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

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.

About Katherine Stone

is the founder of Postpartum Progress. She has been named a WebMD Health Hero, one of the fiercest women in America by More magazine, and one of the top 20 Social Media Moms by Working Mother magazine. She is a survivor of postpartum OCD.

Tell Us What You Think


  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.

    • I am currently in the indecisive period. My son is nearly 3 and I feel time is going so quickly. I suffered/suffer with bad anxiety and depression and after my son was born I went through a very bad time, I never felt anything but love for him, I just hated myself and was constantly on edge and waiting for my next panic attack. I still get them and I don’t know if I can go through the whole pregnancy again with the fear for the babys arrival growing by the day! My husband says its up to me, I just don’t know whether to risk having another child and the probability of being I’ll again or live with the guilt and regret of not trying.

      • Leanne – A lot of moms who have suffered from PPD have these very same feelings. Continuing to grow your family after PPD is a big, big decision. One that shouldn’t be taken lightly. It’s okay to have mixed feelings. It sounds like you’re doing some important soul searching and with time you will hopefully be able to figure out what’s best for you and your family. You’re not alone.

        • Leanne, I’m also going thru the same thing…trying to decide what to do. I’d love to have another child but not sure I can handle another bout of PPD. My son is now 4yrs old and I still sometimes have anxiety and depression popping it’s ugly head. At the same time, I also don’t want to regret it later for not having another child. It’s such a tough decision to make. I often do feel alone in this matter, so I’m very glad I came across this blog.

  9. This was such an amazing article to read, thank you so much for showing both perspectives of moms that have gone through and suffered from PPD. I went through a very bad spell after my daughter was born and was on anti depressants for over a year. Looking back, I also had a lot of risk factors that contributed to my PPD that I didn’t realize at the time. My husband had just gotten out of the military 3 weeks before our baby was born, took a civilian job over 2,000 miles away from anyone that we knew, I quit my full time job to be a full time stay at home mom, and felt totally isolated with my husband working 10-12 hour shifts sometimes 7 days a week. Even talking to family and friends was difficult sometimes since there was a two hour time difference. Now, our daughter is close to her third birthday, and the idea of having another baby excites me and terrifies me at the same time. My husband and I have started to talk about the possibility of another baby (mainly bc he wants a son so bad he can’t stand it) but having been through PPD once, and still having some anxiety issues, I just honestly don’t know if I could handle my strong willed daughter, a crying newborn, and going through PPD again. But, it is comforting to know that it is possible to expand your family and not suffer after a second baby the way some of us suffer after our first. On the flip side, I’ve heard comments from family members (on both sides) about how awful it would be for a child to grow up without a sibling or how sorry they feel for kids that grow up as an only child. Personally, I think it would be worse for two kids to grow up with a mama that resented them or her husband or was constantly unhappy and miserable than for one child to grow up happy and loved by herself, and I also wish people would be more considerate about “encouraging” someone to have a second child when it may or may not be in the best interest of the immediate family members involved. Thank you again for offering a little insight on a topic I feel is not addressed very often.

    • Hind kiwan says:

      Please can anyone rassure me…will this ppd fade away one day?..i have a boy 2.4 yeas and a girl 4 month… and a month ago i began to suffer crying so much of no clear reason..always afraid…having stomach cramps afraid my children will be alone if i died…thinkinf negative all the time..i feel as if there is a wall between me and the surrondings…i do all my duties towards my son and daughter but i feel as if i dont feel!!!!!……isolation in an involuntary way…i didnt seek any medical help…do you think one day i will be okay…please help me tell me positive words ….

      • Heather King says:

        Hello there, I’m so sorry to hear you are struggling like this. You can get better and you will get better, if you get help. You said that you did not seek medical help. You can get better if you do ask for help from a doctor or therapist who understands postpartum mental health. This is an illness and it is treatable. The PPD will fade away if you start a program of recovery that works for YOU. Getting professional help is the place to start. It’s going to be okay, mama.

      • Please get to the doctor and get on medication it could save your life. Reading your story is like reading my own. It will get better but you need support and medication.

  10. I had PPD 22 yrs ago. It was before it was ever talked about very much, not in the news, no real internet. I had attended my 2 week OB appointment and relayed all the symptoms I was feeling and that doctor totally dismissed me. The pediatrician mentioned PPD but never helped me get connected to real help (what is it, how can it be treated, etc) I went home and suffered for 2 month before finally telling my Nurse practitioner that I felt like I had the flu that wasn’t going away. She diagnosed me and wouldn’t let me leave her office until I had an appointment with a psychiatrist (still no real help as in information, counseling, support). It took months (and hospital stay) before I finally began to feel human again and felt like I might make it. Friends and family were no help to me at all. Husband was frustrated and helpless (clueless how to not cause more harm) as was his employer. Even though Its been 22 yrs it was still a very traumatic experience that I still get treatment for. I have also continued to at stressful times lapse into anxiety and depression.
    I decided to not have more children because of the trauma I experience. One of the most disheartening, disappointing things I experienced was things my closest friends and family said to me and how they acted toward me. They were the people I should have been able to count on but failed me.
    Thankfully I do have a beautiful, very well adjusted adult son! That’s the biggest blessing in the whole big picture

  11. I had very bad post-partum anxiety and depression after the birth of my first child, caused by a combination of (1) a history of lifelong depression and anxiety, (2) a traumatic labor and birth, and (3) a super fussy, screamy baby who had a hard time breastfeeding for the first 4 months of his life. I actually think #3 was the biggest factor, because my symptoms improved significantly when he got out of the “fourth trimester” screamy phase. When I had my daughter I stayed on my anti-depressants throughout my pregnancy, had a super fast and relatively easy labor and delivery, and she was an average-temperment baby (she cried, but not inconsolably at random times all day and night like her brother had, and no feeding issues). Everything was SO much easier the second time around. But I was scared too.

    • I agree with you EBlack, the second time around was so much better for me too! I think it’s because with my first child I went 7 months without getting any help because I didn’t really know what was going on. The second time around I stayed on antidepressants during & after pregnancy and it went so much smoother! & also to any moms reading this who are currently suffering trough ppd, especially the first year after having your baby, just know that there is light at the end of the tunnel. I recovered 90% both times. I still have occasional anxiety but it’s a lot better!

  12. Thank you for this. I know it is an old post now and you may not be reading any new comments but I feel compelled to share…
    I have just finished a course of CBT for OCD. I was only diagnosed with OCD 8months ago but having undergone 16weeks of therapy I now know that I have suffered with it for a long long time.
    My daughter will be 4 in October. She is the light of my life and an absolute joy to behold. Before I had her I was desperate to become a mum, and wanted a big family. Then I had an awful time after she was born, suffering with post natal anxiety (and what I now know was OCD too).
    We fell pregnant again last year as I so wanted to expand my family despite how awful the first 6 months of my daughter’s life were… But I couldn’t handle it. It was terrifying. I had such shit scary intrusive thoughts. I didn’t understand they were just thoughts, I thought that by having them I would act on them. I was so scared I was dangerous and would hurt my new baby or myself that the only way I could cope was to terminate the pregnancy….
    Fuck. That was hard. But a relief as I felt free of all the worry… But then a few months later I was really mentally ill again; thus the eventual proper course of CBT and medication.
    Now I am thinking about whether I want to expand my family. Whether I can do it. Whether my thoughts and head will allow me or not. My husband is terrified as post-natally and second pregnancy were the worst times in our lives…
    I want to allow myself to be okay with having another child but I’m so scared that I will relapse and everything that I have learnt will disappear.
    How do I surround myself with support? What do I do to minimise the risk of this happening again should I decide to take the leap and have another baby?
    You said you did that-please can you give me some tips?
    This has been very scary sharing this. Please be kind anyone that chooses to respond to me!

    • I feel your pain. I have a 3 year old and terminated a pregnancy 6 months ago because I was in a terrible place with the thoughts of the darkness again. Thank you for posting and letting me know I am not alone in my despair.

      • ❤️❤️❤️❤️❤️ you are not alone. It’s not something that is talked about enough. Seeing/hearing that we are not alone can really help. Sending lots of love. I feel your pain. It will be ok though. Well done for making the decision that was right for you in that moment xxx

  13. Thank you for sharing your experience. As you can imagine I’m pretty terrified of a second after my awful experience with pp anxiety. I am interested in learning more about your sleep plan? I’m convinced that the main issue for me was not being able to sleep and certainly not getting enough. I’ve never in my life had sleep issues and the thought of going to sleep was the most terrifying thought during those months because I would often wake up or have a panic attack before falling asleep. Can you say more about your sleep management program that you prepared?


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