Giving birth was like being peeled apart from myself.
The pregnancy was far from what I had imagined. High blood pressure made the last weeks a constant trip to the doctor’s office, and my body retained so much fluid that I couldn’t fit into my husband’s shoes, let alone my own.
Refusing pain medication was the one part of my son’s birth that I could still control, but the cost was more than I could bear. The pain was so severe that I felt severed from my body. When I finally pushed the baby out and he was put in my arms, I was not the mother that I always thought I would be: responsive, cooing, peering into his eyes. Forget about love at first sight.
No one knew yet, but I was hemorrhaging badly. They waited twenty more minutes until finally the doctor reached her hand inside of me and pulled out my placenta. The blood poured. I lay on the bed unresponsive, unable to move, no connection between me and this tiny boy. All I could feel was the flatness. I was on the ceiling looking down at myself, thinking that I might not make it.
An hour later my baby’s in my arms and I’m trying to nurse. I can hardly hold him, I’m so depleted and weak. Later that first night I can’t sleep at all. The second day we go home and I spend a second night with absolutely no sleep. I don’t sleep the third night or the fourth night. On the fifth day, my uncle dies. The fifth night I don’t sleep. At all. Again.
Sleep deprivation is used as a form of torture. I understand why. Having no sleep for five days and five nights alters how the brain functions and lets loose the nightmares of the mind. And even while the mind understands that it is malfunctioning, it can do nothing to prevent it. I knew what was going on, but I was no longer in control.
I had panic attacks where I could hardly breathe. My mind tormented me and its paper-thin filter let in the horrors of the world without discretion. I spent long nights clinging to wakefulness because I thought if I fell asleep I would lose my last grip on sanity. I could not disengage from the worst-case scenarios running constantly in my mind—my finger continually going under my baby’s nose to ensure that he was still breathing.
My sadness alternated with wild anger and I would not and could not leave the house for three months. I was highly sensitive to pain, making nursing excruciating. My son was a thing I had to figure out what to do with. Besides, the nightmares demanded my full attention leaving little room for my newborn. And when the nightmares were quiet, mystical thinking took their place.
I am typically not a spiritual person and don’t believe in an afterlife, but during this time I believed in and understood angels. I knew I had past lives. I knew God was directly connected with us. But I didn’t know how to go food shopping, how to nurse my baby, or how to do the laundry. I didn’t know how to get back to work. I didn’t know how to be a mother.
I crawled on my hands and knees, lost in a postpartum nightmare. Even though my husband and parents were with me, no one could penetrate the isolated place in which I lived. There, in that loneliness and utter despair, I kept crawling forward, out of habit more than hope. I functioned on instinct—wearing my baby, insisting on nursing, keeping my son close to me. He got what he needed even while I unraveled around him.
And then, slowly, my brain began to recalibrate and recover. My thoughts became more regular, the angels not so loud. Sleep returned in larger doses as I mastered nursing and my baby grew older. I began the long process of becoming myself again.
My grandmother said to me, “You must first mother the mother.” I learned how to do this out of necessity. I found support: a lactation consultant, a friend who was a social worker, a psychologist who understood perinatal emotional complications *, and then another therapist. Sleep medication helped for several days until an acupuncturist made it possible for me to sleep again without medication.
Eventually a psychiatrist supported me to understand what I was experiencing and offered me medication but did not insist. She listened to me but did not have the need to label me. She trusted me to decide what was best for my care, gave me an antidepressant when I finally could bear it no longer, and she understood when I gave it up a month later. My providers were confident that I would recover and never doubted my ability to heal. No one stigmatized my experience in any way. For this, I am very grateful.
I was back on my feet and was adjusting to my new life as a mother in about three months, but my deep healing was a longer, more complex journey that took several years.
Like many women who have been through this type of ordeal, I made the obvious decision: I would never have another baby. There was no way I would consider it. And yet, one day, the thought was there: Should I have another baby? There is no easy answer to this question for any of us who have been through severe perinatal emotional crises. For me, the very asking of the question created the possibility for my full healing to begin.
I was able to unpack my fears and grief, my memories and history that had led to the experience of the first birth and its aftermath. I told my story to anyone who would listen—my husband, family, friends, and counselors. While they listened, I cried deeply and my body trembled. I addressed experiences in my early life that had led to my fears of losing control and facing the pain of giving birth. Early surgeries, my parents’ divorce, even my own birth, played a part in making the experience of giving birth so terrifying to me. As I continued this work my perspective began to shift.**
I made a critical, essential, and seemingly impossible decision for my own healing: I would never again lose control of my mind.
Anyone who has involuntarily experienced an altered reality like I did knows the terror of losing control of the mind. I couldn’t help myself from obsessing about whether it would happen again. I was terrified that there was something deeply wrong with me.
When I decided to have another baby, I had to decide that I would not accept the messages inside of my head. Instead I would replace them with a commitment to know my own wellness and resiliency, and the ability for me to have control of my mind—even when giving birth, even when facing pain, and even when risking being out of control. And then I did absolutely everything I could to prepare.
I was strategic about being pregnant. I knew I was at high risk for a repeat of my first birth and postpartum experience. Even in the face of the statistics, I believed that the second birth would be different. When I doubted, my husband, friends, and counselors insisted that I hold on to the belief that it would be different. I don’t want to misrepresent myself at all. I was terrified. But I was determined to do everything in my power to ensure a different outcome for myself and my family.
There were four key components to my preparation for the second pregnancy:
First, I created my own personal healing team to help me with the emotional aspects of the first birth. I utilized trauma therapies, cathartic approaches, support groups, and peer counselors.
Second, I developed a support team of my family and friends whom I prepared. I insisted that they follow my lead on my plan for care.
Third, I created a team of experts to advise and care for me including traditional and holistic providers. I handpicked them through an interview process requesting their professional recommendations.
And lastly, I had a backup plan in case all failed. I would be flexible and consider taking pain medication during birth and sleep medication afterwards if the pain were too severe, the fear too great, or the sleep not there. I had a psychiatrist on call, my husband was prepared to take a leave of absence from work, and my parents were moving in with us for twelve weeks postpartum.
My daughter arrived five years after her brother. In the moments after her birth, in which I held her, gazed into her squinty eyes, and felt her precious body against my skin, I knew that I had not only recovered from the trauma of the first birth, but that I had transformed myself. I was not the woman I had been before. Now I was a mother who had been to the edge and come back even more fully herself, even more in her power, even more committed to her children and to living in her full experience. My life was forever changed.
Today I am committed to ensuring that no mother ever has to go through what I went through—alone, terrified, and wondering if she is going to make it. I have become the advocate for other women that I needed in my own darkest moments. As the Program Director of MotherWoman.org and founder of our Postpartum Support Initiative, we have created the MotherWoman Support Group, a powerful and replicable support group model for mothers to talk about their real experiences of motherhood.
Through our MotherWoman Facilitator Certificate Program we provide essential education to professionals and layleaders. Our goal is to develop a national network of support groups for mothers so that every mother has the support she needs. In addition, we develop coalitions and advise medical, mental health, and social service professionals in addressing the issues of perinatal emotional health. Our commitment is to create comprehensive safety nets for mothers in both urban and rural communities.
* Perinatal Emotional Complications and Perinatal Emotional Crisis are concepts that we have developed at MotherWoman.org to address the needs to speak about the perinatal emotional experience without adding additional levels of stigma. We believe that it is important for physicians to understand the difference between symptoms of anxiety, depression, and psychosis for purposes of treatment.
**For mothers to be willing to self-identify and get the help that they need we must make it possible for them—including those who are not comfortable with mental health diagnosis—to be able to understand their own experience in an empowering and accessible way.
A Note from Dr. Shosh
There are many points in Liz’s wonderful story that illustrate what helps and what doesn’t in dealing with postpartum complications:
— Any medical issue (such as high blood pressure) during pregnancy increases stress both physically and emotionally. These things are not within our control, but it’s important to be aware of them so additional support can be found.
— Labor is not a test. Doing it without medication does not indicate that you are a better mother or stronger woman.
— Out of body experiences during times of excruciating pain are not uncommon. I too, experienced one during labor with my first child. I never knew they were real before this occurred.
— Insomnia is a serious symptom that needs treatment immediately.
— Past and present traumas will amplify the risk and severity of perinatal mental health issues.
— Checking the baby’s breathing compulsively is a common symptom of postpartum obsessive-compulsive disorder (OCD). Even without full-blown OCD, this type of checking-the-baby behavior is common when we feel out of control. It’s also prevalent when we have experienced unexpected trauma as was the case with Liz.
— It doesn’t matter what we know intellectually when we’re going through a scary time; we lack the ability to control it—no matter how educated or smart we are. These illnesses can happen to the best of us.
— Vigorously and quickly setting up support of all kinds—emotional, psychological, physical, and whatever else you require—will greatly increase the likelihood that you heal more quickly and have a totally different experience the next time around (if you choose a next time) and come through the other side with profound gifts.
Photo by Anne Worner CC BY 2.0