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Guest blogger Maura shares her story of Postpartum Depression and Anxiety

Posted Oct 12 2010 10:49am
This week we'll be reading Maura's story.  Maura contacted me several months ago and asked if she could share here.   As a blogger , she's written a lot of posts, but she wanted this one to be read by those who could be touched directly by her story.  I am honored that she chose Beyond Postpartum as the place to do that.

Here's Maura's storyBefore my daughter was born, I was a high school science teacher and cheerleading coach.  During those years I desperately wanted to get married and start a family, so when I met my husband and we were settled in a house, I was very ready to start a family.  We actually conceived a few months before we were planning on “trying” which threw me somewhat for a loop.  But that pregnancy, along with one after that, ended as miscarriages.  Those were devastating times for me to say the least.  But I never imagined in my wildest dreams that actually giving birth to a healthy baby would have been way more difficult for me!

I had a relatively stress free pregnancy once I found out I made it past the first trimester. Things didn’t start to get “interesting” until I found out my baby was breech. I always thought she was because of the bladder dancing she did and I never had annoying feet pokes in my ribs.  But by 36 weeks, my midwife assured me that she was head down, and I breathed a sigh of relief knowing she managed to find the right position for delivery.  A week before my due date, I had another check-up, and told by another midwife (I go to a practice that has 9 rotating midwives) that she was in fact breech and I had an ultrasound to confirm it.  At that point, I had a decision to make:  I could either attempt an external version to see if we could get her head down again, or schedule a c-section.  I decided I had to at least try the external version, so I didn’t give up all hope of my goal of having a natural delivery.  Luckily the version only took 5 minutes of extreme pressure and pain and the doctors got her turned.  When the procedure was complete, one doctor told me her head wasn’t in the perfect place for delivery, but hopefully it would get in the right spot either before labor or during labor.  A few days after that my water broke and the contractions started right away.  After about 6 hours, I was already 8 cm dilated and the whole experience seemed to be going as I had wanted it to.  This is the part where everything turns ugly...

I remember when I got checked and was told I was at 8cm, I looked at my doula in desperation and said, this is the part that is supposed to go fast, right?  I thought I was finally in transition and the end was in site.  But her bad head alignment came back to haunt me and I stayed at 8cm for like 12 more hours!!  I was defeated with the lack of progress and a few hours of staying at 8cm, I requested, or should I say demanded, drugs to help me get to the end.  My midwife suggested Nubain because I seemed so close to the end and the epidural might slow things down and she knew I wanted to do this as naturally as possible.  One thing I do know is that I am very sensitive to drugs, which is why I wanted a drug-free delivery.  The Nubain hit me hard and I felt like I wasn’t there – like extremely, almost passed out, drunk.  I had no energy to get up and work through contractions and actually started having panic attacks because I didn’t know where I was. The Nubain barely took any of the pain away and I totally regretted using that as a pain management option.  Hours passed with no progression and I eventually got the epidural and Pitocin drip.  My midwife told me to sleep until it was time to push.  I couldn’t sleep much though because I was impatient and anxious and I kept wondering how much longer I would have to endure this.  At some point, the epidural stopped working in one spot in my back, so then I couldn’t sleep at all because each contraction just felt like someone was stabbing me in the back.   Finally, 21 hours into this, my midwife said I was close enough to being fully dilated and that I could try pushing.  I did so for about an hour and had nothing left in me and I just remember screaming to just cut her out of me to end the misery.  Eventually forceps were used and after 22 hours of labor, she was born.  It was actually one day off from the previous year’s miscarriage.  It was a huge relief getting her out and the contractions being over, but I was so literally exhausted and traumatized that I didn’t even care that much to see my baby.

After she was born, they quickly whisked her away to get her Apgar score and weight.  My husband made calls to our family, and I just laid there crying and feeling exhausted, but relieved it was over.  They spent over an hour sewing up my 3rd degree tear. I had no idea at the time what a “3rd degree tear” meant and what I’d have to later endure with that.  I didn’t know that I would be taking ibuprofen daily for the next three months while I waited for it to heal.  I also now know that I have repair surgery in my future because it tore down into my sphincter muscle.

I was in shock that at that point I had to take care of a newborn.  I knew the first step to successful motherhood was feeding my baby and I had to dig deep for energy to do so.  I did try to nurse her as soon as I could, but she wasn’t suckling at all, so we sent her to the nursery to get “suckle training” while we tried to sleep that first night.  Before the delivery, I was adamant about keeping her in the hospital room with us. I was honestly relieved though when the nurse told me that I had been through enough, that I needed sleep, and that they would take care of her that night and bring her in my room for feedings.  I still had to get up and go to the bathroom numerous times throughout the night since they gave me so many fluids during the delivery.  That made for very interrupted sleep, even without the baby in the room.  I could barely walk because I was so swollen and in so much pain, so heading to the bathroom was quite the chore.  Needless to say, I did not feel rested and ready to take care of a newborn that next morning!

Nursing her the next day still didn’t go the best, so one of the lactation consultants gave me a nipple shield because I found out that she was tongue tied and I had “small nipples,” making a bad combo for good latching.  I tried to not let the unsuccessful nursing bother me too much, as I knew it was early and we had time to work things out.  I did though just want some rest and felt like I just couldn’t get any.  People kept coming in, nurses to check vitals, midwife to check on me, photographer for pictures, food staff to ask what I wanted for meals, family visiting and I just wanted to scream and kick everyone out so I could get some sleep.  My daughter started looking a bit yellow that day and blood tests were taken that showed her bilrubin counts were borderline UV light worthy.  Another issue was brought to light when a nurse briefly mentioned to me that I could get a transfusion if I wanted because my red blood cell count was low from losing so much blood during delivery.  Transfusion?  Seriously?  No one talked about that in my birth classes.  No thanks, I’ll pass.  I’m fine.

I still sent her to the nursery the second night because I really just wanted another chance to catch up on sleep so I could somewhat feel like my head was above water.  I did sleep better that night, but I felt pretty guilty for not wanting her in the room with me.

The day we were supposed to go home, we couldn’t because her bilirubin levels were too high and she needed to go under the lights for at least 24 hours.  Now since nursing was still not going well and she was now getting dehydrated under lights, they had to cup feed her formula.  I remember seeing uric acid in her diaper and it looked like she urinated some blood because of the red tint in the diaper.  It was told by our checkout nurse that that was a sign of dehydration and we really needed to supplement with formula until my milk came in.

Once we were home, her feedings were taking over an hour and we were still setting the alarm every 3 hours to feed her because she was dehydrated.  She would nurse on me for 30-40 minutes, and then still take an ounce our two of formula out of a cup.  Cup feeding is tricky and very frustrating, especially when you are lacking sleep.  Both my husband and I were zombies and finally we said that we couldn’t handle these long feedings anymore and said goodbye to the cup and gave our hungry daughter what she needed in a bottle.  So I still fed her like that for a couple more days.  I kept wondering what “let down reflex” felt like and why I wasn’t making much milk.  My breasts hardly felt full of milk and I was wondering why I was even wearing breast pads because I certainly was not leaking.  I kept pumping in between feedings to stimulate more milk production, but would make maybe an ounce total from both breasts, after about 30 minutes of pumping.

During the next few nights, I kept waking up in the middle of the night feeling horrible.  I was sweaty and shaky and felt like I had the flu.  I thought it was because I had low blood sugar because I was barely eating and was still sweating out fluids from the IV.  I would just start worrying about what was wrong with me and couldn’t fully rest, even if my daughter was peacefully sleeping.  I think this went on for another two days until I reached my max.  One week after she was born, I woke up feeling so horrible that I couldn’t get out of bed and I just kept telling my husband over and over again to call 911 because I couldn’t get out of bed and there was really something wrong with me.  I remember not having the energy anymore to cry, but I just wanted to because I couldn’t believe how horrible I felt.

The ambulance came and I went back to the emergency room at the hospital where I delivered.  I told them that I was told that I could have had a transfusion after my daughter was born, and maybe now it was really time to get one.  They did diagnose me with extreme insomnia and anemia.  I remember one of my midwives coming to check on me and she told me that I really needed to get some sleep because she was concerned about me dipping into Postpartum Depression.  Depression?  I’m not Depressed!!  I’m just tired and anxious!!  I really wish that day she would have told me that anxiety was part of the PPD diagnosis!  I got two pints of blood and sleeping medication so I could get back on my feet and recover.  A close friend of mine (and my doula) actually took care of my daughter that day and night.  I tried pumping that day, but was also trying to sleep and I knew I had to “pump and dump” because of the sleeping medication they gave me.  I went home that night and got some solid sleep by the next morning I felt great and was back in the game, except in the area of feeding her.  I still knew deep down that I wasn’t making enough milk for her.  I did feel somewhat better about nursing though because the doctor told me that since I was so anemic, my body was trying to make blood, not milk.  Since I had the transfusion, I was told that I would now see an increase in my milk supply.

Evening time became a challenge for me mentally.  I remember that as soon as the sun went down, I would just start to have anxiety attacks for now particular reason.  Then I would start having uncontrollable, irrational thoughts obsessing over lack of sleep and lack of milk to feed my daughter.  I didn’t want to take sleeping medication anymore because I was still trying to nurse her and I didn’t want to have to “pump and dump.” Plus, I didn’t want to rely on sleep meds, I just wanted to feel normal.  I’d sleep ok for the first couple of hours at night, but knew I’d have to wake up to feed her and then I’d just go into panic mode and couldn’t sleep again after she ate.  I would still feel very shaky and flu-like.  I was also having the worst nightmares I’ve ever experienced in my lifetime.

After a few more days of this, I eventually called my midwife in tears, because I just couldn’t pull it together.  Even if I did have a chance to nap, I would just lay there and my heart would race and was just in a constant state of anxiety.  My midwife and suggested that I try taking Xanax to control some of my anxiety.  When I took it, I felt loopy and slept for 2 hours, but since it was middle of day, I woke up not knowing where I was and was all sweaty and panic attacks continued.  I was upset that once again, a medicine that was supposed to calm my nerves, actually made me feel worse.  I was also told by my midwife that she was concerned that I was showing signs of PPD and that I could start taking an SSRI.  She warned me that it could take 2-8 weeks for them to work.  I hadn’t found relief with any medication thus far, and since it took so long to work, it was not the solution I was looking for.  My parents took her for a night to give me a break and try to get some sleep.  I took Ambien again just so I could try and regulate myself.  I still had to get up to pump in the middle of the night to try and keep my supply even though at this point, a week and a half after she was born, I still never felt any let down reflex and had barely any milk.  I still let her nurse on me 30-45 minutes and tried to pump in between feedings, so I was doing everything I could to stimulate milk production. After what was supposed to be a night of a break, it just turned into another night of insomnia.

My unhealthy, obsessive thoughts continued.  Here is a sample of my racing mind: 
My husband needs sleep because he still needs to go to work so I can’t bother him with what I need, I need to stop thinking irrationally, I need to be a good mom and I feel like I can take care of her or even want to take care of her, I need sleep, I need to recover physically, I don’t want to eat nor do I ever have time to eat, what if she doesn’t sleep and I don’t sleep, I don’t want to think about the nightmare of the birth anymore, what if there is something else wrong with me like a thyroid issue or vitamin deficiency that is causing these thoughts and feeling physically ill, maybe I just have severe “baby blues” and I’ll be fine, I don’t want to have nightmares anymore, I never want to have kids again, how will I do this again because I know I want more kids, I guess we’ll have to adopt for our second child, antidepressants take 2-8 weeks to work and I can’t wait that long for relief, I don’t want to take any more drugs, why do drugs make me feel worse, I’m not made to be a mother, I hate the newborn stage and just want to get past 2 months where she’s sleeping through the night and I don’t have to change a million diapers in one day, when will I ever get a routine, when can I ever just go grocery shopping, when will I get more normal life back?
I’m sure the list could go on and on, but that is what I was thinking – all day long.  So that night, I finally made the choice, with the support of my midwife, my doula, and all of my family, to give up nursing and go to bottle.  I gave nursing all I had and it wasn’t working and at this point my daughter needed a mentally healthy mom more than she needed breast milk.  So I thought that would relieve enough stress to take me out of panic mode.  Well, it didn’t, and over the next two days, I went downhill even further.  I spent both days at my parents house while my husband was at work.

I did decide to start taking Zoloft, but had to survive extreme dark hours where I really just wanted to die.  I tried so hard to want to take care of my daughter, but I didn’t even want to be around her. I hated that drug. I really felt better after it was out of my system.  So the next day I switched to Paxil.  Since I was no longer trying to breastfeed, my treatments options widened because I no longer needed to just try drugs that were safe for nursing (as Zoloft is marked safe for nursing and Paxil is not.).  I still took Ambien at night, but it didn’t help me sleep the whole night.  My parents even took care of her again for another couple of nights because at this point I was virtually incapable of taking care of her at all.

The next morning, I realized I had hit rock bottom and couldn’t go on.  I begged my husband to take me to the psychiatric ward to get evaluated, which is what midwives recommended I do two days prior, and I finally gave in.  I really didn’t want to go, didn’t want to get admitted, but reality was it was either this or die.  I really, really wanted to die at this point.  I’ll clarify though that I wasn’t suicidal because I still couldn’t take my own life.  I just kept begging God to heal me or kill me and I fully meant the “kill me” part.  My husband took me and the whole time I just kept apologizing to him because he had to take another day off of work and that I was a horrible mother who couldn’t take care of my baby.  I think being in the psychiatric ward getting evaluated was the scariest thing I had ever done.  Looking back on it now, it really wasn’t a big deal.  But I had never felt so much fear and panic and anxiety in my life.  After my evaluation, which was just a bunch of questions from the staff, they said they had other medication options to try as I clearly needed something else to treat me.  I DID NOT want to spend the night there, but they wouldn’t let me try a new drug unless I committed to staying one night for evaluation.  I said I did not want to be in that particular impatient department where there was, as I said, “yelling and craziness from other patients” because I just wanted to sleep.  They did let me stay in the quieter outpatient area and I was allowed to even let a friend stay with me because I was so scared to be alone.  As soon as I was “their patient” they gave me Klonopin for the anxiety – and within a half hour, tears of joy streamed down my face because I felt normal and happy for the first time since before my daughter was born. It worked like instantaneously and it finally gave me a clear and relaxed state of mind that I was looking for.  They gave me a different sleep medication that wouldn’t make me “hung-over” in the morning like Ambien did and would help me sleep the entire night, and not just half of the night.  I was able to sleep for 11 hours straight and it was amazing!  I felt awesome and just wanted to get home the next day because I was dying to see my baby.  That was the first time in like a week that I actually wanted to be with her!

At this point, I thought that I finally had the answer and I would be fine.  I didn’t know then though that it would be like another 8 months until I 100% felt like myself again.  For the first few months I had good days, and bad days, and just woke up everyday wondering how I was going to keep myself busy so I didn’t have a bad day.

I had decided to not go back to my teaching job, so I could be a full time stay-at-home-mom.  I love it now, but in the beginning it was quite an adjustment to not be “needed” outside of the home.  I actively sought out social outlets and activities to keep me busy.  My goal was to get out of the house at least once every day.  I kept taking Paxil, along with Klonopin every night and when I needed it during the day.  Once the Paxil was fully working (which took about 2 months), I really wanted to get off of it because I heard the nightmare stories of how bad it is getting off of it (which I can attest to because I have been slowly decreasing my dose for the past 4 months and withdrawal symptoms are not fun.).  Plus I wanted to know which drug would work for me in case I needed one in the future for another baby that would be safe for nursing if I ever wanted to try and nurse again.  So I tried Celexa.  I slowly went down on Paxil and then slowing increased Celexa.  I could see myself slipping back into more of a depression and was finding myself wanting to take more Klonopin to avoid panic attacks.  It was a gradual relapse, but I definitely relapsed into an unhealthy state.  When my daughter was about 4 months old, I remember telling my husband that he better get me some help or the next day he’d come home to a dead wife and a crying baby.  I definitely wanted to die again.  I still didn’t think I could actually take my own life, but I was thinking of ways how I could and just flirting with those thoughts meant I was in real danger.  I instantly went off Celexa and went back to Paxil.  Literally the next day after the Celexa was out of my system, I felt fine.

I did struggle though all winter because of the lack of sunshine and just felt very down when there was lack of sun.  As soon as daylight’s saving time hit in NY, which was mid-March, I’ve felt 100% back to normal again.  I now understand people who suffer from seasonal affective disorder.  I used to just roll my eyes at people who mentioned that they had to go on an antidepressant because it was winter.  Heck, I used to roll my eyes when someone mentioned depression and just thought they should take a pill or get a life so that they wouldn’t be depressed.  Let’s just say that my compassion for those battling depression has sky-rocketed!!
I’m still very much battling fear for when I’m ready for baby #2.  I know for sure I want to have one more baby, but I do not want to be dependant on drugs and just want to be 100% set free from all of this!  I’m still trying to do more research on other women’s experiences when they try again for a baby after PPD recovery.
Now that it’s in the middle of the summer, I’m almost off of Paxil, rarely take Klonopin, and my life is very much enjoyable.  It’s hard for me to believe that I’m writing all of this and it was about exactly a year ago when all of this happened!  I’ve come a long way!!!!!!!

**Even though I mentioned in my story the drugs that helped me feel better, I have to say to not use me as a reference as to what will work for you or for someone you know.  Everyone’s body is different and everyone responds differently to medications available for treatment.  Finding the right drug combo is an art form, not a science.  That was a tough process that for me, and was NOT FUN!  But I am thankful for the drugs.  I remember my Pastor telling me a story about the grandmother of a close friend of hers who suffered from PPD. She was taken away from her home in a straight jacket and admitted into a mental institution.  This was probably close to 80 years ago when that was the only “treatment” a woman could get.  She caught Tuberculosis in the institution and died.  I hate the fact that I had to take an SSRI or anti-anxiety medication, but I sure am thankful for the treatment options we have available today!!!

Later this week, I'll post an interview with Maura in which she shares about her life now and her advice to new moms.  Thanks again, Maura, for your open and honest approaching to telling your story!
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