I consider myself to be quite young when I had my first baby. I was 20, thought I was in a safe happy relationship and had a roof over my head. Ideal time to bring a baby into the world I thought. Apart from horrendous morning sickness and pretty bad SPD later on, the pregnancy went very well. I even started my maternity leave early and would laze around in the mornings watching baby programmes on the discovery channel. Even the start of labour was straight forward, a week late, membrane sweep, then a few hours later the trickle of water. I progressed pretty fast, but baby was back to back so took a lot of hard work to get out. An episiotomy and vacuum delivery followed with legs up in stirrups on my back. Gosh it makes me shudder! No one encouraged different positions, not a lot was communicated with me and I think a lot of this was to do with my age. Okay I wasn’t 15, but I still think I was naïve and not treated accordingly. There wasn’t really informed choice, I was just told what was best and expected to go along. I should have been active, on my feet, on all fours, over a ball! Anything except on my back, waiting.
Anyway, eventually she was out and I was filled with euphoria, high on endorphins. We were a family. A short stay in hospital and then I returned home to the bubble of motherhood. The tenderness disappeared and I was getting used to this little bundle of noise that always wanted feeding and cuddling. I was coping ok….for a while. Even at the postnatal check, I was fine, even if a little sleep deprived.
A few weeks after this, I started to feel not quite right. I considered myself lucky, because the women in my family had all suffered from postnatal depression so I knew what was happening, well I thought I did anyway. I popped down the doctors and told her the family history and what I had been feeling. She said “well what would you like, some tablets?” In hindsight I was stupid, I should have asked if there were any other alternatives. But I was young, naïve and trusting of the doctor because of her position. Anyway, my mum had had tablets, I just presumed it was the norm and it would make me better.
She scribbled her prescription and a few weeks later it did. I started to feel normal again for a short while. We then relocated to stay with family for a few months. It was during that time, things got a little worse. Having a baby in someone else’s home was tough, not to mention the clash between the woman of the house and I. The tablets were losing their effectiveness. My dose was increased and all was well again.
Little one’s first birthday came and went. Life was good and we started trying for little monkey number two. She was conceived and the whole cycle started again, this time whilst in temporary accommodation. After we found another home, my partner left and I continued the pregnancy alone. It was incredibly daunting, but this time my experience was different. I had exceptional care from my midwifery team. I was supported with an active labour and there were no complications during delivery. I was an emotional wreck because of going it alone, but I had my babies and was supported exceptionally by the team of midwives and health visitors. I suspect this was for two reasons: I was under a completely different trust and I was already in the system as struggling with perinatal mental health issues. I was back on medication, but things were manageable because there was a support system in place.
I was also referred to Home Start for a volunteer to come and see me for a couple of hours a week. This was a fantastic help. Not so much for what could get done when she was around, but more in how I could talk to her. I didn’t see her as a health professional and so I didn’t feel I would end up in a psychiatric unit with what I disclosed to her. She probably did have to have conversations with the managers, but I trusted her to convey that I wasn’t a risk. She did a fantastic job, listening to me, supporting me.
I met my present husband after a while and we fell in love very quickly. I suffered a bereavement of someone close and because my PND still had not completely resolved I continued to see a counsellor and the health visiting team, just to be safe. Eventually it got to a point where I felt my medication was doing more harm than good. I actually couldn’t feel anything and missed having strong emotions such as joy and anger. I came off it and I started to feel better very quickly. I was coping well. I don’t know if this was because I felt more in control now I was off medication or it could have just been the old cliché that time was a healer. Very quickly, I fell pregnant with child number 3. Although planned and although I was feeling much better, I couldn’t help but feel anxious about what lay ahead. I was worried that the PND would be much worse this time, because I hadn’t properly dealt with the bereavement I had had. There was also an intense fear of my husband leaving, because of what had happened in my second pregnancy. I was right to be worried, not about my husband but definitely about the depression.
My little boy was a shock to the system. His birth was great, everything went smoothly and quickly and we were home within hours. Lovely. What I didn’t anticipate with this one, was the complete lack of sleep. If I thought I had missed out on sleep before it wasn’t a patch on the sleep deprivation I was about to experience. The first two children, for reasons I regret, I formula fed. Although they still awoke in the night it was tolerable because they would actually sleep. Not this one. For the first couple of years he needed me all the time, always needed feeding to sleep, would never stay down when I put him down and left me without a life.
I actually couldn’t cope.
The tearfulness was too much. Blazing rows ensued. The whole family felt in bits because of the turmoil I felt and was inflicting on others. My eldest struggled with her behaviour, adding fuel to an already out of control fire. There was so much conflict and I felt it was my job to resolve everything and hold everything together, that is what mums are for. I just couldn’t. I didn’t get out with my little boy, didn’t do hardly any of the things I wanted to. I wanted to go to groups, but couldn’t face putting on a brave face or pretending I was enjoying this part of my baby’s life. I was wracked with guilt, thinking I shouldn’t be feeling like this! I had so much love for my son and the others, why did I feel this way? Why couldn’t I just pull myself together? Sleep deprivation really took it’s toll and I found I was having intrusive thoughts all the time, about me, my husband and my children. I felt completely abnormal, thinking perhaps I was a psychopath or something. I didn’t dare talk. I knew deep down I wouldn’t do anything, but I still felt frightened by the thoughts. I was terrified that one day they wouldn’t just be thoughts. I didn’t even tell my husband for fear he would leave (and given how rocky life was, that was feasible). I just struggled in silence. I was uneasy with what I could be capable of and worried something might just send me over the edge, like one day, it would just be too much.
I was terrified of my family being ripped apart, of ending up hospitalised with the children going into care. To protect my family, I hid it all. I hid it very well, in my eyes we all lived together through it, being separated even if health professionals thought it would be safer, just wasn’t an option for me. It was us all together or not at all. I know now, that it wouldn’t have been like that. But when you are in the thick of it, that’s not how you think. A lot needs to be done to reduce the stigma associated with care management of perinatal mental health. Women need to feel more in control and informed, rather thinking they are going to be carted off in a straight-jacket!
I don’t know how we held it together as a family, I really don’t. This time I had to manage without the medication because I was breastfeeding. Thankfully that is no longer the case for women, there are some safer anti-depressants that can be used while breastfeeding. Thankfully, we did make it through, all together.
I started doing whatever I could just to get by, setting small achievable goals, organising chores a little better. These goals became bigger, I decided to do the Race for Life even though I was always rubbish at running. I did it! And because of having to train for it I got better at exercise and increased my fitness levels. My confidence and self-esteem rose. I felt like someone again, someone who could achieve whatever they put their mind to. I was signed off from Home-Start and I started setting goals all the time, always something giving me a focus outside of family life, something for me. The real turning point was setting my goal of achieving my midwifery dream. I then set about researching the role even more and putting smaller goals in place to achieve it. I started volunteering at the maternity unit, I volunteered for Home-Start as by now I had recovered enough to help others and help the charity that had helped me. I started to feel more fulfilled.
I then went on to have another daughter. This time I was very anxious. I was frightened for me and frightened for my family. This time I made a decision that changed everything for me. I started to quiz the females in my family. It turned out all suffered from severe PMS the same as I did. All had had PND. And all the older women had struggled more than most with menopause. I began to think there was, I don’t know, a hormonal link? I started to reflect back on my own experiences of PMS and PND. My PND only ever started at about 8 weeks post-partum. Right after I had always started hormonal contraception. I am no expert, but I decided to chat with my doctor and opt for non-hormonal contraception this time round. She agreed there could be a relationship between the two and that it was worth a try. Well I tried. And it worked. Twenty months later, still sleep deprived (actually more so this time!) and yet no depression. It could of course be coincidence. It could be more a mind over matter thing. It could be that it wasn’t going to happen anyway – not every woman suffers with PND every pregnancy. But I will never touch hormonal contraceptives again because of it. Unfortunately there is no evidence (or indeed very much research) to substantiate my thoughts. I wish there was. One day there may be. Thankfully, I trusted my instincts instead of lack of evidence (I am not advocating that, by the way, it is a flaw of mine that I will address!) and on this occasion I actually came away better off.
My life now feels completely transformed. It is of course, not a bed of roses! I am a busy mum, with children that are growing up, knowing their own mind and constantly challenging me. Life is not easy by any means. But there are others worse off. And I can cope. It may sometimes feel like I am drowning. Especially at particular times of month! But I know it is temporary and within a few days I can reclaim some control.
I am now undertaking an Access course to try to achieve my midwifery dream and am in the process of setting up a local group for mums with perinatal mental health problems. A place they can come with their children and not worry about the brave face or pretending to cope or enjoy motherhood. They can make like-minded friends and their children can make friends. And they can talk, in a safe environment, without fear of judgement. When I achieve my dream of becoming a midwife, I fully intend on specialising in Perinatal Mental Health and working with others to reduce stigma associated with these issues. I want to help more women in the antenatal period and increase awareness and vigilance of this dark, frightening illness. It is time to change things.
Please note: I am not a health professional, giving evidence based advice, this is just my story. I hope it helped in some way.