The 'T' word

Let’s talk about the ‘T’ word. Trauma. PTSD. I used to think you could only develop PTSD or trauma related symptoms after being in the armed forces, surviving a disaster or abuse but it seems this is not the case.

I was diagnosed with birth trauma/PTSD symptoms when Alice was around 6 months old. It was a relief that I wasn’t losing my mind and that I finally had evidence it wasn’t post natal depression but part of me didn’t quite believe you could be traumatised by something as ‘natural’ as childbirth.

The Birth Trauma Association identifies the following as risk factors for birth trauma:

• Lengthy labour or short and very painful labour
• Induction
• Poor pain relief
• Feelings of loss of control
• High levels of medical intervention
• Traumatic or emergency deliveries, e.g. emergency caesarean section
• Impersonal treatment or problems with the staff attitudes
• Not being listened to
• Lack of information or explanation
• Lack of privacy and dignity
• Fear for baby's safety
• Stillbirth
• Birth of a damaged baby (a disability resulting from birth trauma)
• Baby’s stay in SCBU/NICU
• Poor postnatal care
• Previous trauma (for example, in childhood, with a previous birth or domestic violence)

Trauma isn’t tied to a particular experience such as war; it is more about the experience of the individual. Trauma can occur when the individual experiences an actual or perceived threat of serious harm to them or someone close to them, a feeling of horror, feelings of helplessness and probably lots more that I can’t remember!

The Birth Trauma Association identifies the following as characteristics of PTSD following a traumatic birth:

•   A response of intense fear, helplessness or horror to that experience.
• The persistent re-experiencing of the event by way of recurrent intrusive memories, flashbacks and nightmares. The individual will usually feel distressed, anxious or panicky when exposed to things which remind them of the event.
• Avoidance of anything that reminds them of the trauma. This can include talking about it, although sometimes women may go through a stage of talking of their traumatic experience a lot so that it obsesses them at times.
• Bad memories and the need to avoid any reminders of the trauma, will often result in difficulties with sleeping and concentrating. Sufferers may also feel angry, irritable and be hyper vigilant (feel jumpy or on their guard all the time).

Since having Alice I’ve experienced all of these. I’ve also experienced intense bursts of anger, panic and sadness. I have sometimes felt intense grief and almost been trapped in this feeling that she did actually die even though she might be right there in front of me.

I had nightmares that I had another baby, was pregnant again or was giving birth again. Thankfully these stopped a few months ago. There are films I could not watch until recently, food I couldn’t eat, places I couldn’t visit. At its worst point I hated going to the toilet in our old house because of the memories. I have had bouts of insomnia where I just could not sleep despite being exhausted because I was so on edge waiting for something to happen.

I never realised it was possible to feel so awful and to feel so god damn lonely. I honestly feel that I have been broken by the experience of birth and I hope with all my might that it is only temporary. I adore Alice and I have bonded with her but at times it is bitter sweet. She is wonderful and without a doubt the best thing I have ever done, but the day she came into the world was the worst day of my life and I am yet to recover from it. In the darkest moments of my darkest days I feel that she is the best thing and the worst thing to ever happen to me. Let me clear, I do not regret having Alice for a single second, I have never wished for my ‘old life back’ before I had her, but some days I feel like I am surviving rather than living. I love my daughter ferociously but I wish things were different sometimes.

I am probably taking a risk putting this out there but I feel I need to. I need to be 100% honest, to not feel ashamed no matter what the response. I need to own this experience and there is a tiny part of that hopes someone else will read this and not feel as lonely and guilty as I did (and do sometimes).

If you are reading this and thinking ‘this sounds like me!’ then this bit is for you.

Whatever happened to you to make you feel this way was not your fault, and if it was someone else’s fault there probably isn’t much use blaming them because it won’t change anything. You are not an awful human being because of how you feel and you are still an amazing parent despite all the crap going on in your head.

You need to talk and talk and talk and talk. You might feel like you are boring people to death but the people who love you will listen and each time you talk about it your brain organises your experience a little more and it becomes a little more bearable.

There will be really tough days but there will be awesome days too. Hold onto those days and don’t condemn them when the bad days roll back around, instead use them as umbrella and remember the sun will shine again.  Forgive yourself when you struggle, do not feel weak, you are strong you’re just a little tired. Let yourself take a break and keep going.

Do something creative to get those feelings out. Sometimes it is hard to understand what is going on until it is in front of us somehow, it might help loved ones understand a bit more too.

Finally if you feel the same after a few weeks seek professional help it can make such a difference.

Since I started talking about how I felt after Alice’s birth I have been met by lots of different reactions, the majority supportive and helpful and a few that were not. The response I get the most often is ‘do you not feel bonded with Alice?’ I think people find it hard to believe that you can feel such strong emotions at the same time but it is possible. I have had people tell me I am depressed or that it’s just ‘new mum anxiety’. Again I think people find it hard to see how anything as natural as childbirth could be traumatic.

To anyone who might read this who knows someone who has experienced birth trauma, or might be here are some things to say and not to say. Please bear in mind however that this is only based on my personal experience and everyone is different.

‘When are you having the next one?’ or variations of this. I had and still have this a lot, even when I am completely honest about how I am feeling. You see birth as completely normal but to me it is currently the most terrifying thing you could ask me to do. If I had just had a horrendous car accident you wouldn’t be asking me when I was going to drive again and you certainly wouldn’t be dismissive if I said I just can’t manage it at the minute.

‘You forget the birth as soon as you hold them for the first time, then you are just filled with pure love’. Don’t get me wrong I was overjoyed when Alice was born but I have not forgotten the birth to this day and we are a year on. 

‘Your baby is healthy though that’s the main thing’. This is usually said when talking about a horrible birth. I totally understand that people are trying to get you to be positive about your experience but it makes me feel like my experience is being dismissed, as if my horrendous experience doesn’t matter because Alice is here safe and sound. Don’t get me wrong of course I am relieved and happy she is but her health now doesn’t take away the fear I had in labour that she was dead.

‘Don’t talk about the birth too much or it will bring it all back’. This seems to be a common misconception. Talking actually makes things better, it seems to help process it.

‘You are depressed’. Just because everything isn’t sunshine and flowers now Alice is here does not mean I am depressed. It is not as simple as that, I think the experience of motherhood is more complicated than that.

I know on the whole people mean well and it must be so difficult to know what to do or say. I have some wonderful friends and family who have been supportive. They have listened to the same stuff over and over again, sometimes at 3am. My husband has been my rock through everything. He has held me when I cried for no reason, he has been patient and calm when I have been angry, he has even stayed awake telling me stories when I couldn’t sleep. I used to think I knew how much he loved me but I don’t think I had even the slightest clue until this experience.

It must feel pretty damn hard supporting someone through this, I have no idea how my husband does it. I truly don’t know how he has coped with the moods and the lack of sleep!!! But he has (thank God). Here are some simple sounding things that make the world of difference (or have to me anyway)

Patience. This is not going to be sorted overnight. It will take time; there will be ups and downs, good days and bad days. Things will get better, things will change.

Love. I don’t know about other people but I quite often I feel like the worst human being ever. I feel weak because something ‘natural’ has affected me so greatly. I feel ashamed and embarrassed. I feel sad and guilty that I am putting my family through this, I feel frustrated that I am not ‘getting better’ as quickly as I would like. Love helps people to open up, to talk and therefore move forward. It reminds me that I am not my experience, that it is only part of me.

Listening. You will probably hear the same things over and over again. You might here the birth story over and over again and if you think it’s boring remember, that person is probably reliving it over and over every single day. Being allowed to talk helps process what happened and therefore helps the person to move on. You aren’t expected to know all the answers just to listen to the problem.

Understanding. Some of what is said might be strange, you might not agree with it, some of it might hurt but trying to understand what it is like from that persons point of view without judgement will help them move on.

The face that reminds me that this is all totally worth it.
 Not for a second do I regret having this cheeky little girl.
My impossible girl. 

For information about birth trauma visit http://www.birthtraumaassociation.org.uk/default.asp

Item not in stock: Experiences with EPAU.

I think prior to this experience I believed that because pregnancy was a physical change that happened to your body it was pretty black and white as to what was happening whether this was good or bad. Apparently I was wrong and that is one of the biggest lessons I learned from my pregnancy.

In an older post I talk about how I found out I was pregnant. At the same time as this I was booked in for an ultrasound to check that it wasn't an ectopic pregnancy and maybe to double check I wasn't a few months pregnant. As I figured I would be sent home from the scan as I must only be the tiniest bit pregnant I had insisted Husband stay at work. 

I went in for my scan which ended up being internal as nothing could be seen on the normal ultrasound (lets not go into exactly what an internal scan entails, my mother reads this after all).

After only a few minutes the sonographer turned to me and said ‘I’m really sorry I can’t see anything, I think something has gone wrong with the pregnancy. There are some tissues on the side there, you can wait in the reception area and a nurse will speak with you shortly’. She then walked off to her desk to record my scan.

Devastated is only one part of what I felt. I also equally felt embarrassed, humiliated not to mention completely bewildered. I had three tests confirming I was pregnant, I’d had no bleeding, what was going on? I have never felt so vulnerable in my life up until this point. I put my clothes on as best I could and returned to the waiting room. I began scolding myself for ever believing I could have been pregnant, I started to tell myself that I must be so desperate to have a baby my body produced some kind of hormone and tricked all three tests. This sounds preposterous now but it felt very logical at the time. All of a sudden the tears came just to add to the feeling of utter humiliation.

After what felt like hours I was called back in with the nurse. I was not shown a picture of the scan. She explained to me that I had what was called a molar pregnancy and she was very clear that this pregnancy was not and would never be viable. I had no idea what she was talking about, I had heard of miscarriages, missed miscarriages, stillbirth but what on earth was a molar pregnancy? According to her it affects around 1 in 600 pregnancies every year and is a genetic abnormality caused by a faulty egg or two sperm fertilising one egg. To be honest the scientific mumbo jumbo isn’t important. The rest of the conversation I had with the nurse isn’t important, what is important however is that she was insistent that this pregnancy would never develop into a healthy baby. She did reassure me however that I could and would have lots of healthy babies in the future.

Speaking with a couple of friends who have experienced miscarriages I am aware that this seems to be a common phrase to say to women who have experienced or are experiencing the loss of a baby. I’m sure it comes from a good place; people want to reassure you that you will have a family in the future. Although this comes from a good place, here is how it sounds to the women who are going through a loss or how it at least sounded to me.

A life was created inside you and now it is dying or has died. There is nothing you can do to stop it and there is no reason why it has happened. You will have a baby in the future however and forget this one ever existed as you all walk off into the sunset to live happily ever after.  

Wherever you are with your grief the last thing you wish to be told is that you will one day move on. It made me feel dirty, how could I ever forget this tiny life? The first tiny life I created that was so cruelly taken away. For me (and maybe for other first time mums) it took away the wonderful feeling of excitement of finding out you’re pregnant, that no matter how many positive pregnancy tests you get from now on they would all be tainted by this loss.

After this devastating news I still had to walk home, collect my car and pick Husband up from work.

I still had to phone him and break the news to him, how was I going to tell him his baby wasn’t a baby? Even though I knew it was absurd I felt that in some way this was my fault, that I had raised his hopes of becoming a dad only to crush them. I think I phoned him and said ‘it’s not good news’. I can’t remember much else of what happened before getting home and I don’t want to. I do remember being at home sitting on Husband's knee crying my heart and soul out; I don’t think I have felt so awful emotionally in my entire life. The feeling of loss and disgust was indescribable. I felt disgusted and spooked by the idea that there was a strange cystic mass inside me.

Grief changes people, even if it’s only temporarily. I found myself having some very dark thoughts, mainly the thought of wanting rid of whatever was in my uterus. I actually prayed that I would start to bleed and miscarry, I prayed for it as hard as I had prayed to become pregnant.

Following my first scan I had several blood tests to check my hCG levels. One of these blood tests took place at that maternity unit. I sat and waited surrounded by bumps of varying sizes, watching mum and dads to be cooing over the scans of their babies whilst mine was dead or dieing. It was like the worst kind of torture I could imagine. The tests showed that my hCg levels were at a level for a normal pregnancy rather then higher then usual as was typical with a molar pregnancy. I was called back in for other scans which continued to show cysts inside my womb but also showed the firs signs of a developing baby.

 Over the next 4 weeksish I went through cycles of hope and despair, sometimes within 10 minutes of each other. I’m not sure they knew what was going on. In total I think we had 4 early scans, possibly 5. At the time it was like some strange torture but looking back now we had the privilege of seeing our little girl grow from the tiniest of specks into...well, a baby. At one point she looked like a pixelated black and white fried egg on the screen.

At around 6 or 7 weeks we went for a scan with a consultant. I was incredibly nervous. At previous scans we had been told that Alice was developing but there were also cysts in my uterus. It had pretty much ruled out a ‘full’ molar pregnancy but there was still a chance that it was a partial molar.

The scan with the consultant showed Alice was continuing to grow and develop despite the cysts still being there. It was also one of my most memorable scans as the consultant pointed to this tiny white flickering light and told us that it was Alice’s heartbeat. This tiny thing that looked like baked bean had a heartbeat, it was alive. Alice was alive! I have never felt so protective in my entire life. In my mind (although I know it wasn’t quite like this) Alice was fighting all the odds to survive. Her resilience gave me strength that no matter how painful it might prove to be I would not give up on her or the idea of her. I couldn’t believe that only 2 weeks before I had been explicitly told that this was not a viable pregnancy,it never would be and that a D&C would be arranged.

A scan at around 9 or 10 weeks showed that Alice was developing perfectly normally and the cysts had miraculously disappeared. To this day no one has been able to tell us what they were, to be honest I don’t think anyone cares which on the one hand is great but sometimes I think it is rather sad that we were put through such misery for nothing. The cystic structures did need investigating yes, but to inform a couple that the baby they want and already love is lost when there was in fact a chance this wasn’t the case is shocking. I don’t believe they listened to what I had to say about far along I was with my pregnancy, they didn’t entertain the idea that it might be far too early to see anything.

One of the best days ever! The first picture we ever got of our little girl.

Although this experience was a terrible one I did grow because of it and I learned a great deal along the way.

Professionals are human too, they are capable of error and a second opinion should be considered. There is a chance that you will remain disappointed but then nothing is lost. If you ignore your gut instinct and act without a second opinion you could lose everything including part of yourself.

We now call Alice our ‘impossible girl’ because it seems so unlikely that she should be here. I only ovulated on 2 other occasions that year. What were the chances that I ovulated on a day that did not fit in with any other cycle I’ve had before or since, that we just so happened to not use contraception in time to catch the egg, that this egg was then fertilised, implanted and we just so happen to find out early enough for me to start taking care of myself. If we had not gone to Urgent Care that night I would not have done another pregnancy test and we would not have discovered I was pregnant until a few months later when I had an ultrasound to find out why I wasn’t having periods (imagine how embarrassing that would have been!). On top of all of this what were the chances that I would be wrongly diagnosed with a molar pregnancy when there was at least some evidence to suggest this pregnancy would not be viable? Even after all of this the diagnosis turned out to be incorrect and we had a healthy low risk pregnancy ans we now have a healthy, happy nearly one year old.

Alice at 3 months old, her first Christmas. Here she is dreaming of Santa.

Yours sincerely, the Mum in you #3

Dear my angry anxious self,

Hello you.

It's been a while since we spoke.

I get the impression you're not listening to loved ones right now so thought I had better step in.

You are doing great.

Alice is a happy, curious, lively little girl. She didn't get that way by accident. 

She will be one in 2 weeks time and I know this is on your mind. People tell you not to let the events of a year ago cloud her first birthday which of course means you're focused on it more then ever. 

Don't let what happened during labour taint your relationship with Alice. Some women with similar experiences forever feel resentment towards their children and see them as indirectly responsible for their trauma. 
You don't.
You love her fiercely and she knows this.

You often focus on all the things you can't be for her, for husband or for yourself and this leaves you feeling sad and useless. 
Focus on all the things you are and can be right now, the rest will come in time. 

Time will forever move forward whether you like this or not. Things will change, Alice will grow and you will miss this if you continue to the way you are. One day you will look at her and think why the hell did I give a crap about all the other stuff? Why did I waste my time trying to get other stuff done or worrying about things that aren't as important?

Let Alice remind you of all the little joys in life. She is seeing all of this for the first time, it is all new and fantastic for her, let her teach you to see this too. 

And please talk. 

There are people waiting for you to let them in so do it. 

Yours sincerely, 

The Mum in you