CW: This post contains descriptions of anxiety & panic attacks as well as discussion of perinatal loss that may be triggering for some.
Got ya there with that title, didn’t I? While the statement itself is currently true, let’s back up a little bit and get some context.
Many of you who follow me may know that we were expecting a new baby this fall. You may have had a general idea of his “due” date, and you may have known he was a rainbow baby. What you may not have known, is exactly how emotionally fraught the end of this pregnancy was for me and how tumultuous the events were that immediately followed his birth. So let’s revisit life around 38 weeks, when things started to get interesting.
Up until this point, pregnancy had been a dream this time around. After two losses, 1 medically complicated child, and 1 premature birth, I was THRILLED to be experiencing one of those unicorn pregnancies you hear about. You know, the ones where women are 7 months along and climbing Machu Picchu and you smile while they tell you how they aren’t really sure what morning sickness is and you hate them. One of those pregnancies. I was blissfully floating along my merry home-birthing way, relishing my low-intervention midwifery care, my minimal complaints, and working happily the whole time. In fact, I attended my very last client birth 2 weeks before my due date. I felt great…until I didn’t. You see at 38 weeks on the nose, I went into labor. Full.blown.labor. And I was thrilled! Everything was ready. I was ready. So I labored at home for several hours and warned my husband not to dilly dally at work that night coming home. My doula came over to help me relax and get settled. And together my hubby and doula low-key timed my contractions as I moaned and swayed and switched between the birth ball to walking, walking to the couch, the couch to laying down, and back up again. As my contractions intensified, closing in on 3 minutes apart, they went ahead and alerted my midwives and photographer to make their way over. We were clearly having a baby soon! So one by one, my two midwives, my student midwife, and my photographer arrived and started getting set up.
And my friends, within 30 minutes everything stopped. Poof, gone. Like nothing had ever happened. As I began to feel labor petering out, I experienced my first brush with major anxiety. I had been laboring for hours, and working hard. I was coping awesome! And now nothing? NOTHING?! Around 2am my husband convinced me to take a few laps around the block with him to see if we might convince things to kick back in. It didn’t work, and every minute that went by I felt more and more like my body had failed. I wasn’t *really* in labor. Maybe I had overdramatized. I felt so stupid. After 2 kids, you should KNOW when it’s real, right? I felt as though I had inconvenienced my whole team. I was embarrassed. So defeated and crying, I told my doula to send everyone home. No baby tonight. As the night went on, my anxiety grew to feeling nauseated and slightly panicked, but eventually exhaustion kicked in and I fell asleep. The next day involved a harried phone call to my husband at work, after convincing myself despite all my knowledge and education that something must be wrong. Why would labor just stop? I could’t wrap my head around all the facts and statistics about how very normal this was. My midwife called me while I sobbed, panicked that I would “miss” something key and be at fault for something terrible happening. And ever true to form, my midwives went above and beyond in their care and came to my house again that night just to listen to fetal heart tones and reassure me that everything indeed looked great. This was my first real experience with what would become a crippling struggle with perinatal and postpartum anxiety. I didn’t even realize at the time that this was the moment things started first taking a turn into dark and twisty places.
Following the night of prodomal labor and all my feelings that went with it, I tried to shake it off and carry on as usual. My midwives encouraged me to stay active and busy, so I did so. I went hiking, I planned activities for my family. Sure that at any moment, I would go into labor for REAL, and I’d be holding my baby. Any. Minute. Right?
39 weeks came and went. 40 weeks came and went. I tried soothing myself with idioms and affirmations, and clung to my practice of mindfulness & hypnosis (one of the only things that actually helped during this time), while nearly every night crying to my husband that I just didn’t understand why our baby wasn’t here yet. I had at least 2 more extended periods of hours of contractions. During these times I didn’t call my team. I was desperately afraid of the idea of having another “cry wolf” experience. It didn’t seem to matter how much my team reassured me that I was no inconvenience, that this was super common, that they were happy to come. I couldn’t let that happen again. This was marker 2 on my slope into what I’ll ruefully reference as my own personal Upside Down.
41 weeks arrived, and I felt more defeated than ever. In the state of Maryland, CPMs are only legally allowed to attend births at home between weeks 37 and 42. I was rapidly running out of time. I spent my birthday during this week devastated, as I had been 100% sure I would be holding my baby by this time. Complicating matters emotionally, I was also remembering and reliving the year previous where instead of giving birth, we had been attending the memorial service for our last angel baby Norah. The further into pregnancy I walked, the more the pain of that loss snuck up on me and dragged its fingers down my spine, reminding me how very little control of this process I actually had. And yet, through it all I remained staunchly firm in my desire to hold to my birth wishes until I absolutely had to go to plan B. Everything in the pregnancy still looked great and remarkably healthy. Other than having a slightly long gestation, everything was going beautifully. I knew both intrinsically and rationally that there was no reason to pursue a medical induction yet as risks still outweighed benefits. At 41 weeks and 4 days, my midwives and I decided to go ahead and try a membrane sweep to see if we couldn’t finally get this little one to make an entrance. This was a HUGE decision for me, as up until this point I had purposely had a very hands-off pregnancy. My husband and I felt good about this suggestion though, and knew that of possible interventions it was very low risk out of other potential options, and certainly more low risk than a hospital induction at 42 weeks.
That night happened to be Halloween. We walked the WHOLE neighborhood with our gleeful 4 & 5 year olds, retiring early from parental exhaustion and too much sugar. As we went to sleep, I laughed rather pitifully to my husband that once again, I was shocked that even that much walking didn’t put me into labor.
That night at 11:47am I woke up to a contraction. Mentally I prepared myself for another fruitless night of discomfort and no sleep, and no baby. But something was definitely different this time and by 1:45am, I was holding my beautiful baby boy. Completely in shock that it had actually happened, it was actually over. I’ll write out the story of those crazy 2 hours another day, because this post is primarily about what happened in the next two weeks.
At first, it was bliss. I experienced a profound sense of relief that I had been able to have this baby safely and without much ado during the actual labor. I had birthed him at home as I wanted, even though the details were a bit different than I’d envisioned. Life was good, right? My husband had taken a week off of work and we were simply going to bask in the new baby glow as a family. That was Wednesday. By Friday, everything went wrong.
Friday we went to our pediatrician for well visits for the older children and an initial check up for the little guy. What should have been a very brief in and out turned into a 3 hour ordeal due to overbooking at the office. By the time we emerged, I was in agony. I should NOT have left the house two days postpartum, let alone to sit on a rock hard surface trying to nurse a newborn in a doctor’s office. I sent my husband to the store for preparation h, desperate to get some relief of the postpartum hemorrhoids I had in full force. That night I laid in our room nursing and sleeping while husband and kids got themselves ready for bed. Sometime during that process, our 5 year old came into our bathroom without us realizing it. See, she had run out of toothpaste. Being the independent helpful girl she is, she didn’t ask for help- she simply came to our bathroom looking for our toothpaste to borrow. And she used the preparation h instead. And never said anything to anyone. The kids went to bed. Around 1am, Pepper came out of her bedroom gasping and coughing. I immediately thought croup, and went to the bathroom to start a steamy shower running. That’s when I saw the preparation h container open next to her toothbrush. And I immediately panicked. In the hours that followed, two calls to poison control occurred, an emergency room visit ensued, and a very long story short- we discovered she had a respiratory virus that had come on out of nowhere and it actually had NOTHING to do with the accidental ingestion. But for me, that was one of the most terrifying nights of my life. It didn’t matter that the ER doctors and poison control emphatically reassured us that the ingestion had nothing to do with her illness. Everything inside me screamed that this was my fault. Here I was, 48 hours after having a baby, terrified I had harmed one of my other children accidentally by even needing to have this medication in the house. By not supervising her closely enough even though she was doing something she did independently every single night. Even though there was another competent adult in the house. This was my failure. My brain couldn’t comprehend any other conclusion. I fell apart when my husband came home from the ER with her, safely tucking her into bed. As my terror for her safety abated somewhat, a new one, for my new baby, began to set in. Gripping me like vines that crept up my legs and into my heart, I became terrified of the idea that my newborn would catch whatever respiratory virus my kindergartner had. So instead of receiving the love and support and helping hands of my husband and older children, I quarantined myself and the baby to our bedroom. I begged my husband to wash surfaces and scrub hands. My middle son caught the illness next and my fear increased. It was Saturday night that I experienced my very first full blown panic attack. My face flushed out of no where and nausea hit me like a freight train. I couldn’t breathe. I started sweating and shaking. I walked out to my husband in the living room, white as a sheet and he asked me what was wrong. All I could sputter out was that I didn’t feel ‘right’. Something was wrong. And while I can clearly articulate to you now the whats and whys of how my anxiety began and peaked, in the moments it was happening it was much less clear. He soothed me as best he could and declared I was way too sleep deprived (I was), took the baby and sent me to bed. The next time I woke up several hours later than panic had faded and I resumed life. I thought it was a freak incident and mentally pondered to myself if that might be what people meant when they said “baby blues”. By 7pm the next evening, I was experiencing my second panic attack. What was happening? Why was it happening again? My husband continually tried reassuring me that everything was fine, that I was fine, that we were safe. But I felt anything but safe. It felt as though every single thing in my world was the definition of unsafe. That I was powerless to do the one thing in the world I was supposed to do- protect my children. I repeated the cycle of sleep-feel somewhat better-wake-panic another full day until suddenly the panic didn’t abate so easily. I couldn’t fall asleep anymore. The panic was all day, every minute, not just a few in the evening.
By Tuesday I decided I needed some serious help, and asked to be driven to the ER. I didn’t know what else to do, but I was desperate for help. I knew from my work as a doula and a childbirth educator that what you’re supposed to do when you’re in crisis is ask for help, and I was in crisis. And here, after much history, is the ultimate point of this post. I, who had sought out and had the most low-intervention, hands-off birth imaginable, went to a hospital seeking a pharmaceutical option for anxiety relief. I, who had vetoed the gestational diabetes testing and thumbs downed cervical exams an entire pregnancy, went off knowing that I needed something more than I could get from an herb or an oil or any home remedy.
In my complete vulnerability and desperation I met over the course of two days doctors and nurses who were frankly, uneducated on how to possibly help. Multiple times I was told that unless I consented to stop breastfeeding, they couldn’t do anything for me. I sat in a hospital bed in the emergency room shaking and sobbing through yet another panic attack, being forced to decide between the one part of postpartum that seemed to be working (my breastfeeding relationship), and my mental health. I had walked through unimaginable fear that I would be labeled as crazy or an unfit mother to reach out for help, and was met with a collective shrug. I knew in my gut that I needed to keep breastfeeding. It was comforting and grounding to both me and my baby, even amidst everything else I was going through. So I stood my ground and after much back and forth, found a P.A. who was willing to write me a prescription for Ativan at the lowest possible dosage, hesitantly admitting that it was “probably ok” to take while breastfeeding. My own research while in the ER had me reading multiple sources that corroborated Ativan was quite safe while nursing and I felt comfortable with this course of action. I took my first dose in the ER while waiting to be discharged and within 20 minutes took what felt like my first deep breath in a week. The grip of the vines that had been choking me loosened, and I actually smiled on the way home. We went to the drug store to fill my prescription. Ativan is considered a controlled substance and prescriptions can’t be called in. I picked up my script. And realized, the doctor had given me 12 of a pill I was allowed to take every 6 hours as needed. The hospital had not been able to get me a follow up appointment with a psychiatrist or Obstetrician for over a week. I did some math. This was only 3 days of medicine if I took it as directed. The panic set in again. I began to play a very scary and very dangerous game of “how long can I make it without needing to take my meds” because I was terrified now of running out. I couldn’t go back to The Upside Down. I couldn’t be hyperventilating and sweating and gasping for air again.
I’m not sure how I made it through those first few days, but for the grace of God. What I do know is that somehow I forced myself to attend a breastfeeding support group at a different local hospital and it was there I met my earthly saviors. The lactation consultant listened as I unburdened the events of the previous week and connected me with the hospital OB Coordinator. The OB Coordinator personally got me almost immediate appointments with a sympathetic OB and psychologist specializing in perinatal and postpartum mood disorders. I went to these appointments, and I started to get better.
I’m now on a daily low dose of Zoloft, and I still have the Ativan (this time an appropriate amount) in case things get really hairy emotionally. I’m happy to say I haven’t been back to The Upside Down since Thanksgiving, but I’m not too proud to say I’m out of the woods quite yet. Every day has its ups and downs. Postpartum is a veritable gauntlet even when you’re not suffering from a postpartum mood disorder. I go to therapy once a week, and I still attend that breastfeeding support group as well as a group once a month for moms struggling in postpartum. I have learned how to ask for help, and I have learned how to say yes when people offer (both exceedingly difficult for me).
What’s the ultimate point in all this? That I want all of you to see one of the faces of postpartum anxiety and panic attacks. That I want you to meet someone who isn’t ashamed to say that the only reason I have my relative sh*t together right now is because of carefully monitored medications combined with talk therapy. Friends, thousands of women are struggling like this all over the world. Your friends and neighbors and family. Every day I meet women who are in the throws of postpartum mood disorders through no fault of their own. They are seeing the warning signs, and they’re terrified to reach out for help. They’re terrified of taking medication because of the stigma attached to mental health disorders. They’re mortified for anyone to know they aren’t handling motherhood the way they’d hoped. They’re sitting like I did, on the edge of their bed, anxiety meds in hand, hoping – pleading – that anyone will tell them they aren’t less of a mother and woman for needing them. The thing is, anxiety and depression lie. They wind and twist their way around your head and your heart until what you used to know means nothing anymore, and the person you are starts disappearing a little more each day. It makes you believe that if you were just a little stronger, a little tougher, a little more worthwhile of a human, you wouldn’t need help. So we have to reach out to each other. We have to change the conversation around mental health and support mothers in the midst of this struggle. We have to be willing to say, “Good for you for getting the help you need” whether that help comes in the form of yoga and aromatherapy or your friendly neighborhood pharmacist.
So I’m here to be that person, to say that you are not less of a mother or woman if drugs are a tool you use to get back to being yourself. If the grip of panic has a hold on you, or the storm clouds of depression are obscuring the love you have for your children, I am here to say you don’t need to be ashamed. There is help out there. If you have hit walls when reaching out in the form of uneducated or unsympathetic doctors, I’m here to say I’m sorry. That’s not all there is. You have options. You can feel better. If holistic and alternative therapies didn’t cut it this time, it’s OK. You’re not a failure. You tried hard enough. You are enough.
If I didn’t know what I do, and have the support network I do, I can see a thousand ways I might have fallen through the cracks. I shudder to think what that reality might have looked like. Do I hope to have to be on prescription drugs forever? Of course not. I’ll cross that bridge eventually and see what happens on the other side. I’m not married to a date I’ll be off them. Because they’re a tool. No one picks up a nail and is ashamed a hammer is the best tool for the job. Right now, mommy on drugs is the best tool for healing. And I’m OK with that.
If you or someone you love is struggling with postpartum mood disorders, there is help out there. Learn more at www.postpartumprogress.org