I said I’d never do. The thing that makes other mothers look at me and say, “Oh, you have to have another one! You can’t have just one!” (Is he a potato chip or something? I digress.) I’m treated like just wanting one child gives me two heads, and I find this extremely unfair.

So tread lightly on women you come across who feel ill-equipped to have more children. You don’t know the pain and guilt that may be underneath.”

I do. I know it well.

After taking a year to really get over my postpartum OCD and anxiety, I was not willing to go through that horror for even a second more. I was as done as done could be with having children. No more intrusive thoughts for me. No sobbing. No lack of appetite. No inability to sleep. No overwhelming sadness and guilt. No thank you.

Then I got pregnant. I wasn’t trying to, I just did. And given the circumstances, which I will be kind enough not to go into, I really shouldn’t have gotten pregnant. At all. It was nearly a miraculous conception. My husband and I were forced to rethink our choice, and in the end we chose to keep our baby (who I would be remiss in not sharing turned out to be our amazing blessing of a daughter Madden). The choice was not without trepidation. You can imagine our fear.

As an empowered patient, I knew this time I would, at the very minimum, put a team of people around me who were specialists and knew what they were doing. I was watched like a hawk throughout my pregnancy. I received counseling. In the interest of full disclosure, I also took medication, a risk I chose to take based on my personal medical history and after very comprehensive consultations with both my psychiatrist and my OB/GYN.

Being a mom to a newborn the second time around was pretty awesome, as I wrote in this piece at the time called “On What It Should Be Like To Be A New Mom”. I can’t say whether it was the meds, or the therapy, or a good sleep management plan, or the fact that I had more knowledge about postpartum OCD the second time around that prevented me from getting it again. I have no idea. What I do know now that I didn’t know before I got pregnant with my second child was that we all have choices. We don’t necessarily have to end the growth of our family after having experienced a perinatal mood or anxiety disorder like postpartum depression. Not if we don’t want to.

Am I saying I think you should have another child after PPD? By heavens, no! I’m not advocating that you should continue to have children, and I’m not advocating that you should cease having children after having had PPD or a related illness. I have no opinion on what the size of anyone’s family should be (except, I must admit, when it comes to those Duggars. Would they just stop it already?) I’m simply saying that those of us who have had postpartum depression or a related illness have more than one option.

I respect the choice of the mom who wrote the ParentsConnect story. I truly do. I made that same choice. I also respect the choice of moms who choose to press on, despite having a history of perinatal mood or anxiety disorders.

As Karen Kleiman writes in her book”What Am I Thinking? Having A Baby After Postpartum Depression“, “The good news is that with proper preparation and planning and a healthcare team that is mobilized on your behalf, we can intervene in ways that will minimize the likelihood that you will experience a depression to the same degree that you did previously.”

You do have a choice.

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About Katherine Stone

is the founder & editor of Postpartum Progress. She was named one of the ten most influential mom bloggers of 2011, a WebMD Health Hero and one of the top 25 parent bloggers using social media for social good. She also writes the Fierce Blog, and a parenting column for Disney's Babble.com.

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  1. My second child was so so so so much worse, that I had my tubes tied as fast as I could. I couldn't risk it. We had come so close to catastrophe-I couldn't suffer through that, or risk a child again.
    I wish I could, but I know what would happen. Of course, being complicated by a mood disorder on top of normal PPD doesn't help. Sucks.

  2. This is such an interesting topic to bring up, and I really haven't seen much discussion on this before, but it's so relevant.
    First of all, I appreciate the awareness that people need to butt out when it comes to family size (although…I do agree with you on the Duggars), especially when we don't know what mothers/families have been through the first time around.
    Second, my feelings about more children have changed the more time has gone by. I feel better prepared to handle things. I feel like myself and my family know more about what to look for, and I trust my doctor.
    After being treated with PPD and then – with my doctor's support – going off meds after 6 months, I'm back on them again, so this will certainly be an issue to tackle when the time comes.
    I don't know what will happen next time around, but at this point – I want to give it a shot.

  3. Thank you so much for this post. Having another baby is a very personal decision. So glad to know you were okay the 2nd time around! If I had the option to become pregnant again, I would do it again in a heartbeat, despite my scary brush with PPD! Can't tell you how many times I've been asked when/if I'm going to have another baby (to keep my daughter company)….I don't beat around the bush…I look them straight in the eye and tell them I can't, followed immediately by an explanation of why (missing biological part=no baby possible). Otherwise, there would be this same ol' exchange…but why not? You're still young….you don't want your daughter to be lonely….it's no fun being an only child. It used to hurt having to get this question, but I'm okay when I'm asked nowadays.

  4. Michelle S says:

    I chose not to have any more children because of financial reasons, but my history with PPD was certainly a factor. However, I don't believe my history alone would have led to that decision. Four factors would be very different if I had another. First, I would be prepared. I'd have support systems in place. Second, I would not try to breastfeed. I would not even allow the hospital Lactivist into my room. Third, I would not quit my job. Fourth, my husband would be prepared. He was clueless last time, came under the wrong influences, and said all the wrong things, until he finally saw the light after 4 and a half months. But I know that not every mom has such four readily identifiable risk factors or the means to address them, so I would never tell another woman how to make this decision.

  5. Thank you for sharing your story so openly and honestly. This is a helpful topic for all women and especially mothers. Through sharing your story, hopefully others won't feel so isolated and alone.

  6. I have been struggling with PPD and anxiety for 14 months now and even though my good days far out number the bad ones, the pain still remains fresh.
    I've come along way since the days of locking myself in my house, too terrified to leave, panicking because I couldn't choose what outfit to wear, the enourmous guilt for not instantly loving my son and practically wishing that someone would take him away…the racing thoughts, the anger, feeling utterly alone and wanting to just fade away. It litterally has been a fight for my survival and the thought that I could potentially suffer like this again, really terrifies me.
    Obviously, we are not ready for a second child, and when the time comes, this experience will weigh very heavily in our desicion. It has been a nightmare… so do we really want to risk going through it again?

  7. I chose not to have another one after my experience with postpartum psychosis just over 6 years ago. Too intense, and my chances of having it again are very high, especially since I personally would not medicate during pregnancy or breastfeeding.

  8. Thank you for this article. I am so scared to have another, even though everyone around me knows now to watch and help. I have such guilt over my indecision. My partner wants another, my child would probably like a sibling… But the thought of another baby, of going down that rabbit hole…. The guilt is suffocating. Thank you for the article. It is nice to know I’m not the only one who was/is scared.

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