Sunday, 24 April 2016

Bloggy Holiday

It's probably become apparent that updates are a bit few and far between these days. I'm in the final stretch of writing up my PhD thesis, to be submitted in October, and have decided to put the blog on hiatus until then. See you on the other side!

Saturday, 19 March 2016

What would you tell an expectant mother?

One of the many odd things my brain does when it wanders off is to come up with ideas and content for antenatal classes. My own were expensive but inadequate. I think it's an interesting question: what do you wish you'd known? What would you tell an expectant mother?

I wish I'd known more about perinatal mental health. I knew about the existence of postpartum psychosis and depression and that was it. I didn't know that postnatal depression can strike up to a year after the birth. I didn't know that birth trauma existed, or antenatal depression, or perinatal anxiety, or perinatal OCD, or mother and baby units. When I developed PTSD after the birth, I had no idea what was happening to me.

I wish we'd talked more at antenatal classes about health in general. One of the most challenging things about being a mother is that you are not just a mother. You're a personal assistant, secretary, life coach, cheerleading squad, chef, nose-wiper, bum-wiper, counsellor, valet, entertainer, cleaner and god knows what else to this little person. I feel underqualified. You're also somehow supposed to become a doctor and a nurse.

I mean, of course not literally. We are fortunate to live in a country with an NHS (though I'm not sure for how much longer with a Tory government) so qualified medical help is available. But you are obviously still required to make judgement calls about seeking that help, to administer medicines, to treat things at home and to navigate a vast sea of conflicting advice. It isn't easy.

Wouldn't it be great if antenatal classes covered common baby and toddler ailments and evidence-based solutions? I mean stuff like teething, cradle cap, colic, oral thrush, the various rashes, the various wheezes, fevers, chicken pox, etc, etc. So that mothers didn't end up googling this stuff at 2am and then being told bollocks on mumsnet.

The NHS has recently brought out this infographic:

There's one on a poster in our GP surgery. It's useful. I'd love to see someone make a paediatric equivalent, including the health visitor, maybe, because it's not necessarily the same. In the past, I've struggled to make the call whether I should be making my son a GP appointment or calling 111 or an ambulance or what: simply the questions "How urgent is this?" and "When should I worry?" Babies seem to get worse (and better) so much more quickly than adults.

Something happened in our home in the last fortnight which demonstrates this. My two-year-old slipped on our kitchen floor ten days ago, had a bit of a cry and then seemed fine, but I noticed he was limping. I gave it a couple of days and, since he was still limping, though running around happily nonetheless, I made a GP appointment. The earliest I could book was this Thursday just gone, eight days after the injury, so off we went then. The GP shocked me by telling me to take my son straight to A&E.

He didn't look like a child who needed to go to A&E. I wouldn't take myself to A&E with a slight limp but, in small children, it can be very serious. I had no idea. The likelihood is that it's a toddler fracture. Nothing showed up on the x-ray but sometimes it doesn't until later on when the bone is mending. I'm to take him back in a few days' time, two weeks after the injury, if he's still limping, which I think is likely as there's been no improvement. He'll have another x-ray and a blood test to rule out other, far more serious causes of limping in children. In a small number of cases, it can indicate really horrible things; the doctor kindly spared me the specifics and I don't want to know.

But effectively I've probably been allowing my little boy to run around on a broken leg for over a week, without doing much of anything about it. I feel awful. I wish someone had told me that a limp in a small child needs looking into urgently, that a child can run on a broken leg, that toddlers break bones before twisting or spraining joints as adults do, because I would have acted differently.

You live and learn. But I do wonder if health professionals could come up with a leaflet's worth of medical information that it would be useful for parents to know - it would ultimately make their lives easier too - and if that information could be shared at antenatal classes, or in a leaflet from the health visitor. Perhaps I should have looked up "toddler limp" on the NHS website but he seemed okay so I didn't think to do so.  If someone had said to me before it happened, "If he ever gets a limp, take it seriously and get it seen to," I probably would have. Food for thought.

Tuesday, 15 March 2016

In the Daily Mail

I've been interviewed in today's Daily Mail about Arthur's birth, and the link to the article is here.

I got a journalism request through this blog and it seemed like a valuable opportunity to raise awareness of birth trauma. The journalist, Jane, was lovely and worked with me on the sections about myself throughout. It's been a long (and often painful) process, establishing the particulars of my extremely complicated birth story and balancing our different intentions for the piece. Jane has been extremely patient and accommodating as I have fussed over the sections about me and I think she's done a good job of putting across the opposing points of view around some contentious debates.

Wednesday, 24 February 2016

Birth Trauma Two Years On

I don't really understand why trauma anniversaries have to be a Thing. But somehow they do. They insist. The body insists.

With birth trauma that's complicated by the fact that it's also your child's birthday. A happy time. That's why I have always been so determined for it not to be a big deal: it's Arthur's birthday, not my birth trauma anniversary. It's not about me.

My plan has always been to ignore it. Delete Timehop. Tell Facebook not to notify me about "On this day..." (Facebook is stubbornly doing so anyway. Sort it out, Facebook.) Wrap the presents. Bake the cake. Convenient distractions. Happy birthday.

It didn't work. It's been worse this year than last. That worries me. I mean, it's supposed to get easier, isn't it? Time's a healer and all that. What if it just gets worse and worse every year?

Arthur's birthday falls on the 20th. Last year I was okay until the 16th, the day I went into labour. That afternoon I had a sort of flashback marathon: a series of them, one after the other, and some new memories. It had me feeling ropey for a while. But it was definitely better than the last fortnight has been.

The night of the 10th Arthur slept through, which is a rarity. I had a horrendous nightmare, in which I won some award and left Arthur in a sort of crèche while I went to the ceremony. I went to check on him and found the doors locked and no answer when I knocked. The crèche was in the top room of a tall tower. This being a dream, I flew through the window in my friend's aeroplane. The room was full of babies and toddlers but no adults in sight. They had sat Arthur in a corner in just his vest and he was crying. The sound was just heartwrenching. I ran and scooped him up and he was soaking wet.

I woke up in tears - it was morning - and rushed to check on Arthur. He was fast asleep. All that day, and afterwards, I couldn't shake the dream. It was one of those dreams that clings to you. I kept reliving it, felt a gnawing unease.

My usual anxiety went into overdrive from then on. You know rationally that not much is happening but your body is going EMERGENCY! EMERGENCY! EMERGENCY! All the time. So you end up making trivial things into an emergency because then at least it makes sense that all your muscles are tense and you feel sick and you can hear your heart. Then people get irritated with you because you're being ridiculous and their irritation is the new emergency.

The stupid thing is that I don't remember feeling afraid during the labour, or the birth. I don't remember any emotions at all. It's just snapshots, static frames, like each one is a painting. But I don't remember being distressed by any of it at the time.

On the 12th, or thereabouts, I was on a bus, while Arthur was at my mum's, and I wasn't thinking about anything much in particular, when suddenly there was an intense pain in the back of my left hand. I looked down and there was a cannula in my hand. I was on the bus and it was there. I could see it and I could feel it. I froze and just looked at it in horror. My hand was terribly bruised. It was there for about fifteen minutes and then went as quickly as it came.

The last time I had a cannula Arthur was two weeks old and I had been readmitted to hospital with an infection. I don't remember a cannula during the birth. I vaguely remember taking the first shower afterwards - the slow agony of it - and I think there was something about trying not to get my hand wet. So I guess I must have had one.

The cannula thing happened again that evening, exactly the same, as I was getting Arthur to sleep. Since then I've had the pain a few times but couldn't see it. It's freaky shit, I tell you.

We got through it. The birthday's over. I'm not feeling a lot better, though. This time two years ago we were still in hospital and I was still a state. Tongue-tie hell was going on. A photo came up on Facebook: I look grey, swollen, exhausted and completely dead behind the eyes, with a tiny jaundiced baby held up to my chest.

It feels like that time, two years ago, is still going on, in parallel, and like something is trying to suck me back.

Tuesday, 9 February 2016

The Kindness of Strangers

I participate in a handful of online communities, usually centred around Facebook groups, and I gain an enormous amount from them. I don't get out much! Each has a strong ethos of mutual support and caring. One is a sort of extension of the #PNDFamily, another centres around vintage fashion with a side helping of feminism and attachment parenting, and another is for Patreon supporters of Amanda Palmer, known as "sloths".

I've posted before about my Amanda Palmer fandom. The Patreon Facebook group (at the time of posting) has more than 4000 members from all over the globe. Its size and diversity means that there is inevitably drama at times (I stay out of it!) and it can be difficult for it to feel like a "safe space". On the flip side, though, it's brilliant to be able to instantly connect with such a range of people and I have met some genuinely intriguing characters. There is also, given our shared love of Amanda Palmer, a culture of asking and giving on a regular basis.

There are lots of spin-off groups - sloth parents, sloth insomniacs, sloth readers - and a slothcycle: Freecycle for sloths. I posted in the slothcycle group over the summer, asking if anyone had any spare secondhand clothes for my tall and ever taller toddler. I didn't go into the fact that we'd been forced to move house again and fleeced of hundreds in the process, or that I'd just been cleaned out by Arthur's hypermobility boots and we were feeling the pinch. Nonetheless, one wonderful lady posted a box of clothes from the US, which must have cost a fortune, and someone else invited me to start an Amazon wishlist, which I did, and then people also bought things new.

The packages started arriving. Here is Arthur back in September in his Tigger pyjamas (Sorry it's a bad photo - he was tired, and you can see the chaos in his wake!) Sean also sent a package for me - self-care materials which were so needed! I was so stressed and exhausted at the time and it meant so much to be thought of and cared for in that way. I had a little cry.

I still feel uncomfortable asking for things. It is counter-cultural. No one wants to be a charity case. But I've learned that people can utterly dwarf even your most optimistic expectations. Even strangers. There are a lot of very loving people out there. I have since requested materials for my planner and keep getting envelopes of stickers from abroad in the post. I think that, in general, people do want to be kind and people do like to help one another out where they can. We should probably ask more often. 

Wednesday, 3 February 2016

I will celebrate. - On "The Motherhood Challenge"

The latest Facebook furore centres around 'The Motherhood Challenge', in which mothers 'tag' one another as an invitation to post three (or sometimes five) photos which make them happy to be a mum. Some people are very cross about it: see here and here and here.

The main criticism, levelled by various people, is that it is unhelpful to portray motherhood as easy, ceaselessly joyful or perfect, and that doing so makes mothers feel inadequate. I completely agree. But I think that the 'challenge' Facebook post with the photos is just one post among many in a woman's social media presence. It can't be taken out of context. I too get fed up when I see mothers post an unrelenting stream of posts gushing about how advanced their children are, or how well they sleep. I too feel inadequate when I see photos of everyone looking clean and smiley and deeply trendy with the immaculate house in the background, often with an Instagram-type filter to make everyone that bit more attractive. There has to be a balance. I try to be honest and anyone who follows me on Facebook or Twitter or this blog gets a mix of exasperation, misery, humour and, yes, sheer unbridled joy, because all of those things make up motherhood.  

In order to truly support one another, we must share the good and the bad: the post-poonami commiseration and the first steps celebration are both needed. I like to see photos of my beautiful friends and their beautiful kids. It actually cheers me up. The fact that your child looks super cute in his Gruffalo onesie does not distress me, simply because I've just found mine trying to climb into the toilet: if we're really friends, I'll know that you don't find it easy either. I am wary of anyone who attempts to speak on behalf of all struggling mothers.  

I think it's fair to say that I have struggled - I do struggle - more than most. My son's birth, in February 2014, was a five day ordeal which nearly killed me. Two weeks after he was finally born by emergency c-section I was back in hospital with an intrauterine infection, probably due to the tearing of the incision during surgery and subsequent haemorrhage. The recovery was gruelling and I was in agony for weeks. I played the part of the doting mother but what I couldn't admit to anyone, even to myself, was that emotionally I felt nothing but numbness. Alongside all of this we were fighting to get treatment for my son's tongue-tie as he couldn't feed. Eventually, just as I turned the corner physically and regained my mobility somewhat, the floodgates burst open and my mental health deteriorated rapidly. Six weeks after my son was born we were admitted to a psychiatric mother and baby unit.

Since then a number of things have happened. I fell deeply in love with my baby. We have battled his eczema, his asthma and the many resulting hospital trips, the difficulties associated with his joint hypermobility, my ongoing mental ill-health... It's been hard - really hard - harder than I could have ever imagined anything being. But it's also been amazing, and we are both still here. We are thick as thieves, my boy and I. And he is healthy. He's running around. He's hilarious. He's cute as a fucking button. And I am deeply, deeply thankful, both for him and for what we have overcome. How dare anyone tell me that I am not allowed to celebrate? 

Tuesday, 2 February 2016

It wasn't my fault.

It can be a fight to get birth trauma acknowledged. "Of course childbirth is awful. It's supposed to be. You have a healthy baby and that's all that matters. Why aren't you more grateful?"

Such attitudes are changing, I hope. But there is another, subtler stigma. Even the most right-on birth advocates can unthinkingly imply that traumatised women are to blame for their experiences.

It's unintentional, but when women say, "Oh well, I had a lovely experience because I... hired a doula / had realistic expectations / was educated about the process / felt positive and confident / did hypnobirthing / had a good support network / was active in labour / birthed in water / bounced on a ball, etc, etc, etc..." they imply that because of their choices, there could have been no outcome other than a positive one.

Equally when health care professionals say, "Women will have a positive experience if they... (see above list!)" they suggest that there is a formula to guarantee a positive experience. Thus they blame women who have had a negative experience because, somewhere along the line, they got it wrong.

In birth, there are no guarantees.

Yes, there are things which are wise to do, which increase the chances of a positive experience, but you cannot be fully in control. You could do all of them and it could still be awful. Equally, you could do none of them and come out feeling fine.

We cannot tell traumatised women that it would have been okay if only they were cleverer or better-prepared or more resourceful or more determined or more Zen. We cannot tell new mothers that they have already failed. The cost is too high.

I cannot help but note the comparison here with blaming victims of sexual assault. Is this just what we do to women? In some ways, being a birth trauma survivor is not dissimilar to being a survivor of sexual assault. There can be many overlaps: post-traumatic stress, sexual difficulties, struggle with necessary gynaecological treatments, struggle with subsequent pregnancies...

Someone once told me that the reason I had the birth experience that I did was because I stubbornly insisted on a "natural" birth and ignored all medical advice. That person was in another country at the time. And that simply wasn't what happened at all. But it must have been my fault, obviously. So they filled in the gaps.

We need a cultural shift in how we think about women's experiences. And we need to be more mindful of our language.