PTBD (Post Traumatic Birth Disorder)
In my hospital room on the 9th floor of Winnie Palmer Hospital a few days after the birth of my daughter, I found myself frantically trying to change the channel on our television. There was no way I could watch what had just come on, the twinges of a panic attack were proof of that. What was this horrifying, panic inducing television program?
Scrubs. There was a pregnant woman going into labor.
I suppose I should have taken that as a hint that I wasn't totally OK in the wake of my birth experience. In the days that followed, I couldn't comfortably look at pregnant women, and any pregnant woman on TV called for an immediate channel change. I would later be diagnosed by my therapist as having a case of PTSD.
I can now say (more than three months later) that I'm OK with what happened. I can think about it, usually without getting upset. It took weeks for me to even get to the point of reflecting on it at all. I couldn't even talk to my OB about the details of what happened until I went in for my 6 weeks postpartum check up.
I thought I was prepared for any scenario; I'd followed everyone's advice and had "no birth plan," was prepared to just go with the flow and let whatever happen. I read all the books, watched all the shows, and was ready for an anxiety-free birth experience, whether it be the old-fashioned way or by C-section. I'm writing this account as what I consider the last step in moving forward: being honest with myself about what I do remember (which is everything, although I denied that for a while).
The following is a true and complete accounting of the birth of my child.
I was diagnosed with gestational diabetes during my pregnancy. I had mastered the diet and blood sugars like a champ, but my OB was still concerned with me having a large baby. We agreed to bring me in and try induction just two days after my due date. If we didn't see adequate progress in the first 12 hours, we'd go for a c-section and be done with it. This plan was all so that my OB would be there at the hospital (Mondays being his hospital day). A few hours before I was scheduled to check in on Sunday to start the induction (I had not slept the night before, of course, excited as I was), I got a call from the hospital that they had no prepartum rooms available, and that I would be "on call" for the next available room. That room didn't become available until Monday afternoon. One guess as to whether I slept Sunday night.
Started cervodil at 3pm on Monday. I had NO natural dilation/effacing (my OB suggested my cervix, while excellent for gestating a baby, might be "hostile" to induction) leading up to this. I'm hooked up to all kinds of monitors. Daphne is not fond of her heart monitor and kicks it off at least once an hour, leading to beeping alarms and the nurse having to come back and replace it. At 3am the cervodil is removed and I'm checked... 1 cm. We do another cervodil. Horrifying cramping, back pain comes intermittently. One guess as to whether I slept Monday night.
Monday at 11 am they check me... 2ish cm. They decide to move me down to labor & delivery floor and start me on pitocin to get some good contractions going. I'm a zombie, but I'm excited to do SOMETHING. Before we start the pitocin I ask to get a walking epidural, because I'm uncomfortable already and i've heard horror stories about pitocin contractions. The walking epidural is a pile of fun. I feel sort of tipsy and silly. I have a great room with a huge window. I walk around for a while, bounce on the ball. Contractions come on stronger and the lower back pain is getting pretty bad. They check me. It's around 5pm and I'm at around 5 centimeters. The doctor decides to break my water. I ask for a full epidural at this point. I think I fell asleep for an hour or so, numb and happy. I am woken up by a dull ache in my lower back. As I watch the contraction monitor, it gets worse and worse with each contraction. I push my epidural button, nothing is happening. Ian has to start counting me through the contractions. My contractions are crazy strong, but not consistent or regular (I'll have two right on top of each other then go a few minutes). Time goes SO SLOWLY. The pain/pressure in my lower back is absurd, so I ask to be checked again. The nurse doesn't think much time has passed and she's reluctant to check me because she thinks I will find any lack of progress discouraging. There is no way progress hasn't been made, not with this pain I am feeling. She checks me... 9 cm. Take THAT. It's around 8 pm. She tells me I'm doing great, still a little bit to go, then we can call in the doctor and start pushing.
I'm elated. I wanted to go for vaginal delivery but my doctor has only given me a 50/50 shot that it would be possible and here I was, super close to doing just that. I am in a LOT of pain for someone with an epidural. Suddenly, the pain eases but the pressure to push is intense. It's only been 30 minutes. I call the nurse back in. Sure enough, no more cervix. It's about go time. The epidural has magically started working again. She calls the doctor, he's about to come in when he gets called to an emergency c-section. Nurse says 30 minutes. An hour later we get everything in position, and we start pushing without the OB. Other than giving myself a raging headache, I'm not too uncomfortable. It's been more than an hour of pushing, the nurse says the baby is having trouble getting past the pelvis; she keeps creeping down then inching back up. Eventually I push her past that bone and it's like someone turned off the epidural button again, because I FEEL EVERYTHING. The doctor is there now, telling me to "slow down." Ian's holding my hand and there's a nurse on either side of me coaching me.
A moment of hilarity just before I delivered my daughter: I'm pushing and I don't know what physically happened but the OB says "Whoopsie!" and a giant globule of blood and... lord knows what literally shoots out and up and ALL OVER the nurse intern. Ian and I look at each other, desperately trying not to laugh, as the other nurse tells her she can go change her uniform. Bless that intern, she looked down at herself, looked up at me and smiled and said, "No way I am missing this!" Pushing, pushing, doctor saying "slow down," he turns around to grab something, I yell something along the lines of "F*** F*** F***, get it out get it out!" and out comes my daughter.
It is 12:01 am on July 4th.
We snuggle, she's weighed and measured. Meanwhile the OB is stitching me up. I ask how bad, he says "barely a 2." I feed my daughter. I feed myself a turkey sandwich (haven't been allowed more than broth since around 9am). They take out my epidural and catheter. The grandparents come up to meet the baby, then go back to their hotel room. I ask for a nurse to help me go to the bathroom.
On the way to the bathroom, I faint. I come to sitting on the toilet with nurses all around me. I can't pee, but I need to. They recatheter me and 900cc of fluid comes out of me. They say it's ok, happens all the time. They change the pads under me. I'm feeling woozy, but I notice the nurses keep checking me and checking the pads and whispering to each other. I faint again, and they bring the doctor in. I'm fuzzy about the details here but every poke is hurting, I'm being prodded, I feel tearing, then the doctor says "I want her in the OR NOW."
People are scrambling around getting ready to take me to surgery. They want to give me a spinal, but my epidural catheter is gone and the thought of getting another is terrifying to me. The anesthesiologist says "don't worry, I'll give you general, you'll be fine." I ask him if it matters if I ate a turkey sandwich. He gives the nurses a dirty look. Ian, who has been such a champ, is holding our daughter and crying, panicking at last. This moment and memory is still the hardest for me to revisit. I remember telling him it was no big deal and not to worry about anything. They wheel me off to the OR at 4am and I have to sit up to get a spinal catheter AGAIN.
The anesthesiologist pumps me so full of drugs most of the surgery is a blur. I was awake, but I was cold and thirsty. And babbling. About who knows what. I do remember asking the nurse to find my husband and update him.
At 7 am I am reunited with my husband in ICU/recovery. I am about to faint again. I am given 2 units of blood. It takes a few hours, but I'm finally given my room on the surgical recovery floor and get reunited with my daughter. I have missed 8 of the first 12 hours of her life.
I'm on bedrest. I have machines hooked up to my legs to keep clots from forming. I can barely move anything below my ribcage. I'm trying to breastfeed my crying daughter. I haven't really slept in three days. My pulse is very low and my hemoglobin count is in the crapper (a "normal" count is around 15, a post partum mom is around 11, mine was around a 7). They have to give me more blood transfusions. They don't know when I can go home, because they aren't sure if I'm still losing blood. I get to take a shower on Friday (best moment EVER). I finally check out of the hospital and get to go home on Saturday afternoon. Longest. Week. Ever.
So what happened? I had some severe blood pooling in some hematomas inside and out, but the real kicker was that my darling, perfect, beautiful child tore one of my arteries on her way out, and they had to go in to find it. That was why I kept bleeding. They still aren't sure how much blood I lost but it took 4 units just to get me back up to a 9.
So there you go. The cause of my PTSD. I know there have been less ideal experiences, and goodness knows it could have gone MUCH worse than it did. Looking at it now, I'm surprised it had such a strong negative effect on me, but it did. Maybe it was compounded by all the crazy postpartum hormones, the delayed milk supply for my daughter, the lack of sleep, the total shock of newborn care, who knows. Let this be the last time I have to tell this story in detail, and let it be the last step in letting go and moving forward.