This is a long one so get a full cup of coffee first. I want to talk about my depression during pregnancy and my mental health issues following a traumatic delivery and I want to do it in one big post so I can get it all out and move on! (With lots of run-on sentences. And fragments.)
I haven’t written since June of 2016. That month, I found out I was pregnant (yay!) and felt miserably sick almost immediately (not yay). The nausea, exhaustion, and sudden weight gain (I started “showing” at 8 weeks) took a devastating toll on my mental health. The depression I thought I had figured out how to manage through life’s highs and lows left me unable to do simple tasks or enjoy anything. It was so, so scary. I should have just been happy to be pregnant, right? I should have been so excited to be carrying what I would find to be the most important part of my life, right?
The guilt I felt from being depressed and pregnant led to more depression; an endless cycle.
Although I talk a lot about how mental illness can happen to anyone and no matter what you do physically, sometimes your brain is wired for depression and anxiety, I thought FOR SURE that a healthy happy pregnancy was something I could control. I eat healthy and work out and take my Zoloft so I’ll be like a pregnant Wonder Woman, right?? Women who don’t eat right and work out while pregnant are just lazy, right?? Not even a little bit. I was so naïve to think that pregnancy and mental health were not entwined. What a humbling (and miserable) experience that was. A healthy, happy pregnancy is absolutely possible but if your hormones want you to shame spiral into a shitstorm of depression instead, that’s what’s going to happen regardless of whether or not you make it to morning spin class and eat gluten free crackers at 2am instead of cookies. When it came to mental health and pregnancy, even I had a lot to learn.
I started working from home and was in bed probably 20 hours a day. I increased my Zoloft dosage but went back to my regular amount as my due date got closer since it wasn’t making enough of a difference to me. (I slowly made changes to my dosage over time so that I didn’t “shock” my system, which can happen on Zoloft, and did all of this with my doctor’s supervision. Definitely a must anytime you are thinking about changing your antidepressant routine, but especially during pregnancy!) My doctor and I never felt concerned about me taking an anti-depressant while pregnant but a lot of other non-medical people did *eye roll*. Anyone who expressed concern about me taking an antidepressant while pregnant or asked me if I was going to stop taking it got the following response: “No, I hear you have to be alive to have a baby.” I lost the ability to censor myself when I was pregnant and am happy that I haven’t really gotten it back yet.
My biggest fear throughout my pregnancy was that the physical and mental changes were permanent and I would have to somehow raise a child while being miserably sick. I would often say to my husband (Jeff) “this can’t be right – we should have waited” or “it’s not fair that he will have a mom like me.” I knew Jeff was sad that we were not having a “fun” pregnancy and that created more guilt. I obsessed over having a natural delivery because I thought maybe pregnancy was so hard because it was like studying for a test – I can still pass with flying colors if I just am really good at taking the test, or in this case, delivering a baby. I practiced breathing techniques, I read my natural delivery book five times, and I watched videos of natural childbirth. Even though I knew how naïve I was about thinking I could control my pregnancy, I thought I could control my delivery. I did not prepare for alternative delivery methods. I got mad when people asked if I would have to have a C-section because the baby was too big. I am a person who talks about and manages mental illness all the time and I still could not recognize my obsession with natural delivery as coming from a bad mental place.
That’s how hard mental illness is – even those of us who are seemingly doing everything right to manage it and talk about it can fall victim to our brains.
My depression and my fear that my baby would grow up with a sick mom and my obsession with a natural delivery catapulted my anxiety to catastrophic levels as my due date got closer. A few weeks before my due date, I cried to Jeff that I could not shake the feeling that I was going to die in childbirth. I couldn’t see my future past this pregnancy because the version of me that I had come to know had completely disappeared. And you know what? My anxiety was right. Yes, really. After nine months of misery, I was not blessed with the wonderful natural delivery I had practiced for and thought I deserved. I did in fact face imminent death and needed urgent medical intervention to save my life. My anxiety creates a lot of bad in my life but at the end of my pregnancy it was one of a few key factors that saved me and the baby. It continued until my due date, Thursday, February 9, 2017, when I began itching uncontrollably over my entire body. I waited one miserable day and then called my doctor to tell her I could not stand the itching and everything I Googled about itching in late pregnancy was scaring the crap out of me. She ordered blood tests but said the results wouldn’t be in for a week and tried to reassure me that I had not shown any other signs of an unhealthy pregnancy. I went to bed Friday feeling miserable and sure I needed to have this baby ASAP. Saturday morning, after barely any sleep, I called again and begged to be induced. Anything to get rid of this itching! They agreed on the reasoning that I could have Cholestasis and the blood results wouldn’t come back in time for a safe delivery. I went into the hospital Saturday afternoon and my itching stopped almost immediately.
Trigger warning: This part of the story is hard to write and will be hard for some of you to read.
Between Saturday afternoon and Sunday night, while in the hospital, I had a placental abruption (placenta tore away from my uterine wall) and the trauma of the abruption triggered Disseminated Intravascular Coagulation (DIC). Basically, I needed an emergency C-section to get the baby out safely and my blood had no clotting factors left so it was a free-for-all in the bleeding department. Whatever higher power you believe in sent me a nurse who knew to check for DIC when she saw that I was bleeding from my epidural site and prepared the blood banks to replace what I would lose during the C-section. Not knowing what DIC meant or what we were in for, Jeff scrubbed up for surgery and I was wheeled back to the operating room. My poor mother, a nurse who understood exactly what DIC meant, watched in horror and disbelief. At 12:03am on Monday, February 13th, our baby Jake was born, perfectly healthy, weighing 8 lbs, 9 oz and 19.75 inches long. I heard his little pterodactyl cry (can’t really explain this one but that’s exactly what it sounded like) and then began struggling to breathe. As soon as I told the anesthesiologist what I was feeling, they made Jeff leave the room and placed a mask over my nose and mouth. Jeff saw the doctor holding my uterus in his hands and the last thing he heard as he left the room was the team saying they were trying to stop the bleeding.
Beside himself with fear, he walked into the lobby where my panicked family was waiting and they watched as staff ran by them from the stairwell (the elevators weren’t fast enough) carrying coolers of blood to me. In the hours that followed, my family learned that I was out of surgery but on life support. With Jeff so shaken up by what he had seen and so scared that he was now a single dad, my identical twin sister Sarah was the first person in my family to hold my son. Jeff knew how excited I was about skin-to-skin time right after Jake was born and spent hours with Jake on his chest while I was out. He even fed Jake for the first time from a little cup and changed his first of many diapers. He pushed Jake’s little bassinet into my hospital room so he could be near me and took picture after picture so I could see Jake’s first hours if I woke up. For the record, he would have been a great single dad.
About twelve hours after Jake was born, I woke up while on life support to see my dad’s scared face. The amount of fluid put into my body had caused my lungs to fill and go into respiratory failure. A ventilator was breathing for me, which was horrifying. I felt like I was suffocating. My hands were strapped to the hospital bed so I couldn’t instinctively pull out the ventilator. I prayed to God to let me fall back asleep until it was over. I woke up a few more times to my family talking to me, most memorably Sarah singing “You Are My Sunshine” and brushing my hair and Jeff asking me if I wanted to see pictures of Jake, to which I said no. I was in too much pain from feeling like I was suffocating to want to do anything but go back into the blackness until I could breathe on my own. The fact that I said no to seeing what my baby looked like haunts me to this day and probably always will, but I know I was in too much pain to fully comprehend his existence. That first breath after the ventilator was removed is what I think about now anytime I am stressed or scared or reliving my time in the hospital. It was amazing. My mantra is now “I can breathe. I am breathing.”
Jake knew me before I knew him. Jeff and the lactation consultants took turns bringing him to my room in the ICU while I was unconscious. Once I woke up, they even expressed colostrum from me since I was too groggy to nurse him. They were so determined to help me bond with him and knew I wanted to breastfeed so they didn’t give up. He drank my expressed breastmilk before I even remember being awake. I am so grateful to them and to my family for allowing me to breastfeed in my condition. My first real memory of nursing him is Jeff and my sister Carolyn trying to get Jake to latch, all three of us sweating from the effort (to be fair I was sweating from the medication and stress and couldn’t really move to help them, which is why they were sweating). From that point on, Jake and I have had an easy time with breastfeeding, which I truly believe is a gift given to us for all the trouble we went through.
I believe very strongly that I lived because my anxiety brought me to the hospital before the placental abruption occurred and a higher power brought me a nurse who saw DIC coming and prepared for the worst.
Recovering from Jake’s birth opened my eyes to a world of mental health concerns I had not experienced before. Every time a doctor walked into the hospital room I began shaking and crying uncontrollably, so afraid I would have to go back on life support. I didn’t want to see visitors and, worst of all by far, barely wanted to see Jake. The idea of taking care of him overwhelmed me in my scared, painful, drugged up state. In my mind, the fear I had for nine months of pregnancy that I would be too sick to take care of him had become a reality. For a week after I came home from the hospital, I woke up yelling for help after nightmares that I was still on the ventilator and strapped to the bed. Even now when Jake cries, I go back to how I felt in the hospital, unable to help him. I’m getting better at handling it (babies do cry) but I have spent a lot of time learning the signals he gives me before he starts crying so that I can avoid blowups.
Learning how to cope with this trauma is a whole new ballgame for me. Depression and anxiety I understand: constant, hovering, always needing to be managed. With post-traumatic stress, I’m still learning how to handle sudden changes in my mental state brought on by triggers. When I tried to go to a spinning class for the first time since Jake’s birth, I cried as soon as I clipped in to the bike. I couldn’t do it. That person who used to go to spinning three times a week died and this new person doesn’t know what she’s doing on this bike. I sold my favorite dress of all time: the Kate Spade Tiffany Blue Bow dress I wore to my bridal shower. In all fairness, it will never fit me again, but I sold it because I’m not sure I know the person who wore that dress. When I have a slight tickle in my throat or upset stomach I panic that I am not going to be able to take care of Jake. The other day I opened a file at work that I had last updated in April of 2016, when Jeff and I decided to have a baby. I was so, so sad thinking about how excited I was to try for a baby and how I had no idea what was to come.
There is a silver lining here. I think it’s because I was so miserable during pregnancy and because I am so grateful for every day I get to live and Jake and Jeff don’t have to go through life without me. Whatever the reason, I do not have postpartum depression. I am so, so lucky that any bad feeling that comes up is immediately relieved by holding Jake. He doesn’t sleep well at night because I held him all day for the first five months of his life before I went back to work. I need a reminder that he’s there at night so getting up with him does not bother me. I need him as much as he needs me. Holding him calms my anxiety and reminds me that I am okay. We lived. He has a mom. Jeff has a wife (not that he would have had a hard time finding another wife but I would have haunted her until she left and he was wife-less again). I cannot imagine the agony that is postpartum depression and I am so grateful that I did not have to experience it in addition to recovering from the trauma of childbirth.
I have a new appreciation for mental health issues surrounding pregnant women and new mothers. Holy shit have we all been through a lot. Even the easiest pregnancies and deliveries are still PREGNANCY and DELIVERY. There is a human in your body. There is a human COMING OUT OF YOUR BODY. Of course our hormones are making us miserable and we have a hard time recovering mentally. Paid maternity leave should start when you get pregnant and continue until the baby can walk. Or drive.
Now, more than ever, I realize the importance of supporting those with mental health issues and removing the stigma surrounding mental illness. The most important people in the world – moms – have a whole lot of mental health issues to deal with and should not have to spend even one second thinking they are alone. I am working every day to make peace with what happened and am so excited to get back to helping others. It is truly amazing how many people in this world are recovering from trauma, no matter how big or small. I am so grateful that I get to be here to talk about it with all of you.
Jake, 5 months old