In this post I will review the book What Am I Thinking: Having a Baby After Postpartum Depression by Karen Kleiman. A copy was graciously provided to me by the author, who has written several books on perinatal mood disorders and runs the Postpartum Stress Centre.
Reconciling the desire for another child with the fear of experiencing perinatal mental illness is a challenging thing. Ms. Kleiman provides an evidence-based look at this issue that is realistic yet reassuring. She does not minimize the impact of postpartum depression or the likelihood of it occurring again, but empowers the reader to work towards a concrete plan to cope with a second round of PPD.
She divides the book into the four sections of the psychological road leading to having another child. These sections are Fear, Gaining Control, Making the Decision, and Preparing for Pregnancy and Another Child. In Fear, she addresses just that: the fear of experiencing depression, anxiety, or OCD again. She discusses how the second time will be different, even if there are mood concerns, and all the ‘what if’ questions that spring to mind. Gaining Control reviews the symptoms of, treatment options and risk factors for PPD. Additionally, she guides the reader through making a mental health history and examining what was and was not helpful in dealing with the previous episode. Making the Decision discusses using psychiatric medication during pregnancy and breastfeeding (note that the recommendation to schedule breastfeeding around using medication is not supported by all lactation experts, and that some medications should be taken in the morning to avoid insomnia). Preparing for Pregnancy and Another Child talks the reader through the nitty-gritty of the postpartum plan, including supporting your older child(ren).
This book is short and easily read (great for busy moms!). Despite its length, it provides detailed and comprehensive information on the topic. The author includes plenty of questions for self-reflection and journal worksheets to personalize your pregnancy and postpartum plan, and identify your key issues and concerns. I would definitely recommend this book to any woman or family wondering what they are thinking by having another baby!
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