Sunday, June 5, 2011

PTSD: my birth trauma

As many of you know (and many of you don't), I had a really traumatic birth experience when I had Henry (who at the time of writing this is just about to be seven months old so it's still fresh in my mind).

This was quite a shock to me because not only am I a planner (perhaps obsessively) but I am also very holistic and new-agey and tend to err on the side of being that annoying woman who skips asprin when she has a headache because I don't like chemicals in my body and yada yada yada.

Of course therefore I intended to have a medication-free, natural birth. I had the whole thing imagined in my mind: the would be lights dimmed, my soothing playlist would be singing from my iPhone, my husband would be massaging my back like we learned in childbirth class and a doctor would be there and he wouldn't be doing any kind of intervention whatsoever; in my mind he was basically just going to put out his hands and catch my perfect baby once I pushed him out easily and without smearing my eyeliner. And then we would wait for the cord to stop pulsating before cutting it, the baby would be placed on my stomach and he and I would gaze into each others' eyes and just have this beautiful sense of knowing recognition. There you are we would both think and it would be magical. And then I would nurse him and someone would take pictures that I would put in black and white and post on my blog and the whole thing would be just perfect.

Obviously that's not what happened. Not even a little bit.  Not even close.

I wrote a really long Birth Story but in case you are in the tl;dr crowd (too long; didn't read), i'll attempt to sum things up for you here in a shorter bullet format (though I warn you now, I'm not good at writing short accounts of anything):

- I was in false labor for 4 weeks before giving birth. I don't know if this has anything to do with my birth going down the way it did but it did set me up mentally to be in a bit of a negative place from the beginning. Being in false labor is like being in a tortured state of limbo. I scrawled out cryptically emo status updates on facebook. Things like, "I am forever in a waiting room."
It's just that false labor is tough: you have constant contractions that don't go anywhere and just when they start to formulate a pattern, they pitter out. And then every time the contractions start up again you get excited that something is going to happen and that this might be It...but it's not. It never is. and then you get upset and wonder why your body is doing this to you, what is wrong and how you can fix it.

- So this happened for four weeks and three days. And that sucked.

- When labor finally began for real it moved quickly and progressed easily. Things were going great. I was at 7 centimeters within about three hours and the pain was completely manageable.

- then transition came and something changed. Things started getting really, really, really, REALLY painful.

- did i mention it was really painful?

- Transition is supposed to be painful so I was expecting this. But then it stayed that way. And stayed. And stayed. And it hurt so bad. And I had basically stopped progressing. I stayed at about 8 centimeters for what felt like forever. I tried walking around but I almost threw up from the pain.  

- I also couldn't change position without crying because it hurt so much. Laying down was excruciating, moving from the bed to a chair was unbearable, being on all fours was a nightmare. The only position in which i was even somewhat okay was sitting up. And even then I was in searing pain. I just could somehow cope with it that way.  

- Seriously though, this labor pain was it was so bad that i quite literally could NOT prevent myself from screaming at the top of my lungs when a contraction would come. Like i wasn't yelling, i wasn't moaning, i wasn't calling out in pain, I was screaming. Screaming like someone was murdering me. The people who do the sound effects for horror films should have been there to record me, that's how big and bold these screams were.  And the worst part was that I could not control it. I couldn't. I just couldn't stop myself - I tried. I would apologize to my nurse in between contractions because i felt so awful and embarrassed for carrying on that way but i could not help it. I knew that all of the nurses in the hall were probably rolling their eyes at me: the Natural Birth lady who was screaming bloody murder and probably scaring their other patients.

- On top of this my contractions, the ones causing all the screaming, were doubled up. Apparently this means that I was having one right after the other. And I was having them every sixty seconds. That meant that there was one minute break in between them. So two contractions in a row for two minutes, one minute of rest. Lather, rinse, repeat.

- this went on for hours.

- I tried to figure out a way to describe the feeling of what was happening to me during these contractions because I had always wanted to know what contractions would feel like (and by the way, this is atypical, so don't be scared if there are any first-time moms reading this): it literally felt like what i would imagine it's like if someone were to snap my pelvic bones into pieces from the inside out. That's the closest description i can come up with. Bone snapping torture for two minutes in a row with a one minute break in between.

- Finally after two or three hours of this my resolve broke and i tearfully gave in. I asked for the epidural. (note: they tell women who want a natural birth that there will be a time in all births when you think you want the epidural and to come up with a "code word" to use to tell your husband/partner/support team member that you mean business. The rule is you only get the epidural if you say the code word otherwise you can say "give me drugs" all you want but you won't actually get any without uttering this magical phrase. The code word is the access key to the epidural. My code word was "Lord Voldemort" (i figured i should pick something no one wants to say for something i didn't want to do, right?) so when I started screaming "Lord Voldemort" through my contractions, my husband knew it was serious business lol).

- The epidural lady came and had me sign some papers. This wasn't easy but I did it after a few last harsh words to myself for giving up on my natural birth. "I just never expected this much pain" i said to try and justify it. At this point somehow no one had noticed that anything weird might be going on despite my insistence that i typically have a really high pain tolerance.

- She inserted the epidural and we waited.

- and waited...

- and waited.

- and nothing happened.

- oh and the worst part? I had to lay flat for 20 minutes. 20 minutes of sobbing because laying flat was the worst possible position for me. It hurt the most.  Laying down at all was excruciating. I remember thinking to myself, "I literally don't think I can survive another contraction like this....can people die from pain?"

- After 20 minutes was up, my nurse ran an ice cube up my legs to see if they were numb.

- i felt every single drop of that ice.

- the epidural failed to take. It failed completely.

- and so i soldiered on.

- Finally within about forty minutes I felt the overwhelming urge to push. I started yelling out to someone that I needed to push (because at this point in the game it's a NEED not a want. Your body just starts pushing whether you want it to or not). And a resident ran in to check me. "You have a little bit of a lip left. Don't push just yet." she said. riiiight like that's even remotely possible. (hint: it's not. your body pushes whether you tell it to stop or not).

- I tried not pushing for ten more minutes but it became impossible. "I have to push! i seriously have to!" i yelled. She checked me again. "Okay, the lip is gone, go ahead! you can push!"

- I was given brief instructions on how to push and away we went. I started to push, the resident put her hand in me during the push and suddenly her eyes got wide and she said, "STOP." she felt around for a moment and said, "Do NOT continue pushing." and got up and ran into the hallway.

- I panicked. Not only did my body want to push and I couldn't control it but something was obviously terribly wrong. A doctor came in with the resident, not my doctor, just whatever doctor was wandering by. Suddenly she was checking me. Her face registered concern and then she looked up at the nurses and other doctor and said, "Call the OR."

- She looked at me and said, "This baby is coming face first. You need to have a C-Section."

- There was chaos in the room, someone pulled my bed out from the wall, someone started to lean the headrest back. I screamed, "What? No! How?" and then i said, "I can't have a C-Section: the epidural didn't work!" She said, "I know, we're going to have to knock you out."

- this is where time paused and my brain broke a little bit. Knock me out? Sorry but did they not read my birth plan? That is the exact OPPOSITE of what I was ready for or able to process.  I had read horror stories about this kind of thing. I didn't want to miss my baby's birth, I didn't want him being unresponsive when he was born and full of those drugs. I didn't WANT to have surgery, i was terrified of surgery. What if they knocked me out but it didn't work just like the epidural didn't work? What if i felt them cutting into me?

- So then time unpaused and i said, "I want my doctor! Where is my doctor? I do NOT consent to this, I need another opinion. Oh my god, I want my doctor!"

- and i guess that was the daughter-of-a-lawyer in me screaming out these commands but I think that they heard the words "do not consent" and they sent someone looking for my doctor. The threat of law suit in the medical field is a huge thing.

- Within a minute my doctor was in the room and he was checking me (not very gently I might add but at that point who cares).

- "This baby is face first." He said and we all nodded, old news. "But she CAN deliver him safely. He's sunny-side up as well so he'll be fine...if he were face down, then we would need an emergency C-Section."

- At this moment, despite the pain i was in i managed to smile, "Thank God!" i said. and my bed was wheeled back and my feet were put back into stirrups and I was finally allowed to push.

- Slowly word spread of my face-first baby being delivered. Apparently this is very rare (only 0.4% of births are born this way, I googled it later) and since I was delivering in a teaching hospital, my room started filling up with people. Seriously there must have been 30 people present at the birth of my son.

- "His lips are being born first!" the doctor said. "This is so amazing, such a miracle!" and people leaned in and watched.

- After only 30 minutes of pushing (pushing felt amazing by the way, finally somewhere for all that pain to go), my little 7 pound 12 ounce baby was born. Henry Ryan entered the world.  And the room broke out in applause.

- but did i get to hold him? No. Did we make eye contact? Did he nurse? Did the cord pulsate? No, no, no. He was immediately taken away. He was suctioned to make sure he could breathe because his face was extensively bruised from being born face first.  He was wrapped in warmers and bright lights were shined all over him. I don't even know if he cried.

- He was taken to the NICU "just in case". I barely got to see him, my husband had to bring me a picture of him snapped over the shoulder of a doctor on his cell phone so i even knew what he looked like. And just like that he was gone from the room as if he had never even been there and I was immobilized on the bed being sewn up from my second degree tear. I wanted to get up and run down the hall after him. My baby, whisked away just like that.

- And then I was alone. My husband was with the baby, the nurse was getting some paperwork. The doctor had sewn me up and my room had emptied out. I was alone. My body was physically shaking, my emotional state was shaken and I was stunned and dazed. The baby who had been literally a part of my body just minutes before was gone and I was alone.

Since my birth I have had several flashbacks to it. For hours after giving birth whenever I would feel a cramp as my uterus shrunk back to size I would start to cry a little bit in anticipation of the horrifying pain of a contraction. My whole body would tense up, I would cringe in fear of it happening again and I would wait for the crippling pain to come over me. Of course it didn't, the birth was over and I wasn't having contractions anymore. My logical mind knew that but my body and my emotions didn't and those parts of me were afraid.

Speaking with my nurse and googling things later taught me that this kind of birth is probably one of the most painful experiences you can go through. A baby being sunny-side-up is more painful than a baby who is positioned correctly. A baby being sunny-side-up AND face first is even worse. In fact, it's probably THE worst. This was bad, really, really bad.

Not only that but I felt like I couldn't trust anything anymore:

I couldn't trust myself because my body had abandoned me during the birth, it had turned on me. Not only had it lied to me during my four weeks of pre-labor but I couldn't control the pain, I couldn't get through it. My entire life I have had a mantra during painful situations that goes "the mind has control over the body" and it has gotten me through the terrible stomach aches that plagued me as a child, the migraines and back pains as an adult and whatever illnesses i've also encountered along the way. That mantra had been, up until this point, flawless. But when I tried saying it through this experience nothing happened. Nothing. I was still in pain, i couldn't make it go away and not only that I couldn't even stop myself from screaming. I had no control over it whatsoever. None. And that felt like a betrayal.

I also couldn't trust the hospital: my epidural had failed. After all that. It had failed. Just when I finally gave in and admitted defeat relief didn't come to me.

I had made all of these careful plans, I had researched every, single, little thing and nothing had happened the way I thought it would and that really and truly threw me for a loop. I guess I had thought that if I informed myself of everything, if I planned for the most natural and healthy thing I could and if I was diligent enough that I could make sure everything went well, that everything would be okay. How wrong I was.

But being wrong in this situation really did a number on me.

I had nightmares about my birth for weeks. I cried about it all the time. When I would try to fall asleep at night I would remember that woman doctor saying, "we're going to knock you out" and fear would surge through me again as I envisioned it happening.

Lucky for me I have a network of great friends and they all told me the same thing when I would talk about this: GO GET SOME HELP.

And so I did. At only 10 weeks post partum, I started seeing a therapist.

After our first meeting she said, "You absolutely have Post Traumatic Stress Disorder from this birth." and then she told me it was going to be okay and we would get through it.

We talked. We talked a lot. She told me to talk even more with my husband about it. She told me to write about it and talk with myself.

So I did. And slowly my perceptions began to change.

I said to my husband, "I feel betrayed by my body...I couldn't stop screaming even when I wanted to." and he said, "What if that's not your body betraying you but your body helping you? What if that was exactly what your body needed at that moment? What if that was the best thing you could do for yourself in that moment?"

I hadn't thought of it that way.

I talked to myself and I realized that I had been so afraid of my birth that I had tried to plan the whole thing out and remove every single unknown factor so I could have control over it. Unfortunately though you can't have control over everything in life. You don't get to control how someone is born. Just like I couldn't stop the false labor on my own terms, I couldn't choose how Henry was born either - HE got to decide both of those things all on his own.

I talked to my therapist: i said, "I feel like I let myself down." she said, "are you kidding? you stood up for yourself! you wouldn't let them wheel you into the OR. Do you know how brave you had to be to stop them from taking you in? to demand a second opinion at that moment? You didn't let yourself down, you stood up for yourself."

I slowly pulled myself out of the fear of it, I slowly moved away from the trauma.

And the point of me telling you all of this is to say: you CAN have control. No, not over the experience itself but over how YOU see it retrospectively. 

There is a LOT of power in looking back on a situation and reframing it. There is a lot of growth to be found in the dissection of trauma and the desire to view it with new eyes and a true wish to move on. I looked back on my birth over and over again and realized that I was there for myself that day, that i did cope with things to the best of my ability at the time, that i was an advocate for myself and for my baby and that even though a lot of things happened that were completely outside of my control I was always there making the best choices I could with the information I had for myself and for Henry.

I'm proud of myself for that.

Even if I had gone through with the C-Section, I would have been proud of myself then too. And even if the epidural had worked I would be proud of that as well.

The point here isn't that natural birth is superior or that c-sections are bad or anything else. If you take either of those messages from this than you're really missing what I'm saying. My whole entire point here is that it is overwhelming and scary when the birth experience you wanted fails and when the rug of it all gets ripped out from underneath you. It is horrible to go through a traumatic birth and it can scar you for a long, long time. Emotional scars like this aren't visible, they lurk around in your brain and come up again and again when you least expect it but they are real and they are strong and they an hurt.

BUT there is a release from it. There CAN be salvation from those scars! That's the point here - you don't have to have those flashbacks, you don't have to relive those moments, you don't have to be afraid of that pain anymore. You really, really don't.

There is personal power to be gained from reframing a traumatic birth. There is empowerment and courage and appreciation and a greater sense of self to be had from seeking out a therapist and talking about what happened.

Birth Trauma is a real thing, don't let anyone minimize it or tell you that it isn't. If you've had a traumatic birth and if it weighs on you and causes you fear and heartache, you are going through something very real and it deserves attention just like any other kind of trauma. It is something that not only deserves being addressed but it is something that you MUST address in order to be well. You can get past it, you just have to put in a little work. 

Birth Trauma is not a joke, it's not silly and it's not something you should disregard if it has happened to you. Post Traumatic Stress Disorder can happen to anyone who has undergone a scary event that causes injury or the threat of injury to your person. It's terrifying and it's real and it deserves attention. Don't leave this untreated if you are going through it because you can get past it and you can find power in the experience, even if it seems hopeless.

I thought that my birth was horrible. I thought that something had happened TO me and that I would never get over it. I thought that this birth ended my dreams of having a large family and more pregnancies in the future.

Now I know that I can trust myself, that if and when I do have another baby that i CAN get through it - even if (GOD FORBID) the same thing happens again, I will be okay, no matter what the outcome because I will be there for myself in whatever way i need to be - even if that way isn't something I can predict. Now I know that I can relinquish control and trust the process a little bit more. Things will work out alright in the end if I just have a little bit of faith and if I realize that I will always have my own back.

Now I know to look at the positives in situations, to see what's being done FOR me instead of what's being done TO me.

Now I know that there is power to be had even in the most frightening of experiences. Empowerment is always there to be seized, even if we don't see it at first. And now I know how to give myself credit for it when i do reach out and take that power (like by demanding to see my doctor for example) instead of just feeling sorry for myself and letting the fear overrun me.

Everything that happens in life is up for interpretation. I choose to look back on the birth of my child and to see it as a gift, as a miracle and as a place where I got to really learn just how much I can take and just how much I can do. I am proud of myself and I won't let it get me down anymore.

You can do that too. Don't be afraid. Don't let your past dictate your future.

If you've had a traumatic birth it's never too late to talk to someone and to reframe it and to get the fear out. That fear is ruling your life and scarring your interactions. Find someone and get to work on yourself because chances are that you are doing much better than you give yourself credit for.

For help locating a trauma therapist in the U.S., treatment center, or support group in your area, contact the Sidran Traumatic Stress Institute by email or by phone at (410) 825-8888 ext. 203.


Victoria said...

I love this paragraph from your therapist:

"I talked to my therapist: i said, "I feel like I let myself down." she said, "are you kidding? you stood up for yourself! you wouldn't let them wheel you into the OR. Do you know how brave you had to be to stop them from taking you in? to demand a second opinion at that moment? You didn't let yourself down, you stood up for yourself."

Because that is EXACTLY what I was thinking while reading this. You should be so proud of your knowledge, level headness and research during and prior your traumatic birth. So many mothers do not inform themselves about what labor entails, your options, what can happen, what can't etc. Your knowledge was your power and you didn't just give in to the staff, you took what control you did and avoided major surgery! I'm not knocking c-sections (I had one after all!) but if you plan to have more children it is so much safer for mother and baby not to have cuts and scar tissue on your uterus. I'm proud of you for pushing through it and doing whatever you could to just survive. YOU DID IT! You suffered through something horrific but you came out on the other side and have become that lovely mother/son image you conjured up in the beginning of this post. I see the pictures of you and Henry staring lovingly at each other, you have that now and I'm so happy for you <3

Raquel said...

Rhian, this post is amazing. You are so brave and wise to share this experience with others and help them learn through your experience. I'm really glad that you took what happened to you seriously and went to seek help, because it truly seems like it helped you turn a hellish memory around into a learning experience. Asking for help isn't a sign of weakness; it's a sign of love and respect for yourself because you know that with some guidance, you can get through the pain and come out on the other end stronger and wiser. Thank you for being so honest and amazing! XOXO

FrumLady said...

Sounds like you may have Postpartum Depression. You are super hung up on the "trauma" of having successfully had a healthy baby. The only trauma here that I can see you suffered from was not having your "birth" your way. The dream didn't come true. That is silly you know.Grow up.

Rhian said...

Isn't it fun when trolls come give you feedback on things they don't understand?

Thanks for not leaving a link or real name "frumlady", however I was diagnosed with PTSD from a specialist and he is the one who empowered me to call it like it really was: a traumatic birth. If you haven't gone through the physical agony of something like this not the emotional turmoil of your body betraying you than maybe that's why you don't "get" it and in a way, I'm happy for you for that. However you should never call anyone else's emotional experience silly or say to them to just "grow up". I am grown up and I have grown up which is why I'm strong enough to share this story and to heal myself. Whoever treated you the way that you are now treating me and probably many others was wrong and shouldn't have diminished your feelings that way. It doesn't make it okay for you to go around doing the same thing however. You must at some point become the kind of person who is just that: kind.

Good luck in the future but please refrain from trolling my blog. This story has helped many people, I get emails about it regularly. That says something in and of itself.

Anonymous said...

I enjoyed reading this. I think it was smart and self aware to go and find help so that you could, as you say, reframe the experience. I am working on that myself - so I found this a good reminder and even inspiring. Thank you for sharing. My guess is that frumlady did not read to the end and find that you were good at showing the trauma you felt in the moment and then later - how you have worked to move past that. Happy New Year :)

thalidomide birth defects said...

You are very brave. You've been through a lot, and I think you just need you just need to take it slow.

Mama 'beetus said...

I so appreciate you sharing this. I have been processing my own birth trauma on my blog, and shared this post and some of what you said. I really appreciated your comment on empowerment being available no matter what. Thank you.

birth injuries said...

"Don't let your past dictate your future" - I love that .

Ghostwritermummy said...

How wonderful that you had such a supportive network, who understood what you had been through and urged you to get help. Even better, how fantastic that your PTSD was recognised. After my son was born (under GA) I was in pieces but everyone around me pretty much told me to get over myself. Two years on and I still have flashbacks and nightmares, and that's after going on to have another baby. I cannot let go of what happened with my son and I am trying desperately to raise awareness of birth trauma in the UK. Thanks for your post. I'm sorry you had to experience this but I'm thankful you were able to share your story. Its so good to know I am not alone.

Lauren said...

Thanks for sharing your story. I also was diagnosed with PTSD postpartum due to a traumatic birth. You can check out my story on my blog, I think it is wonderful to be spreading the word. Too often, women are misdiagnosed, or even afraid to seek help because our society often stigmatizes things that they don't understand. I look forward to following your blog.

Giana Forzareli said...

I would love to see the perfect world that "frumlady" live in. Birth injuries and trauma are no joke. I am a psychology grad, and I have been known to make assumptions from time to time, but I would never attack a persons emotional stability when it comes to birth. She probably read a paragraph on postpartum depression and now she thinks she is a expert on the subject. Don't listen to her. Keep your head up, it looks like you are getting happier by the day.

hopeofdreams said...

I had a very similar birth experience with my daughter. Face first presentation, almost a c section. The only reason I did not have one is that I worked for months to ensure a natural childbirth. I went 29 hours without an epidural for a 31 hour labor. I really didn't want the epidural, but my midwife was afraid of an emergency c section, and needed to help the baby move from a brow first presentation to a face first. She was so nice that she wouldn't have been able to cause me the pain. Thank God the epi took for me.

I have PTSD symptoms too. I am unable to fall asleep most nights. I have nightmares about my baby being disformed. I have flash backs. I am 3 months post partum and haven't been able to bring myself to get help.

We did not have a csection, which was important. We don't use birth control, and I could get pregnant again at anytime. I want a large family, but I'm afraid of the impact this birth will have on my next ones.

Anonymous said...

I find you very brave to come out on the other end, I too have been told I have maybe got PTSD, it's been 5 years since I gave birth to my beautiful little girl !!! I had a horrific birth ,I knew something was wrong when all the doctors came in with a scan to delivery room then was giving a emergency C section that went awfully wrong the epidural didn't work I screamed out feeling the cutting, the burning of my skin !! Feeling like my insides were been ripped out of me, when they realised I could feel and it was not the pulling and tugging I was too scared to be put out I felt I would die, I have flashbacks, nightmares , I could not bond with my little girl for months, I have never truly felt myself since the birth !! I see someone a therapist we are starting edmr soon, my little girl has learning difficulties too which I wonder is it fom the traumatic birth that I can never know

birth injury lawyer said...

I just wish you all the best. having birth trauma is never easy and I salute you for being so brave about what had happened. Keep blogging and keep inspiring.