I was ready for postpartum depression. I’d had depression of varying degrees of seriousness since my teens and I was aware that I was at a higher risk for PPD. Before I even began trying to get pregnant I went to see Chris Raines at UNC so that I could discuss medication changes during pregnancy and trying to conceive. I wanted her to see me at a baseline…how I was before… in case I got PPD. I read books. I read blogs. I saw Chris again a few more times after my husband and I got pregnant after 7 months of trying. I spoke with friends who had had PPD. I read more books. I was ready for postpartum depression. What I was not ready for was postpartum anxiety.
The first night in the hospital felt surreal. I delivered at 4:17. Moved to recover after 7:00. Ate dinner around 9:00 and everyone left our room around 10 and we were alone with our baby for the first time. I didn’t want to miss a moment. I wanted to bond. I wanted to hold my sleeping lump of baby. I wanted to be a family. And I was scared. I had hemorrhaged after birth and then passed a blot clot the size of a soft ball hours later. I hurt in very delicate places and I was still in shock from my precipitous labor…less than 4 hours from start to finish. My baby was very sleepy and I kept checking to make sure that he was breathing…I’m sure that’s normal, right? I’m not sure if we slept that night at all. I remember feeling some relief when the sun rose outside our hospital window. My parents returned in the morning and I was hoping that we would go home that day. I was ready, but Johnny was not. He was grunting when he breathed and people were concerned about it. He was checked on several times that day and night by nurses, doctors… even the head of pediatrics. My milk had not yet come in and I was concerned that he was hungry. I was concerned about every squeak and grunt he made. Again that night I didn’t sleep. The nurse offered to take Johnny so Matt and I could sleep. I refused, but she convinced me that we needed to sleep and I was finally convinced and let her wheel my baby from our room. I woke up two hours later drenched in sweat and, clutching both of my thumbs in my palms. I snuck out of the room and went to get my baby. It was the first time I’d left my room. I wheeled my sleeping baby back to our room and got back in bed. Matt was still asleep so I thought I would go back to sleep too, but I couldn’t. I jumped up at every sound to check Johnny. I was once again relieved when the sun rose.
Coming home was exciting and scary. The car seat, the traffic, and the ride in the elevator…everything was scary. We got home and my mom was there waiting and the house was clean. It was great to be home…for a while. My husband’s father, his girlfriend, my sister-in-law, her partner and their young son all came over for Chinese food. It was too much. I wanted to be alone. I didn’t want other people to touch my baby. I was afraid that he would get sick or they would drop him or he would wake up and cry and I would have to try to nurse him. My nipples were already sore and beginning to chafe and I was starting to dread nursing him. Matt convinced me to go to bed until the 3 hour mark when we would need to wake Johnny up to nurse again. I couldn’t make it up the stairs. I was shaking and tears were falling down my cheeks. My heart was pounding and I was sweating. I hadn’t felt like this before, but I had hardly left my bed for two days and I had lost a lot of blood. I finally collapsed into bed exhausted…but I couldn’t sleep. I could hear laughing downstairs. It seemed too loud for my baby who had so recently heard everything through the muffled layers of my belly. I knew they were drinking wine and celebrating. I was so afraid that someone would drop him or forget to support his head. I don’t think I slept at all. Soon Matt brought Johnny to our bed and I began the chore of arranging pillows and holding this tiny baby up to my sore nipple in hopes of feeding him. During the night Johnny woke up from his newborn slumber and he began to really cry for the first time. I had no milk and no earthly idea how to soothe him. I started to panic. I tried to manually express some colostrum but was unable. I tried to use my breast pump and the strange noise made my dogs bark. I was topless because I was trying to nurse and bottomless because I had been lying in bed with an icepack on my stitched together vagina. I no longer had any modesty and I was desperate. Naked, I carried the baby into our spare room where my mother was sleeping and simply said, “Help me. I don’t know what to do. Help me.” She took Johnny and rocked him in the nursery while I rummaged through the stuff from our baby shower until I found a newborn pacifier. I worried that it might give him nipple confusion, but I had to stop the crying. Again, I was relieved when the sun rose.
We took Johnny to the pediatrician this day and learned that Johnny had lost a lot of weight. He was down to 5 pounds, five ounces. The pediatrician looked at my breasts and said we had thrush. I was devastated. How could I have thrush after only 4 days? I was relieved when my milk finally arrived later that day. But that came with more pain. My breasts ached and my back felt like it was tearing in half between my shoulder blades where I had been injured in a car accident in 2004. I was hoping that once my milk came in the pain of nursing would stop, but things just got worse. My nipples were bruised where Johnny had bitten me and the entire top of my left nipple was raw and bleeding. I dreaded the three hour intervals of attempting to breastfeed. I felt like a failure and like I was starving my baby. I was afraid to hold him because if he smelled me or woke up I would have to nurse him and latching hurt so incredibly bad. My toes would curl and I would scream when we latched on. Matt would hold my shoulders and whisper encouragement.
But the worst was nightfall. I could not sleep. I couldn’t sleep if he was in the room...or out of it. I couldn’t sleep if he was awake. I couldn’t sleep if he was asleep. I wanted an adult to be awake watching him through the night. For some reason, for the first time in my life, I didn’t trust my mother. She is the best mother in the whole world, but I didn’t trust her with my baby and I felt horrible about it. I was afraid she would drop him or fall asleep holding him and he would smother. The guilt of feeling this way was intense and I didn’t feel like I could tell her or Matt. So when it was her turn I would say I wasn’t sleepy and offer to take the shift. I didn’t sleep more than 2 hours at a time for a week. And every time I woke up I felt horrible I would be drenched in sweat, weak, shaky, weepy, and my heart would race, I felt nausea, and dizzy. I’d been on the phone several times with my midwife. She felt that I had hypovolemia and very low iron due to the hemorrhage I had after birth. So my husband and mother both badgered me to drink constantly and I took iron supplements. A week after my delivery my son had yet another weight check at the pediatrician. I could barely walk down the hall to the exam room. I remember the nurse asking, “Are you okay, Momma?” I said “yes” but inside I was screaming, “NO. I’m not okay. Please someone help me. What is wrong with me? I’m failing….miserably failing.” I was trying to nurse and crying when the doctor came in. I told her how I was feeling and she recommended I make an appointment for myself and come back. This was unthinkable. I had used all the strength I had to come to this appointment.
When we got home I called the midwives again. This time I cried when they said they had stopped seeing patients that day. I was put on hold and then told to come in as soon as I could. We left Johnny at home with my mother because I was too scared to have him in a waiting room where others might be sick. My husband helped me into the car and off we went. Again, I had a difficult time getting out of the car and into the office. A nurse saw me struggling and came to help me. They put me in a wheelchair and started talking about a blood transfusion. They took my blood pressure laying down, sitting and standing. I had to have help getting into each new position and silent tears fell down my face the entire time. Based on my symptoms and blood pressures, the midwife felt I needed a blood transfusion. Normally, they would draw blood and wait for the labs, but she was positive that I needed the transfusion and didn’t want to waste time sending the test to the hospital from their office. She asked Matt if he thought I could make it to the hospital or if he would prefer to use an ambulance. I was worried about the cost of an ambulance so they all three helped me back into the car and Matt and I set off for UNC.
At the hospital I was seen by a different midwife who took one look at me and said, “Yeah, you look a pint low.” She was kidness herself to me. Stroking my face and telling me how I would feel so much better after the transfusion. She took me to a room, reassured me again and left. They had to draw blood. I’ve always been anxious of having my blood drawn, but it was extreme. I was shaking and panting and crying. I felt like I was going to throw up. When the nurse finally got the needle in no blood would flow into the vial because I was so tense. She told me again and again to breathe and relax. Finally the blood draw was over. At this point I had been away from Johnny for at least 2 hours. I remember telling Matt, “I want my baby. Please get my baby.” So he left and I was alone. This was the first time I had been alone in a week and it wasn’t good. I cried…sobbed and thought about my Mom and Matt and Johnny getting killed in a car accident on the way to the hospital. They were all going to die coming to me and it would be my fault and I would be all alone. This played on a loop in my mind over and over again.
I had a friend, Mandy, who was a nurse at the hospital. I asked the nurse to call her. I couldn’t be alone and I was afraid they would come back to do the transfusion while I was alone. I started sobbing when my friend came to the phone.” She couldn’t understand what I was saying. I finally choked out that I was alone in the hospital and about to get a blood transfusion. Could she please come see me? She couldn’t leave her floor, but said she would call another of our friends, Miriam who also worked at the hospital. Mom, Matt and Johnny finally arrived. Quickly on their heels came Mandy and Miriam. Suddenly there were too many people in the small room. Everyone was talking about Johnny. Mandy and Miriam hadn’t seen him yet. I felt bad that they had left their jobs and come to me, but now I wanted them to leave. The nurse came back to start an IV. I started to panic when the nurse swabbed the back of my hand. “Not there. Not there.” I said. Please put it in my elbow. She said I was dehydrated and the transfusion needle was too big for my elbow and went ahead. The shaking, crying and body stiffness started again and got worse and worse as she stuck me repeatedly in the back of my hand. Exasperated she stopped and said, “Do you want something for anxiety?” I said, “I don’t know. I’m breastfeeding. Will it hurt the baby?” She said it would be fine, but I was too scared so I told her to keep going. She finally got the IV started and before she got the tape on my hand it “blew” and my hand began to burn. She said, “I’m going to have to use the other hand.” I refused in a hysterical tone and asked her to please use my elbow. She asked about the anxiety medicine again, but finally agreed and started the IV in my elbow. After a while I needed to go to the bathroom. Matt held the IV bag as I got out of bed, but he accidentally dropped it and some bubbles formed in the bag. I became hysterical saying that if the bubbles got in my arm that I would die. I nearly tore the IV out, but the nurse came in at that moment and I asked her in a frantic voice if I would die if I got a bubble in my arm. She looked at me funny and very slowly and condescendingly said, “No.” and left the room again. I’m not even sure what she had come in for.
Finally, the midwife returned and her reassuring, motherly attitude had completely changed to a brisk businesslike manner…bordering on rude. She informed me that according to the tests I did not need a transfusion. She said the problem was not physical while looking knowingly at my Mom and Matt. She never used the words postpartum or depression or anxiety. She did make an appointment for me to see Chris Raines on Monday and for that I am eternally grateful. However, she also recommended that I get some sleep and start going to the “breastfeeding café” and the local children’s thrift store. I could hardly go to the bathroom, much less a breastfeeding café. After she left the room, I apologized profusely to Matt and my mother. I was terribly embarrassed and felt like I had just been chastised for “faking it.” By this time shifts had changed and I had a new nurse. This one was HUGELY pregnant and looked like she could deliver at any moment. I felt deep pity for her…for what she was about to go through. She was very tired and asked if she could sit on my bed. I agreed and she sat down and talked to me…not my mother…not Matt…to me. She told me over and over again, “Never ignore your symptomatology.” I remember it because I had never heard that word before, but I knew what she meant. She told me that I HAD to sleep…that it wasn’t optional. She told me again that I had done the “right thing in coming in and never to ignore my symptomatology.” If not for the kind words of this nurse… I don’t know what would have happened to me. She helped me feel like I was okay and that I could last until Monday when I would see Chris. She took away some of the shame, embarrassment and guilt that I felt for wasting everyone’s time. It had only been a week since I delivered, but I was completely miserable, scared, exhausted and raw. I felt completely undone. I was failing at everything. I was afraid I had made a huge mistake in becoming a mother…yet I loved Johnny with a love so deep that it frightened me. His death was the worst thing I could imagine and it played over and over again in my mind: SIDS, drowning, choking, burning, car accident, home invasion, dropping him down the stairs. Each scenario played over and over in my mind in horrible vividness. Seeing Chris two days later started my slow recovery. I only waited 9 days for treatment. I don’t think I would have survived if I had waited longer. I wouldn’t have survived if I hadn’t had the steadfast support of my husband, mother and sister-in-law. I was never left alone and was prodded to take care of my basic needs. I didn’t recognize my symptoms as PPD because they were so physical in nature. I had no idea that anxiety was such a physical response. I thought I was ready for depression…I just didn’t recognize it.