Kaya ngang doorabiny noonook djinining
I would like to acknowledge that I am telling this story while sitting on Wardandi Boodjar and pay my respects to the Noongar people and their elders past, present and emerging.
I would also like to acknowledge my privilege in being able to share my story with you. I am a white, educated, financially secure woman with very good health literacy. My story is one of billions of women’s and mothers’ stories worldwide. We must hear more stories from women about their experiences and importantly more stories from Aboriginal women, CALD women, women living with disabilities and gender diverse people. We need to consider how we make space for these women to share their stories and give women options so that they feel safe to share their stories. I can tell you it is incredibly intimidating to share my story and to speak about it in front of other people. I can’t imagine how much more difficult this would be if you are a minority and have experienced additional past traumas in your life.
My daughter was born in mid-2018. I did everything I could to prepare for her birth. I was working full time in a busy job as a health manager while I was pregnant but I made time for yoga, plenty of exercise and I made sure I ate well. I went to a Calm Birth course in Perth with my partner, I went to a sleep workshop, I attended an Australian Breastfeeding Association meeting, I read books, I participated in the Midwifery Group Practice (MGP) program, I saw my GP regularly, I organised a birthing pool and a playlist. I had a detailed birth plan but I was prepared for if things didn’t go to plan.
When I was about 37 weeks pregnant and on Maternity Leave, I went to the Lions Shed auction and out of thousands of books to read I picked one called Fractured. It was about post-natal psychosis. I had never heard of it before. I said to my partner – this sounds absolutely awful I didn’t know this could happen. Look out for any of these signs in me. Little did I know what was to come.
At 40.5 weeks I went into labour at 3am. The contractions were mild at first and we waited at home. In the early afternoon we went to hospital. My two MGP midwives and my GP weren’t on shift so I had staff I hadn’t met before. I laboured all afternoon in the birthing pool, but my labour had failed to progress so they gave me morphine so I could rest overnight. That night my waters broke, and I developed eclampsia – I needed to be monitored and I didn’t get much sleep. The next morning, I was induced. It was too uncomfortable to sit or lie down so I spent the whole day on my feet. By the late afternoon I still hadn’t progressed, and I was exhausted, so I had an emergency caesarean.
In recovery I went into shock – I was shaking so hard the young inexperienced nurse couldn’t take my blood pressure – but she kept trying until my arm turned blue and I told her she had to stop. I didn’t sleep much that night. I was in hospital for six days as they couldn’t get my blood pressure under control.
Pressure is on
My partner went back to work. I am not sure exactly the order of events over the next week. A couple of days after I was discharged, I went to the Pharmacy with a friend. I knew something was very wrong. At the Pharmacy I cried and said I think something is not right with this medication I am taking. My blood pressure was still sky high. He sent me back to my GP. Somewhere in this week I also saw my Child Health Nurse for the first time. I was barely getting any sleep but I had so much energy. I would get up in the morning and tell my baby today is going to be a great day. I am normally a very conservative spender, but I bought a whole bunch of clothes that didn’t even fit. I was talking very fast, I bought donuts when I normally am very conscious about eating unhealthy food. I started wearing makeup and doing my hair everyday even though normally I rarely wear makeup.
I went and saw my GP again. When I walked in, I said, “Doctor, I think I am developing symptoms of post-natal psychosis.” He said, “Thank goodness you said that. I think you may be too, and my hardest job today was going to be to tell you that.” He referred me to a Psychiatrist at Community Mental Health. The Psychiatrist diagnosed me with an acute stress reaction and sent me home on Seroquel. The MGP midwives kept visiting. My partner and Mum told them how concerned they were on the Friday and that weekend they arrange for me to go to the Mother-Baby Init at Fiona Stanley Hospital in Perth.
Being admitted to a Mental Health Facility when you have never had a mental health problem before is quite confronting. They didn’t tell me their standard process was to monitor women 24/7 when they were admitted until they had had an assessment. Until I went to bed that night, they set up a nurse in a chair less than two metres from my bed which was extremely distressing to me. The complete loss of dignity, the shame of needing to be admitted, not being able to care adequately for my baby and now needing to be watched all night while I slept. Despite my admission experience the Mother-Baby Unit was amazing. I had a very medicalised post-natal recovery – I was still very physically unwell – they thought I had a PE (Pulmonary embolism). I has chest x-rays, CT scans and more blood tests than I can count. I started on Risperidone and Ativan. Luckily in three to four, days my symptoms had largely resolved and after two weeks I could go home.
We went to a friend’s wedding in Vanuatu when our baby was three months old. This is when my anxiety started to increase. At the same time, we were looking to buy a bigger house and we put an offer in. Initially I was on board with the house we chose but then I began to feel we had made the wrong decision and I began to get very distressed and extremely anxious. I continued to have anxiety and depression over the next 12 months. The stress related to buying a house and moving meant that, even though our daughter was sleeping well, I had a lot of difficulty sleeping. I saw a Psychologist, I went to mums and bubs yoga, I went to mothers’ group and play groups, I took my daughter to swimming lessons. I slowly started to feel better.
When our daughter was 18 months, I decided I wanted to start trying to come off my medication. I had already stopped taking Ativan. With my Psychiatrist’s help I weaned off Sodium Valporate with no problem. Then I started weaning off Risperidone. This was extremely difficult because even reducing the dose led to an increase in anxiety and insomnia. Combined with COVID and work-related stress this meant that I got very little sleep in 2020 despite the fact our daughter was sleeping through the night, which was very frustrating. My doctor prescribed Melatonin and I weaned very slowly but there wasn’t a lot of help to come off the medication. It was only because I was determined to be medication free. and I kept telling myself that the withdrawal symptoms would subside, that I succeeded.
After 2.5 years I am in a good place. I feel back to my old self, I am sleeping well, I am not experiencing anxiety or depression and I have been medication free for a year. I am back at work part time in a management role, I am playing hockey and I can run 5 kilometres. I have lots of friends and I am really enjoying being a mum and spending time with my beautiful daughter.
I still feel sad and guilty that I wasn’t as present for my baby in the first few weeks as I feel I should have been. This experience knocked my confidence as a mother, my personal confidence and my professional confidence. It was very hard going back to work and it took a long time to build my confidence again. I always saw myself as a highly competent resilient person, this experience challenged me and made me question everything that I thought I knew about myself. It took me a while to accept my diagnosis and that what happened to me wasn’t my fault.
I’d like to tell other women experiencing post-natal mental health difficulties that you are not alone and it is not your fault. Do whatever you can to access help, try to get specialised professional help when you can and build a support network as much as possible.
My Birth Story – Second Time Around
This is a story about achieving an amazing natural vaginal birth after caesarean (VBAC) against all odds. I am 37 years old with two children aged 3.5 years and newborn.
The birth of my first daughter and subsequent postnatal period 3.5 years ago was traumatic. It involved spontaneous labour at 40 week + five days, pre-eclampsia in labour, failure to progress, continuous monitoring, induction with syntocin and ended in non-elective caesarean 33 hours after labour commenced.
Needless to say, it took us a while to decide to try for a second child and we consulted an obstetrician prenatally to discuss risks and prevention. In April 2021 I fell pregnant with our second. I immediately thought I would like to try for a VBAC. I saw my GP/Obstetrician at ten weeks and the first thing he said to me was, “Please tell me you are going to have a caesarean.” I immediately responded that I had already discussed delivery options including VBAC with an obstetrician. But this comment played on my mind the whole pregnancy.
That evening (38+1) I went to the toilet, when I stood up, I felt a trickle down both legs and was pretty sure it was amniotic fluid. Half an hour later I had my show. I rang the hospital to let them know, told my partner, and went to bed. The surges quickly started to increase. I got a heat pack, put the tens machine on and downloaded the Freya app to time my surges. Within a couple hours the app was telling me I was in established labour. My 3-year-old woke up at 2.30am, my partner settled her and then I called him in and said I think we need to get ready to go to the hospital. He got the hospital bag and everything we needed, and then had to go next door to get our neighbour to come over to sit with our daughter and my parents started driving up from where they live one hour away.
At approximately 7.30am the OBS registrar came in and asked if they could look at doing a VE soon and a cannula. I said do the VE now and then we can talk about the cannula later. I was fully dilated! I got on all fours over the back of the bed and started pushing. After approx. 25 minutes of pushing my daughter was born in a huge rush, so quickly that the midwife couldn’t catch her. She came out screaming! I was able to reach between my legs and bring her up to my chest. We enjoyed 1.5 hours of uninterrupted skin to skin, immediate breastfeeding, and delayed cord clamping. I had the injection to deliver my placenta. They had a bit of trouble getting it out, but it came out intact and I was able to get stitches for a small second-degree tear in the birth suite using the gas for pain relief. After some breakfast and a shower, I was on the ward by 11am and we were discharged the next day (baby had low blood glucose due to Gestational Diabetes so we needed to stay 24 hours).
Baby Alice Matilda was born at 8.45am 12/1/2022, 2.98kg, 51cm. My VBAC experience really couldn’t have been any better it was so magical and such an amazing empowering and healing experience.
The things that helped me were counselling, positive birth program, daily affirmations, swimming, TENS, heat packs, the Freya app, supportive midwives, reading lots and lots of positive VBAC stories and talking to friends who had had positive VBAC experiences. I was alternating between going for an elective caesarean or VBAC throughout my pregnancy and in the end, I just decided that I would go for the VBAC and really believed that I could make it happen. My experience second time round is the polar opposite from my first birth and 11 days later I feel amazing!