To the mother who…
To the mother who wishes someone would have told her, To the mother who would have done something differently, had she known what she knows now, To the mother who yearns for a version of herself that she never knew she'd miss so much, To the mother who cries alone in the bathroom at baby showers that aren't her own, To the mother who finds it self-preservingly necessary to shield herself from all things pregnancy-and-baby, I feel you.
"Enjoy every moment!" ""Enjoy every moment," people would say, fully committed to the idea that this was supposed to be a joyous time. They weren't mocking me, although it felt that way. They seemed to earnestly believe that that was a reasonable expectation, or helpful advice. I would spend days (that turned into weeks that turned into...) wondering when I would start to fully enjoy any of the moments, let alone every single one of them. The reminders that I couldn't even enjoy the wondrous child that I had created with my supportive husband became almost unbearable. In 2016, I almost quit my job as a pre- and postnatal exercise specialist to save my mental health. I was working exclusively with perinatal women, as were my co-workers. Many moms-to-be came in with the same goals I had had: come out of this on the other side and be able to quickly and effortlessly dance into motherhood. They wanted the birth that I had wanted, that I had "worked" for. They still believed in magic. They still believed in their bodies, and in themselves. Six days a week, I tried to believe with them. Every day, I caught myself from saying the worlds I wished someone had told me: you might not be okay. Every day, I stopped myself from sharing that sometimes I wish I'd never become pregnant. Every day, I wondered if this would be the session that ended with me crumpled up on the ground, roaring out the tears I'd desperately needed to shed. And every week, one of my co-workers would post a picture of a newborn in our ongoing group chat. Heart emojis flooded my notifications as I tried to quickly respond so that I could close out the thread. I didn't see the face of a newborn baby, nestled on a new mother's chest in those pictures. I saw only my trauma.
Women with pelvic organ prolapse describe feeling alone, broken, defective and ashamed. Additionally, they describe difficulty in discussing their symptoms (Ghetti et al., 2015). Sixty seven percent of mothers with levator ani muscle trauma (and subsequent pelvic floor dysfunction) display symptoms of PTSD. In my experience, every single person managing the psychological consequences of childbirth has felt as if they were alone, and without anyone to whom they could talk. We don't want to hear about the women who are irreversibly impacted by birth. We don't want to hear about the people for whom parenthood is a painful reminder of a body that doesn't perform the way we wish it would. We don't want to hear about the life-changing consequences that span well beyond sleepless nights and sore nipples. We don't want to hear about the pelvic floor as being just another example of our inevitable destructibility. For many of us who were coming to terms with a new normal that felt anything but normal - we were right: no one wanted to hear about it. I would glance at pictures I took when I was pregnant and wish desperately for the ability to unlearn what I now knew. I would replay the conversations I had with my healthcare providers and wonder if it was "pregnancy brain" (eyes rolling) or if it really was just that no one had ever told me about what could happen. I would wake up with an 8 month old, then a 17 month old, then a 2 year old, and wonder not how time had flown by, but how I had been robbed of it. I would routinely need to excuse myself from conversations about pregnancy and birth, but would be the first to offer assistance, if another mother seemed to be managing what I was, desperate for anyone I could lock eyes with, knowing that someone really did understand. As humans are wont to do, I would begin haphazardly searching for purpose in all of this. I couldn't go back, and however fervently I tried, wishing for a different outcome didn't make it so. If anything, it kept me from moving forward.
Over time,
I would learn that I was deserving of self-care, and that self-care sometimes meant building shields and fortresses to make it through the day. Taking care of myself meant giving myself kindness over judgment when I would need to pass on the chance to hold a new baby. I would viscerally experience the power of community and connection when I would finally meet someone who said "me too". Taking care of myself meant being honest about my experience, and knowing that I could only hope to support others in their experiences, not shield them of mine. I would fully appreciate the nonlinear process of grief that accompanies loss, particularly the loss of a former version of yourself. The process of grieving expectations that would never come to fruition was like trying to dress yourself in a climate with an erratic weather pattern. I would walk outside, feeling appropriately dressed, only to be suddenly caught in storms I hadn't anticipated. I would buy warmer and more waterproof clothes as time went on, but I am still sometimes prone to finding myself unexpectedly stuck in the rain. Now, I know that I will, eventually, dry off again. I would be forced to live in the juxtaposition of the awareness that I wish I could have done something to change all of this and also knowing that this was the experience I needed that would teach me things I didn't realize I would have the opportunity to learn. I would be driven more strongly to efforts to support those who had stories like mine than I would ever be drawn to anything. There are few things I am more convinced of than the fact that we have failed to provide evenly remotely adequate care for mothers. I am one of the lucky ones: someone who would be able to find function and solace, treatment and support. Many are not. And if some fall through the cracks (or if those cracks are actually giant, gaping, obvious holes in diagnosis, treatment, and care), we have so much work to do. Until everyone has access to acknowledgement, resources, and a network, we have failed. Releasing myself from the seemingly never-ending sense that I was consistently failing as a parent, woman and wife has allowed for me to place my (righteous) anger where it feels more fitting: as a catalyst for action. It's not the mothers who have failed (although we might feel that way), but the people who ought to care for them. I would become louder in volume and clearer in tone. I would refuse to continue the silence that had slowly suffocated me. That would mean conversations that would feel awkward, at first. It would mean facing my shame and slowly, but surely, unraveling it until nothing but shreds remained. It would mean learning to weave something new - something cozier than what I'd worn before. I would realize that nothing was more imperative than asking how she really was - not how she thought she was supposed to be, not how much her baby slept the night before, not how feeding was going, or when I should drop off lasagna, or even how her pelvic floor was doing - how she was doing. And, in knowing this, I would also know that I wasn't owed an explanation or an answer to that question. I would know that sometimes all I could do was drop off lasagna and ask the question in another month, year, decade. I would realize that, yes, she will sleep again. Yes, she will come to a time when taking a shower doesn't feel like an insurmountable task. Yes, she will hopefully find herself out of the immediacy of the postpartum period. But she will never forget. Some will walk away without consequences that will challenge their ability to forget. Some won't be that lucky. We show up for everyone. The hardest thing I would come to realize is that time goes on. Your baby grows up. Your pelvic floor heals, or doesn't very well. Your hair turns grayer. Your heart expands. Your symptoms will wax and wane. Your perspective will shift. You find a new normal. I desperately wanted time to stop - so that I could go back and rewrite the script. But the show goes on, and so do you. Sometimes, this is a triumph. Sometimes, this will feel like the final crushing blow. It will be both and you, broken as you feel, will find yourself becoming more whole.
To the mother who is (or has been) me, I feel you.
To the mother who has given so much of herself that she's begun to feel like even she has failed to show up for herself, you are doing the best you can. It's the rest of us who have failed to meet you where you are. To the mother who is angry, grieving, lost, and heartbroken - your feelings are valid, valuable. They aren't always true. They are rarely forever. But they are right now. I hear you. To the mother who is (or has been) me, please know that you are not alone. As angry as I am that the resources for you have been few and far between, I do believe that there are people out there who are ready to show up for you the way they showed up for me. Some will have professional letters following their names. Some will be the people who have been here, too. I wish I could wave a wand to show you that it gets better. I wish that I could say the thing that would *poof* make it all go away. While I can't cast a spell, I guess there is still a part of me that believes in magical things: I believe that you are resilient, adaptable, and capable of finding yourself again amidst what feels like a thick covering of rubble. I can't promise that moving forward will be painless, seamless, quick, or simple. But I feel confident that it will be worth it. I don't think I'm on the "other side" (and I'm not sure one exists), but I can tell you that view - however obstructed it can feel .- is pretty damn good.
For an incredible community and resource for anyone managing trauma related to birth, please visit the website of the Australasian Birth Trauma Association.
Ghetti, C., Skoczylas, L. C., Oliphant, S. S., Nikolajski, C., & Lowder, J. L. (2015). The Emotional Burden of Pelvic Organ Prolapse in Women Seeking Treatment: A Qualitative Study. Female pelvic medicine & reconstructive surgery, 21(6), 332-8. Skinner, E.M., Barnett, B. & Dietz, H.P. Arch Womens Ment Health (2018) 21: 341. https://doi.org/10.1007/s00737-017-0802-1