"You think you can control and predict it. You think your birth plan covers [all of the contingencies]. You think because I did yoga, acupuncture, massage and ate well during my pregnancy, I'm going to have this chill kid. You think because I was so prepared for a natural birth that everything will go as planned. That’s not what happened. And, that’s just the way it goes."~ *Kelly, age 37.
Kelly, a healthy, vibrant, confidant, generous and intellectual woman knew she wanted a family; to be specific, she knew she wanted 2 children. Like many, she and her husband's road to a family took assistance, time, and patience. Over the course of 3 years, Kelly and her husband *Zach worked hard to become pregnant, trying various methods and eventually a successful IVF which led to the birth of their son. Kelly stated, "That was the easy part [trying to get pregnant]. Even the IVF and it's $30,000 price-tag. My pregnancy was uneventful and unremarkable. I enjoyed being pregnant and threw myself into every class to be as prepared as I could be [for the birth and afterwards]. We were so ready. I had everything planned, my birth [preferences], the cooling pads to help ease discomfort [after a vaginal delivery]... We even met with a sleep coach."
PMADs (perinatal mood and anxiety disorders, formerly known as postpartum depression and anxiety disorders) don't have a set person they will strike. While some women have experienced conditions and/or difficult life experiences which place them more at risk, (e.g., a history of anxiety or depression, family history of mental illness, prior pregnancy loss, single mother, domestic relationship violence, etc...) a lot of women have zero previous risk factors. PMADs can also strike because of birthing and post-partum experiences (e.g., traumatic birth, hormonal shifts, baby experiences a physical health issue, breast feeding difficulties, sleep deprivation, etc...).
According to the World Health Organization, in developing countries, 15.6 % of women experience PMADs during pregnancy and 19.8% of women experience them post-pregnancy (World Health Organization). These statistics are likely underreported as there are women who do not report their experience of PMADs, whether this is because of stigma, lack of screening, or fear of repercussions.
Pregnancy is supposed to be this amazing, glowing, peaceful experience, right? Labor, while supremely difficult is a pathway to meeting your baby and feeling the ultimate bliss, yeah? Everything is going to be joyful and perfect when you hold your baby for the first time, true? Once we are mothers, we will find that despite little to no self-care or sleep for ourselves, we will love the act of surviving. Well, not exactly.

Kelly stated, "Throughout the whole infertility process, I held onto one thing, the moment when the baby comes through the birth canal. I was just waiting, waiting for that moment. I never got to have it. I never got to experience that overwhelming moment of love and joy. I never felt like I gave birth. Instead, I [had a c-section] and I hated every minute of it."
An exhausting labor, vaginal delivery turned into emergent major surgery, loosing the bonding time you envisioned, your baby's undiagnosed painful health issue and related nearly around the clock screaming, your extreme sleep deprivation, the toll of stress on your physical body and recovery, difficulty initially with breastfeeding, learning the c-section caused lasting nerve damage to your body, and your entire vision of new motherhood traumatically ripped away from you.
"I don’t remember any sweet moments. [Post-partum because he was in so much discomfort], I could never put him down and I could barely ever sit down. I would wrap him up and we would be in constant motion; if not, he would constantly scream."

Kelly's experience of PMADs was the result of a traumatic labor and delivery combined with a 4th trimester of experiencing overwhelming sleep deprivation, doubt, anxiety, sadness of what happened, physical impacts of a marathon labor, extreme stress (she developed a severe viral infection caused by stress), her son's intense discomfort and screaming, and much more. Kelly stated, "I remember being in the rocking chair and he’s screaming. He screamed so much. The poor guy was in so much discomfort but we didn't know why until much later. I put in my ear plugs and just let him scream. At one point, I used my phone to look up newborn adoption. I felt so overwhelmed."
Never ending days and nights morphed into a cycle of feed baby, hold baby upright, try to put baby down and baby screams, hold baby all day long, sleep deprivation, try to eat, shower rarely, feel yourself slowly dwindle into hopelessness and anxiety, scream out in rage and desperation, and feel a need to seek a way out. Kelly stated, "I remember thinking at one point how we have really sharp knives in the kitchen and i could just go sit in the bath tub and slit my wrists. The only reason I didn’t do it was because of my husband. I went to talk to [a therapist] soon after that."
Today, while she is nearly 3 years from his delivery, the vulnerabilities of those moments remain. "It’s really sad to me that the biggest trauma of my life is the birth of my son. I used to always think I'd have 2 kids, but after this, I can't. I can't do it again."
There is a lot of pressure on us to have the best pregnancy, the healthiest and most natural of deliveries, and to be the perfect most together mama. To return to work and thrive. To be able to manage the daily tasks of home life on little to no sleep. To heal from a major surgery without adequate nutrition or rest. To maintain a loving relationship with your partner. To not fall apart.
Coming out from the fog takes time, compassion, understanding, emotional expressions, physical healing, SLEEP, adjusting to a new life, support, reconnecting with your loved ones, and acceptance. "I feel like I am much more empathetic now, much more understanding that not everyone's experience is the same. I have always been a supporter of therapy and I'm very thankful for it."
When asked about what could have been done differently to support her recovery, Kelly stated, "The one factor in all of this that [doctors, therapists, etc...] could never do for me was, sleep. They tell you in order to [have a good supply of breast milk] and function, you need 4-5 hours of sleep concurrently, but also to feed your baby every 2 hours. It's a ridiculous and [pressure filled] expectation. There's just no way to properly heal without sleep, yet how can you possibly get it when your baby is in so much discomfort."
Mamas are extremely powerful and resilient beings. But even mamas have the right to fall apart and seek help. It's heartbreaking to detach from our hopes and dreams, yet this is part of our healing.
Know that there is no perfect experience of motherhood and some of our experiences are really terrible. You have the right to grieve your hopes and expectations. You have the right to feel anger, rage, desperation and deep sadness. You even have the right to literally scream. You also have the right to gaze upon your new life with compassion, recognizing that while it wasn't what you envisioned and you might trade it for that image of a perfect hippy naturopath home water birth happiest baby who sleeps through the night, your path is yours and you can find your footing. "It’s added to the fullness of my life. It is what it is. I’m on my path for a reason."

*Names changed for confidentiality purposes.
** My sincere thank you to *Kelly for her bravery, sincerity, truth, and vulnerability.
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