Studies done to date indicate that after an episode of post-natal depression there is a 50% chance of a recurrence of the illness after a subsequent birth. Post-natal depression can recur and as yet there is no certain method of prevention. However, there are currently three methods of prevention in use and some basic advice may be of help.
There is evidence that extra psychological support during a subsequent pregnancy reduces the likelihood of an episode of post-natal depression. Your doctor or health visitor may be able to arrange this for you. There are two drug treatments used for preventing further episodes of post-natal depression. One method involves having high doses of progesterone injected during and after labour. The progesterone is given in decreasing doses for eight days after birth by injection. You then use progesterone pessaries until menstruation starts again. If you are interested in this treatment you need to discuss it with your GP and midwife so that the treatment regime can be planned. It must be stressed that this treatment is not as yet proven but results indicate that it can be helpful in some cases.
The other method involves the use of anti-depressants in late pregnancy, usually in the last three weeks. Many doctors feel that exposing the baby to anti-depressants even in late pregnancy is dangerous. However, some feel that the benefit to the woman outweighs the risk to the baby. It is advisable to discuss your options with your GP and midwife. In planning terms when you have already experienced post-natal depression you are best advised to assume that you will become depressed after a subsequent birth and try to plan accordingly. It can be helpful to arrange for as much practical support as possible after the birth ie help with shopping and cooking. Also it is useful if you can arrange for help with the care of your older child or children.
It can be useful to try and build up a network of support that suits your needs. Try to find out what help and support is available in your area and make use of it after the birth. ie Homestart.
It may be useful to discuss with your GP starting anti-depressant therapy without delay if you experience depression symptoms after the birth. If you already know an antidepressant that helps you this will make treating a further episode of depression much easier. If you expect to become ill again you may feel more able to seek treatment quickly should you notice any symptoms of depression after the birth. If you do not become ill then nothing is lost and the support that you have arranged may have been helpful in preventing a further bout of the illness.
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