Week 51 postpartum: PTSD and me

​After having some amazing comments about carrying on writing my blog last week, I felt it was only fair to share something I have found very difficult to talk about – and still do. I have been so honest about motherhood and all its ups and downs, it only seems right to be open about this – and I hope I can help other mums that might be going through the same thing. I was diagnosed with Post Traumatic Stress Disorder (PTSD) at the beginning of the year in connection with Rafe’s birth. I kept my feelings hidden for a while and I didn’t really know what was going on – but I knew something wasn’t quite right. I was experiencing flashbacks of certain traumatic parts of the birth and it was causing me to have what I can only describe as panic attacks. You would never know I was having them – I became very experienced in hiding them from my friends and family. But it was affecting my relationship with my husband – and that is why I reached out for help. I was so closed off and detached from him because of what I was going through – I couldn’t even bear to be hugged. I was referred to Obstetrics and Gynaecology Health Psychology Service and during my initial assessment, I had to do a number of questionnaires. On one of the questionnaires connected to the diagnosis of PTSD – I scored 50, the guideline for diagnosing PTSD was 33 and above. To start with and to an extent still, there was a huge feeling of shame and embarrassment. PTSD is something I am aware of due to the nature of my husband’s job. “All I did was give birth – I haven’t been to war,” was what kept circulating in my head. I didn’t know much at all about PTSD and birth and I have always been someone that has just kind of plodded on and got on with things so I felt frustrated I was 'stuck'. I couldn’t just ‘get over’ this. My psychologist put it well when she said because of my husband’s job, the PTSD bar was set quite high and that, along with my own self-judgement, was where this shame and embarrassment came from. That worry about what people would think and how I would be judged. “Her husband has done four operational tours and it’s HER that has PTSD.” Irrational maybe – but that’s how I felt. Also, so many women give birth, their experiences can be incredible – or so, so much worse than mine – why have I got PTSD? Why has this happened to me? Why is this affecting me so much? I kept comparing myself to others, like my trauma wasn’t worthy enough, but was reminded that everyone's own experience of trauma is incredibly different. And my psychologist reassured me when she said that I was not alone in suffering from birth trauma and reminded me that when giving birth, you are at your most vulnerable, you are in the worst pain of your life, your body is in flight or fight mode - and then to throw in a genuine fear for your baby's life, it was understandable why I felt traumatised. I had to write a trauma script (the part of my birth story I most struggled with) which was extremely difficult but shows where the trauma originated. It wasn’t the whole birth – just certain moments that seem to have had a huge impact on me, moments where I genuinely thought my baby’s life was in danger. I will share the script with you as it is hard to put into words really. If you have read my birth story (which I look at now and I think that was a PG version of what happened, although you can see the trauma sifting through a little) you will know I was blue lighted to another hospital as Rafe’s heartbeat was dropping (I planned to give birth in a midwife-led hospital). The flashbacks that have plagued me were all connected to the genuine feeling that Rafe was going to die. And I wouldn’t be taking him home with me. I haven’t even properly talked about this to my husband, family or friends as I just sometimes can’t seem to find the words – but I find it easier to write down. I thought if I had known more about birth trauma and read about someone’s experiences – that might have helped me, just to know I wasn’t alone. And I wouldn’t have felt so much shame and avoided getting help. So that’s why I’m sharing today. It's quite a big step for me to do this as I haven't openly talked about it in great detail to anyone and I must have changed my mind about sharing this a million times. Quite scary to share this to be honest! But I’ve been so honest about the exhaustion (HE IS STILL NOT SLEEPING), the nap obsession, the routine stress – the first gorgeous smiles and poo explosions – it didn’t feel right not to talk about this. Because it’s nothing to be ashamed of. Although giving birth is an incredible experience (minus the pooing yourself) - it’s a huge trauma on your body, you not only need to take time to heal physically, sometimes mentally too.

​My flashbacks started back in December last year and just seemed to come out of the blue. I don’t know whether Rafe being in hospital when he was 6-weeks old for bronchiolitis and finding out about the hole in his heart had maybe suppressed my feelings – or had triggered them. But they do say symptoms tend not to appear until after those first few months. Makes sense as you are pretty much in a fog of nappies and hormones and don’t really have time to think about much else other than baby. One of my flashbacks, although a less common flashback, was when Rafe was in hospital and they had to put a feeding tube down his throat which was difficult to watch as I just felt so helpless while he was crying. I don’t know whether that hospital stay, finding out about the hole in heart - on top of the birth trauma all just came together and collectively caused these feelings – or I was always going to struggle because of the birth. I guess I’ll never know. I always felt quite emotional about the birth and would often think, fuck that was scary, but the flashbacks and feelings of anxiety were on a different level a few months down the line. I don’t know if I would have ever actually reached out to get help if it wasn’t for my feelings towards my husband. As far as I was concerned, I was managing the flashbacks and I wasn’t depressed, I had no negative feelings towards Rafe – I was doing a pretty good job at this mum malarkey. But take away the genuine feelings of husband hate that I often joke about – and what we all have experienced! I felt detached emotionally from him and claustrophobic if he tried to touch me – I knew that wasn’t right. We have always been really affectionate so this was on the total other scale. And I’m aware that after you have a baby, weeks, months and months down the line, the majority of women aren’t like, you know what I really want to do right now? Have sex. Nope, we just want to sleep. And we couldn’t feel less sexy in our maternity bras and dry shampooed hair. But this ran deeper than the ‘norm’. And I felt quite angry a lot of the time - not at Rafe, just a feeling of anger and I didn't know why. So I spoke to my health visitor who referred me to my doctor and then eventually a phycologist. Both my health visitor and doctor queried Post Natal Depression but I just kept saying, “I’m not depressed”. “I don’t feel detached from Rafe”. It’s difficult as we are all quite rightly so, clued up on PND – just not all the other stuff to do with mental health and having a baby. So initially I just felt a mixture of – I don’t have PND so I must be fine – to what the fuck is actually wrong with me? ​

After I was told I had PTSD, I felt a huge wave of emotion as it was almost a relief that there was a ‘label’ on what I was feeling – but then all those other emotions came into play – shame, embarrassment, guilt. I had to write and then read my trauma script out during one of the first sessions and it was like the floodgates opened – it was hugely emotional as I had been suppressing a lot of those feelings for a long tine. Here it is (underneath the line, is what my psychologist and I wrote together in one of the follow-up sessions when Rafe was 8-months):
My waters broke in three separate gushes and I knew something had changed. My husband had to go and drop our dog off at a friends and I was alone in the house when they broke. I felt quite frightened. But then almost talked myself out of the fear and kept repeating everything would be okay. But the pain had gone from totally manageable to horrendous. We went back to Arbroath and the midwife who greeted me wanted to hold off until the midwife who had saw me earlier came back from a community visit. I remember standing in the corridor and having one of my contractions and the midwives looking at me as if to say: “yeah, she’s definitely in labour.” I was taken into a side room and while we were waiting for the other midwife to come back. However, she then saw me have a contraction and wanted to check me over herself. She checked my pulse at first and she kept checking it and checking it. She had an almost confused look on her face. I thought that maybe something was up but she wasn’t saying anything so I tried to stay calm. She then checked baby’s heart rate and immediately wanted me on the monitor. My heart rate was sky rocketing and the baby's heart rate began to dip. There were a couple more midwives in the room now. All of a sudden the baby's heart rate dropped to in the 70's and the midwife screamed out for someone else to come in the room and things started to get more frightening. When I say screamed – she screamed. “GET THE OXYGEN.” And she looked so panicked and frightened. Her face I can’t get out of my head – I can see it so vividly and I can hear that scream. I know health professionals are still human but you expect them to not show their fear or concern – to reassure you. But her fear made me realise something was seriously wrong. I was in so much pain and I felt totally out of control. I couldn’t control my pulse, my breathing, my body, my baby. I felt totally helpless. They shoved the oxygen mask on my face and told me to breathe and be calm, which felt impossible. They were trying to explain that baby’s heart rate was dipping really low and that I needed to be transferred to Ninewells hospital. I don’t remember whether I was saying this out loud but in my head I was saying: “please let my baby be okay, please.” I starting pushing and couldn’t stop and they kept shoving the oxygen mask over my face and the midwife was telling my husband he had to get to Ninewells now, again with such urgency and panic I just felt like I didn’t know what was going on. My husband looked so scared too but was holding it together. I didn’t want him to go. When he left the contractions got worse and they said I was five cms but I still kept wanting to push. They kept telling me not to but I literally could not stop myself from pushing. Everyone seemed so panicked around me and moving fast. When they checked me over I saw that there was blood/mucus discharge and they were unsure if the baby had poo’d inside me, which I knew meant he/she was distressed so I just felt so terrified. And alone. My husband had gone and I although I was left with midwives, I felt totally alone and scared – for my baby and for me. I thought something bad was going to happen to me – and even worse, to my baby. I had this image of me giving birth to a dead baby and I couldn’t get that out of my head but kept trying to tell myself it would be okay. But I felt like nobody could reassure me. The paramedics came and they strapped me into a stretcher which was horrendous. I just remember them looking at me as I was quite vocal about wanting to stand up and how much pain I was in and I felt so vulnerable. These two men were trying to help me but I was in my most vulnerable state and I had nobody there who I loved who could reassure me – and I just kept thinking that something serious was going to happen to my baby as his heart rate kept dipping. I was desperate to move during my contractions, so being strapped in made the pain seem unbearable. And I kept wanting to push. In the Ambulance, I kept saying, “why am I pushing?” The paramedic looked quite concerned as there was no way of monitoring the baby’s heart rate in the Ambulance, so I had no idea what was going on. I kept imagining being rushed into theatre – and giving birth to a dead baby. That image – and that midwives face screaming for the oxygen just haunts me. Absolutely haunts me. Because I felt that fear I had – was the fear she had on her face. Because nobody could tell me what was going on, because they did not know. My instincts knew something was wrong and the speed of everything meant I just couldn’t take anything in. I couldn’t breathe. Although the blue lights were on - it was still a good 20 minutes to Dundee and felt like the longest journey of my life. Between contractions I was trying to talk and be calm but I just wanted to see my husband. And for him to hold my hand and tell me that everything was going okay. His face when I was wheeled into the hospital is also a face I can’t forget. I can’t even put it into words how I felt at that time. So vulnerable, frightened, in the worst pain of my life, out of control and totally alone, with this overwhelming fear that this baby I had felt kick in my belly and had sang to every night and I had dreamed about and had spoken to and dreamt of that first smell, that first kiss was going to be placed in my arms – but I wouldn’t be able to take them home.

Can’t write anymore for now.
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Once we got to Ninewells and I recognised the midwife and saw Chris, I started to feel safe again. When the midwife confirmed I was full dilated, it validated what I knew and I felt relieved I could let my body do what it was trying to do and felt natural doing. I knew I was in the best place and I felt in calm, safe hands.

Now Rafe is nearly eight month’s old, he is happy, safe and healthy. I am safe and healthy but have found managing the impact of how absolutely terrifying labour was – not so much actually giving birth, but the emotions, the vulnerability and the fear of losing my baby that has come to take over any other emotions I may have had. I am working hard to validate and come to terms with how I felt. It is okay that I am feeling what I am feeling. I am human and it is entirely understandable. By showing myself compassion, I can begin to feel better and we can move forward as a family.

I must stress that in no way are my criticising the midwives - or hospital staff during my labour - they were all incredible. Superheroes. My psychologist said that if that midwife didn't have that fear - then maybe she wouldn't have reacted so quickly and did what she had to do. She also summed up my symptoms in a letter to my doctor: In terms of Faye’s mood, she told me she does not feel sad or depressed, but is aware she feels highly anxious a lot of the time. Faye describes regularly experiencing sudden waves of panic, feeling intense fear and as though she can’t breathe. Triggers to this can be external, for example a TV programme which reminds Faye of her birth experience, or internal, for example when a particular thought comes into her mind, again related to her birth experience. If Faye is alone with Rafe, she will manage by steadying her breathing and then grounding herself with a task in the house or with Rafe. However, if she is with anyone else she instinctively feels she must hide what is happening to her and puts significant pressure on herself to hold her panic in. In those moments, she is unable to communicate with others other than to snap at them if they ask her what is wrong and there is a sense she almost tries to hold her breath until the fear passes. It has been a significant step for Faye to access our service as she feels deep shame about her current difficulties. Faye has been someone who has always “coped” with life events and circumstances independently and had anticipated that birth would be no different. During labour she was overwhelmed with feelings of fear for her own and Rafe’s life and how out of control she felt and is now experiencing significant trauma symptoms.

Faye has managed her trauma symptoms by trying to keep a “tight hold” on all her emotion, fearing that if she were to let any of them out, she would “fall apart”. Faye has become incredibly skilled in this, to the extent that she can experience a panic attack in company and those around her would not be aware of the severity of her distress inside. An unintended consequence of this understandable emotion avoidance is the maintenance of trauma symptoms, as the difficult emotions and memories are unable to be processed. In order to keep such “tight” hold of her emotions, Faye has also become emotional distant to those around her, with the exception of Rafe. The magnitude of this task is meaning her emotions are then intermittently “busting out” as irritability with her husband, which is reinforcing the distance between them and a cycle of Faye feeling frightened and guilty to express what she is feeling inside and others now knowing how best to support her.”

I wasn't necessarily affected by my PTSD every second of the day. It just wasn't helped by the fact I kept suppressing my emotions and I did not want to deal with the flashbacks, the fear and the anxiety. The moments I did have these flashbacks, they were difficult and I felt incredibly anxious. I was an expert at just batting the feelings away. When I was with Rafe and my life with him, the day-to-day, was never affected by my panic attacks, I was able to carry on as 'normal' - it was more the detachment from other people, in particular my husband that was an obvious sign something was wrong. I think I was working so hard to keep the trauma in, I was unable to show any form of affection to my husband, to allow any type of intimacy. But looking back, especially I would say before I got help, so December/Jan, the beginning of the year in particular I was quite anxious in certain situations. And when I had these flashbacks or these feelings of anxiety, I would describe them as me being on the edge of emotion, tottering along, knowing something needed to give but not willing to let it.

One memorable and difficult panic attack happened when I was in the car with my husband on the way back from the cinema. Randomly – like a lot of my triggers, had been from a film. There was a scene where a young gorilla was basically watching his mum be killed and I was suddenly overwhelmed by my flashbacks. It could literally happen at the most random of times, over a TV programme, a film, a newspaper article, if Rafe was poorly - if I heard bad news - or just out of thin air sometimes. I can only describe the attack as like I was punching out of my body erratically but trying to keep it all in and not show I was in any distress. But these are few and far between now. I haven’t ever been able to read my trauma script again like I did that first time. However, we were able to break it down ​(I went every two weeks for a 50-minute session), talk about it, how I felt then, how I feel now, how Rafe is safe and along with cognitive behavioural therapy and me working hard to try and deal with the flashbacks through breathing, grounding – and not pushing them aside, the flashbacks are less frequent – and are more like emotional memories now. But the connection with my husband will still take time as I guess I’ve switched my emotions off – and need to re-connect again. (He has been INCREDIBLE through all this, so so supportive - it's obviously been really hard on him too). So it’s not like I’ve suddenly woke up after months of therapy and went WOW, EVERYTHING IS OKAY. It’s better. And I don’t feel so ashamed or guilty. And I never want to paint birth as always being this terrifying experience. Mine just went so far from what I imagined, from hypnobirthing/water birth to totally out of control and fear, that I don’t think all the calm breathing in the world would have helped me get over it. And the actual giving birth part isn't a traumatic memory for me (despite feeling like my vagina was on fire). It was just the bits in-between that have caused me distress.

Like I mentioned earlier, another thing I’ve struggled with is that I know people have went through worse trauma than me – and they haven’t got PTSD. Why me? Everything worked out okay. Rafe was classed as a ‘normal' delivery in the end. That’s where a lot the embarrassment and shame has come in – but shame is quite a common symptoms of PTSD too. So I'm learning to accept that it doesn’t make me weak for struggling. My feelings, the flashbacks, the trauma were out if my control, it’s just up to me to deal with them now. But I'm okay. And most importantly so is Rafe - I will forever be thankful for that.

I realise I have written a lot here – and maybe also glossed over it a little. But that’s what I wanted to tell you. It’s just hard to put it all into words. So if anyone wants to chat further, please just get in touch. I do think that birth trauma is something that needs to be talked about more. Sounds silly and naive for me to say this now, but I didn't even connect that you could suffer from PTSD from giving birth. I also wanted to reassure everyone that all my emotions I have been writing about since the birth – the husband hate, the nap obsessions, the exhaustion, the worrying about what the heck I'm doing – those have nothing to do with PTSD – I was always going to feel those normal feelings that come with being a mum! And I will keep writing about those exact feelings every week – (thank you for all your amazing comments on my blog last week, I felt hugely emotional knowing that my blog had reached so many people) and I still live in hope with you all that we will sleep again. And I will probably touch on the PTSD sometimes (I have been discharged from the Obstetrics and Gynaecology Health Psychology Service for now) – and like I said, if anyone wants to talk to me about it, please do get in touch. If you’re going through something similar – don’t be ashamed or scared – you’ll be okay. Just make sure you reach out and get the help you need. It can happen to anyone. It doesn’t make you a bad mum – or a bad person. There’s nothing wrong with asking for some help.

Thank you for reading.

Faye x

And to further end on a positive. Rafe after his first hair cut this week! How grown up?!