Labor Pains: Surviving a Near Miss

My son, my third and last child, is a beautiful, bright, big, and sweet blessing to our family. I went into my expectations of labor with him confident and assured. While I hadn’t had children in over ten years, my body knew how to, and I trusted in that. I trusted that it knew how to endure the process of pregnancy, labor, and delivery. In many ways, these expectations proved true. I knew that I would be sick for most of the pregnancy, and I was. I knew that my body would feel heavy, painful, and uncomfortable and it was. I knew that the side effects of pregnancy would walk that fine line between insanity and hilarity, and they did. You don’t know intimacy in your marriage until your partner has to apply hemorrhoid ointment to your grapes of wrath. What I didn’t know and could never have planned for was the physical and emotional toll an unexpected c-section and near miss experience would have. I share my story today to begin a dialogue about birthing trauma. Birth is beautiful, painful, exciting, terrifying, empowering and soul crushing. If you have ever given birth to a child, I celebrate you and honor you. I hope that in sharing my story you know that you are not alone. I see you; I hear you and I understand you.

Toward the end of my second trimester, I learned that my son was measuring larger than he should be. The doctors did all the necessary tests to conclude that the baby and I were healthy. I recall during one of my visits my doctor gently asked, “so is this baby’s father the same as your other children?” Looking at her confused, I said, “No. He has a different father.” Slightly relieved, she looked at me and said, “Oh well, then this is what the combination of your genetics makes.” While I was reassured that we had an explanation for his size, I was far from reassured that we had a solution for his delivery. I did my due diligence and asked about early induction, c-sections, and cervical ripening. I further shared that my largest child was 7 pounds, 9 ounces and that she was forcibly removed with forceps. I expressed my concerns that a 9-pound baby would not be exiting my body gracefully. While the doctors heard and understood my concerns, there was nothing they could legally do. Neither I, nor the baby, met medical criteria for an early induction. At 34 weeks, I measured full term, and my body began contracting. I was in and out of the hospital having the contractions monitored. Every time, they were deemed false labor, and I was sent home. As I approached my 38th week, I jokingly concluded that I would not be getting out of this without stitches. This joke sadly became very true.

At 39 weeks, my cervix finally showed signs of ripening. The doctor felt comfortable that I could now be induced, and he sent me to labor and delivery. Not being my first experience, I pre-gamed with doughnut holes. I crammed as many of those things into my mouth as my compressed stomach could hold. This turned out to be the best decision I made that day. Arriving around 10 AM, I finally got into a labor pattern with my contractions five hours later. Everyone wanted me to try a vaginal delivery, self-included. I still wanted to trust that my body knew what it was doing and would figure out how to perform a miracle. I labored until 8 AM the next day. This included four hours of intensive pushing. The nurses coached, cheered, yelled, and encouraged, but the baby could not descend into the birthing canal. I cried when I made the decision to have a c-section. I felt as though I had failed. I knew logically that it was my only choice but emotionally I could not square it in my heart. I knew how to do this. My body knew how to do this. Why wasn’t it doing this? My doctor encouraged me to push more but ultimately respected my choice to have a c-section.

I recall a brief discussion of possible risks. I heard him say uterine rupture and quickly dismissed this thinking it was a mere myth or something that happens to other people. I also think that I could not allow myself to feel anymore fear or exhaustion than I already did.

Never having had a c-section, I was markedly surprised at the pace. It was the equivalent to a sprint. My husband wasn’t even in the room before they began cutting. My son was removed from my body in less than 10 minutes. I felt the pressure they warned me about but nothing more. I had a moment of relief that it was over. This near 24-hour process was coming to an end. Unfortunately, this feeling was brief as I soon felt woozy, disoriented, and strange. I began stating on repeat, “Am I okay?”, “Is the baby, okay?”, “I’m going to pass out.”, “I feel nauseous.” No one answers me. The energy in the room changes as people begin talking with tension in their voices and more people rush in. I knew I was in danger. I spent the next, what felt like an eternity, drifting in and out of consciousness. I hear them order blood and I tell them that I am A positive. They asked my husband to leave. They allowed me one brief kiss with my son, and he is gone. It was shortly after this that the ketamine induced hallucinations began. These hallucinations became my own personal hell as I saw my life having ended. Suddenly I have lost everything and everyone that means anything to me. When I come back into consciousness the questions begin again, “Am I okay?” and “Is the baby, okay?” All I am told is that we are both okay but in need of special care. I appreciate the sentiment but immediately understand the inherent inconsistency in these words.

I spent the next 12 hours in ICU. I receive blood transfusions and constant poking and prodding. My delivery physician visits my bedside and I apologize for her trauma. I acknowledged what a shit day she had, all the while not evening begin to understand my own. I ask repeatedly to see my son and repeatedly I am denied. I will finally meet my son at 9 PM that evening. I still remember the tears that flowed when I held him. I thought I’d lost him and here he was, perfect and sleeping soundly in my arms. Over the next couple of days, my trauma is reinforced with constant reminders of how much blood I’d lost. I am told that my uterus “split open” but I don’t really understand what this means. I would not know the name of what happened to me until I got home and googled it. I’d suffered a complete uterine rupture. My son was born heavily bruised down his back from having been thrust against my pelvis with repeated contractions. I later learn that he was stuck and required considerable force to pop him out like a cork. While he recovered within a week, my recovery was much more extensive and to be honest, ongoing.

For the better part of a year, I could not watch anything pertaining to miscarriages, maternal death or mom and baby separation. I had severe body trauma which I learned about the hard way when I had my blood drawn. The resulting panic attack was both confusing and validating. My body knew what I’d gone through even if my mind was still trying to piece it together. I’ve received 12 sessions of physical therapy to repair the damage and a similar amount of talk therapy to process the trauma. I have many take aways from this experience but none more powerful than the realization that birth is a trauma to the body and anyone undergoing this trauma needs much more support, understanding, treatment, and care than what we currently receive. 

Options for Treating PTSD

The National Center for PTSD estimates that 6 out of every one hundred Americans will experience PTSD in their lifetime. While there are vulnerability factors (i.e. a prior history of trauma, a pre-existing mental health condition, a lack of social supports, and a lack of resources), anyone can experience PTSD following a traumatic event. Below are options for treating and stabilizing someone suffering from PTSD.

1. Medication management. Depending on the severity of symptoms, medication management may be indicated for the treatment of PTSD. It is important to state that medication is not a stand alone treatment for PTSD as resolving and processing the trauma is the necessary intervention. Medications can stabilize symptoms (i.e. sleep disruption and heightened anxiety) while the individual works in treatment to resolve the trauma.

2. Individual therapy. There are several modalities of treatment that research has shown to be effective in treating and reducing symptoms associated with PTSD. Trauma Focused Cognitive Behavioral Therapy (TFCBT), Eye Movement Desensitization and Reprocessing (EMDR), and Accelerated Resolution Therapy (ART) are three of these options. My personal opinion is that a combination of EMDR or ART with TFCBT is likely to result in the best overall results. Not every therapist is qualified to provide these types of treatment so it’s important to make sure that your therapist possesses these credentials. My story is an example of a trauma narrative that someone receiving TFCBT could create.

3. Support groups. There are support groups for many types of traumatic events (i.e. veteran’s support groups, divorce support groups, grief and loss support groups, and Mother’s Against Drunk Driving). While not preferred by everyone, support groups can offer grounding and reassurance by normalizing someone’s symptoms and experience.

4. Equine support. Equine therapy offers a unique and powerful approach to healing from PTSD. Individuals are guided toward recovery by building trust and confidence, regulating emotions, and reflecting on emotions and behaviors. This renewed since of connection is critical for many survivors of PTSD who have suddenly lost their sense of safety and community.

5. Body work. Bessel Van Der Kulk wrote a powerful and insightful book entitled, “The Body Keeps the Score.” In his book, he uses recent scientific advances to show how trauma literally reshapes both body and brain, compromising sufferers’ capacities for pleasure, engagement, self-control, and trust. He explores innovative treatments - from neurofeedback and meditation to sports, drama, and yoga - that offer new paths to recovery by activating the brain’s natural neuroplasticity. Part of my recovery following the aftermath of my son’s birth, involved pelvic floor physical therapy. Not only did I have to learn to trust my body again but I also embraced acupuncture as a part of healing my body physically and desensitizing my brain. My therapist was exceptionally calm and patient with me and allowed me to be in control of how quickly she inserted needles and how many I was comfortable with.

6. Sleep. Honestly, you could ask me about treatment options for any mental illness and I will say sleep. Sleep is so critical in repairing the body and regulating the mind that without it you will struggle to survive, let alone thrive. Sleep aids can be used to assist with falling asleep and staying asleep. Medications for break through anxiety may also be useful for individuals suffering from nightmares associated with traumatic memories. A dream journal can be kept and processed in therapy. Often times, our brains will attempt to process unresolved trauma in our sleep.

Recap of Topic: Options for Treating PTSD

An estimated 6 out of every one hundred Americans will suffer from PTSD in their lifetime. While there are vulnerability factors, anyone can suffer from PTSD. The origins of PTSD are as unique as the individuals suffering from this disorder. There are several options for treating PTSD to include medication management, individual therapy, support groups, equine therapy, body work and sleep stabilization.

Supporting a Loved One with PTSD

Supporting someone with PTSD requires patience, mindfulness and self-care. Holding space for someone to share their trauma with you is healing for the traumatized individual but can challenging for the recipient of the information. Loved ones of someone with PTSD will need to be proactive in knowing and understanding their limits. While there is not a one sized fits all to supporting someone with PTSD, there are some things a loved one can provide which are usually helpful.

1. Respect boundaries. A core requirement for the development of PTSD is a complete and utter lack of control in the face of a potentially life threatening event. It makes sense that as part of the recovery from PTSD survivors need to be in control of a great many aspects of their lives. So long as the person is not making choices that are harmful to self or others, allowing for a period of exerting control will help with recovery.

2. Listen without judgement or solutions. The process of sharing the trauma story is healing in and of itself. This is why there are first responders to tragic events like a mass shooting or a natural disaster. The sooner someone can begin telling their story the sooner their brain can begin processing the event. It is important to note that not every survivor wants to tell their story and should never be compelled to do so. This is especially true for chronic and historical trauma.

3. Respect triggers. Every trauma survivor will have triggers. For me, anything involving needles, watching media pertaining to the death or separation of moms and babies, watching Home Alone and going to my OBGYN’s office were all triggers. I could be fine one minute and after being confronted with a trigger be an absolute crying mess. In case you are wondering about Home Alone, I watched both the first and second movie while I was laboring with my son. If a PTSD survivor tells you that something is a trigger, respect this and do not intentionally expose them to this trigger. While ultimately avoidance of triggers is counterproductive to long-term healing, in acute or recent trauma the individual has had little time to heal.

4. Plan for triggers. While you may not intentionally trigger your loved one, neither of you can control for the existence of triggers. Triggers will happen. Talking to your loved one about how he or she wants to handle unexpected triggers and what is needed from you, takes the pressure off of both of you to respond effectively in a highly emotional situation.

5. Encourage your loved one to move. As previously stated, movement can help in the healing of trauma by reinforcing confidence, regulating mind and bodily functioning and feeling a sense of mastery. Inviting your loved one to a Yoga or martial arts class can be a helpful and supportive gesture.

6. Support normalcy. This gesture goes back to allowing your loved one to reestablish a sense of safety and control over his or her environment. An emphasis on normal activities and routines helps the individual begin to believe that life is predictable and manageable again.

7. Follow through. PTSD survivors have often times had their faith in themselves and others shattered. When you follow through, you are helping them to dispel anxious thoughts that the world and others around them are unsafe and unpredictable.

Recap of Topic: Supporting a Loved One with PTSD

Recovering from PTSD is a long road and often involves multiple treatment modalities. Loved ones can be a helpful resource for survivors and adjunct to treatment. It is important for supportive friends and family to monitor their own mental health for burn out and vicarious traumatization. While there is not a one sized fits all to supporting someone with PTSD, there are some things a loved one can provide which are usually helpful. Respecting boundaries, listening without judgment or solutions, respecting triggers, planning for triggers, encouraging your loved one to move, supporting normalcy, and following through are helpful ways to support a loved one with PTSD.

^{Recommended Product of the Week}

This week’s recommended product(s) is The Body Keeps the Score by Bessel Van Der Kulk.