Living with Birth Trauma

Trigger warnings: birth, hospital procedures

My daughter’s birthday should be about joy. It should be about a homemade cake with two candles burning on top. It should be “Happy Birthday” sung with questionable tunefulness. It should be smiles, and presents, and balloons. It was. It had all those things.

For me though, it also brings a lot of unwelcome memories. The aftermath of her birth. The mental toll. The physical toll. Those memories in turn bring something good: confirmation of my healing process. I’m still here, still living each day and generally enjoying life.

This birthday was better than last years. This year came with extra hurdles.

My son had a pediatrician appointment the day after her birthday. In the same hospital she was born in. Just down the hall.

Walking into that hospital is like walking along the edge of a cliff. I’m always aware of that drop.

As I walk part of my brain feels the nightmare again. My brain tells me: this is where terrible things happen. As I walk down the brick corridors I also see the walls, the ceiling, sliding past me as we run. My mind is capable of being in two times at once. My head spins and the blood roars. All I can do is look firmly in the other direction. Hold tight to the present.

There’s a word for that – trigger.

Say it out loud and feel my cheeks flush with shame. Such a snowflake.

One day, maybe, hospitals won’t bother me, at least not anymore than your usual person. But I’m not okay with visiting a hospital -the hospital – yet. I’m not even okay in the lead up to the appointment. I’m on a knife edge, and lack the tolerance to deal with the usual getting the kids out of the house antics. These appointments are significant enough both my husband and I go, but it is also inconceivable that I could manage to take my son there on my own.

Yet, I get through.

I walk the halls. I don’t fall.
I wait with my kids. I don’t fall.
I sit and talk with doctors. I don’t fall.
I make our next appointment. I don’t fall.

Living with trauma doesn’t mean we’re weak. It means we are strong.

Trauma is by its very nature deeply personal. It is hidden and secret and it is hard to share it with the world – for me to write and publish these words. I know though, that buried trauma helps no one, it will only suffocate you in silence. We need air, and light, and space to heal. to belittle someone’s trauma is to throw a shovelful of sand in. To bury the trauma deeper. To make the cliff top higher.

I get fed up with articles bemoaning trigger warnings as some sort of mollycoddling. How nice it must be to live your life blinkered to other people’s personal cliff top balancing acts. How many people who met me that day would have guessed I spent the whole day not falling? I went to that appointment with the benefit of warning, though. How would I cope with an emergency visit? Would I fall?

This is what I want people to understand: trigger warnings do not exist to massage the feelings of the easily outraged. That is not what they are supposed to do. A trigger warning is a small accommodation in the face of adversity. A tiny signal that says ‘I will try to make this easier for you’. An outstretched hand that says ‘I don’t want you to fall’.

Humans of New York once ran a series, Invisible Wounds, that featured a doctor working with sufferers of PTSD. I can’t do better than his description of PTSD, and how and why it forms:

“Trauma causes the brain to malfunction. During a traumatic experience, memories cannot be processed correctly. So a person with PTSD is still carrying those traumatic experiences around in their body. Because those experiences were never filed away into the ‘past tense,’ the brain continues to operate as if the trauma is happening in the ‘present tense.’

Trauma is not like other strong negative memories. We all know anger, grief, or shame. I know what it feels like to be momentarily overwhelmed by grief for my mother. I know how it can well up at inappropriate and unexpected times, and I have for the most part learnt to deal with that, to cope with my grief. But these are normal feelings, and normal reactions. Trauma is something abnormal. Trauma is something that overwhelms the rational part of brain. Trauma is not in the past tense.

These days I live a normal life. I am not plagued by nightmares the way I used to be. My anxiety levels are higher than they were before, and I am still hyper aware of the fragility of our biology. How we are all only one chance moment away from disaster. Mostly it just feels as though I walk around in skin that is too thin. But then, something reminds me, and I am flayed again; naked and bleeding. Many of these things are so intangible it would be impossible to create warnings for those feelings. Sometimes I wake in my bed, on my back, my right arm flung out next to me. When I open my eyes I don’t just see that arm. I see the other arm; the one that is strapped down to an operating table, so brightly lit by the light above me I can’t see beyond it, multiple IV lines, a needle going into my shoulder as I watch. It only lasts a split second. But in that moment it is as real to me as the other arm.

I suspect hospital lights will always trigger some response in me. I went to the movies and watched Dr Strange, knowing there would be scenes in an operating theatre. There turned out to be a lot of them. In particular, at least once the film suddenly cut to a point of view shot from a patient lying on an operating table looking up into these bright, bright lights.  I had to shut my eyes. I can’t, don’t, expect TV and movies to have warnings for hospital scenes. I just have to cope with them, with those unexpected wobbles. Given that fact, when something clearly has potential to remind someone of a traumatic event, is a little warning too much to ask for?

People want to discuss these type of responses as irrational. While the reaction might be irrational, out of proportion to any present threat, on another level there is nothing irrational about it. Humans are designed to learn from experience. Hospitals are a reminder to me that what happened was real.

I’ve learnt to live with the precipice in my mind. I teeter occasionally, but I haven’t had a bad fall for a long time. I’m not going to turn my back on the cliff. I don’t want it to loom unacknowledged behind me, waiting for me to stumble. I will see it, and I will follow its edges, hoping to get further inland. The story of my daughter’s birth is part of my life now. Part. It does not define me, but it has shaped me.  It will be part of my story for the rest of my life, and I am not alone in that.

For those of you reading this who are living through this now, who are stuck in both the past and the present, have faith. Reach out for the hand that will balance you as you walk. Find that air, and light, and space you need to heal.

I walk along that cliff edge. I do it. One day you will do it too.

And you won’t fall.

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Into my arms, oh Lord/ Into my arms

There are a lot of blanks the day my daughter was born.

A lot of moments that I don’t remember that I’m glad I wasn’t conscious for.

A lot of moments that I don’t remember that I wish I did.

I remember seeing her, the midwife lifting her into the world, purple and covered in vernix. A beautiful sight. I remember her being laid on my stomach. And I remember her being taken away again. And then they are running, running. And my mind has already gone.

There is an accepted narrative, and I felt guilty for a long time that I don’t fit it. I can’t force my story to follow its simple arcs no matter how many times I rewrite it in my mind.

Months after I told a midwife that I felt like my brain went through its final moments, that the last time I blacked out would have been my last thoughts if I hadn’t been in an OR lifted onto a table when they occurred. She didn’t disagree.

I felt guilty that I hadn’t worried about the baby, worried about who would look after her now. That I didn’t worry about my son. Or my husband. Or my father. What kind of person does that make me? That I didn’t think of everyone I love? Isn’t that what people are supposed to do?

Ridiculous, right? I was essentially criticising myself for dying wrong. As though that’s a thing. As though if I had been capable, or had had the time to worry I wouldn’t have done exactly that. But I didn’t. It was all too fast for that.

So I’ve stopped feeling guilty. Really. But I do feel sad. I think I’ll always feel sad, and that’s ok.

I’m sad that I didn’t get to ‘meet’ her. I didn’t get to lift her to my chest, and gaze at her eyes, count her fingers and toes, touch the tip of her tiny nose. I didn’t say hello, or tell her she was beautiful. I didn’t get to smile at my husband while we marvelled at our baby.

I’m sad when I see photos of women beaming with their newborns, and not because I begrudge them, just because I have one photo of me on the day my daughter was born. I do love that photo, because that moment was the best part of that day. But it is nothing like what new baby photos are meant to be like.

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I’m sad because my daughter is wearing a hat in this photo. I knew she had hair. I wanted to see it, or at least feel it against my skin. But someone had put a hat on her while I was in OR, and I was too weak to talk, and nobody knew how I felt. So I didn’t get to feel her hair.

I’m sad that the first time my husband held his daughter it wasn’t a quiet precious moment for the three of us to enjoy. It was when a nurse told him to get the baby out of the way.

I’m sad because once again, my husband had to ring his parents and my father to say they had a grandchild, but…

I’m sad when I’m with a group of women and they laugh about how tired they were after labour, or how hungry they were. How they finally ate the sushi they’d been craving. And I remember how when my daughter was twelve hours or so old, my husband fed me some ice-cream, because I was too weak to feed myself.

I’m sad that my son didn’t meet his sister until she was 48 hours old. And when he walked into the room he was obviously overwhelmed. I desperately wanted to see him, and I’m sad that when I reached out my hand to touch him he was frightened by the IVs, and drew back from me.

I’m sad when people say you forget the pain the moment you hold your baby in your arms. It did feel wonderful to hold my daughter. But nothing will take away the horrors of beginning to wake up again in the OR, strapped to a table with no understanding of what was happening. We all think we know the story; trauma patient is sick, doctors make them better, then they wake up surrounded by kindly nurses who explain what happened and hand them a baby and congratulate them. But the truth is I was not anesthetised – I was unconscious. Conscious and unconscious are a sliding scale and I veered back and forth. Sometimes able to open my eyes, sometimes able to think, sometimes able to talk. The memories of that first day are disorienting, all fog and blurred edges, even now.

I’m sad because people say missing out on those first few moments doesn’t really matter, in the long run. And I know they are right, because I missed out with my son too. I know it didn’t really matter. But the defining memory of my son’s birth for me is hearing my blood splattering on the floor. Of being alone and confused and only holding him later. And I hoped, I hoped, this time would be better. To hold my new baby. And it wasn’t and I didn’t.

I’m sad when I see statements about childbirth not being a fairy tale, and all that matters is the two of you walk out of hospital alive. I’m well aware of how lucky we are. But that doesn’t mean that what happened in that in-between doesn’t matter.

Wanting to hold my baby was not just a desire, it was a biological function – a hormone rush that in my case was left unanswered, confused, overwhelmed with drugs. It’s the moment that gets women through the last difficult weeks of pregnancy, the days and hours of labour. So it’s hard when that moment is lost. We’ve lost the end to the story of our child’s arrival; we’ve missed the start of their life journey. Yes, there are many firsts over our children’s lifetimes. But to miss out on the first first, to have that day so filled with blanks, it feels a little bit sad.

It’s true what they say, that grief is the price we pay for love. Because this sadness is a type of grief. It sneaks in when I see baby photos, when she snuggles against me in the dark, when I run my fingers through her hair. I have to air it, or it will suffocate me. My heart grew with love for my daughter; there is room in my heart for this grief too.

The way your face could light/ the bitter dark

I listened to Joyce Carol Oates on the radio recently, discussing her widowhood. I can’t remember her exact words, but she said ‘I never knew how weak I was’. Those words really struck a chord with me. On its own parenthood, motherhood, can be hard and exhausting. Combined with my mother’s death, and an extremely traumatic birth. It’s fair to say it has been too much.

I’m not entirely comfortable with using the phrase ‘triggering’. It sounds a bit zeitgeisty, a bit pretentious, a bit precious. Yet, it is a good word for what it can feel like sometimes. Facebook is determined to advertise for blood donations to me. When I see that ad, I see the mess of bruises on my hands and arms from four IV lines, numerous other injections and blood tests. The hospital undershot on my transfusions, and I received more two days after my daughter was born. I feel the chill of the stored blood hitting my veins. When I hear a siren I cringe, thinking no paramedic could have saved me that day; the 200m sprint to OR was far enough.

My son can be anxious sometimes. I’m not sure how it started but sometimes he finds it reassuring to spend time listing our worries; it’s a way for him to get things off his chest. The other day he told me he’s worried he’ll be left at børnehaven. It broke my heart to hear it. That he has been so worried about something that has never, and may never happen. That he is old enough both to imagine it, and articulate it.

And it troubled me because it is so close to my own fear. The fear of leaving my children motherless. I’ve spent the last year reassuring him that although we all die, we expect to live a long time. In the months since his sister’s birth those words have felt like ash and lies in my mouth.

I don’t want to pass on my fears and anxiety to my children. I know I will never forget those moments of my life, but I have to let go of the fear, the guilt.

Because I am here.

I did live.

Sometimes the fear can be crushing. Some days I am so drained I’m not as patient with my children as I would like to be. Some days I’m overwhelmed by the washing, the cleaning, the cooking, the sheer amount of needing.

Some days are glorious.

Some days we read, and bake. We go to the market and count the apples as we put them in a bag. We wrap ourselves in coats and mittens, and throw snowballs, or go for frosty walks, M zooming ahead on his bike. He runs, and bounces, and laughs.

And my daughter?

She watches. She watches the world from the safety of her parents. She watches and smiles. When she turns her bright eyes to mine I feel the aptness of her middle name; the name we chose because it belonged to my mother, and grandmother before her. Joy.

And those restless thoughts that/ cling to yesterday

*warning* this post contains medical information & imagery related to childbirth

Maybe I’m falling. I’m no longer sure which way is up.

I’ve never liked glass lifts. As the lift moves, and my floor and the floor outside separate my brain lurches. If I’m not holding on to a wall I’ve been known to stagger. Unsure which way I’m moving. Unsure which way is up.

There is a moment in the story of my daughter’s birth that dissects it into two stories. The first story in which she is born, and it was a bit complicated, and everything you expect birth to be, or maybe not, but ultimately I was fine. She was fine. And the second story, after her birth. The afterbirth. In which I was found, in the Darwinian sense, to be ‘unfit’. The story in which my uterus fell out of my vagina.

Reach your hand into your pocket, and pinch the bottom of your pocket with your fingers. Now without letting go pull your hand out. There, like that.

It’s called a uterine inversion. Don’t be surprised if you’ve not heard of it. They are extremely rare. They are also, as you might gather, extremely serious.

I remember realising that I was bleeding. I’d haemorrhaged when I had my son as well, but not nearly as much, only 900mL; although I lost that fast, in just a few minutes or so. It is hard to describe that feeling. It’s like a head rush when you stand too fast, but it doesn’t stop. It keeps rushing, and rushing. And as the blood rushes my mind is falling. I no longer know which way is up.

I remember my husband backing away from the bed, as a nurse places on oxygen mask over my face.

I remember being jerked awake as I am lifted onto the table in OR. My head flops to the side, I see the blood on the bed.

I remember being told it would feel like I was being kicked in the stomach.

I remember the bright lights. I remember seeing IV lines in both my hands and arms, while the anaesthetist buzzes around me, more injections into my thighs, my shoulders.

I remember being told I was stable, and once they had finished stitches I would be moved. It is only when she tells me this that I notice someone is stitching my perineum.

I have since been told that inversions present somewhat ‘uniquely’ in that they have an immediate effect on the central nervous system. This happened in my case. I had a massive drop in my blood pressure and was no longer stable before blood loss was heavy enough to cause this. Blood loss in inversions is very rapid; they liken it to turning on a tap. I lost 3.7L of blood, but was put back together and in the recovery ward within an hour.

It all sounds terrifying. In a way it was. What I find the hardest part though is the lack of fear. The knowledge of how quickly my mind was gone. I didn’t think of my newborn, my husband, my son. I had no fear that I was going to die. Other than a flicker of recognition as my husband steps away from the bed there is no ‘me’ in these memories. Only the pain. The need to breath. The falling.

We met with the obstetricians recently, in an attempt to fill in the gaps. I now believe I was unconscious for most of the time in OR. That nearly everything I remember is after they had pushed my uterus back, and the ‘kicking’ was the attempts to contract it once it was in place. On a purely factual level it should not be surprising that my brain struggles to place these memories in context. Deprived of blood and oxygen, my body pumped full of a variety of drugs, my mental processes were impaired to say the least.

My husband was allowed in to see me straight away, carrying our daughter. They lie her on my chest and she even attempts to feed. I don’t remember them arriving. Instead I have vivid memories of the shaking from shock, how cold I was, and being unbelievably thirsty, while attempts to sip water resulted in vomiting on my shoulder. But I also remember lying there, her tiny body on my chest, skin to skin. And despite it all, a feeling of peace. A feeling of completeness. I was back to where I needed to be.

We went forward from there. At first I couldn’t sit on my own, couldn’t support her weight, too headachy to think, too nauseous to eat. But slowly I recover. We name her. I make it out of bed. I make it home. I’m strong enough to walk holding my daughter. It is about a month before I have the strength to lift my 2 year old. I laugh. I cry. I get better.

Most of the time, I’m fine. For months I really just felt glad to be here. Grateful for the doctors and nurses and blood donors who saved my life. But then I would go to bed at night, and in the dark all the fear I didn’t feel at the time comes creeping in. I can’t shake the knowledge that for all the complexities of our lives, all the amazing and wondrous things we do, we are dependent on our heart, our lungs, our brain. I can’t shake the memory of what it felt like for them to be slowing, dragging me down into the undertow.

I wake in the night. I feel like I’m trapped in a glass box. I feel like I’m falling.

Read my follow up to this piece here