MY EXPERIENCE OF PND AND POSTNATAL ANXIETY – RACHEL HAWKINS - PANDAS Foundation UK

Before I begin, I want to make it clear, this blog is not another ‘Mum blog’, there’s plenty of decent ones out there and it’s not my style.  We all know the trials and tribulations of parenting, the funny stories (my son threw his dirty nappy across the room last week) and the tough days that almost leave us mentally scarred and grabbing for the wine.

This post, is for me to discuss my experience in the first days and weeks after giving birth and how in my opinion, more needs to be done to prepare women for the emotional and mental difficulties many new mums experience when they’ve had a baby.  I really feel we could do more.

Looking back to my pregnancy, I can’t recall ever discussing the emotional and mental turmoil you can experience after giving birth.  My pregnancy was a consultant led pregnancy as I’m a haemophilia carrier, so all attention was focussed around the implications for my baby, should he be a sufferer and the birth plan, as I had elected for a caesarean section for medical reasons.

I can recall being around 6 months pregnant and having a conversation with a friend of mine who has 2 children, she asked if I was nervous about the mental health side of things once I became a mum.  In my naivety, I told her I’d given it no thought and knew I would be OK because I’ve had anxiety etc. before so would know how to deal with it.  I was so wrong, so ignorant and so naïve.

My pregnancy had been relatively easy, aside from some SPD pain and worrying about the potential haemophilia status, it was in no way as bad as it could have been.  I was even looking forward to the caesarean section, I knew the day my baby would be born and had heard some very positive stories regarding C-sections.

Things didn’t quite go to plan however.

I won’t go into too much detail regarding the birth as 1) too much information and it’s quite gross a story and 2) probably quite boring for most. However, what I will say is the elected C-section became an emergency C-section a week prior to my scheduled operation.
I’d gone into early (and very fast) labour and everything went from being relatively calm to anything but.  I was terrified.  Wes came to the hospital just as I was experiencing very painful, fast contractions and was getting prepped for surgery, he looked like he’d seen a ghost.

We were totally unprepared for this.

I remember going to an ante-natal class and switching off when they were discussing contractions and labour etc. – because let’s face it – I wasn’t going to be experiencing this.
I actually felt like I was back in a Maths lesson in school, watching my concentration fly out the window.  My concentration only came back into the room when the midwife mentioned C-sections very briefly.  I probably rolled my eyes as I knew all the information she was providing already (misplaced arrogance).

After being on the operating table for over an hour and a half (I always thought it would only take 30 minutes) and being presented with my gorgeous son, not only did I feel absolute elation, I also felt totally and utterly struck with anxiety.

I recall being in the recovery room with my mum and my new-born son and being told I’d lost a lot of blood, genuinely asking the registrar what time I would be dying.
No joke.
I was petrified I was going to pass away, the same day I welcomed my baby.

It transpired I’d contracted an infection due to the complicated birth.  All sorts was going through my mind, am I going to die?  Am I going to have to have surgery again?  A blood transfusion?
I felt like I’d been hit by a double decker bus and was looking down on myself from above.  It was the most surreal, out of body experience I’ve ever known.

I felt utterly traumatised.

So much so, I refused to sleep the first night I became a mum, I made myself keep my eyes open the whole night, despite being exhausted from having no sleep for nearly 48 hours.  I was worried that if I closed my eyes, I wouldn’t wake up and my son would be without his mum.  Looking back, my heart aches for myself.

This had huge bonding implications, I remember looking at him in his cot next to my hospital bed, he was literally the most gorgeous thing I had ever laid my eyes on but I couldn’t allow myself to fall in love with him.
I was so concerned that I wouldn’t be around to see him grow up.  The infection I had would kill me or I would have to have another operation and wouldn’t survive it.  I was literally on the edge.

Fast forward a few hours and I was moved to a different ward, it was hot, noisy and I felt like the walls were closing in on me.  Before I know it, I’ve got out of bed and hobbled out of the ward, crying hysterically, leaving Wes and our son next to my hospital bed.  I didn’t know where I was going, I didn’t even know what was going on in my head, but I sobbed so much I thought my surgery wound was going to split open.  Luckily a midwife found me and took me into an office and calmed me down.  I had a word going round and round in my head, it was psychosis.
I was absolutely terrified I was suffering from it.
The midwife assured me I wasn’t, I was suffering from severe anxiety and was having a terrible panic attack.  Some time later I calmed down and was moved to a private ward for my own wellbeing, I felt incredible relief at this and immediately felt better.  I could see my old self creeping back through.

But it wasn’t to last.

Recovery from a C-section is hard, especially an emergency one and because it had been a complicated operation, I was in a lot of pain.  Trying to breastfeed was the most difficult thing I’ve ever done and I was beginning to feel like a failure.
I have to be honest, I can’t say I felt pressurised by the hospital midwives but there is certainly an element of expectation.  I had a total breakdown on the last night I was in hospital, I couldn’t feed him, I was struggling to change his nappy as I couldn’t bend over and he was crying, I literally didn’t know what to do.  I called Wes and told him he had to come back to the hospital even if the staff refused him entry.  I was losing it again.  I felt like the midwives were losing patience with me and they thought I needed to ‘man up’ and just get on with it.  I have never felt so alone in all my 27 years.  I then decided to give my son formula as he wasn’t latching on and I was exhausted from trying and worrying about his weight.  A lovely midwife came and sat with me and I remember us having a conversation, it took my mind off of how frightened I was feeling.  I managed to get a small amount of sleep that night and looked forward to going home the following day.  Everything will be OK once I’m in my own bed, with my family around me.  5 days in hospital was quite enough thank you!

Once I got home, the anxiety didn’t leave me, I felt totally and utterly on edge as soon as I got in the door.  I didn’t want to be left alone with my baby, I felt totally overwhelmed by responsibility and worried I was going to get things wrong.  My baby had lost over 10% of his birth weight because he wasn’t feeding properly and I was so panicked.  Suddenly, the support of the midwives and hospital staff had gone and the spotlight is on us now, to keep this tiny little human alive.

My mind was racing, I’d sit in the bathroom googling ‘post natal depression’ or ‘post natal anxiety’ and the worst word of all ‘psychosis’.  Convinced I was a danger to myself and I should be locked up.  The fear was real.  I lost over a stone in one week because I didn’t eat, I felt permanently sick.

I remember a community midwife visiting me at home for a check up and me being so worried about telling her I was abandoning the breastfeeding and going down the formula route.  I was so concerned my son wasn’t getting anything and I was totally and utterly exhausted.  The pain of trying to breastfeed was almost as bad as the contractions during labour.  My midwifes response? “I won’t give you a hard time as I know you’re struggling at the moment and you’ve had a rough ride”.  At the time, I was grateful for her somewhat curt response.  Looking back, my blood boils.  Actual steam could emanate off my keyboard right now where I’m typing so furiously.  Won’t give me a hard time?  What the hell does that mean?  Are midwives supposed to apply as much pressure to already exhausted and hormonal women just so they can promote the breast is best mantra?  I wondered if perhaps they’re performance targeted on how many new mums they can get to persevere with the breastfeeding.  Cynical I know, but I just couldn’t understand this approach.  We all know breast is best, but so the bloody hell is happy mum, happy baby.  You don’t need me to tell you of stories that have been in the press about new mums who have taken their life because they felt like failures as they were unable to breast feed their babies.  Tragic, totally and utterly tragic and it breaks my heart.
My baby thrived on formula.

Because my anxieties lasted past the normal “baby blues” period (2 -3 weeks apparently) I was referred to a mental health team who came out to assess me just before Christmas 2013, it was determined that I was suffering from severe anxiety and would need support.  I tried to take anti depressants but they made me feel worse so I just got through Christmas as best I could and slowly but surely the overwhelming feeling of anxiety began to lift and I started to feel better.  Don’t get me wrong, I was still anxious and in dire need of some therapy but I didn’t feel permanently on edge.

I started some CBT (Cognitive Behaviour Therapy) from January 2014 onwards which really helped – I’d recommend it to anyone who has any anxiety issues.  This continued into June and by the Summer I was definitely feeling better, I wouldn’t say I was like my old self, I would get bad moods and still feel anxious but it wasn’t anything like the first few weeks post partum.

Once my CBT sessions finished I was told I would have to wait at least 6 months if I wanted to have any more therapy.  I was sure I’d be fine without and time would be a healer etc. so carried on with my life.  Finding weaning very hard work but I had a healthy, happy baby who slept through the night so I had it very easy compared to others.

Towards the end of the year I started a new job (part time), I felt totally overwhelmed again, I felt guilty for leaving my son after spending every day for the last 10 months with him.  I felt like I couldn’t do my job and that it was bigger than I was.  I could feel myself heading for disaster once again.  My son’s first birthday was only round the corner and we had lots of celebrations planned, not to mention Christmas too; I was determined to carry on as normal and forget about how unhappy I felt.  My son had started waking through the night screaming, it was a really hard time and I felt once again like I was losing all control and the walls were closing in on me.  I was trying to get to learn a new job, planning 1st birthday parties and keeping everyone around me happy.  I looked knackered, I felt knackered and my spark had well and truly left my body.  I didn’t know who I was anymore.

On the morning of my son’s 1st Birthday, I remember hearing a new mum had gone missing from the hospital I had given birth in, I didn’t give it a huge amount of thought.  I just hoped she was OK and thought she may have gone for a walk or something.  Come the evening, the news wasn’t looking good and I was obsessed with it, checking every few minutes for updates until the worst was confirmed.  They had found her body; I broke down.  It was a year to the day I’d been through what I had been through in the very same hospital.  I’m not saying I was suicidal, not for one second, but what I will say is I was terrified, I was walking around the hospital, not knowing who to turn to and feeling incredibly lost.  Perhaps not too dissimilar to what this poor woman was experiencing.  I couldn’t get it out of my head, I couldn’t stop crying about it.  I thought of what she must have been thinking in her final moments, or what her family must be going through.  I was angry that no one had stopped her from walking out of the hospital, or that the lovely midwife who had helped me exactly 12 months previous, hadn’t stopped her and given her a shoulder to cry on or some much needed support.

From then on the days merged into one and although relieved my son’s birthday was over and I didn’t have to persevere with ‘keeping up appearances’, I was getting exhausted and nervous about Christmas.  I wanted everything to be ‘normal’ – whatever that is.  I wanted the racing thoughts to stop and the constant worrying to diminish.  Christmas came and went, it was nice but hard work as we were hit with a seasonal cold, cue many sleepless nights and tensions running high.  My son was soon better and cold free and I looked forward to a night out with my closest friends for NYE, I’d not had a night out in so long.
The following day (New Years Day), I felt uneasy, on edge, scared, frightened, worried, concerned – all sorts of anxious.  I wanted to either pace the floor or not get out of bed.  The thought of a new year petrified me, what would it bring?  What would I fail at?  My confidence was sub level and my nerves were shot to pieces.  I didn’t get out bed for days, I gave up caring about anything and everything.  I was non responsive, there in body but not in mind.  I was a shell basically.  I just wanted the racing thoughts to go away, I wanted to be in control of my thoughts again.  I remembered I had another type of anti-depressants in my drawer that had been prescribed to me some 2 months previous.  Because I’d had a bad experience with AD’s the year before I was too scared to try them but now I had nothing to lose.  I couldn’t carry on how I was, my mum was desolate, Wes was so concerned and I wanted to will myself to get better for my lovely son.  He deserved more.
So I took the tablet and was determined.  I persevered and although the first week was tough, I took the week off work and just rested.  My head hurt, I was dizzy, I felt sick but for the first time in a long time, I was beginning to feel positive, I felt like I might be able to see the much needed light at the end of the tunnel.  I went to see the Dr to discuss my side effects, dosage etc and saw a new Dr I’d never seen before.  I opened up about how I’d felt and she was amazing.  She didn’t judge me, she took me seriously and wanted to refer me back to the Primary Care Team, she knew I needed more than tablets and wanted me to be seen by a Mental Health Nurse straight away.  The start of this year was very tough, we lost our beloved cat, we had a lot of bad news and many stressful situations to deal with that required a huge amount of strength.  But, with the help of the tablets and some counselling and therapy, I felt like I could deal with the issues.  I took time out from my friends and people around me, and chilled out, I would be kind to myself.  I wouldn’t apply pressure on myself.
I would talk A LOT to my mum or to Wes, instead of keeping everything in for fear of what they might say.  I learned to just keep putting one foot in front of the other and dealing with worries one at a time, weighing them up and thinking what is the worst that could happen?  I talked about the birth and about how I felt for the first few days and weeks after my son was born with my counsellor.  It felt like I’d put it to bed and had learnt to come to terms with it.  It didn’t frighten me anymore.

Today, I’m so much better.  I’m still on anti-depressants, mainly for my anxiety. I’ve been diagnosed with Generalised Anxiety Disorder, along with my OCD which was diagnosed when I was young.
My Dr has said I’ll probably be on the pills long term, but that’s fine with me, I’ve come to terms with that.  I’ve finished my counselling & therapy and I feel the most positive I have felt in years.  I feel confident and I feel very happy.  I’ve learnt a lot this year, a lot about myself and a lot about what I can deal with and how strong I am.  Above all, I’ve learnt to love being a mum, warts and all.  I’d fear that I would lose my individuality and see myself as being someone’s mum as opposed to being Rachel.  I’m still me, I’m still that annoying, loud, talkative, random, sometimes moody, up for a laugh person, just with the best gift of all.  My son.

This post was two fold.  Selfishly, I wanted to write my experience out for cathartic reasons (which believe me, it’s worked) but secondly I want to advocate mental health.  I want expectant mums to be slightly prepared for how hard it is emotionally after giving birth.  Yes, we need to be prepped for birth, breast feeding, changing nappies and all that shit (literally) but we need to be prepared for the hormonal changes.  The overwhelming emotions that we can experience shortly after birth, and not just for the first 2 or 3 weeks after.  The midwives need to be looking out for signs that women are struggling and be empathetic, perhaps referring them to support networks, therapists etc. that can help.  They should relieve pressure for new mums and provide up to date, accurate and helpful advice.  Yes, we all know breast is best, I mean it’s been rammed down our throats often enough, but it isn’t always as cut and shut as that.  And at what expense some times?

I just always hope that any new mum gets help straight away if they are struggling at all, be honest and open and not worry about people judging or what the Dr might or might not say.  Becoming a first time mum especially, is a frightening experience.  You’ve just gone through something that is quite traumatic, you ache in places you never knew existed and could be rather traumatised from the experience.  People need to be accepting and sympathetic to this.  I would encourage women to talk about a traumatic birth, I remember the first time I watched One Born Every Minute after having my son and actually recoiling and sweating whilst watching a caesarean section. I had to turn over.

Women need time to come to terms with what has happened and time to recover physically, mentally and emotionally.

Some links that may help, should you need them:

https://lift.awp.nhs.uk/ (they really helped me)
http://www.oasis-talk.org/
http://www.mind.org.uk
http://www.pandasfoundation.org.uk/

Please share this blog post, I really want to raise post & pre natal mental health awareness and if this post can help others, then it’s been totally worthwhile putting finger to keyboard.

To read more from Rachel, please see her blog here.

AUTHOR

Catherine Jones

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