Life After…Birth Trauma

Many of you will know the background to my and Hugo’s story. Hugo was born by emergency Caesarean section on February 20, 2014. The circumstances of his birth were hugely traumatic because it was literally a life-and-death situation.

The legacy of the trauma of Hugo’s birth has affected me ever since. Flashbacks, a feeling of disconnection, like I am telling a story about something that happened to another woman, not me.

For a long time I thought I was going completely forgotten. Then I was fortunate to find a wonderful community of peer supporters on Twitter, including lovely Laura. These women have had different experiences of pregnancy and birth, but shared very similar difficulties afterwards. It was incredibly reassuring for me to know that I was not alone in my feelings.

In a very strange coincidence, Laura’s son Arthur was born on the same day as Hugo. Fortunately Arthur is now a lively toddler, but his mummy still battles the effects of life after birth trauma, as she describes. I will pass you to Laura to tell her story…

_____________________________________

On 20th February 2014, my son, Arthur George, was born by emergency caesarean section. That much is definitely true.

Almost everything else is up for discussion.

I remember my labour beginning on the 16th. I believe I was told much later that my son was in the occiput posterior position, at an angle so that he was jammed and could not turn.

I laboured in a great deal of pain for days on end and reached 4cm dilation. During that time, I had two shots of pethidine.

Finally, exhausted, I had the epidural, which only worked partially, and the oxytocin drip, which then had to be increased.

My notes, which I have seen only briefly, record my heart rate at 180bpm consistently.

I pushed before I reached full dilation, because I couldn’t not push, then was given the go ahead to push and pushed for another four hours. Then there was a failed forceps delivery, during which I tore badly. Then the spinal block and caesarean, during which the incision tore open and I haemorrhaged, losing about a third of my blood. The transfusion I was promised never materialised. I went home five days later but was readmitted about a week after that with an infection.

To me, it is a familiar story, but it feels like it happened to somebody else.

Life now is certainly different. I am mummy to a lively little boy and I juggle the mundane – the nappies, the Weetabix dried to cement on my kitchen floor – and the profound – that love – much like other mummies up and down the country. It is relentless and I am tired, much like other mummies. 

Unlike other mummies, I carry a deep grief. I grieve for the months that I was on autopilot, consumed by my own trauma, unable to love. I see photographs of my son as a newborn and I do not recognise him. It feels as if I missed that time, as if I were somewhere else, and I can never get it back.

It is mingled with the grief of yearning for another baby and knowing that it would not be the right choice for our family. In my mind, Arthur has a little sister. I see her so clearly. I know her name. I even talk to her sometimes. And sometimes I like to pretend that she will one day be in my belly, then in my arms.

I know pain – physical pain – as a companion in a way that I could not have understood before. Pain was always a temporary inconvenience. Now it is normal, and it is likely to be normal for the rest of my life, so I have learned how to work with it. I can no longer go from lying to sitting in one movement. I roll on to my side to get up in the morning. There are some chairs that I cannot get out of gracefully. One adapts. None of these things are world-changers, and actually I am astonished at my body’s ability to piece itself back together. 

My mental health took a harder hit, I think, though I was nobody’s poster girl for mental health to begin with. This was, in a way, a blessing: when you are used to carrying a heavy load, a few extra pounds are perhaps easier than if you had never lifted anything before.

Still, I know the hypervigilance makes me a nightmare to live with: every moment is a crisis, an emergency, whether it’s something minor or something imaginary or even just a vague, gnawing unease. It is exhausting for me to be terrified so much of the time and it makes me irritable and stressful to be around. 

Then there are the flashbacks. They come without warning and you cannot prepare for them. Imagine having a time machine but the machine is control. It can transport you back whenever, wherever.

I appreciate that this sounds odd; I will give an example. One evening, a few days ago, I was in a rocking chair in my son’s bedroom, with my toddler dozing happily, sprawled across my lap. My body noticed before I did that I was thirsty. (Thirst is a huge trigger for me now, and it’s difficult in this hot weather.) I was tired, and I lay back for a moment. 

Suddenly I am so, so thirsty. The thirst is pain. I am on my back, unable to move. I have forgotten that I am having a baby. I have forgotten even who I am. All I know is the moment I am in, no context, no meaning. And the thirst. I am trying to speak, to ask for water, but there is no saliva in my mouth. Whenever I see a face, I try to plead for water with my eyes, but they don’t hear me. Then I see a face that I recognise – my husband – and he is holding a white plastic hospital cup of water. In that moment, he is Jesus Christ, Buddha and all four of the bloody Beatles rolled into one. He holds the cup to my lips – and it spills, soaking into my hospital gown. It is too awful. He is back, with a brightly-coloured plastic straw in a new cup of water. I manage the smallest sip before the next contraction consumes me and everything rolls away.

And then I am back and it is sixteen months later and the baby is here, grown tall and fair and fast asleep on me. I am in a warm, dimly lit room – his bedroom. I tell myself things – the date, my age – to remind me of the present. The past is gone. I am shaking a little, but it is time to put my little boy down in his cot, to go downstairs and tidy his toys, to eat dinner and live the rest of this day.

That’s all any of us can do, in the end. I call it ‘the assault of memory’, the way I relive parts of the labour, birth and postnatal period over and over. But I know that I am fortunate to be alive. I am so fortunate to have Arthur, who is everything and more. I hope that I can forge meaning from my birth experience and one day help others.

___________________________________________

If you are interested in maternity services, you may be interested in joining the Maternity Experience community.

Got a Life After…story to share? Get in touch – headspace-perspective@outlook.com

 

You Don’t Need A Mummy Tummy To Be A ‘Real’ Mummy

My son was born just over a year ago.

You might not believe that to look at me: I weigh a little less than before I was pregnant. To be honest, my tummy has never been flat, but it is flatter than before. My tummy is unadorned by stretch marks. My son was born via Caesarean section, and the scar (admired as being ‘beautiful’ by many a midwife and obstetrician) is neat, tidy and has faded so much it can barely be seen. My son guzzled up my breast milk, but my boobs are as full as they were pre-pregnancy.

According to articles such as this one, my post-pregnancy body is not ‘the real deal’. It implies I am not a ‘real mother’.

There really is little to envy about my post-pregnancy body. My tummy hasn’t really changed and has no stretch marks not because I was lucky to avoid them, and not because of lavish application of Bio Oil. My tummy hasn’t really changed because it didn’t get a chance to: I was pregnant for only 24 weeks.

My pregnancy came to an abrupt, traumatic end when I was diagnosed with the rare, life-threatening pregnancy complications HELLP syndrome and pre-eclampsia. My son Hugo was born by emergency Caesarean section. Sadly, Hugo was too small and premature, and died in my arms aged 35 days.

Me a few days after Hugo’s birth – bruised, no stretchmarks, but still a mum!

My boobs haven’t changed because while I expressed my breast milk for Hugo, he was so premature my body wasn’t quite ready, meaning the amount I was able to express was small.

I now weigh less than before I was pregnant because I am taking care of my body: having pre-eclampsia puts me at an increased risk of cardiovascular disease. I have had quite enough of illnesses and hospitals. However, in the months immediately after Hugo’s death I comfort ate my way through my body weight in cake and chocolate.

Hugo is my first and so far only child.

I am very much, emphatically, without doubt, still a mother. Anyone who dares suggest otherwise, for whatever reason will rather wish they had not.

Me and Hugo, aged about 4 weeks.

The body of the article itself is great. I understand that articles such as the one linked to above seek to reassure women that seeking to emulate celebrities who snap back into shape soon after giving birth to their children is unrealistic, and unnecessary. Post-pregnancy bodies are beautiful, and nothing to be ashamed of, whatever size they are. After all, that body has done something incredible: grown a brand new human being.

The headline: “The real shape of a mother: Flabby tummies and cellulite” is the problem. Yes, headlines need to be eye-catching but it’s another example of the importance of considering the impact words can have. The headline is no doubt well-intended, but carries the implication that mummies without flabby tummies and cellulite are less of a mother.

Ridiculous, I know. But there is so much pressure on women in general, and pregnant women in particular. Whether or not to have children; when to have them; how many to have; how you give birth (let’s not get started on those who think having a Caesarean section ‘isn’t really giving birth’), the type of pain relief you have in labour, breast or bottle, cloth nappies or disposable…the list is endless.

Every human being is different. We each have different interests, life goals, hair colour, height, weight, different looks…you get the idea. The main point is that we are all different. Diff-er-ent.

Judging someone because they have made a particular choice (or ignoring the fact they didn’t actually have a choice), or have a particular body type is absurd, and can be hurtful.

Why can’t we give other women a break for the choices the make (and the choices they are unable to make, decisions taken out of their hands)?

This is a debate I have been aware of for some time, and I was inspired to write this post because of being so cross after reading Budding Smiles’ post. I felt cross not because of anything Hannah had said, I hasten to add, but because she felt she had to write it, and wonder if her size 8 body and lack of stretchmarks meant she isn’t a ‘real mum’.

As Hannah rightly says, it needs to be okay to just be a mum. If you love a little human being with all your heart, you are a mother. You don’t need to have grown that little human being yourself, either – women who have adopted, or have their baby thanks to a surrogate are all mothers too.

Post-pregnancy photo galleries often feature an image of the woman while pregnant, and next to it the proud new mum holding her baby against her tummy. These compilations never feature mothers who have experienced a loss, as I discussed in this post.

Me at 20 weeks’ pregnant, and about 6 months after Hugo’s birth.

Let’s stop the judging, the labelling, the pigeonholing. Let’s instead reconsider the way we view motherhood, and what makes a mother.

Let’s support each other, send each other some love and support.

Let’s remember you don’t have to have a mummy tummy to be a mummy.

Let’s remember those who have lost a baby, at any stage of pregnancy or after: without a baby in your arms, you are most definitely a mummy.

No matter what your body looks like.

___________________________

For Your First Birthday, Hugo

My Darling Hugo,

Mummy and Daddy so wish you were with us tomorrow, so we could sing ‘Happy Birthday’ to you. We wish we had a mountain of presents to wrap, to add to the others you would get from friends and family. We wish we could watch you unwrap them all.

And ignore the toys to play with the paper and boxes, no doubt.

You made your very early arrival in the world a year ago tomorrow, Hugo. Your very early birth was something that none of us wanted. The doctors came to see me that morning. They told us that Mummy was very poorly, and that meant that you were very poorly, too. Mummy and Daddy sobbed and sobbed. We had hoped for more time, for you to grow bigger and stronger.

We knew that you would have to be born by an operation called a Caesarean section, where you would be cut out of my tummy. Mummy was so sick I had to be put to sleep for the operation. That meant I wouldn’t be able to see you be born. I so wanted to be able to cuddle you when you were born, look at you, marvel at you, get to know you with Daddy, but that was not going to be possible. I was going to be asleep, and Daddy wasn’t allowed in to the operating theatre.

I didn’t want to sign the form that meant they could do the operation for you to be born, but I didn’t have a choice, Hugo. If I had got poorlier I could have had seizures or a stroke which meant you would have died anyway, and I might have died too.

We were not sure if you would be born alive. Daddy and I were inconsolable. However, you were born fighting at 11.19am. I don’t know if you cried, but you were strong and feisty and the doctors were able to put a tube in you to help you breathe. You were put into an incubator. Daddy managed to catch a glimpse of you as you were whisked past to be taken to the neonatal unit.

Hugo, on the day he was born.

Daddy says that when I woke up he told me you had been born fighting, and I gave the biggest smile ever.

Mummy so wanted to be able to see you, Hugo, but I had to make do with photos. Mummy will always feel sad that I didn’t get to see you on the day you were born. I know why it wasn’t possible: you and I were both so poorly. It still makes me sad, though.

I still feel sad that I didn’t get to meet you until about 9pm the next day. We were kept apart from each other for too long. You needed me and I needed you. You needed to hear my voice, feel my touch. I wonder whether you wondered what on earth was going on. Suddenly taken out of your Mummy, wires put in to you, put into a plastic box, surrounded by voices you did not recognise. I’ll always be cross with the people who kept us apart. We can never get that precious time back.

Hugo, you brightened up our lives with your antics, your mischief, and your fighting spirit. Daddy and I did not know it was possible to love anyone so much.

We don’t know what we would be doing tomorrow if you were still with us, Hugo. Perhaps you would still be in hospital. Perhaps you would be home with us, but Mummy and Daddy wouldn’t be letting anyone come around in case they had yucky germs that could make you poorly.

Even better, if things were different you wouldn’t even be celebrating your birthday for a few months yet. We would be celebrating your first birthday in the sunshine of early summer. Or hiding inside while it rained. It is England, after all. We wouldn’t have minded though, Mummy and Daddy would have loved to have seen your face when you saw your presents.

We will miss seeing your face light up on all your birthdays, Hugo. We will miss seeing the joy on your face when you got the toy you had been asking for. We will miss organising parties for you and your friends.

We miss you, Hugo, so very much.

We know you are enjoying adventures in the stars, our precious Star Boy, but we wish you were having more earthly adventures down here, with us.

Tomorrow, we will be celebrating your arrival in the world. We will be celebrating the impact you have made to so many people’s lives.

So many people have taken you in to their hearts, Hugo. You were, are, and always will be a very special boy. Mummy and Daddy are so very proud of you.

We love you to the moon (which is made of cheese and you get to in a spaceship) and back a million times.

So many kisses, cuddles, stories and songs.

Mummy and Daddy xxxxxxxxxxxxxxxxxxxxxxxxxxx

Mummy, Daddy, Hugo – and lots of medical equipment.

 

 

Fighting the fear of pregnancy and birth

I always knew I wanted a baby, but for many years I had a fear about the whole process.

Everything I had seen and read about the process seemed like pregnancy and birth was scary. It’s not surprising, really, because everything I ‘knew’ about pregnancy and birth was gained from the media. Of course, nice stories about straightforward birth don’t make good telly or sell newspapers.

A few years ago I joined the NHS. I’m a communications person, and had the benefit of learning about all kinds of things. I was most fascinated about maternity, and got to know many professionals. I led health promotion campaigns about things like normalising birth and seeking to remove fear; getting new mums to feed back about their views about their experiences to make sure the service was the best it could be, and dispelling myths like women who have had a C section can’t try to have a vaginal birth for subsequent deliveries.

When a BBC TV crew were doing a programme about a young couple having a baby at the hospital I worked at, I sat in on all of the sessions to supervise them. The midwife was absolutely wonderful and explained the physiology of labour and birth. I was gripped.

I was in the delivery room for those long hours while the mother was labouring. It was such a privilege to be able to witness such a thing without being directly involved in the process. I could see that it hurt and that it was exhausting, but it was all calm and under control – no mean feat under the gaze of two television cameras. I was completely in awe of the midwife and of the labouring mum.

The labour seemed to be progressing quickly, and the baby’s head was crowning but it didn’t get any further. In the end, the baby was born by emergency C-section – the baby was back-to-back. I was so disappointed to not see the baby come into the world, but the main thing of course was that all was well for mum and baby.

So, when I got pregnant I was a card-carrying, t-shirt wearing, flag-waving member of the group that promotes pregnancy and birth as being perfectly natural, normal life events that are nothing to be scared of.

Me at 20 weeks

I thought I knew so much about pregnancy and birth. I thought I had read everything that was possible to read. I thought I knew all the risks of pregnancy and birth. I thought I had mitigated the risks by doing everything in my control, like eating well, exercising and going to my antenatal appointments.

I thought there was no such thing as a ‘normal’ birth, and was totally relaxed about a birth plan. I was relaxed in the knowledge that midwives and obstetricians know what they are doing and would do only interventions that were necessary for the safety of me and my baby.

Hugo

So when tragedy struck me and my baby in the form of two conditions: one I’d never heard of (HELLP Syndrome) and the other (preeclampsia) far earlier in my pregnancy than I thought possible it was like being mown down by a truck. All my choices were taken away from me in the situation that was literally life-and-death for me and my baby.

I have said this before, but it bears repeating: I am unlucky this happened to me, but I am lucky to have been caught in time by my midwife because I had absolutely no idea I was so ill, or what the dangers were to me or to my baby.

The women I know who have had HELLP syndrome had never heard of it before, either. They are as lucky as me to be here to tell the tale. Thankfully, it is rare. Thankfully, because of the excellent antenatal systems we have in place, most mothers do live to tell the tale and everything possible is done to help the babies.

Sadly, some women have died from HELLP syndrome and from preeclampsia. I am determined that no woman or baby should die because of a lack of knowledge or information about any of the risks that can happen in pregnancy, and how to recognise the signs and symptoms.

Organisations such as the MAMA Academy, which I am a proud ambassador for, and Count the Kicks seek to empower pregnant women by teaching them about positive pregnancy. Positive pregnancy and empowerment, to me, means knowing all the facts so you can face pregnancy and birth without fear, whenever possible – or at least be able to manage the fear. There needs to be a greater awareness and proliferation of the work of these organisations, and others who are doing similar work.

What happened to me was extraordinary, but I do still believe in pregnancy and birth as a natural process. I’m heartbroken to have lost my baby, Hugo. I’m also gutted that should I get pregnant again I will be high risk with bells on and unlikely ever to have the sort of straightforward pregnancy and birth I dreamed of. Helping other women and babies is a way through the heartbreak.

There are still so many myths perpetuated about pregnancy and birth. Yes, it can be risky, and yes, things can go wrong. Some women (like me) have enduring psychological problems relating to birth trauma and/or loss of a baby. There are too many interventions that are unnecessary, and I’ve heard anecdotally that some women hold a fear that will happen to them.

Me and Hugo

However, so many pregnancies end happily, and the proud new mum is able to take their beautiful new baby (or babies) home.

All women need to feel empowered during pregnancy and birth. They need to know the facts, the risks, how likely those risks are to happen and how to mitigate them. They need to feel in control of their own bodies and have enough information to make informed choices. Being pregnant can be a stressful and anxious time because you don’t want anything bad to happen, so there does need to be a fine balance with not frightening expectant mums.

So, what’s the answer? Well, if I knew I wouldn’t be sat in my dining room writing this blog. Instead, I would be sat sipping cocktails somewhere exotic because I would be very rich.

The media is unlikely to change its tune, and not every woman will be able to  witness a birth.

But – I’ve always believed that knowledge is power, and knowledge can help fight fear. Knowledge is about communication.

It can often be about managing expectations. So, the answers might include being open, honest, sharing our stories and experiences. Treating women as individuals, with their own hopes, fears and expectations. Being open about what we’re frightened about without fear of judgement, so we can be reassured. Celebrating the positive birth experiences. Telling providers about the bad ones, and the providers listening so they can make necessary changes. Improving the information that is available to pregnant women. Acknowledging that while choice during labour and delivery is the gold standard, not all women will be able to have a choice if something happens such as preeclampsia.

For me, the key words are information and communication.

I hope that when I am ready, I will have enough information about the facts and risks to face another pregnancy with a manageable amount of fear – and I have to acknowledge that having experienced a loss, a certain amount of fear will be inevitable.

What do you think the answers could be to fight the fear of pregnancy and birth?