Content Warning: Potentially graphic post-surgical images.
Today I share a part of my birth story that I have not before. I experienced a traumatic birth, a quiet nightmare that stretched into weeks postpartum.
Because I was delivered early due to preeclampsia, a c-section was our only option. Ben was not strong enough to survive inducing labor. In fact, the c-section that was scheduled for Saturday, March 21st was not an option. By the previous Friday evening, Ben had quieted, no longer moving because my body couldn’t provide him the energy. An urgent c-section was warranted.
C-sections are common in the US; approximately 40% of mothers have them. But mine would be different. I would experience complications that less than 1% would see. And I want to show you what that looks like.
These are the bruises on my body 8 days after my surgery. Five days after I was released from the hospital (the second time; we returned via the emergency room the very same night I was first discharged on March 22nd). Two days before I would make yet another trip to the ER because of the blood seeping from the open wound in my abdomen.
I experienced two catastrophic complications: a hematoma and wound dehiscence. There was so much blood in my abdomen that my incision split open, the pressure too great for the stitches and staples. And I did not receive appropriate wound care – instead bleeding through abdominal pads – until March 30th, my last ER visit and the beginning of a weeks long process of packing and unpacking the wound so it would heal properly.
It’s possible that both the preeclampsia and it’s treatment, magnesium sulfate, contributed to the complications. Surgical error is a possibility. Even the beta blockers I took for the initial hypertension are suspect. We will likely never know the exact causes.
When I returned home, I would experience flashbacks of the pain and fear caused by the hematoma and open wound. Nightmares of gushing blood while my husband held me upright in the shower. Packing clean abdominal pads in Ben’s diaper bag before I left to visit him in the NICU, knowing that I would fill one to soaking on the way to the hospital. Walking myself from the NICU down to the hospital’s ER, sobbing in terror and pain because my still-rounded belly continued to seep blood ten days after the birth of my son.
In writing this, I shake. I’m sweating, and I feel my rapid heartbeat and soaring blood pressure. I am still not entirely recovered, and I wonder sometimes if I ever will.
This is terrible, everyone would say. They grimace and murmur in response to what must sound like a horror story. But what does it have to do with maternal mental health?
While perinatal mental illness can affect any pregnant or postpartum woman, there are risk factors that contribute to the likelihood. I checked off many of them. A previous miscarriage. A difficult, high risk pregnancy. Illness during pregnancy. An unplanned c-section. A baby in the NICU. Post-surgical complications. Check, check, check.
I continue to experience anger and frustration with my birth story. Could something have been different? Why was I not informed earlier what the experience of preeclampsia treatment would entail? Should the surgeons have been more careful, more thorough? Why did I find out later than wound dehiscence was a rare complication that should have had treatment much earlier? Why was I released from the hospital with a bleeding, open wound and belly black with bruising blood? Why had this all gone so wrong?
But this does not preclude the mothers with the perfect, ideal pregnancies and births, like every diaper commercial and baby wash ad we see in the media. They are at risk, too. Because maternal mental health disorders do not discriminate. We are all at risk. All mothers who suffer perinatal mental illness deserve care and compassion. Every one.
Caregivers must be made aware that stories like mine cannot end with a simple hospital discharge. Signs of trauma and complications need follow up with psychiatric care options. Obstetricians and pediatricians must communicate clearly and frequently with all of their patients regarding maternal mental health. We must support all mothers, those with healthy babies, NICU babies, or no baby to bring home at all.
All wounds need care, those of the heart & mind, as well as the body. I hope mine, while still painful, can save another mama out there.