I went into the birth of my second child absolutely convinced I'd experience at least some degree of the postpartum depression I dealt with after Indy was born. It was something I brought up at my very first appointment after finding out we were expecting, and something that I touched base with my doctors about over the course of the next few months. I didn't want it to catch me unguarded and without a plan in place, because with a toddler and an infant to think about, being that emotionally out of sorts even for even a day didn't feel like an option.
My primary concern: you know how I've written extensively about my insomnia (which is largely related to my anxiety)? Well, when you have a newborn, you sleep even less. And less sleep = a greater chance of suffering from PPD.
At the mid-point in my pregnancy, I went to meet with a psychiatrist (which I should have done a long, long time ago), because even though I didn't want to start any new medications while expecting, I figured you know what? I've been dealing with this problem long enough. I've tried lots of different things - some that have worked for a time, and some that haven't worked at all - and if there's a longer-term, more stable solution, I'd like to find it. What we decided: that I'd start on an extremely low-dose daily antidepressant immediately following the birth. I don't suffer from depression, but apparently this kind of medication can help to shut off the sort of ruminative thinking that characterizes my particular type of anxiety.
(As a side note, this decision to try medication wasn't something I was going to talk about here - it feels so, so personal - but then I realized: am I ashamed that I suffer from insomnia and anxiety? No. Am I ashamed that I've tried lots of different things over the years, and that now I'm going to try this? No. And I know that these are issues that a lot of people suffer from, and that a lot of people feel ashamed about, and I believe with all my heart that there is no shame in being open about your struggles and seeking out help wherever you can find it.)