Trigger Warning – Secondary Postpartum Haemorrhage
Stop. Sit. Just be. Be with the shadow. The shadow that no one talks about. The shadow I know all too well. It’s the shadow that appears from a complicated birth. It’s birth related trauma and in Australia, as many as 43% of childbirth events are experienced as traumatic. So, you may say it’s not uncommon. But why is it not spoken about? Why are our lips sewn shut? For me, it was and still is, the hardest thing to talk about. It’s my shadow in the room and it clings ever so tight. So, in order to cope, to beat the shadow, I repressed it. Pushed it so far down that the only way it could come up was through triggers, flashbacks and night terrors. When I mean night terrors, I mean physically shaking in my sleep, every single night. My subconscious had become the home of the shadow.
For a long time, I physically and emotionally couldn’t cope with the shadow being on the front stage. I hated that feeling when it was in the spotlight. I am not alone with my shadow. For a long time, I thought I was. But this silent shadow is one that many women struggle to be with and it needs to have a voice. It needs to be spoken about. It needs awareness. The story I am about to share with you is one that was life changing and by far the most important and dominating domino in my life. It’s not my wedding day. It’s not the day my daughter was brought into the world. It actually arrived a week later. It’s the day I experienced the trauma associated with Secondary PPH.
Secondary Post-Partum Haemorrhage is excessive blood loss occurring more that 24 hours to 6 weeks after delivery. It is a significant contributor to maternal mortality. A week after I’d just feed my baby girl and put her down to sleep, I noticed stomach cramps. They felt similar to a period pain. I hopped into bed and assured myself that it was normal. 10 minutes later, I felt a heavy bleed. I’d filled one pad in an hour. I changed and upon agreeance with my husband, we’d wait and see. ‘Google’ had told us the rule of thumb of when to act, being when you had filled two pads in two hours. I went to sleep treating it like afterbirth pain. I woke up two hours later, only to have blood gush out of me as I stood up. It was everywhere. From that encounter, it took me four months post recovery to actually want to sleep in our bed again.
But that wasn’t the trauma that had impacted me the most. That was only a shadow of the shadow. The most, was from the treatment I received whilst in the Emergency Department. I struggle and still struggle to put words to my physical trauma of that night. My trauma cannot be compared to that of another mother. For what is trauma to one person, may not be so for the next. No matter if you tore, forceps were used or you were rushed in for an emergency caesarean, we all have one thing in common. It hurt. Not having a baby hurt. I’m talking about another kind of hurt. The kind when everything goes wrong and you have no say or control. The hurt of being frightened and vulnerable for your life or the life of another. The emotional hurt. The physical hurt. The scars we are left with. The scars you cannot see.
And wow, how these scars are linked to self-blame. For a long time, I beat myself up about it. It was my fault I didn’t use my voice. It was my fault I was alone. It was my fault I had bled out. It was my fault I had this shadow. I was the one always in control. But this monster came out of nowhere, caught me off guard and ripped me into pieces. How it liked to remind me of how much it was in control. My shadow mainly came out when I slept. Replaying over and over, the memory of that night. I couldn’t escape it. I was trapped.
I was trapped on that hospital bed. Trapped in my own blood loss. Trapped in tremendous pain. Trapped in continual bimanual uterine massage without explanation, reassurance or pain relief. Trapped in shock. Trapped in not knowing how to make it stop. Trapped with strangers touching me. Trapped in the knowledge of being up for a possible hysterectomy. Trapped in the fear I was going to die without seeing my gorgeous baby girl again or my husband. That’s the trauma I have struggled to share. That’s the darkest point of my shadow. It has taken me nearly a year to be able to open my legs again without them violently shake, to be okay about someone touching my shoulder and to be able to relax when I’m alone. That’s birth related trauma and my body remembers the memory.
For a long time in my recovery, I thought I was the only one who had experienced trauma like this. ‘‘I am a bit unique’’ I would often tell myself. I’d done the Googling. Only 2 percent of Australian women who give birth actually go through the trauma of Secondary PPH. In 2016 there were a total of 311 104 births. 2% of that, is 6222 women who have experienced Secondary PPH. The statistic was higher for its association to Post Traumatic Stress Disorder. So why me? Why was I cursed with this experience? I delivered an intact placenta. I had a great birth story. I had had the horrible pregnancy. I was owed a good birth. I was owed it. That’s what people had told me. That’s what I had begun to believe. Reassurance to keep me going throughout my never ending problematic pregnancy. I knew for many they couldn’t say that. I didn’t want to be the person who was torn, who was rushed to surgery, who would lose their uterus, whose life was in jeopardy. I thought I’d escaped all the trauma. All the trauma possibly associated with bringing life into this world. But how wrong I was. Trauma regardless of whether it has occurred during or after birth, it is still birth related trauma and I’m living proof of its ability to follow you even when you thought you were safe.
It took 3 months for me to explain what had happened to me to my husband. The person I loved and trusted the most. I had done this for two reasons. I didn’t want him feeling the burden of not being there. I didn’t want him to feel guilty about what had happened to me. It wasn’t his fault. He needed to be with our newborn. Family support was an hour way. The other reason, because I literally couldn’t physically get the words out. The trauma was too horrific. The hurt was too much and I couldn’t give it words. I struggled to be okay. I held it from those I loved. I didn’t want them to feel my pain. But we need them to understand. We need to challenge the shadow and voice.
I’ve made many people I love cry. Those I love and those who have cared for me. In the beginning, I didn’t want their tears. I didn’t want their sympathy and it made me angry. Why should you be crying? It didn’t happen to you. But after learning how to change my thinking, look at it from their eyes, another’s perspective, I realised they were showing the healing I need to feel. It wasn’t sympathy. It was empathy. I had told my story so well that they were now there with me. Staring at those fluorescent lights for distraction, trying not to move, screaming in pain and realising why I feared and avoided medical environments. It was reassurance that it wasn’t okay what happened to me and it was okay to struggle with this.
But my shadow didn’t just come out of nowhere. It had evolved. It started with anxiety. The statistic, 1 in 4. For months in my recovery I thought the shadow appeared from ‘the event’. But it was with me my entire pregnancy. It grew from the anxiety associated with being sick for 6 months. Feeling like I was being robbed out of that ‘glow and ore’ that society and the media portrays of the ideal pregnancy. It grew from the anxiety of being diagnosed at 7 months with Gestational Diabetes. A condition portrayed by society for women who carry too much weight, don’t eat right and don’t exercise. The humiliation of walking into the Endocrine’s office, to sit in a waiting room with people three times the size of you, with missing limbs, added to the growth of the shadow. The anxiety of avoiding insulin each visit. The deflating response you had to tell people you knew, who would often want a justification for why you had GD, when you couldn’t eat healthier, exercised well and fitted easily into a size 10 pair of maternity jeans at 28 weeks pregnant. It made my whole insides curdle with frustration and it fed the shadow. Why was I being diagnosed with this condition? In the same antenatal classes, I would line up with people twice the size of me. I was half their weight and half their baby bump. I just had to make it to the finish. I didn’t want to continue. But my pregnancy wasn’t finished. It was missing the perfect trifecta, preeclampsia. I ended up in hospital early to be induced only with the knowing fact that there are never any nice outcomes or stories about people who were induced.
Kim Kardashian had officially become my new best friend. What’s Kim, off a ‘trashy’ reality TV show got to do with birth trauma? She was all I knew at the time of someone who had been through it all. And this is why we need a voice to the shadow. Whist I was in hospital, my sister got me onto Kim Kardashian’s birth stories. She had turned into my idol. A celebrity who was comfortable to voice about the shadow, to talk about the trauma and to say this is how awful it was and it was okay. Serena Williams recently took the shadow into the spotlight too. But I’m not asking for celebrities to be our role models or voices on birth trauma.
We are our own role models. Role models to our daughters, to our daughter in-laws, our sisters and to our girlfriends. We need to be the light and shine over the shadow. Talk about what happened so we can heal from the hurt. Birth related trauma needs awareness. It needs to come through that curtain, be on that stage and have a voice to an audience that wants to listen. Just like the ‘Me Too’ movement has brought about awareness to women as victims of sexual assault, birth related trauma deserves its place in public awareness. For everyone has a mum. A mum who may have the hurt. The hurt and shadow of birth related trauma. I’m determined to not let my shadow be the dictating reason for why we don’t have another baby. For my shadow of birth related trauma now has a voice.