pregnancy at 39

Hello Doctor;

I am 39 yrs old in about a month and have a three years old beautiful healthy daughter. Unfortunately I was diagnosed with PPD when she was 11 months. I have been taking Effexor XR since Jan/08 and in May/09 I increased (gradually over time) to the final dose of 262.5 mg a day. I have been feeling good for the most part and started thinking of the possibility of trying for another baby (refused before). I did tell my husband (and he was extatic...) but I also said I need another year before I am ready. Even though my theory is if it happens great if not we tried I would realy love to have a sibling for my daughter..and... I would like to know your opinion. I guess I just need reassurence... I realize my age and the meds (I hope to start decreasing at some point). I once heard the shift in hormones might just put my body into balance (would be great). I had two miscarriages before we were successful  and with my second and third pregnancy I was incredibly sick (could not even take the trash out for three- four months and was taking diclectin the whole preg.). Is it possible my next experience could be completely different? And what would you suggest would give me the best chance of a successful pregnancy? Thank you Dr., I appreciate your time.
Marta

[Elaine Brown, MD]

Hi!
Anything is possible!  In my years as a doctor, I have seen all of the scenarios. I have seen moms really sick with number 1 and fine with number 2.  I have also seen moms really fine with number 1 and very sick with number 2!  What I have noticed is that even if they are sick again with number 2, they seem to tolerate it better.  Maybe because number 1 keeps them from dwelling on it, or maybe because they now know that it is only temporary.  ( I remember wondering if I would ever feel normal again!).
If you do want another healthy child, you should not wait too much longer, but your chances are probably quite good despite your age.  
One other thing to consider, is continuing to take your medications through pregnancy at the lowest effective dose, and then bumping that dose up again as soon as the baby is born.  That may help to reduce the symptoms on the second go 'round.
Would you ever consider adoption?  I guess technically that's "cheating" but, it might be a wonderful answer for both you and the baby!
Good luck!
Dr B