Mental note-This blog post isn’t meant to scare first time mommas. If your a first timer. Happy trails sweet momma! Your pregnancy and birth are going to be just as beautiful as you are!
Perspective
As a healthcare provider, when things begin going wrong with someones health that we care about, the saying often comes to mind….”sometimes we just know too much!” That’s not meant to sound as if we are just a bunch of smarty pants. It means when stuff hits the fan, we recognize it from our experiences working in the hospital, or even from our schooling. Recognizing what’s wrong with your family can be very painful.
However, literally knowing the play by play on your own destiny is a whole different experience that only those of us who have experienced it, can actually comprehend.
Memories bring Understanding
I recently had a patient who was suffering from some pretty significant postpartum PTSD/depression. She wasn’t going to voluntarily share this tidbit of information with me, she was VERY much compartmentalizing and telling herself she was simply overreacting. Since, I personally had a similar experience I was able to instantly understand the issue at hand right away.
Basically, her delivery didn’t go as planned and from there on out, neither did a lot of her expectations or the vision of her postpartum time at home with her baby. As I continued to see her month after month, helping her to process, adjust, and balance to her new norm. She tried to find the simple joy in her new life with her precious baby. It was during this time, that I recalled my first sons birth.
It had me considering a question. Are we discharging new mothers with postpartum PTSD and not even addressing it? So, is the postpartum depression dilemma actually PARTLY our fault as healthcare providers?
I’M Pregnant!
My husband and I found out we were pregnant with twins in 2011. We were so excited and nervous! But there was a problem! One of the gestational sacs didn’t look complete. And by our second trimester we knew we would only be having one baby. I learned to make the joke; “it’s cool, my baby ate his sibling!” When many people I worked with would say, oh its was just a case of vanishing twin syndrome. (Sarcasm)
VAnishing twin syndrome-is a term used to describe the spontaneous loss, or miscarriage, of one developing baby very early in a multiple pregnancy. The term is reserved for a twin that “vanishes” in the first trimester of pregnancy. (source)
So we moved on, but I still silently thought about the fact that there was really supposed to be two…
Complications
As my pregnancy progressed I developed UN-DIAGNOSED gestational diabetes and began rapidly gaining weight. Soon, I was diagnosed with preeclampsia and was being induced 3 weeks early. I was excited I’d get to meet my boy a few weeks early! And let’s be real…My back was killing me y’all! I knew that the studies showed that most babies thrived at 37 weeks!
I was induced and in 3 hours the doctor came in to prep me for my epidural only to be told that my white blood cells were much too high for an epidural so I’d be flying all natural, and after delivery I’d need to go see a hematologist because they’d been high for awhile.
Say what?
My water was broke and she breezed out and at this point my rational nursing brain was in over drive.
Why. Were. My. White. Blood. Cells. High. Did I have that rare pregnancy cancer? Was my baby sick? Was I sick?
So many thoughts were flying through my mind. At that moment a contraction began and it went on, and on, and on…… and on. The moment the nurses ran into my room to prep me for an emergency surgery; I had already calmly explained to my husband and parents, that the nurses would be coming in, and I was likely going to need to have a C-section because Greyson was decelerating.
Trauma
I was suffering from an intractable contraction due to the medicine they used to induce me, a very high blood pressure due to the preeclampsia, and a blood sugar that was rapidly dropping in my baby were all causing my sweet baby to be in a lot of distress.
In the 3-5 minutes it took the nurses to prep me and roll me into the operating room, the only thing I could think to ask my OB was, “Please if something goes wrong just save my baby! But, if everything goes good…….please don’t cut me down the middle!” Mind you I was in my eleventh minute of a nonstop contraction!
Oh sweet vanity, it was there even in the middle of a crisis! My OB’s response, “it’s always the healthcare providers that this happens too!” A tear rolled down my face, and I shivered as the nurses stripped me down then tied me to a cold OR table. The very last thing I remember is her pacing over me asking why I wasn’t out yet, with a scalpel ready in her hand.
My babies life that I thought I was going to miss flashed by in my brain as I went under anesthesia. I woke up later in massive pain, only to find out I was hemorrhaging. I believe that the pain from them trying to stop me from hemorrhaging, is hands down worse than the surgery itself or someone’s natural childbirth. Later that evening, my kidneys began shutting down from the trauma of everything my body had been through that day.
He is HERE!
When I finally woke up, I learned my baby boy was in the NICU from low blood sugars (8), because I had gestational diabetes. When I finally saw him 21 hours later he was so swollen anddddd so chunnnkkkyy!!! The guilt of me doing this to him washed over me uncontrollably. I should have known I had diabetes! I had failed my 1 hour test but passed my 3 hour glucose test. How could I have missed that!
Why did I eat so much pizza? How was I going to be a good mom when I couldn’t even keep him safe inside of me. Yet, 6 days later, full of new and raging hormones we were discharged from the hospital with a very jaundiced baby boy. While driving home with our new baby and a strangers blood donation coursing through my veins, I finally thought about it for the first time……we were so close to heavens door that I literally thought we were dying.
So what did I do? Well I pushed it down into a compartment of course to be dealt with later.
Home
The first 2 days I was home, my house was filled with visitors stopping over for socialization. I was smiling but on the inside, I was in complete turmoil. I was in so much pain, the last thing I needed was to cook and clean. But yet, there I was trying to entertain my guests. It’s who I was before I was a mom.
Yet, I was so stricken with guilt every time I handed my baby to someone and they commented on his size. Inside my head i would think, “I did that. I made him sick.” Learning to breast feed became my obsession to right my wrong for him. No one tells you how unnatural it is to breast feed. How much it can hurt. And how much you GIVE to make it happen.
It. Is. Exhausting.
And my days turned in to weeks, and my weeks into months. And slowly the postpartum depression that I knew nothing about, And never even expected, crept in and it very nearly consumed me alive.
It can happen to any of us.
While I was good at pushing down my fear, I didn’t know how to compartmentalize this overwhelming guilt and sadness I was experiencing, I am generally a very upbeat, pretty positive, easy going person. But what I was experiencing was so confusing.
I had this amazing little guy that truly filled me up with such joy, yet I couldn’t stop staring at the wall. I didn’t want to get off the couch, or put him down. I couldn’t stop worrying about how one of us was going to die, and how would he make it without me or me make it without him? Every moment was full of anxiety.
Everything I I knew about childbirth did not prepare me for actually experiencing it.
And not one health professional ever stopped and asked how I was doing mentally. Sure they asked about my bleeding and my incision. Everyone asked how he was. Everyone asked how my husband was handling the adjustment to our baby. I even had some say, well your a nurse! You got this! And yet every time I looked at my baby with so much love, the tears would run down my face because I felt so dead inside, I felt like I was a failure to him.
Practice through Experience
I NOW understand that what I had was ACTUALLY postpartum ptsd, and what I needed after birth was someone to direct me in opening up and talking about my birth experience. I NEEDED help to process all the scary things that happened during my delivery.
Today, I have 3 beautiful boys, and I am happy to report that my next 2 scheduled c-sections were seamless. But I have learned that postpartum depression is real even when there is immense joy.
And maybe the PTSD from facing my own mortality through my very own nurses eyes will continue to help my patients struggling to understand, that they are going to be ok too.
Allison Laney, FNP
The Takeaway
Every new mom definitely needs a good meal, a warm shower, and a kind hug. But what a c-section Mommy really needs is to be asked the question, “How are you, really? Are you doing OK after going through such a scary day?” “That must have been so hard for you!” “Tell me how I can help you process that day.”
Let me help you understand that you are brave. You are a momma. And you can handle anything now that you’ve conquered that massive change in your plans!
Maybe, if we acknowledge that a trauma has occurred during such a miracle we can prevent postpartum ptsd from turning in to postpartum depression. Go check on your pregnant friends. Bring them a meal, or drop it off if they want some space. Hold their baby if you’ve washed your hands and offer to let them go shower or sleep. And then talk to them to see how they are mentally holding up.
And do not overstay your welcome. They are tired and they are all in pain.
What are your thoughts on postpartum depression? Did you experience a traumatic birth as well that altered your experience?