Teachable Moments

[trigger warning – birth trauma]

So much has been happening since my little FireChick was hatched last October that the original purpose of the blog has gotten lost. It’s been such a whirlwind dealing with her illness day to day that beyond a few tweets, I’ve not really talked much about her birth, working through the trauma of the first and my mental health afterwards.

I can honestly say that I think of her birth fondly, with that warm glow that I expect many are lucky enough to experience first time around. So much so I think the full story deserves its own post, at a later date.

I’d like to share a moment from the birth though, where unfortunately I did re-experience some trauma and flashbacks. It was a solitary moment in an otherwise good birth, which I share because I think sadly it could have been avoided, in much the same way that wonderful planning and support did avoid any more significant trauma throughout the rest of the birth.

Labour was pretty well established, and I felt like I was in my stride using gas and air and hanging off a knotted scarf for pain relief. Due to my risk of postpartum haemorrhage I’d agreed to be cannulated – in case I was in need of emergency medicines or a transfusion. I remember nothing of the junior doctor who came to cannulate me – barely even their gender. They were not particularly rude, condescending or cold, nor remarkably warm, understanding or patient. A routine doctor for a simple routine procedure. Yet unlike every other staff member I worked with during this labour, I don’t believe they were informed of my trauma history.

I was asked to sit still on the edge of the bed while the cannula was placed. Anyone who’s given birth or witnessed it knows that this is no mean feat. But I managed it, cannula in despite my position making things more painful. The only thing left was to tape it down. Except I felt a contraction coming. I needed to change position. I managed to communicate this but was told no, I had to stay sat where I was on the edge of the bed. I pleaded that they could just wait and do it once the contraction was past but again, no, it had to be now, this way. The midwife told me to use the gas and air for the pain.

I huffed long and deep, too much, and that horrifyingly familiar, greyed-out, floating feeling crept over me. A feeling I hadn’t had for three and a half years, a creeping horror that I was in fact still in my first labour and about to die. I let out a throat ripping scream as I felt my vision and my sensibilities fading. Yet through that fog, I felt my husband’s gentle hand on mine. I heard him explaining to the bewildered doctor that I was having a flashback, an explanation he repeated to me, quietly and calmly. He reminded me where and when I was and showed me a photo of our older daughter. “She’s grown up, look, you’re not there anymore”. Shaking, I came back in to the room. I trudged the soles of my feet against the floor. I took in my surroundings, naming boring objects I could see as I’d learnt in EMDR trauma therapy. I let out a few heaving, shaking sobs and got on with the business of birthing my second baby.

Now why was that necessary? I wasn’t in danger. I didn’t need urgent medication, fluids or blood. Perhaps the cannula may have needed to be placed again, but so what? A little patience, a little more explanation to the doctor and I don’t believe that moment needed to happen at all. It was a small moment in the middle of a very positive birth, it didn’t ruin the experience but I do believe it was avoidable. The clear trigger had been the high amount of pain, awkward position and being told I couldn’t move. All three could have been avoided with better positioning and better understanding.

I hope that doctor went away with more than a sense of bewilderment that night, perhaps with curiosity about birth trauma and how to prevent it. Perhaps they just moved on to the next patient without a second thought. If you’re a health professional, it’s these little teachable moments that can make all the difference in preventing trauma and re-traumatisation, don’t let them slip by.

For more information and support on birth trauma, contact The Birth Trauma Association @BirthTrauma or join the Twitter hashtag #birthtraumachat on Monday evenings UK time

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So this happened…

I don’t really know why I took a pregnancy test this morning. If you were to ask me my mood over the last week, I’d have to say ‘PMS super bitch’. So imagine my delight then when that faint little pink line appeared!

Last time we told parents the day after the test, such was our excitement. This time I’d like to enjoy the secret for a while (anonymous blogs don’t count, OK!). This means not telling FireGirl, unless we want her blurting it out all over the village. She’s taken to jumping knees-first in to my stomach though, so we’ll see how long that lasts.

The other half wants to wait a while before booking in with the midwife too, so we can delay the shitstorm for a while. So, here’s to a few weeks of peace! Wish me luck…

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Just the basic facts, can you show me where it hurts 

I had a horrible labour. I had a horrible birth. I lost 3 litres of blood after days of back to back labour and a failed epidural. I believed I was going to die. I spent 5 days in hospital in total, and was discharged home with a bruised pelvis from the forceps, and a bucketload of medication. I started motherhood with a heavy dose of anxiety, exhaustion and confusion about what had happened.

At home my girl was instantly starving. She breastfed constantly, for hours at a time, including 8 hours straight that first night. I remembered the safe sleeping advice that said you should never fall asleep in a chair with a baby, and that bedsharing was dangerous, and I began to feel incredibly anxious about staying awake. I was terrified I would fall asleep and accidentally smother her. Yet it seemed imperitive that I continue. I willed the the sun to come up, and thought maybe if I could just make it through the night I’d  be alright. I cried; that seemed to be happening a lot lately.

The next few days were a haze. I tried to rest. I became obsessive about sleeping enough, though I was actually sleeping very little even when I tried to. Husband would try and settle little one in the conservatory to blank out the noise of her cries, but I couldn’t sleep thinking that she was crying. Dark thoughts entered my mind that he would try and kill her to shut her up. I crept downstairs and convinced myself I saw murderous intent on his exhausted face. I couldn’t talk about the birth or the thought that I’d nearly died. My baby carried on feeding continuously, and I asked a breastfeeding support worker to visit for advice. She gave me the sympathetic head tilt and parroted the old stomach-the-size-of-a-marble bit, and said everyone likes a snack and I just needed to carry on, as my latch was fine. I tried to get across just how exhausted I was, how I wasn’t eating, or showering, or sleeping. I asked this stranger for permission to express milk and feed a bottle so I could rest. She reminded me that breast really is best and left. What did I know. I’d never done this before. 

My community midwife came to visit and was worried about me. I wasn’t keeping up with my various medications, my stitches weren’t healing and she thought I seemed different. She asked me directly if I’d felt depressed or suicidal. I cried and confessed that at a lowest point I had fleetingly thought I would rather die than be the kind of woman who couldn’t cope with feeding her child. Then I hastily tried to backtrack, and expended all my energy one day showering, dressing and conversing brightly to prove to her I was coping. She didn’t buy it and referred me to perinatal psychiatry without my consent. They called and I fobbed them off, wanting nothing to do with them. 

My parents took the baby for a walk one day so I could try and sleep. As I lay in bed, I realised it was exactly a week since she was born, coming up to the minute. A wave of sadness overcame me as I reflected that this was not at all where I expected to be at this point post birth. Days locked in the sweaty embrace of breastfeeding, struggling to find a bond with the closed eyes and swallowing jaw that were a source of dread and regret and terrifying memories.

I began to sob as dark thoughts of suicide as the only escape crept unbidden into my mind, taking root and spreading. I called out for someone. Anyone. Suddenly, the desperate feeling of needing help and nobody coming caused me to lose my grip on reality. I dissociated to that place of terror in surgical theatre when I thought I was going to die. I let out a raw, animal scream. 

Suddenly my husband was in front of me shouting my name like a short, sharp slap. I came round, but couldn’t put a coherent sentence together. I just managed to say Ambulance…now….999… he was confused but started dialling anyway. He asked what was wrong, and from the depths of my mental health knowledge I dredged up a phrase…puerperal psychosis. 

Somehow he got me dressed, with me talking terrified gibberish, and not understanding why no one seemed to see the urgency I did. There was no time. He guided me downstairs as I wouldn’t break eye contact with him. He asked if it was safe, and I roared NO I’M GOING TO KILL YOU, I’M GOING TO PUSH YOU DOWN THE STAIRS, then horrifyingly, the words I’M GOING TO KILL MY BABY. I felt animal and dangerous and I didn’t trust myself to do anything. The trip to A&E and the wait for a psychiatrist took an age. I couldn’t understand why they didn’t rush me there. Why did they think this could wait? I felt the entire time like I was on a precipice, about to slip off into oblivion. I had to keep talking whilst all the time my mind threatened to dissociate back to terrifying memories I felt would consume me. I screamed to be locked up, away from everyone and pumped full of drugs. I wanted oblivion, numbness, escape from this mental torture. 

During my psychiatric assessment I put my fingers in my ears so husband could explain my traumatic birth. The psychiatrist tried to persuade me I’d just had a panic attack and to go home with some sleeping tablets. She mentioned the mother and baby unit, but the thought of being around my daughter terrified me as I felt convinced I would harm her and she wasn’t safe with me. 

So I went home. Baby girl had been taken to my parents house with a bottle of formula. They’d gotten advice from a helpful checkout lady in ASDA, as the on call midwife wasn’t interested in giving bottle feeding advice. We went to my parents to get some more support as advised. I coiled up on their sofa, terrified to sleep in case of nightmares but knowing I desperately needed to. I felt despicable, disgusting and unworthy of motherhood. The sight of my daughter feeding from a bottle was pure anguish. I made a gut wrenching decision that I had to stop breastfeeding so that I could start to take care of my self. That was that, no follow up advice, the end of our breastfeeding journey. 

I began to suffer from panic attacks, intrusive thoughts about harming her, harming myself, SIDS, her overheating, her stopping breathing and dirt and contamination and I would frequently wake with a start looking for her, believing I had fallen asleep feeding and smothered her. I felt myself spiralling against a tide of trauma and exhaustion and expectation and I just couldn’t process it all. Above it all was a pervasive doubt, the psychiatrist had said it was just anxiety. It felt like so much more. I obsessed over diagnostic labels – did I have OCD? Anxiety? PTSD? Postpartum psychosis? Or just the baby blues? I flushed the rest of the sleeping tablets down the toilet and asked my husband to lie through his teeth to keep psychiatry away from me. 

Before I knew it it was the second week anniversary and the time of birth was coming up again. I couldn’t stop my thoughts from racing. I was staring at the clock in the kitchen and didn’t know how I got there. Time seemed to freeze. I was aware of husband asking me if I was ok, but he seemed to be talking to me from another planet. Another century. The time never seemed to get any closer to 2.51, the time of her birth, and I became convinced that time had frozen for me because I was actually dead. I had died in childbirth. I had bled all over the floor and everything that came after was my poor dying brain snuffing out. This must mean I was still there. I was still in that hospital room and still in labour and it was all still happening. Wild and terrified again, I began to hit out, shout, scream. I had to stop this, I had to change it, I had to wake up and fight fight fight not to die. I was convinced. This reality, in my parents kitchen, it was not mine, it was a fantasy. I had to wake up urgently or I would die. I began smacking my head against the wall, the floor, straining to open my eyes to a reality that never came, hallucinating nightmarish scenes from the birth. Perhaps I was wrong. Maybe it was my baby that was dead and this was my demented grief. Where was she? DID I KILL HER? I HAD to find her, run to her, husband stopped me, I hit him, he restrained me, I kicked him in the ribs and fell on the floor bruising my back. A hundred different abhorrent realities raced through my mind. I was dead. I was dying. I was still in labour. She was dead. I killed her. Where is she? End it all. Kill yourself. Somewhere in all this I realised I was desperately ill and needed urgent help. I pleaded with husband to get me help, then would dissociate again and beg him not to leave me. 

I didn’t quite know how, but now I was in a car on the way to A&E again. It felt ok. I was going to get help. The mother and baby unit wanted to see me. Then followed days of agonising waiting for a bed, sedated and curled up in self loathing and despair. Bursting in to tears of relief at finding my way to the mother and baby unit and being reunited with my darling baby girl. Kidding myself it was like a spa. I panicked during my admission assessment and tried to run away. Shit, I’ve gotten myself locked up, I must have dissociated in to another nightmare. Why is this door locked

Slowly, the terror was replaced by a numbness that pervaded for months after I was sent home. A nurse on the unit confided that she’d seen many women driven to the brink by pressure to breastfeed. I was ashamed of what had happened and felt that I should have been able to see it coming, prevent it. What if I’d been more assertive during the birth, cared less about breastfeeding, cared more about breastfeeding, slept more, tried harder. It became a shameful secret that hung over me at every mother and baby group, every coffee morning and I felt fraudulent and false.

Gradually, I forced myself to go out, stay active and connect with people. I connected with my daughter and delighted in her company. I started exercising, took up baby swimming lessons and made new friends. I had a six week follow up with an obstetrician, who re-explained what had happened and why, and answered all my questions. I took a deep breath and asked her if I’d nearly died. She didn’t miss a beat and said no, not a chance. They’d been worried about me, but I’d always been safe. I stopped having panic attacks that day. I pushed HARD to see a clinical psychologist and talk though my experiences, we even revisited the delivery suite and reprocessed my traumatic memories. She signposted me to a drop in support group that enabled me to start telling my story and find other women who’d shared similar experiences. I got braver, and told a few newer friends what I’d been through when I was able to talk about it without having flashbacks. They were compassionate and understanding and have been my salvation. Bit by bit, I came back to life.

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