When Birth Breaks You – My Healing Journey Through Birth Trauma

Posted on May 9, 2023May 5, 2023 by MMHI

By Janean Doherty

Trigger Warning: Birth Trauma

Beautiful.

Sacred.

Natural.

Transcendent.

Golden Hour.

Perfect.

These are all words that would come to my mind when someone would bring up childbirth. During all my years as an OB nurse, I participated in probably close to one thousand births. I saw the good, the bad, and the ugly, and spent a lot of time dreaming about my future birth, much like we do as girls when we dream about our wedding day. I had a picture in my mind of how my births would go, and so once it was finally my time to have my first child, I held on tightly to that picture and did not want to let it go. I was excited more than nervous for my birth, despite it being the beginning of c*d, because I had spent so much time and effort preparing my body, mind, and soul for this experience.

Josie’s Traumatic Birth

However, after 48 hours of labor, very slow progression, no sleep for days, and 4 hours of pushing all without an epidural, I was feeling frustrated with my body, like it was failing me. In a last ditch effort to avoid a cesarean birth, I got an epidural, pushed really well for an hour, but still was unable to bring my baby’s head down past a zero station. Her head was asynclitic (head down but sideways) and stuck. But I was adamant about wanting a vaginal delivery. So, since my baby’s heart rate was still good, I asked my doctor to try a vacuum. I got a pudendal nerve block and a bolus of anesthesia in my epidural, which are both measures to prevent me from feeling any pain. From there, he attempted a Malmstrom vacuum extraction, which is an old powerful vacuum (most vacuums used by OBs are kiwis. However, there was a fluke complication with the vacuum and it tore me inside, which I felt, despite all the medication on board. So, after all of that, they rolled me back to the OR for a c-section, followed by an internal repair. Of the words I listed in the beginning of this post, I did not feel my birth was any of them. It took a while to process everything that had happened during the birth of my baby girl, but I did a lot of external processing with friends and gradually was able to accept it as our own unique story.

Dean’s Traumatic Birth

Fast-forward almost two years as I’m getting ready to delivery our rainbow baby, I had built this birth up to be my redemptive VBAC. I had spent the last year preparing for this, with weekly Webster Chiropractic visits and pelvic floor therapy, implementing Spinning Babies balancing practices, hiring my favorite doula, and doing mental preparation with prayer and positive affirmations. I knew that I had a small pelvis but did everything I could to avoid another major abdominal surgery. Everything started out absolutely dreamy, just as I had been imagining, but the same issues I had with my daughter’s birth began to arise, and I knew that a c-section was probably in our very near future. However, the fighter that I am wasn’t going to go down easy, so I asked for an epidural in the room to be able to give pushing one last shot. This was my last chance to ever be able to have a vaginal birth with any baby. But long story short, some negligent care turned my “redemptive birth” into an emergency c-section and left me with a whole slew of physical, mental, and emotional problems.

The Aftermath

I was so unwell that my husband was basically a single dad for the first two months of our baby’s life. I suffered from birth trauma, lingering medical issues from the poor care, bonding issues with my baby, postpartum depression and anxiety, and feeding issues. Things got so bad that we had to drop my two year old off at a relative’s house for a while because it was unhealthy for her to see her momma in such a bad state. I was experiencing intense, debilitating anger directed towards my birth team (besides my incredible doula!) while grieving the loss of my redemptive birth and ability to ever have a vaginal delivery. I was unable to ever breastfeed and we spend almost every day for the first few months at different doctor appointments. I remember feeling like an absolute monster because when I looked at my baby, I felt nothing. There were even days when my perinatal mental illness directed my anger at my baby, making me think, “You are the reason I feel this way, and the reason I can’t even be a good mom to my toddler right now.” It was one of the scariest experiences of my life. I was completely going through the motions as a mother and wife and hated my whole self- body, mind, and spirit- for failing me and my family. There was a part of me that knew from a logical lens that this season would not last forever, but gosh, that part was completely enveloped by despair most days.

Picking up the Broken Pieces

When I reflect back on those early months, it is honestly a blur. I felt robbed of the joy of having a newborn, of my maternity leave, and of the entire fourth trimester. I felt much jealousy towards women who had beautiful vaginal births and who could breastfeed and bond with their newborns as much as they wanted. I was angry for so long, feeling like my dream birth experience was stollen from me. I had nightmares about my birth, racing thoughts reliving the traumatic events day and night, and PTSD flashbacks from having been a helpless party watching negligent care happen to me. I will never forget the feeling of utter desperation I felt when listening to my baby’s heart tones drop down to 50/60 beats per minute but not being able to do a darn thing about it. I was unable to move, breath, or talk while my blood pressure was bottomed out to 50/30 – all from the anesthesia – in the terrifying moments leading up to our emergency cesarean. I felt like it was all a horrible dream, and I wanted so badly just to wake up and have a totally different story. I could not talk about it without crying for many months. I still cringe when I think about the place I was in for so long. It brings almost a palpable pain to my momma heart. I still worry that my kids will remember their momma sobbing and having anxiety attacks, but I trust that their young age and innocence will protect them from those memories, and that they have inherited some of my resilience. I hardly have any pictures of my baby from those early months, and even less of me/us. But maybe that’s a good thing. I was unwell for about the first 7 months of my Dean’s life, but my baby is 10 months old today, and I finally feel like:

“I MADE IT. WE MADE IT.”

Letting Go

There were countless times over those first 7 months that I asked God, “Why me? You know I don’t ‘suffer well’ so why didn’t you give me easier deliveries? This isn’t fair.” I was angry with Him for allowing me to suffer so much, especially because my suffering directly affected my family. I wasn’t able to be the mom/wife I wanted to be, or the mom/wife that my family deserved. I wasn’t able to be a good friend, especially to those whose experiences I envied. I had to say “no” to most things during that time, including play dates, church events, meal train sign-ups, and outings, which would make me feel guilty. And I never knew if a good day would turn into a terrible without any warning and the thought of risking it was too much for me to handle. In fact, most things felt like “too much.” I didn’t know if I would ever understand why all of this happened to me in this lifetime. BUT God put something on my heart that changed my whole perspective:

“God does not waste our suffering.”

Finding Meaning in Suffering

I have been able to rewrite many “ANTs” (automatic negative thoughts) with this revelation. It’s all making so much sense now. My experiences have brought me an incredible amount of awareness, empathy, and compassion to a population that is pretty gaslit. Now that I am on the “other side” of it, I can totally see a piece of God’s plan for my life. With my professional and now personal experience in the world of birth trauma and perinatal mental health, I know that I can use my suffering to help others. I can help be a voice for those who suffer silently and help bring awareness to the effects that these struggles have on women. In my current line of work as a counselor at a pregnancy center, I pull from my experiences daily to help women. I am even creating a FREE online postpartum education course that will have TONS of education and resources for women on everything postpartum, but especially birth trauma and perinatal mental health. I can honestly say that I feel the best I have ever felt in my whole life. I have peace, joy, and energy every day, and a love for my family that is so big it hurts. Though I wish this season of happiness would last forever, I know that our lives are made of different seasons- easy and hard ones. But it’s the tough ones that shape us and bring about truly beautiful things. I was just talking to a mom friend who is currently in a difficult season and who was feeling guilty because she has to say “no” a lot and cannot make it to play dates and outings. I felt for her because I was just in that season not too long ago. I told her:

“We do what we can, when we can.”

Having Patience with Myself

Sometimes it’s all we can do just to get food on the table. Sometimes we can’t even do that and have to DoorDash meals and groceries. But, eventually, we will be able to do more than we ever dreamed possible. I am currently in a season where I can chase my dreams and make things happen. But I haven’t been for very long, and I know I won’t be forever. And that’s okay. Because through all of this, I have learned to appreciate the suffering, as much as I can appreciate the good times. Because it’s only through suffering that true beauty comes forth.

Occupational Therapy and Perinatal Mental Health

Posted on April 12, 2023April 7, 2023 by MMHI

By Mauly Her Lo

Trigger warning: brief mention of stillbirth

I found out I was pregnant exactly one month after I graduated with my master’s degree in occupational therapy. Beyond graduation, there were plans to study and take the National Board for Certification in Occupational Therapy and be employed full-time. Plans changed when I was filled with repetitive thoughts and fears of losing my pregnancy.

“You can do anything when you put your mind to it.” A phrase that we often hear too much. You can be pregnant and study, take the boards, and apply for a full-time job. I (my mind) did not feel healthy enough to take on too much. Witnessing my mother go through depression, a sister’s ectopic pregnancy, and another sister’s placental abruption that led to stillbirth was something I knew I did not want to experience. Fortunate enough to have an occupational therapy and healthcare education background, (1) I knew the risk of having depression increased because of my family’s history and (2) I had some knowledge of how to broadly care for my mental health.

What is Occupational Therapy?

You are probably wondering, “What is occupational therapy and how does it relate to perinatal mental health? Is it about getting a job?” Or maybe you know someone who had a stroke and had occupational therapy to work on dressing, feeding, bathing, and toileting skills and don’t know how it relates to perinatal mental health.

The mosaic beauty of occupational therapy supports the physical, psychosocial, and mental well-being of every individual across the lifespan – from those who are not yet born to elderly adults. Occupational therapy uses a client-centered, holistic approach to empower and support individuals to regain independence in all areas of their lives. By taking into consideration the whole person and their strengths and abilities, occupational therapy also recognizes the need for both the body and mind as well as other factors (age, gender, cultural values, beliefs, environment, etc.) that influence their participation in meaningful activities.

Simply put, occupational therapy uses meaningful and daily life activities to enhance engagement, participation, and health at home, in the community, at work, and in other settings.

Where does Occupational Therapy fit in with Perinatal Mental Health?

Being a first-time mother or having a new baby is a major life event. This significant role change impacts the habits and routines that have developed over time. A mother’s sense of identity begins to evolve, as well as their beliefs and expectations of being a mother. The transitions during the perinatal period can influence their self-esteem and self-confidence with:

Self-care activities: personal hygiene, sleep, nutrition, or sexual activity
Parenting/Caregiver activities: feeding (bottle/breast/pumping), changing, bathing, positioning/holding the baby, or playing with the baby,
Daily activities: meal preparation and cleanup, household chores, shopping, or religious and spiritual expression
Play/Leisure/Social activities: family and friend relationships, sports, exercises, reading, or arts and crafts
Work/Education activities: bending, lifting, sitting, standing, typing, or writing

Occupational therapy practitioners have the knowledge and experience to conduct screenings, assessments, and evaluations, deliver treatment and interventions, and measure progress and outcomes. Considering their strengths and abilities, daily routine and habits, motivation, interests, meaningful activities, and social supports, we can collaboratively establish individualized interventions and goals.

Perinatal Period	Examples of Occupational Therapy Practitioner’s Role/Interventions
Prenatal	Maternal mental health screening, preparing for a change in role, facilitating home modifications before arrival, pain prevention, education awareness for perinatal mood and anxiety disorders, supporting groups for parents/caregivers
Postpartum	Maternal mental health screening, postpartum recovery – personal hygiene after vaginal birth or Cesarean-section, enabling the development of healthy routines for themselves, functional and positional support during feeding, dressing, changing, lifting, and carrying the baby), breastfeeding support, supporting co-occupations between mother and newborn, self-regulation, and developmental milestones, returning to sexual activity, returning to work, supporting groups for parents/caregivers

Overall Benefits of Occupational Therapy in Perinatal Mental Health

With the support of an occupational therapy practitioner, mothers can

Become more aware of perinatal mood and anxiety disorders,
Advocate for their health and well-being by identifying resources and community support,
Increase their self-esteem and self-confidence in their roles and abilities as a mother/caregiver, partner, worker, and/or student,
Establish a secure co-bonding relationship with their newborn,
Create a safe and healthy environment for themselves and their family, and provide grace for self-care, daily, play/leisure/social, and work/education activities

Through our holistic lens, we advocate and work on what matters to you, your health and well-being, and your family.

Learn more about OT & Perinatal Mental Health! Join Mauly & MMHI for an Instagram Live on April 14th at 1:30 p.m.

The Healing Power of a Postpartum Doula

Posted on February 11, 2023February 8, 2023 by MMHI

by Michelle Wilkins

Trigger Warning: Domestic violence

O’ The joy of being a mom!

2015 is such a memorable milestone year for me. To be more specific, that is the year that I would find out that I was pregnant with my baby boy. I was 19 years old, in a fairly new relationship and the idea of having a baby ultimately filled me with so many emotions.

On one hand, I was super happy and excited and on the other I was extremely nervous and terrified. I was young, and I was not ready for a baby. Deep down inside I knew that there were so much more to learn about myself and life. Immediately I knew that from that moment on, my life would change forever.

Pregnancy is much harder than internet “supermoms” makes it look. Everyone fails to mention the depression associated with body changes, morning sickness, fluctuating hormones and the fatigue that merely takes over your entire existence. Being pregnant was overwhelming and I wanted nothing more than to jump to the end!

My pre-pregnancy weight was 106 however I gained almost an additional 100 pounds while battling pre-eclampsia and high blood pressure. I was defeated, broken, sheltered, lonely and completely disconnected from myself.

There were many shattering battles along the way such as domestic abuse and postpartum depression. Although, my healing has always grown through the grace of my amazing son, the long nights without sleep were one of the hardest adjustments.
The offset of my postpartum depression = I was sleep deprived, but I knew that my main priority was to make sure my son received genuine love and care. Breastfeeding caused my nipples to become untouchable, ultimately detaching me from my body. The days without showering were simply embarrassing and the hormonal imbalance gave me extreme anxiety as my home no longer brought me peace. The dishes and laundry were beginning to pile. I did not know what to do with myself. My entire existence was about the baby, I abandoned myself to ensure that I was mothering “correctly”.

I needed help. I was silently being abused. No one knew until I had to be hospitalized during my pregnancy because of the Domestic Violence. I was torn when the nurse charted that I was High risk due to DV. Each prenatal visit felt judged. I tried every day to smile for my son and to be happy to everyone around, but little did they know, my smile held so much pain and exhaustion.

I reached out to a doula through Google for a 4-hour post-partum support session in which changed my entire life and existences. She was exactly what I needed. She washed and put away my dishes and helped with laundry. I was able to take a 15-minute uninterrupted shower that helped me feel “normal” again.

Who knew that 4 Hours of help would feel like a full day of catering and self-care.

My Doula was exactly what I needed to help with my postpartum healing!

Michelle Wilkins is a certified doula and owner of Mind, Yoni & Soul. Additionally, Michelle is part of the team at African American Breastfeeding Network.

If you or someone you know is experiencing domestic violence, find help at the National Domestic Violence Hotline 1-800-799-SAFE (7233)

On The Duxbury, Massachusetts Tragedy

Posted on January 27, 2023January 27, 2023 by MMHI

Moms Mental Health Initiative is devastated to learn of the tragedy that occurred this week in Duxbury, Massachusetts. Our hearts break for the Clancy family as they navigate impossible grief following these events.

We’ve witnessed a robust conversation surrounding perinatal mental health following this tragedy, as Lindsay Clancy’s youngest child was eight-months-old. Social media posts and local media coverage reference perinatal mental health as a possible cause of these events. While we do not wish to speculate, nor are we familiar with the Clancy family’s situation, Moms Mental Health Initiative supports responsible discussions on perinatal mental health conditions. Furthermore, perinatal mental health is grossly under-supported and deserves more attention, education and resources.

What is Perinatal Mental Health?

Perinatal mental health conditions impact 1 in 5 mothers. “Perinatal” references the period of time from pregnancy through approximately 18 months postpartum, and is a high-risk time for mental health. While postpartum/perinatal depression is most commonly known, other conditions include perinatal anxiety, perinatal obsessive compulsive disorder, post traumatic stress disorder and, in the most severe cases, postpartum psychosis.

Learn more about perinatal mental health conditions

Postpartum Psychosis

Postpartum psychosis is an extremely rare manifestation of a perinatal mental health condition that separates a mother from reality and may include delusions and hallucinations (visual and auditory). This psychotic state makes her judgment irrational, believing these thoughts to be true (she doesn’t think anything is “wrong”). 70-100% of mothers experience intrusive thoughts- scary thoughts that may include harming themselves or their child. In these cases, a mother is not psychotic but rational in her judgment – she will feel embarrassed or terrified of these thoughts. Postpartum psychosis does not always lead to harm but is a psychiatric emergency in which the person deserves and needs immediate specialized treatment.

Perinatal mental health conditions may worsen if not treated and are the leading cause of death among perinatal women.

A Message to Moms: You Are Not Alone

To any mothers witnessing this discussion, suffering in silence, please know you are not alone. There is hope and there is help. In Southeast Wisconsin, Moms Mental Health Initiative connects moms to qualified providers with knowledge and experience with perinatal mental health conditions. Outside of the area, Postpartum Support International provides excellent resources.

If you or someone you know is experiencing a mental health crisis, you can contact 911 or 988, the National Mental Health Crisis Hotline.

For non-emergency Maternal Mental Health Support, you can call 1-833-943-5746 to reach the National Maternal Mental Health Hotline operated by Postpartum Support International.

Shining My Light: Don’t Wait For Help

Posted on August 22, 2022August 18, 2022 by MMHI

By Mandy Lehman

Trigger Warning: Intrusive Thoughts

Medical and mental health professionals will tell you that if anxiety or depression runs in your family or if you suffer from either or both of these things, then you are at a higher risk for developing postpartum depression after you’ve had a baby. I nodded my head in agreement while listening to my OB tell me this while I was pregnant with my first son. I am very thankful that I only had “baby blues” as a first time mom in 2013. Before I continue, I will say that I suffered from depression when I was about 16-years-old and have had general anxiety disorder since I was a kid. I didn’t truly get a diagnosis until I was in my early 20’s. Both of these things, along with OCD, runs quite high on my mom’s side of the family.

My husband and I had another son in fall of 2015. Since I only experienced “baby blues” with our first son, I kept wondering and thinking if I would have “baby blues” with our second baby. I had heard about PPD and always thought about how horrible it must be when a woman experiences that sort of thing. I had read true stories about women wanting to hurt themselves and their kids while trying to be a mom.

It was exhausting once we brought our baby home from the hospital. He was constantly hungry and wanted to nurse all the time. I was up with him during the night almost every hour. I was battling a Staph infection in both of my breasts while at the same time nursing him. My lactation consultant highly recommended a supplement that worked for me. I had taken this while nursing my first son since I had a Staph infection in my breasts at that time, too. It cleared up the infection both times! I am so thankful to God for that! Our baby also had a hard time nursing and only favored one breast over the other. This was frustrating, but after we got him adjusted by my chiropractor then he was able to nurse on both sides again.

Within a month of being a stay-at-home mom (my husband works full-time), taking care of a 2-and-a-half-year-old son who was diagnosed with mild autism and trying to be a mom to a newborn baby, I was starting to show signs of wear and tear on my whole being! I would cry a lot, I had irritability beyond words, I was very impatient with both of my boys, I didn’t want to even nurse my baby, I would scream and slam doors if one or both of the kids would start crying, I would hover over our baby while he was lying on the floor and I would slap my hands as hard as I could on our wooden floors to try and scare him and to show him how upset and frustrated I was that he was crying, I would walk outside and get away from them for a few minutes, etc.

I went to my follow-up appointment with one of the midwives that I had been seeing and she gave me a depression screener to take to see where I was mentally. Well, I failed that test with flying colors. I didn’t realize how far I had sunk as far as my mental and emotional health were concerned. Not to mention, all of my family and friends are 300 miles away from me. I moved from Minnesota to Southern Wisconsin in late 2007 after my husband and I got married. My midwife talked very seriously with me and said, “I am worried about you.” “I need you to see a counselor and to get on medication,” she said. I nodded my head yes, but walked out of the clinic thinking that I could do things the natural way and I would be just fine (praying to God, deep breathing, listening and singing to music, hiking, journaling, etc.)

Well, things weren’t fine and I was trying to deny my thoughts and feelings. I started having these dark thoughts and feelings such as wanting to hurt my kids, as well as myself. I thankfully didn’t have a plan laid out, but I did have some thoughts about us not existing anymore. I remember one early morning in particular when our newborn son woke up crying in his bassinet next to our bed. Since I had just nursed him about an hour prior I stood up and started hitting my hands as hard as I could on top of the bed! I was practically yelling- “I just nursed you!” “I just want to sleep!!” I can’t remember everything else that I said, but I just lost it and started crying. My husband tried to comfort me as best as he could and I calmed down and picked up our son and nursed him.

Since my husband was at work and I was left home alone with the kids, there were so many days where I didn’t trust myself, my thoughts, my feelings. I would sometimes think “What if he comes home and we’re not here?” “What if he walks through the door and finds us hurt?”

I would also have thoughts while parked in a parking lot or driving around a town that’s close to where I live, “I wish the cops here would arrest me and take my kids away.”

“I am not a good mom and my kids would be better off in a foster home or with someone who can take care of them.”

“I wish I could be put away in a mental hospital.”

These thoughts started becoming more and more obsessive and, thankfully, none of these things ever happened. It was my way of crying out for help even though I didn’t do that enough. My husband didn’t see me act up around the boys while he was home with us. I was really good at keeping myself under control when he was around. I didn’t want to admit that I truly needed help and wanted him to see that I was strong enough to handle my emotions and feelings just fine.

That was until we were packing up for a trip to Minnesota, I lost my cool with our boys. I can’t even remember what happened, but both of our kids were fussing and crying about something and I came over to them and started screaming at them! My husband came over right away and was in shock. I was kneeling down on the porch floor crying and that’s when my husband said to me, “You need to get some help. I didn’t realize how bad it has been until now.” I believe that I not only scared our boys, but that I scared him as well. I told him that I could manage things on my own and with God’s help He would heal and help me. After talking with my husband and calming down I surrendered to his offer. To be honest, it was really hard to do since I thought that if I reached out for help then I would be considered weak and I was ashamed to admit that I needed help. It’s actually quite the opposite! To reach out and ask for help is a sign of strength and courage. It’s the best thing anyone can do.

I remember my husband and I sitting at the computer doing some research on Christian counselors in the Madison area. I hadn’t seen a counselor since the middle of 2007 (after I had gotten out of a bad and toxic relationship in winter of 2006) so I felt like I was ready to get some good spiritual counseling the second time around. I found a really great counselor in January 2016 (3 months after our baby was born.) What a Godsend she was and has been to me! She counsels people that are going through PPD and I felt like I could open up and share my entire life with her! I was also put on medication and it helped at first, but had to wean off of them once 6 months came around. I became more agitated and irritable and so I gave up on medications of any sort. I decided to just get support from God, my counselor, family and friends, church family, etc.

I stopped seeing my Christian counselor who had been helping me with my PPD journey in July 2018. When I look back on counseling, I am not ashamed in any way to say that I needed help with my mental health. To this very day, I have talked with the same counselor a few times since the pandemic started to help with my anxiety that I still deal with.

I have shared my story with some people and they are always so shocked when I tell them of my experience with PPD. I honestly never imagined myself ever getting to this point in my life where I would think about harming myself and my kids and not wanting to be a mom anymore.

My biggest and best advice I can give to anyone experiencing PPD or knowing someone that’s struggling with it is to reach out and ask for help. Whether it be talking with a counselor, being put on medications to help stabilize your moods, getting support from family and friends or all of these things, please don’t hesitate and don’t wait. It might just be too late if you keep waiting and putting it off. I honestly don’t know where I would be if I didn’t finally surrender to my husband’s plea and get help. I know and believe that God was with me while I was going through my struggles and He’s still with me as I am still learning things along the way on this journey of being a mom. I believe that I went through PPD so I can be a light to other women that are on the same path that I was once on a few years ago. Keep shining your light even when you feel like yours has totally burned out.

Author: MMHI