Originally written in May of 2012 during my Post Partum clinical rotation…
This week, I’d like to share some of my feelings surrounding this weeks post conference. The video “The Smiling Mask” touched me profoundly. Watching these people describe their personal experiences with post-partum depression and psychosis, brought me back to my own experiences and how they might impact my care of patients in the post-partum ward.
My marriage began very much like the young women in the video. I was young, happy, in love and looking forward to a fairytale life with a handsome husband and someday starting a family. Birth control, as it turned out, didn’t work for me and we found ourselves pregnant 6 months after getting married. Three months after that I got the call that my brother had committed suicide. At that time my husband was working on the oil rigs in Alberta and he had to come flying home from 16 hours away to be by my side. This baby was an unwitting passenger on a trainwreck of a mother. My family too suffered, not publicly, but inwardly and privately, never fully allowing the grief to be expressed. I tried to be strong (as was my conditioning from my childhood and broken home) and knew that I had a baby coming who needed me to be solid and confident. I tried to convince myself that I didn’t need help… after all, I had a baby to look forward to and that delirious happiness would fix everything. We went for our first ultrasound (baby and me, because dad was away again) and found out that the baby was a boy. I felt it was an answer to a prayer… A baby boy! His middle name would be Michael… after my brother. Five months into my pregnancy the bleeding started and I never felt so scared in my whole life. I never realized how much I was projecting my needs onto my unborn child. The bleeding turned out to be nothing serious… stress, the doctor told me (gee, you think?), and rest would help. The balance of my pregnancy went mostly as I hoped, with mild cramping when I over did it. But, my Mom and Dad were a real help, especially when my husband was away and were a great emotional support. My mother, in fact was my labor coach and on December 1st at about midnight we picked her up and drove through a blizzard to get from Dalmeny to the hospital. Seventeen hours later a baby girl was born…wait, what?…baby girl? But it can’t be a baby girl, I said, I am having a boy. Sorry, replied the doc, but I’m pretty sure you’ve got a beautiful baby girl here. Yup… it’s a girl.
A girl? Now what? How would this help? How would she save my life and my sanity?
We named her Paige Michelle (her middle name from the French, feminine of Michael). There… good….The only problem was that she hated me (well, not really), but I felt that she did. Breast feeding was not going well, the nurses who came to see me at home weren’t helpful, my husband was gone and I wasn’t getting any sleep. I even remember sitting in the living room with the baby (trying to not wake my husband) and the photo of my brother started talking to me. If I wasn’t crazy before, this baby is swiftly getting me there!
Looking back, I realized that while I had no one who truly understood what I was going through, I had masterfully hidden my sadness, anxiety, insomnia and frustration from everyone I knew, at least until my poor husband returned home. Then he had the misfortune of being the only person within range of my rage and tears. Each return home left our relationship more and more strained and on the brink of collapse. Each time he left meant I was again alone with my grief and misery (and my talking photographs).
In the end, my marriage suffered, I suffered, and I have no doubt that my husband suffered. Yet through all this suffering, never had I considered getting help. Perhaps if I’d seen a commercial about it, or had friends who were going through the same thing… maybe then I would have not found other coping methods to deal with my inner pain. Better yet, if I’d sought counseling after my brother died, I may have had a relationship with a counselor who would have recognized the trouble I was in. But it took repeating this post-partum clinical to come face to face with the painful memories of that time, to realize just how bad it was for me. And the tears I shed watching “The Smiling Mask” were for the mother and wife that I so desperately wanted to be, yet felt I had failed to become.
As I write this, I think about the patients I have had who were warned fully about post-partum hemorrhage and jaundice and the possibility of mastitis but don’t think that post-partum blues is serious, let alone that it can happen to them. It can sneak up on you like a thief in the night…. One minute you think you’re blissfully happy, the next, you don’t even recognize your own reflection in a mirror. And how does this even happen? I know in my case it wasn’t ALL hormones working their voodoo on my mind. I had a traumatic event… the unexpected death of my brother…. That I just couldn’t deal with. And although death and birth are normal paths on the circle of life, suicide is hardly a normal path to take. How many other women have had similar trauma’s in their own lives… broken homes, sexual abuse, death of a parent, childhood illness? Forget the external trauma’s we experience on a daily basis that range from terrorism, natural disaster, economic collapse, pandemics, crime waves and global warming! All of these combine to make a ‘perfect storm’ for post-partum depression that thankfully are not made worse by a lack of awareness of this condition.
Today new moms and dads have support groups, help-lines and Healthy and Home to provide the reassurance and care that new moms can count on when their emotions become too much to bear. Families no longer have to suffer in silence, with a brave face to the world, while they muddle through each day wondering if things will ever get better. For me, I know that I would have benefited greatly from having these resources available to me, and will never forget my own experience as a great teacher in how I can help others in my nursing practice.