Recently, one of my clients became a parent in a rough way…their calm pregnancy shattered by an emergency c- sections and premature delivery…landing their son into Neonatal ICU…and themselves into the land of post pregnancy, post-traumatic stress with shadow thoughts, burning anxiety…doubting everyone and everything…a world turned upside down.
Terri shared with me, the inner chaos and darkness she felt. She had dreams of being a nurse and was a student well on her way to reaching that dream. This came to a screeching halt with the rush of blood and contractions…way too soon. In fact, that’s all she remembers that early morning…a stab of pain, rush of warmth…then the words “it’s too soon” screaming at her husband. The ride to the hospital and into surgery…blurs. The doctor leaning over her, with words of “lungs not fully developed” …” not her fault” …the emptiness of her arms and her hospital room…no baby to cuddle or nurse.
Later the agony of seeing her son…eclipsed by the tubes and wires attached to him…the beeping and lights of the machines – registering her little one’s every breath and heartbeat…watching her husband’s face tense, then break into sobs. She remembers wondering how such a little baby could have so many tubes coming out of him…and then shaming herself for such a detached thought. Hours turned into days, then weeks as her son got a little bit stronger each day…gained a little…each milestone she allowed herself to be a little more optimistic and little less guilty for being a “bad mom”, “doing or not doing something that landed in him coming to early”. Despite all the doctor, nurses, husband and family’s words of comfort or quoting statistics on premature births…. Terri felt in her heart and shadow thoughts that she could have prevented this.
Terri’s reaction is all too real, but what is different is Terri’s willingness to share her shadow thoughts, the consuming heat of anxiety and guilt, the cold sucking depression that has wrapped itself around her and drags her down…ready to give up her dreams…struggling to just get through another day. Terri is dealing with a double cocktail of postpartum and post-traumatic stress…and her husband as well.
Most mom’s to be are not well prepped for the mental and physical changes that occur after delivery. I know I wasn’t. Typically, we focus on the end goal…delivering a healthy baby, not giving much thought to the impact of post pregnancy. I had all the important stuff in place (or so I thought) with diapers, car seat, baby monitor, pediatrician…a few frozen meals and nursing bras, but that was about the extent of my preparations for myself as a new mom.
As in Terri’s situation, adding the trauma of an emergency life threatening situation with surgery, her recovery from surgery, her child on life support…and the impact is astronomical! Many clients tell me that years later they are haunted by the images of seeing their child connected to a seemingly endless maze of tubes and wires and the sound of the incessant beeping and alarms from the machines that connected their child to life.
It’s common that our family and friends unknowingly minimize our experience and prevent us from realizing what is really going on and delay the help we need. Honestly, they want to feel better too, they don’t want it to be another big thing…and so they explain it away with very real-life events, but that only masks the situation and delays help. Terri was told “that’s just the exhaustion of not sleeping and running between home and the hospital” or “that is just normal hormone changes” …” you’re not really depressed” …” it’s just a postpartum thing, it will pass”. Most new moms or dads aren’t prepped for postpartum depression and anxiety, let alone post-traumatic stress.
Though we expect moms to break into tears at times or become irrational or temperamental and write that off to the stress of not sleeping or hormones, folks rarely mention the anxiety – the hypervigilance – one’s mind going a mile a minute – preplanning even the simplest task like a bath or feeding (tongue in cheek as there’s nothing simple with a baby). Terri’s son was released from the hospital, only to return a week later with difficulty breathing again. She now divides her days and nights between home and hospital, trading shifts with her husband. Support has dwindled as the hospitalization continues…but the stress and worry have her days a blur. Terri has gotten lost in the drama – putting all her needs on the backburner…stuffing her agony and guilt down as the daily stressors take a higher priority.
What helps is putting a name to the emotions and thoughts a mom is having…normalizing it as part of post-partum complicated by post-traumatic stress and providing support and guidance as they manage the competing needs of a sick child and their own recovery. There are so many factors impacting a Mom in this situation: the physical impact of the birth process, medications used for pain or inducing labor, surgery, anesthesia, blood/fluid loss, the shift in hormones, “milk coming in”, lactation…creating a new hormone rush, stress of being in the hospital, loss of sleep, diet changes.
The nonphysical/biological factors: change in role from being a pregnant “Me” to “Mom”(this is a huge game changer…so watch for other blogs on this topic), loss of specialness = focus on child, role changes for hubby, loss of personal self, loss of control over time and how you use it, family dynamics of mothers, mother in laws and others…telling you how to be a good mom…nurses and other professionals bombarding you with “best practices…how to do’s”, self-doubt, guilt (about anything and everything), anger, depression, anxiety. The list goes on about all that assaults a Mom now. Compounding this is the very real fact that her baby is a priority over anything she needs…sleep, food, showering…self-care is thrown out the window as the baby comes first. So again, we Moms stuff these questions and emotions down for the moment and tend to our child.
For moms that have a life and death birth situation …their needs are really wiped out…once they are medically stable…all eyes and energy are on the baby. Post-traumatic stress becomes a luxury word or “notion” that will be considered once their baby is safe and home. Many moms describe the early days and weeks as a blur…of harsh emotions, bitter anger and grief…mirrored by gratitude the doctors, God, the Universe and grit for sticking in there…cheering for their baby’s next milestone…a sucking response or feeding that went well, a change in color…an uptick in their weight…a chance to touch or hold their baby. They feel raw, ragged, exhausted by the endless tests, anguish over being helpless to prevent their baby having any more pain….
Terri shared that after her son came home and life became “normal” again, she had begun having intrusive and shocking images…of seeing the blood trickle down her leg on the way to the hospital, harsh lights in the OR…of her first moment with her son in NICU. She says she is still haunted by the smells of the hospital…the alcohol wipes…the stale air. These flashbacks – sudden, triggered sights, sounds, smells are all part of PTSD. Her sleep is disrupted- she wakes up constantly- checking on every family member…including the critters. Haunted by a restlessness, anxiety…no longer confident in her future or her family’s security. This unrest, agitation again is all part of PTSD. Understanding that your body, mind and soul has been “under attack” is important in identifying what is happening and then getting the right help.
I always ask that my clients get a complete medical work up to see where they are physically – how their hormones are, how their body is recovering…getting their doctors into the loop is critical. Then we look at the impact these new thoughts, feelings, behaviors are impacting their life. How much is a simple role transition from “Me” to “We”, exhaustion, self-care, old messages, post-partum concerns, post-traumatic stress issues…relationship conflicts that are now emerging or enhanced with the extra stressors. These are fixable, doable…but it takes awareness and information to help start the process. If you’d like more information or to ask me a question – please schedule a private Discovery Call to see how I can be of help.
Hugs- Dr Liz