I had truly terrible PND with my first, went onto Sertraline after a year of struggling. I loved my little boy but couldn't possibly even think of another (also had traumatic induction & emergency c section, plus problems with feeding so there was that side of it too). I agonised over the thought of a 2nd (it had always been our plan & my husband was still really keen), but I was TERRIFIED of going back to those dark thoughts. At their worst I couldn't see how I could survive the next 5 minutes, let alone anything else. I couldn't bear being home alone with the baby, walked around our town with the pram from when my husband left in the morning at 8, until we met him from work at 5.
When my son was 4 we decided it was now or never. I fell pregnant in the first cycle & panicked. I felt like things were just starting to settle (this was the year after covid), & I was gripped by fear that we'd made a mistake. I was 100% certain the PND & anxiety would return, I couldn't see how it couldn't. I spoke to my midwife (I was probably around 12 weeks by that point), & was swiftly put under the perinatal mental health team. I had more regular midwife appointments, regular medication reviews with the perinatal doctor, counselling put in place which started while I was still pregnant, meetings with the health visitor while I was still pregnant. I also had a birth review from the first birth to get some closure on that. It was very much a collaborative approach from the team & they completely scooped me up & saved me.
There were notes all over my maternity file (which was huge!) & thank god I had all of that in place. I was due to have a planned section but 3 weeks before that I started showing symptoms of pre eclampsia, & my baby was showing signs of distress. So the section was done 2 days after I went in to be checked as I was worried. Baby didn't cry & didn't breathe when he was born, needed to be in SCBU for a few days. I panicked on the operating table & said I couldn't be alone, while they were stitching me up my midwife got on the phone to organise a private room so my husband could stay with me. She had also come in on her day off to be there for my surgery. She was truly amazing & I miss her! Fortunately my little boy came through & is a lovely toddler now.
I was convinced that the PND was going to return (especially considering the birth). Specialist counselling was put in place, & I wasn't signed off from my midwife until a month after birth. The first few weeks I couldn't understand why I wasn't depressed or anxious, I kept waiting for the feelings to creep back. But they didn't! All that support honestly saved me, I can't imagine how different things would have been had I not had it.
Sorry that was just so long, I just wanted to share my experience to show that it doesn't have to be how you fear it'll be. Please get some support in place ASAP, even if you decide you cannot continue with the pregnancy as you'll likely need it either way. I wish you all the best.