in pain thou shalt bring forth children

Kate, the Duchess of Cambridge, and I were pregnant at the same time. My daughter arrived first, and despite my extended hospital stay, I was at home to see the footage of her leaving hospital rosy cheeks glowing, Princess Charlotte bundled in arms, another dress more lovely than anything I own. The plaudits soon rolled in; Kate had achieved the highest prize in motherhood – another natural birth. Oh, and a healthy baby.

Sitting on my couch at home I watched the cameras surrounding her. Glad I was spared the scrutiny of their lenses. That I could keep my dressing gown at midday, my grey-tinged skin, and slow painful walk to myself. I told myself the dress, the make-up, all hid the unglamorous reality of birth. Pain-killers and maternity pads can hide a multitude of sins.

After her first was born Kate was praised for her willingness to expose the truth about post-partum bodies, for her expanded uterus puffing out the custom-made Jenny Packer dress. ‘Hooray for Kate’ the magazine columns and opinion pieces cheered. This time people felt the need to criticize her for looking too good. Nonetheless, Kate had given birth only hours earlier. She did look that good. Those facts are true. But was it The Truth?

It seems hardly a week goes by without another facebook post exposing The Truth About Post-partum Bodies going viral. Many are beautiful stories. Many of the women sharing them are facing down daemons of their own, proudly and rightfully. Who am I to say they should not be celebrated. Mothers are judged this way and that way, no matter what choices they make. Ceasarean births are the easy way out. Women who have vaginal birth don’t understand what caesarean mothers go through -at least vaginal birth is what your body is made for. Get the damn epidural. Epidurals are cheating. Don’t cut the cord too quickly. Don’t cut the cord. Your baby needs you – it’s the fourth trimester! You need to rest to recover. Baby blues are normal. Are you at risk of PND? Your body is amazing. Get back to your pre-baby body quickly. Love your tiger stripes!

The proliferation of messages can be exhausting; made all the more over-whelming by sleep deprivation and hormonal swings. So we love the women who cut through all these headlines to show us something raw and real. The bathroom mirror selfie, newborn in a sling. The caesarean scar, a harsh line across the skin punctuating the rage in the writing. The hilarity of adult-nappies snapped in a maternity ward photo.

But are they the truth?

Perhaps they are only part of it.

Because it is easy to share a photo one day post-partum of yourself in nappies, but much harder to admit that you are still wearing them months down the track. It is easy to get shares of your scar photo, but no-one wants to see the infection you picked up, no-one wants to hear about the smell of your flesh in the doctors rooms. It’s easy to talk about how strong you are for growing and birthing a baby, but much harder to talk about how you have been left too weak to hold the baby, let alone take a selfie. It is easy to talk about how you love your body now, how proud of it you are. But how to talk about a body that has let you down? The one that couldn’t conceive, or couldn’t go unmedicated, that couldn’t labour, that couldn’t stop bleeding, that couldn’t breastfeed, that couldn’t heal. That hasn’t healed and here you are months later still wondering why you have been left like this. Or to talk about your body at all when it was not your body that was broken but your mind.

I’m reminded of Sarah Wilson/Writehanded’s piece – Is your feminism ableist? We place so much emphasis on independence, on self-reliance. We judge before we have any understanding of what individual barriers someone faced. We create ideas of what women should be able to do. We are supposed to feel empowered. And so in the rush to celebrate what many women can and do achieve we sometimes leave out those who need the help the most.

We talk about the old days, when it was our great-great-grandmothers who died. We wring our hands in sorrow, or not, over the 800 women who die daily in faraway countries in childbirth. We are told to feel lucky. Reminded the ideal birthplan is the one where ‘both mother and baby survive’. And that is all. As though, that is all.

We didn’t die. Is that enough? Is that enough for you? Is it enough for me?

Jane Seymour, third wife to Henry VIII; the ideal wife. She produced an heir, and then had the grace to die afterwards. She did not live to incur the wrath of Henry as so many of his wives did. Her purpose in life as a medieval women was fulfilled. But what did Jane want? Not death, surely. Her labour was long, two days, three nights – reportedly because of a malpositioned baby. Centuries later, I feel for Jane. Both of my children were malpositioned too. But she had to labour without the medical support I eventually received. I developed a post-partum infection caused by an excessively long labour, this was the probable cause of her death. The loss of her life was a tragedy for her. Just as it is a tragedy for those 800 women dying every day. So many avoidable deaths. Dead not because they experienced severe complications – dead because, like Jane, they lack access to the basics of sanitation, medication and nutrition. They are individual tragedies, not just statistics to be thrown in the face of any woman who has the temerity to complain about her own lot. We cannot dismiss women’s experiences as first world problems. As anyone who does not have it can tell you, health is not a first world problem. It is a problem.

The line between survival and death in a difficult birth can be paper thin. Walk this line and your view of the world changes. You only have to go back decades to get to a time where no women who experienced complications akin to mine survived. I am a historical anomaly. Childbirth has been made safe. So we want to believe it has been made safe for all women. We want to believe we are now in control. But our bodies and minds are no different from what they have always been. The only change is technology.

Have we forgotten so quickly that it wasn’t just a life and death matter? That even back then women survived with injuries that could not be healed. That women were pushed to the margins of history because the burden of procreation kept us there. What space was there in the public sphere for those left crippled, incontinent? Smelly old ladies. Women unable to conceive more children. Women of ‘delicate constitution’ who nonetheless had produced a number of children already. What would history be like if Jane hadn’t died? The truth is a labour that long without medical support could have left her with many significant health problems. How would the raging tyrant Henry we know from history books have treated an incontinent wife? We’ll never know. Jane will never know. This has been women’s shame for millennia. This is the truth. This is a truth.

We are no longer forced into confinement after birth. Women live their lives in the public sphere. We are expected back at work, back at the school run, back at playgroups. If we are expected to do these things we need to acknowledge the physical barriers some women still face. Without being accused of oversharing, or even being ungrateful for our children’s lives. We only get one body, and we have to live in it for all our life.

Everyone has a horror story we are told. We do all endure, however we birth our child, but to claim we all endure equally is false. What happens to you matters deeply to you. Why do we feel a need to lay a claim to the greatest suffering? Why do people then blithely announce that it ends when you hold your baby. That our bodies heal. Effectively shutting the women who have not healed out of the conversation.

We can’t all walk out of the hospital like Kate. The dress, the hair and make-up are the least of it. For many women childbirth is the beginning of a long journey back to health. We need to talk about that. Not least because poor physical health impacts on poor mental health. So while it is wonderful to praise the women who feel strong, and who feel brave, we also need to embrace the women whose bodies and minds are weak and shattered. The women for whom giving life took everything they had and who now begin a journey back to health. The women whose bodies are still suffering. The women who no longer know their bodies any more. The women who feel shame and keep silent.

This is the truth. This is a truth.

Breast vs Bottle

A mother’s group I am part of has had a few ‘debates’ recently about breastfeeding vs formula. I say ‘debate’ in inverted commas, because I really don’t think it is a debate. Ever.

I think that if you have ever had a hungry baby in front of you, at that point there is no ‘debate’ to be had. It is not a ‘choice’, because the alternative is a slow death from dehydration and starvation. How can we portray that as ‘choice’?

I breastfed both of my children, but not exclusively. Breastfeeding is hard. It takes work, and I’m not saying the solution to every problem is to just throw your hands in the air and say ‘oh well. Here’s a bottle.’ But see how thorny this issue is that I feel the need to clarify myself so much?

What I want to say is this: breastfeeding is like a ladder. It always takes work to climb it. But everyone’s ladder is different. Some are steeper. Some have rungs further apart. Some are slippery. Some have broken rungs. So we all need to think about how someone’s ladder differs from our own.

As part of that ‘debate’ I got a little piece of knowledge shared with me. That you never need to offer formula straight away, because you only know you aren’t producing enough milk once you’ve tried. Here is what my own personal experience tells me that is – it’s bullshit.

When my daughter was born I experienced a uterine inversion. That means my uterus came out with the placenta. It is a very serious medical emergency, for many reasons, one of which is that it is typically accompanied with severe haemorrhaging. I lost 3.7L of blood in a very short space of time. Post-partum haemorrhage is directly linked to delays in producing breastmilk. I faced a number of barriers to starting milk production. I was separated from my daughter immediately following birth, I was anaemic, and my body was so short of fluid following the haemorrhage that it didn’t have any to spare for her. Lastly hormone changes after birth that trigger milk production can’t occur because there literally was not blood flowing through my body.

My daughter was hungry and eager to attempt breastfeeding, in fact she latched perfectly. But when my body could not even produce colostrum until day three (really) it was no surprise. We began supplementing early on, and despite this at her first weigh-in at two days old she had already lost 9% of her bodyweight. We increased the amount of formula, as 10% loss is considered a danger zone. Tell me, what would have been gained by waiting and seeing? With me that sick in a hospital bed, listening to my daughter screaming with hunger, unable to produce milk to feed her, and starving her to the point we risked her health. Why should we have sat there thinking that milk would come eventually, when given the specifics of my case, things were going exactly as medical professionals expected. We can all speak in generalities, and discuss WHO guidelines, but guidelines cannot be written that cover every individual case. And, as Monty Python said, we are all individuals.

For me, there was no debate to be had. No choice. No regrets. I will never regret that my daughter was fed formula for her first meals. I am grateful to the nurses who bought it to her. I am grateful I gave birth in a hospital where formula could be supplied by hospital staff.

So that is why when people say ‘oh I’m sure you made an informed choice’ it comes across as patronising. It literally doesn’t matter whether you have read a million studies comparing benefits of formula vs breastfeeding (which frankly aren’t as one-sided as many people seem to think, because any study like that is inherently fraught with difficulties). And that is why people object when people say ‘it needs to be considered carefully, like any medicine’. Formula is not medicine. It is consumed like food, and metabolised like food – because it is food. Someone might have an allergic reaction or intolerance, but that can happen with breastmilk. It is regulated to make sure it meets nutritional standards, but it is not, and should not be, restricted like a medicine.

I am glad I was able to establish breastfeeding eventually. Not because I think my daughter will be healthier for it, but because bottle-feeding is a pain. Seriously: sterilising, getting the right temperature, and most importantly, you need one hand to hold the baby and one for the bottle, so unless you have three hands you can’t use the TV remote at the same time. Rubbish!

Even at the time ‘resorting’ to formula was the least of my concerns, so I’m pretty thick-skinned about my experiences and what someone else might think of them.  But I’m not writing this to defend or explain myself. I just want people to remember that nothing in life goes as planned. A lot of people are absolutely convinced they will breastfeed and then they can’t. And it is devastating for them. Careless words can really add to that pain. Especially when you are in those first weeks of newborn life and just trying to cope. There are some people who seem to think it is just a matter of trying harder (not just feeding – conception and birth seem to bring this out too), but it is much, much more complicated than that. There is a portion of all of this that is just luck.

So if you won in the biology lottery, remember the ladders. Remember that if the bottom rung is missing, like mine was, no amount of oatmeal or fenugreek or pumping or lactation cookies is going to be the answer. And remember some people can do everything right, and find they just can’t get to the top.

I write a lot about not judging others on their parenting journey. But, I’ll admit this – when I see someone standing on their non-slip safety step-ladder, giving themselves a clap and saying ‘it’s so easy. See how I did it!’ while the rest of us wobble around on rickety splintery wood that stretches into the clouds…

That is when I feel a bit judge-y.

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.

DSCN9714

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.

Only the best is good enough

Before my son was born I went to the free breastfeeding class at the hospital. It was terrible. They didn’t spend time discussing common problems women have. No mention of tongue tie, delays, or even mastitis. It was a typical ‘agenda’ class. Breastfeeding is natural. Baby will latch on, your supply will magically match itself to baby’s needs. They did have a mother come in to discuss feeding her infant. She hadn’t had any problems feeding, her baby slept through from six weeks (wtf?), and when she fed her baby in a class full of women there to learn about breastfeeding, she used a cover. Look, this woman had clearly had a lucky start, and while her experiences are just as valid as anyone elses, I’m just not sure it was the most informative perspective.

Feeding a newborn is hard. It is work. It is work when it works out, and work when it doesn’t. New mothers are often so badly supported by the networks who are meant to help them. You can go to a class, and not learn anything, other than they thought they should teach a group of heavily pregnant women who had voluntarily turned up that they should at least try to breastfeed. As though that wasn’t exactly why we were there. And then things go wrong, and people say ‘I didn’t know’.

So in the hope that these words will be read by someone who needs them, I offer up to you my story. My stories that should be. Two very different experiences of feeding newborns.

Feeding my first baby

 I was lucky. Oh so lucky. How I hate that word. Not only did my milk come in, I had an abundance of it. A massive oversupply that meant I was so engorged my son couldn’t latch on without me expressing first. That sent huge gushes down his throat that promptly came back up again. And that meant I was in so much pain I wouldn’t sleep, waiting to get him feeding again to ease the pressure. He vomited and vomited and vomited. But he gained weight. ‘He’s just a happy chucker’ they said, though my son was anything but happy. We were drowning in a sea of milk-covered-washing but he was gaining weight. So we had nothing to worry about. He went from the 10th percentile at birth to just over the 50th. ‘He was born hungry’ they told me, ‘babies don’t overeat’ I was assured again and again and again. So I kept feeding. And he kept screaming.

Our doctor eventually referred us to pediatrician, but we had a long wait; ‘baby screams a lot’ doesn’t exactly get you on the priority list. I spoke to multiple midwifes and health nurses. My supply did adjust (I highly recommend block feeding for oversupply) but my son was no happier while feeding. I gave up dairy. I wept. He wept. Then came the night he refused to try feeding after he got upset. The next morning I managed an appointment with a different doctor. ‘Have you tried medication for reflux?’ No. We were told multiple times a baby gaining weight could not have reflux.

It was silent reflux.

Even though we had to pin him down to syringe the medication down his throat, his mood and then mine improved dramatically. Not quickly enough to keep him growing. He developed a phobia of us putting anything in his mouth. He was eight months before he would try solid food. My milk supply finally let me down, I couldn’t keep up. He woke hungry multiple times a night. His weight plummeted down to just below the 5th percentile. But once he started eating, he didn’t look back, and was fully self-weaned at ten months.

A rare relaxed feed
Feeding my second baby

A difficult birth, with a severe haemorrhage. Blood loss of that magnitude typically causes delays in milk production. My body barely had enough fluid to keep itself going, of course it couldn’t manage colostrum as well. My daughter was a healthy, hungry baby. She latched on straight away and just kept trying. I’ll say this for my babies, they are suckers. But as we got into the second day, she got angrier. Quite frankly we were relieved when a nurse walked in carrying formula. She fed and fell into a happy sleep. She had a few more top-ups, as well as sucking away at me. The next morning she was weighed, she’d already lost nine percent of birth weight. We kept going with breast first, formula for afters. Eventually she began to regain weight. And by a month old we were exclusively breastfeeding. I’m pleased I was eventually able to get there, but I will never, ever, feel guilty that my daughter’s first meals were formula.

This is where I know I was lucky. We had a cast iron reason for why my body was not producing what she needed. Did I feel like my body had failed? Yeah. I felt like it failed when my uterus went walkabout and tried to kill me. But I survived, so after that we just had to deal with where it left us. But lying in the hospital bed, watching my husband feed the baby I wasn’t strong enough to actually hold yet, I cried. Of course I cried. I cried many times. I cried once we were home and I couldn’t tell if she was hungry crying, and needed more formula, or crying because she just wanted something to suck to help her sleep. The two of us were a big crying mess a lot. And while she was louder, she was also cuter.

Sometimes I wondered why I was so persistent, considering how much I hated breastfeeding the first time round. Once it was working, mostly it was okay. Sometimes it was frustrating to be stuck when my boy wanted me to play. Sometimes it was boring. Sometimes, in the middle of the night, when it’s just me and her it can be nice; I’m not pushing her to quit. Sometimes after four years of pregnancies and feeding I really look forward to putting this work behind me and my body being my own again.

Feeding newborns is hard work, however you do it.

When you have a new baby, and you go out and see other women with theirs, it’s easy to feel that they’ve got it all worked out. That you are the only one struggling. But everyone has a story, or will get one eventually. Those mothers might have had a start as difficult as yours, and with just a couple of months under their belt are able to get out and look okay, because things do, and will get better.

It gets better. We tell each other this, we tell all new mums this. But that doesn’t always help someone now. There are too many judgemental people, and too many people unable to look beyond their own problems. I was told so many times to stop complaining about oversupply because it was not a real problem. And that hurt. When I sat in bed crying, trying to convince my son to stop crying, those words hurt. We have to remember it is not a competition and there is no one legitimate problem.

So here is my most important point: how you feel matters.

‘Fed is best’ might be true. But it is also reductive.

It implies that as long as your baby is fed, it doesn’t matter how you feel about it.

There is no job where you are expected to love every aspect of it. People have a moan about loving the work but hating that their colleague is always yelling. The retail worker complaining about not being free to take toilet breaks when they need them. Or, a waiter, who always gets food spilled on themselves, staining clothes and making large quantities of washing. Or the plumber on call 24/7 receiving midnight call outs when they want to sleep. See if it is an actual job, a real job you get to complain.

Newborn babies can spend eight hours in a day feeding. That is a full-time job. A full-time job where at best they fall asleep, or at worst they crap on you.

So, go ahead complain that it hurts and doesn’t work. Complain that you are sore. Complain about being tired. Complain about the mess. Complain that you are heartbroken that it didn’t work out. Complain that people judge you for choosing not to try breastfeeding, because you are still feeding your baby aren’t you? Reach out in the middle of the night when you feel alone and as though you are doing it all wrong. And the rest of you reach back to lift others up when they need.

Feel how you feel. Own it.

But also know this. Eventually you have to let it go.

Thanks for reading. Please drop by my Facebook page to let me know what you think. Or join me on Twitter or Instagram.

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.