Photo: Courtesy of Tara Mandarano
Before I decided that my only child would be my last, I agonized for years over what my family and friends would think of me. Would they call me selfish or uncaring for not giving my kid a sibling, a so-called “built-in friend for life”? The reason I decided not to have a second child is simply because, from a mental health perspective, I needed to be able to survive.
When I was diagnosed with endometriosis and polycystic ovary syndrome in my 20s, my doctors said I might never be able to conceive. But against all odds, I got pregnant after just five months of trying. My partner and I were thrilled at the news, but almost immediately, my natural, low-level anxiety amped up into something I didn’t recognize. At a subsequent appointment with my OB/GYN, I confessed that my anxious feelings were getting out of control and taking over my life. I told her about how I would regularly sit on the edge of the bathtub at home, sobbing and worrying over what could go wrong with the pregnancy. I was terrified that I would lose the baby.
She immediately referred me to a hospital clinic that specialized in reproductive transitions and, eventually, I saw a psychiatrist. Looking back now, I should have realized that I was at risk for a mood disorder during pregnancy. I had my first instance of clinical depression as a teen, and several episodes afterwards. I’d taken antidepressants on and off for years. And whenever life threw me a curveball, I automatically turned to therapists. My new psychiatrist explained that I was more likely to suffer from postpartum depression because of my mental health history.
When my daughter came into the world five and a half years ago, I had brief moments of new-mother bliss before the darkness descended and the postpartum depression and anxiety quietly set in. Suddenly, I couldn’t cope, and I didn’t recognize myself. When I eventually got help and started taking medication, my mood slowly improved, but I remember thinking to myself in the months and years to come: How can I ever do this to myself again?
Around the one-year mark, it seemed like all my friends were already thinking about having a second baby. It was as if they had miraculously emerged from the mental fog and physical exhaustion of new parenthood and were eager to try for another child. Did they have amnesia? How could they be so keen to go back to the sleep deprivation and constant breastfeeding all over again so soon? It baffled me and, in my darkest moments, it seemed like they were just asking for more misery.
I had conflicted feelings about having a second child, and my husband was happy with one. Part of me felt like I was abnormal to think about putting my mental health first and that I should put the needs of my daughter before my own. But how could I be the mother she deserved when I was already struggling with just one?
Turns out, I couldn’t do it. After a lot of therapy sessions and tough conversations with my husband, I finally admitted the secret truth festering in my heart: Although, in theory, I wanted another child—someone for my daughter to grow up with, someone I could lavish more of my motherly love on—from an emotional well-being perspective, I was done having children. The choice was between keeping my mental health stable and having a bonus child, just for the sake of it.
Having one child means that my husband and I don’t have to divide and conquer, like many other parents with multiple children do. We don’t each have to take a kid when they have sibling squabbles. We can also arrange date nights more easily and sleepovers with both sets of grandparents, where one of us takes our daughter and stays over there to give the other spouse the house to themselves.
We couldn’t do this with a new baby. I would inevitably be left alone with a newborn for extended periods of time, and this would be slightly traumatic for me. I didn’t want to go through the emotional purgatory of postpartum depression and anxiety again, not to mention the physical exhaustion and monotony. Having my husband around to support me is crucial to not only my physical health but also my mental well-being, and if he was out of the house or in another room entertaining my daughter, I know it would also take a huge emotional toll on me.
“It can be hard to let go of past wishes for a larger family, but a second or third child comes with many added demands and stressors,” explains Cara Brown, a psychiatrist at the Women’s Mood and Anxiety Clinic, Reproductive Transitions, at Sunnybrook Health Sciences Centre. “Any woman with a mental health history who is thinking of having another child needs to consider many factors, including her current mental health stability, the severity of her illness, her coping abilities at work and home, her parenting and function with her current child, the mental health of her partner, her needs for psychotherapy and medications and the intensity of the needs of her current children.”
Deep down, I knew the chances of me being able to manage my mental health would decrease dramatically if I welcomed another child into the world. I just couldn’t see myself managing two kids’ schedules or being outnumbered if they had meltdowns at the same time. I knew I would panic and feel overwhelmed and end up just wanting to hide. The truth was disheartening on a primal level, but I had to face reality and accept my limitations. Besides, I knew I’d rather be a present, loving mother to one child than an unwell parent who couldn’t handle raising multiple children.
Brown states that after one episode of postpartum depression, the risk of recurrence is estimated to be up to 50 percent, possibly higher if a woman continues to be symptomatic or had severe illness.
“For some women, examining these factors and weighing the benefits and risks will lead her to decide to have one child or a smaller family, even if this wasn’t what she imagined previously,” she says. “This is a very valid decision. It’s important to make an informed choice and not just have another child because it’s expected by society or your extended family or culture. Sometimes it’s also necessary to set boundaries and ask well-intentioned family members to stop inquiring about this very personal matter.”
After I gave birth, I was diagnosed with generalized anxiety disorder and premenstrual dysphoric disorder, which is severe depression, anxiety and irritability that surfaces seven to 10 days before your period. I felt completely overwhelmed. And just last year, I was diagnosed with bipolar II disorder, which was another shock because I didn’t know it could show up in your 40s. Brown says that comorbidity among conditions is common and often sees these conditions present together.For me, it’s a trifecta of mental health challenges that I sometimes struggle to handle. And I’m not going to lie: I get by fine most of the time, but there are definitely some days when motherhood and my mental illnesses inevitably collide.
That’s when I hide in my room, lie in the dark and feel too agitated to deal with the normal ups and downs of parenthood, like my daughter spilling milk all over the floor or not getting dressed after being asked 10 times. These aren’t major problems, but when I’m not feeling well mentally, they can be the last straw to my self-control. But I don’t want to be like this or miss out on my daughter’s childhood. I want to be calm and in the moment, not constantly looking to escape through my phone. I want to soak up the joy of motherhood and navigate through all its stages with the confidence that I can do this because I’m also taking care of myself.
Liza Weiser, a psychologist based in Thornhill, Ontario, agrees. “A woman isn’t a failure for deciding not to have any more children,” she says. “Raising one child doesn’t mean that all your difficulties disappear. It’s just that your ability to deal with them and recognize your limits improves. A mother with mental health challenges will probably still struggle to some extent, but having just one kid means that she is better able to take care of herself when there are fewer household and family demands.”
There is some pretty convincing research that supports stopping at one child for your mental health. Hans-Peter Kohler, a sociology professor at the University of Pennsylvania, discovered that second and third children don’t necessarily increase parents’ happiness. He studied 35,000 adult identical twins in Denmark and concluded that having more children actually makes mothers less happy.
Recent research from Australia also reveals that having a second child worsens parents’ mental health. The study followed approximately 20,000 Australians for up to 16 years. The results showed that second and third children increase the demands of the parents’ role and double the time pressure for parents (especially for mothers). Interestingly, researchers also found that, while a mother’s mental health improves with the birth of her first child, it declines sharply and remains low after the second child arrives.
These days, I go to therapy twice a month and see a psychiatrist, who is able to prescribe medication to balance my moods and dampen my tendency toward anxiety. I am open with my daughter about my mental health and try to explain it to her in a kid-friendly way. We talk about my “feelings doctor” and why going to see her makes her mama feel better.
I’ve also discovered there are many psychological perks to being a parent to an only child. My husband and I can tag-team and take breaks when situations with our daughter get overwhelming. I can also practise self-care more often because I have someone to look after her when I need time to myself. Sometimes it’s something simple, like being able to catch up on reading on the couch while my husband gives our daughter a bath and gets her ready for bed. Even though I can hear all the noise and chaos going on upstairs, I’m detached from it, in my own little bubble for a while. When I have a particularly tough day, this act of kindness is a lifesaver for my emotional sanity. Over the past five years, I’ve learned that prioritizing my own mental health makes me a better mother and improves my relationship with my daughter.
“Maternal mental health is of utmost importance for childhood attachment and development,” says Brown. “If a mother decides not to have another child because she feels like she will be more mentally well parenting one child, then that is the best decision for her and her family. Yet, making this choice can be very difficult for some women. It’s not uncommon for a woman to experience feelings of loss when she lets go of past expectations she had for her family.”
The decision to be a one-child family didn’t really hit home for me until I elected to have a hysterectomy last year due to ongoing pelvic pain. Once nearly all my reproductive parts (bar one ovary) were gone, there was no possibility of changing my mind or going back in time. But I’ve finally come to a place of peace and acceptance about being “one and done.” I don’t need a certain number of children to “complete” our family. And I’m still a real mother, even if I only raise one child. Having another kid would have been an emotional disaster for me, and I would have been in way over my head. I’m grateful that my daughter now has a healthy, happy and loving mother instead.