@farmerdan My comment will seem a little unusual, but my primary fixation during my bout with severe PPA/PPOCD was SIDS or a severe illness affecting my young infant that would lead to death. I know that statistically the first year is a period of vulnerability and that kept my brain in high gear. I sadly had the SAME idea as your sister- no permanent birth control while the baby is still so young. Part of it was "in case" I wanted another, but the other part was being able to have another if something terrible happened. Again, keep in mind that I was spiraling daily! I REFUSED to let my child sleep unsupervised. I essentially forced my husband to share awake shifts with me, so someone was always watching the baby. When my husband resumed traveling for work (baby was 3 months then), I was crying hysterically because I knew it meant I would have to allow her to sleep without me awake. I was SURE she was going to die - it was AWFUL. I also became obsessive with cleaning and sterilization, because I was terrified of her getting ill. She was born during COVID and during flu/RSV season, which made me more anxious.
Now that I'm removed from the situation, I can see how irrational I was being, but I understand the fear. My daughter wasn't even at high risk for SIDS, but I lived in a state of panic. I think MANY mothers have this worry, but you absolutely should not make major decisions based on fear! And yes, it's true, there is no replacement for a child. You cannot have enough children to replace the loss of one. My husband's mother was 1 of 11 kids (she was the youngest). She battled Multiple Sclerosis for years before passing away at 38 from complications of her disease. Having 10 other kids did not stop my husband's grandmother from experiencing profound grief (she herself died a couple of years later). There are countless stories of parents struggle to recover from grief after losing a child, regardless of how many other children they may have. Some people NEVER truly move past that grief and it makes them struggle with being parents to their other kids.