Pregnant After Postnatal Depression & Anxiety – Third Trimester

The overwhelm is real, people.  With less than a fortnight to go Anxiety has definitely come nipping at my heels in recent days.  I expected this, of course, but it still takes lots of hard work not to become bitter and frustrated, and instead just to manage the feelings the way I’ve learnt how.  

For anyone who’s interested, here’s just a sample of the sort of questions racing through my mind when I’m alone with my thoughts these days:

• What if the birth is as bad or worse than Caterpillar’s?
• How will I cope those first few nights alone in hospital without Hubs?  
• Will my c-section recovery be easier or harder than last time?  
• How bad was it last time anyway?  
• Will the Anxiety get the better of me when I’m tired and overwhelmed?  
• Will I feel bonded to her straight away?  
• Will I be short-tempered with Caterpillar and damage our relationship? 
• Will I have intrusive thoughts again?  Will I remember how to deal with them? 
• Will I have trouble sleeping?  
• Will I feel like I’ve made a mistake again?  
• Will I feel happy?  
• Will I feel calm at all or just on edge all the time? 
• Will I be able to remember everything I’ve learnt and apply it, or will Anxiety take hold before I have a chance or because I become frustrated and angry with it?  
• What if all my preparations aren’t enough to keep me well?  

FUN, right?  Don’t get me wrong, I’m so grateful for how little Anxiety I’ve felt during this pregnancy as a whole and, even now, it’s nowhere near unmanageable.  However, I definitely feel like I’m having a sudden crisis of confidence.

As I’ve said before, I definitely feel like confidence and self-belief play a big part in defeating Anxiety.  If you can believe you’re in control of Anxiety, that it’s a part of you and simply excess adrenaline, you’ve pretty much won the battle.  But the minute you begin to fear it, to wonder if you can cope with it, you become a little more vulnerable and it’s grip can take hold.  I’ve spent the last few years feeling complete confidence in my ability to keep my Anxiety levels in balance, but during the last two weeks I’ve slipped a little and I’m wobbling slightly.

Anxiety’s best pal, of course, is uncertainty.  And there are few times in people’s lives more uncertain than the final weeks before the arrival of a new baby.  I still have a lot of hope that once the birth and those first unsettling days are behind me my confidence and some calmness will return.

Another thing I need to be wary of is mental laziness.  A big problem for me during recovery was that I’d learn how to manage Anxiety and it would work very effectively but then I’d get lazy, or more accurately I suppose, frustrated.  I’d suddenly find myself feeling pretty awful again and wondering why.  This would last for a few days before I took a step back and I’d see that, in reality, I’d given up on all my tools.  I’d got tired or cocky or lazy and I’d taken the easier route of letting Anxiety take the wheel again.  I’ve definitely found myself doing this a few times lately; I know everything I need to do but, where I’ve been well for so long, I’ve gotten lazy and cocky and I’ve ignored certain thoughts and feelings rather than dealing with them.  I fear this will occur even more frequently once the baby arrives.

Thankfully, I’m at least aware of this flaw and can attempt to do something about it.  What I need to remember above all else is that staying well is extremely important to me and it’s in my own best interests to prioritise taking the time and making the effort to do the exercises I know work.  I need to accept that some hard work may be required and to try my best not to become resentful of this.  Ultimately, I know the more effort I put in during the early stages will equate to less effort further down the line.

If anyone kept up with that ramble, well done!  But that’s essentially where I am at the moment – mental health wise.

In other third trimester news…

Further Scans

We’ve now had the last of our scans (32 weeks and 36 weeks) and they came back perfect.  Baby girl is growing beautifully and my placenta and fluid etc is all good too.  She’s on track to be a more average size at birth too – in stark contrast to my lovely Caterpillar who is basically a 90th percentile (beautiful!) giant.

36 week scans are standard in my NHS Trust (Southend, Essex) which I think is amazing and should be extended countrywide.

Weight Gain

I’ve also had my final “lifestyle appointment” with the midwife.  These are the extra appointments I’d been having due to having a high BMI and being Consultant-led.

I mentioned last time how happy I was to have (somehow!) only gained 5lb during this pregnancy.  Sadly, this didn’t last and at my last appointment I’d gained around 10lb (Easter eggs – ooops).  Midwife was still more than happy with this though, it’s still within the “normal” range and, given that you lose about a stone from the birth, I probably still wont have gained much at all.

Breastfeeding Decision

Those of you who follow me on Instagram will have heard lots about this already and I’ll likely write a whole post about it at some point.  In Southend, we’re very lucky to have a great breastfeeding service provided by A Better Start.  They offer two antenatal visits, support whilst in hospital and more visits postnatal should you need additional breastfeeding help.

I agreed to the two antenatal visits, even though I hadn’t yet made my mind up about breastfeeding, and – despite how lovely the ladies were – I’ve 80% decided to go straight to bottle this time.

My breastfeeding problems with Caterpillar definitely contributed to my PND / Anxiety & OCD and that’s not a chance I’m willing to take this time around.  Just like I’ve chosen an elective section to avoid the trauma of another emergency section, I think I’ll avoid breastfeeding to avoid the distress of another failed attempt.

I feel quite cowardly writing that but at the same time I know that if someone else was saying that to me I’d 100% tell them to prioritise themselves and their health, so I need to be kind to myself on this one.

Medication

After being scared a little by my Consultant, I made the decision a few months ago to reduce my antidepressant medication.  I tapered very gradually and I’m now taking only 10mg of Citalopram per day.  At one point I’d considered coming off the medication altogether just before the birth, to eliminate the risk of the baby having withdrawal symptoms, but after further conversations with my other healthcare providers (midwives, nurses etc) I’ve come to realise that my Consultant was likely overreacting (as they tend to do!) and the limited studies into women taking antidepressants in pregnancy actually show an extremely low risk.

If I’d been struggling earlier on during this pregnancy there is no way I would have considered lowering my dose.  As it is I’ve felt fine and totally ready but everyone is completely different.

If you’re pregnant and under pressure to reduce your medication dose please seek a second opinion from an expert in the field, such as a psychiatrist.  

SPD

As with Caterpillar, I’ve struggled a great deal with pelvic pain this pregnancy.  This has worsened during the last month or two with pain in bed and early mornings being particularly severe.  It has got me down a little (and Hubs has had to put up with many a tantrum about it!) however I take comfort from the fact that it’s temporary and disappeared almost instantly after Caterpillar’s birth.

Maternity Leave

I’ve now been on maternity leave since the beginning of the Easter holidays.  I began my leave earlier than I originally planned so I could spend those holidays with Caterpillar and it was so lovely.  In hindsight, I’m actually really relieved that I did since the SPD has been so bad and therefore commuting and trekking across Tower Bridge twice a day at this point would have been very difficult.

That being said, I’m definitely someone who struggles with changes to routine and I have found giving up work to be a little emotionally unsettling.  But I take comfort in having a job to go back to this time and a fixed schedule (I was made redundant whilst pregnant with Caterpillar – another contributing factor to PND & Anxiety).

The birth

I’m optimistic about my elective section although I’m definitely more nervous about the procedure itself than I thought I would be.  Last time, since it was an emergency section, there was no time to think about what was happening whereas now there’s plenty!  However, I have a plan in place and I’ll be sharing that on a separate post later this week.

More emotional stuff…

Anxiety niggles aside, I am so excited to meet our little girl.  I’ve been looking at photos of Caterpillar’s early days lately (something I no longer find painful at all, thankfully) and can’t wait to find out what she looks like and what her little personality will be like.

I can’t wait to have her safely in my arms and for Caterpillar to meet his sister for the first time.  I’m looking forward to a slightly easier postnatal period this time around and for our family to finally be complete after such a long wait.  

I’ll be back with a ‘fourth’ trimester update a couple of months after she arrives to give you the honest truth about having another baby after postnatal depression & anxiety.  Meanwhile, the birth announcement will likely be on Instagram & Facebook so be sure you follow me there if you wish to know before I get around to blogging about rainbow baby’s arrival.

If you’re currently pregnant after PND or considering embarking on this journey (or just nosy!) you can follow my #PregnantAfterPND video diary on my Instagram where I’m updating several times a week on everything that’s happening and all the weird and wonderful emotions I’m experiencing! (Just hit the Insta Stories Highlight with the pregnant woman icon).

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Related posts:

Rainbows (Pregnancy Announcement)

Pregnant After PND – Second Trimester

5 Tips For Preparing For Another Baby After Postnatal Depression

What’s In My ‘Fourth Trimester’ Survival Kit?