Motherhood, mental illness and beyond

Posts tagged ‘childbirth’

Birth isn’t always painful

I have 2 children; DD was born in summer 2009 and DS was born in December 2011. Because of my spinal problems both were hospital births but my labours were very different from each other.

When I went into labour with DD we were 8 days past her estimated due date (EDD). I spent the afternoon and evening writing down the time of every contraction, and worrying about how I would manage. After about 12 hours at home I felt that the contractions were getting beyond what I could handle, even with paracetamol and a maternity TENS machine, so we went to the hospital. I was examined and told that far from being in the latter stages of my labour as I thought I was barely 3cm dilated. I was given a gas and air canister and left to get on with things for a few hours (it was the middle of the night and DH was with me).

At around 0630 I became unable to cope with the contractions any more; by now they were every 4 minutes or so and each one sent my back into agonising spasms. The midwives and I decided that it was time for me to have a remifentamil drip (an opiate, offered to me as my spine meant that an epidural wasn’t an option). After much coming and going from a surly anaesthetist I finally received my pain relief at 0745. My waters broke at 1002 and DD was born on the second push at 1006. She came out with such speed that had the midwife not caught her one-handed (she had only had time to don one glove) she would have bungeed off the end of the bed!

Second time around I was rather nervous about the pain, remembering how bad it had been (especially as the opiate drip wasn’t an available option where we now lived). I knew that I could cope with labour though so I was much more relaxed about the whole thing. DS turned out to be just as tardy as his sister and I woke with contractions in the early hours, 9 days after the EDD. Unfortunately this was Christmas Day. DD was 2 and a half and it was the first Christmas that she was properly interested in. I was absolutely determined to see her open her stocking and at least some presents, so I just lay in bed and read until about 0630. DD opened her stocking and the presents we’d bought her, then my parents arrived to look after her.

DH and I got to the hospital at about 0830. We went to maternity triage where I was examined and told that I was already 6cm dilated so would be admitted to the delivery suites. At this point my waters broke. The midwife popped out of the room to get a wheelchair but I already needed to push, just once. She came back in with the chair, DH told her the baby was crowning and she caught him as he too made a rather speedy entrance into the world. He was born at 0840, only 10 minutes after we’d arrived at the hospital (he and I were celebrities on the maternity ward – all the staff wanted to see the Christmas Day baby born in triage!). It only dawned on me some time later that I hadn’t needed any pain relief.

Why the difference between the labours? It may be because it was the second time or it may have been chance. However I firmly believe that it’s because I was relaxed the second time and not panicky. The first time all I could think about was all the horror stories that I’d heard, I had no idea what the pain would be like and whether I would be able to cope with it. I was tense and nervous. This produces adrenaline which is known to suppress the body’s production of oxytocin, slowing labour. Being tense also meant that my muscles were tighter, making the contractions more painful than they perhaps would otherwise have been. The second time I was calm and relaxed, breathing properly (this can make a big difference!) and the contractions were no worse than period pains.

Why am I writing about this? Because I hate that women are constantly told how awful labour is, how painful. Programmes like One Born Every Minute rarely show calm, unmedicated homebirths because they’re not dramatic. Instead we are shown the labours where women are screaming in pain, where intervention is required, and this type of birth has become normalised in a lot of Western societies. Yes, some births are like this. And I am grateful to live in a country where experienced medical staff can intervene where necessary to relieve pain or save the life of the woman and child. But it is my firm belief, having spoken to other women who have had similar experiences to mine, that in a many cases birth doesn’t have to be like this. A lot of us are sabotaging our own labours through fear.

(A great website to look at if you’re worried about childbirth or just want to read positive stories is Tell Me A Good Birth Story. They put nervous and frightened women in touch with those who have given birth and who can reassure them that it isn’t always awful. They match women as closely as they can so that the circumstances and worries are similar, and the experienced mother’s story is relevant).

Musings on motherhood and mental health

When I discovered I was pregnant with DD I was thrilled. DH and I had wanted to start a family for years and so we spent the next 9 months in a state of perpetual excitement and anticipation, acquiring baby clothes and a cot and a Moses basket and a buggy and toys and all the other random paraphernalia that first-time parents are encouraged to think they need. We spent hours poring over my pregnancy book, looking at the pictures of the baby as she was at that moment (even from the early stages when the embryo resembles nothing so much as a mutant space prawn). We were prepared. Except – we didn’t think to do any reading about what it would be like to have a newborn. I mean, these things come naturally don’t they?

The labour was relatively uneventful and when DD was 9 hours old we found ourselves at home again, this time with a tiny person. That’s when the panic started to hit – we were responsible for keeping this tiny little creature alive. The only time I had been solely responsible for keeping anything alive was when I had a hamster at university. I looked down at baby DD and wondered just how transferable my hamster-looking-after skills were.

That first night was a blur. It hadn’t occurred to either of us that the baby wouldn’t sleep in the Moses basket – that’s what babies did after all! So why wouldn’t ours? DD fed well and grew well but continued to refuse to sleep in the basket for more than an hour at a time. Well-meaning friends and relatives gave us books about babies and being a parent. Great we thought – but all the books had conflicting advice. As did the aforementioned friends and relatives. Everyone had an opinion on what we were doing but no two people agreed.

By the time DD was 6 weeks old I was deep in the grip of postnatal depression. This wasn’t entirely unexpected as I have a long history of depression, so DH was on the lookout for any warning signs. The health visitor was less than helpful – she stood over me as I cradled my crying newborn and ordered me to put her to bed and leave her there. I refused. By the time the health visitor left I had the feeling that I had been marked down as trouble. For the next year if I went more than 4 weeks without taking DD to the baby clinic for weighing I would get a concerned phone call asking me to bring her along so she could be checked, or the health visitor would just turn up on my doorstep with the scales. I felt that they didn’t trust me to look after my own child – and I understood that because I was convinced I wasn’t capable of looking after her either.

I remember very little from DD’s first year but I do vividly remember one night. I remember DD screaming, and DH waking to find me crouched in a corner sobbing. I remember feeling thoroughly overwhelmed and despairing and convinced that it would be better if I died, that DD would be better off without any mother than she would with me. I was lucky – DH convinced me to seek help and I had a very sympathetic GP. She understood that I was extremely reluctant to take anti-depressants while breastfeeding and instead referred me for talking therapy and a course of computerised CBT. These helped a little.

But what helped most was the dawning realisation that although DD wasn’t a typical baby, there wasn’t anything wrong with her. There wasn’t anything wrong with the way we were looking after her. She just required more attention, physical contact and less sleep than most babies. (It wasn’t until DS was born and was exactly the same that I discovered the term ‘high-needs babies’. It was such a relief!). The pressures on new parents are immense. From the expectation that the mother will instantly regain her pre-baby figure to the endless (and ridiculous) ‘Is she a good baby?’ questions, from sleep deprivation to the endless stream of well-meaning but conflicting advice – well frankly I don’t know how anyone navigates the first few months of motherhood without cracking up!

I have gained confidence over the years and these days I have very little patience for society’s expectations of how my children will be. I do what works best for us and to hell with what anyone else thinks. I have no time for the competitiveness that seems so beloved of some parents – breast vs formula, cot vs co-sleeping, purée vs finger foods, strict routines vs benign neglect and all that. While it’s great to have confidence in how you are raising your child, thay doesn’t mean that someone doing it differently is doing wrong.

I am convinced that my lack of knowledge and the endless stream of conflicting advice and methods compounded my PND. Every time I thought I knew what I was doing there was another book or friend or ‘parenting guru’ (usually childless) to tell me otherwise. This is wrong. As a society we need to be more supportive of new parents, especially mothers on whom the main burden of care usually falls and who are recovering from the physical process of labour and birth. We need to care for their mental health as much as we care for their physical health, perhaps even more. The stitches I had after DD’s birth healed within weeks – I’m still recovering from the mental wounds.

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