Yesterday on twitter midwife and writer Leah Hazard asked what people who had suffered from birth trauma, PTSD or other health issues realting to a traumatic birth might want to have highlighted – she’s doing an interview on this often overlooked subject on BBC Radio Scotland this week.
It’s a good question. What would traumatised me have liked to have heard, almost exactly 12 years ago when I emerged from labour ward with a broken snatch, a squalling life changing mammal to take care of and a brain which had dislocated so vividly I couldn’t remember if my son was a boy or a girl or what he weighed?
It’s a big question, but the answer was easy: that recovery is possible.
Even as I typed it, I also instinctively realised that this was one of the truly worst things for me about becoming so ill. After a difficult birth which left me with a lifetime of damage I didn’t really realise, or believe, that the shock and upset would ever end. That I would ever get any of me back, even a little bit, that I would always be off balance, fraught and intense.
Becoming mad and traumatised left me anxious, and worried, and often distraught about the minor mishaps and major uncertainties that parenting brings. Having injuries that translated into years of hospital care – appointments, classes, physio, surgeries, device insertion, scans and test – was not only an enormous ballache, but also an intangible but enormous new character in my life, my family’s life in fact.
My trauma and health collapse, which involved incontinence and a great deal of upset was a void of space sitting in the corner of the kitchen. A most ungrateful extra child, that needed care, and nurturing, admin and support, money and time thrown at it constantly just to keep my life, a normal life with work and kids and a partner, on anything like an even keel. It was so much work being physically damaged, and I was hindered incessantly by the voices of trauma whispering and snarling into my sleep deprived ears. The main voice was clear and vicious – all of it, it said, all of it, every mistake, every cut or bruise, every unhealth snack, every reception assembly missed, every school letter mislaid, every forgotten PE kit, or change of clothes for nursery – all of these were my fault for being a feckless, credulous idiot, and not realising childbirth would or could change me.
She laughed at me for not realising this might happen, and for being underprepared. My voice was very nasty to me. Very nasty indeed. And worst of all, she sounded just like me.
She’s still there sometimes, of course, because recovery isn’t a reset, or wasn’t for me, that deleted all the worst bits – nightmares, panic attacks, medication, thoughts of taking my life, running away. Those things have diminished, for sure, and I am calmer now, most of the time. I can see a pregnant woman and not cry, I can walk confidently into the worst hospitals which used to make me want to run into a bus lane when I gingerly went in for counselling and help, too close to the scene of the crime.
But you know, I can hear a birth story without burning, and usually, allow myself to be happy, truly happy when others have had a good experience, rather than feeling happy for them but drowned in a flood wretchedness and failure. I don’t have to excuse myself from the baby shower or the coffee morning, run to the toilets for some deep breaths and privacy. Yes, I can just about listen to people talk about these things without feeling messy and broken and somehow detached in time now. I can navigate the embarrassed, humiliated, slightly frightened feeling that if I do talk about birth stories the tit bits I have to offer to the conversation are so horrible and frightening that I shouldn’t mention them at all – I temper them depending on the audience, of course, but I at least know I do not need to feel ashamed, and as if even letting people know I was torn, left broken, made ill afterwards, for years, was admitting something hideous that would leave them hating and judging me.
And I’ve also, with a great many years and a lot of help behind me, sometimes been able to remember the good bits that surrounded my births: not least my children, but also my relationships, and friendships that endured. And there were many, many more of them than my nasty voice, that told me I was so terrible at all this mothering woman-ing stuff, would have had me believe. The high days and high fives, the spitty kisses and the milk drunk sighs, the wide open eyes and blooming opinions as my children gambolled on through toddlerdom and reception and key stages undeterred by my faltering, endlessly slip-sliding attempt to pull myself together and ‘move on’.
I would not have realised this would be the case though, I couldn’t countenance the hope. And I was too afraid at first to acknowledge the depth of the damage – or how many years it might take to heal.
You see, bad birth injuries can stay with you a long time, sometimes forever – the mental and the physical ones. I know, for me, that the final sign-off session with a women’s health specialist might never come. But what has come has been a move towards accepting who and what I am, most of what has happened, and the impetus to keep moving through it without it being the only thing on my mind.
Endings and acceptances aren’t always easy. But I wish I could at least explain to that terrified new mum at her first fanny physio that my last couple of years of sessions and other treatments slip through my memory now. And I wish I could have known 12 years ago when I had a hot son laid on my chest, salty blood in the air, tears and shock running in waves across my face, that all my memories wouldn’t be seared like that. Carved into my frightened head like a 3D printed migraine. That it would be possible, one day, for those pervasive thoughts to not haunt everything.
I am still being treated for continence problems from that birth in 2007. But instead of being unable to shake the burnt in visions, the replays of every embarrassing encounter, every person looking at my private parts and making an assessment – now, I can take them one by one. And still be fit for work an hour later. I still see doctors and talk about what happened but the memories are like normal memories in a busy life. Silken. Transparent. Fleeting. I can’t recall them in detail. They melt into one.
The last time I saw a urogynaecology department, earlier this year, I left without a falter, there was no explosion of grief. I held my head high and smiled as I took the lift. Let it remind me of all the pelvic floor exercises I have ever done (and all the thousands I’ve forgotten). Up, up, up. Hold, hold, hold. I realised, with this cumbersome reminder to clench, the words of my nurse who’d booked me in for a few months time still sinking in, that for the first time in a hospital in 12 years I was actually unafraid.
As conclusions go, being still a patient, but not being better/BETTER is rubbish. Especially as the beginning was so vivid and visceral, a traumatic delivery, alarm bells, emergencies. A slow acceptance is a damp squib, it doesn’t fit as the right sort of ending. A move into regular maintenance, occasional surgery or support isn’t the happy and definitive conclusion I hoped for. But in that lift I realised why some of the end of the story doesn’t hang together any more. I stopped writing for three years because I felt like I couldn’t grasp things as my years of being one of those traumatised birth women reached a decade.
Partly because I was beginning to enjoy my life rather than just surviving it. It made hospitals weird. It didn’t feel right to do things like see a surgeon and not have them engraved on my brain, like ancient photos on plates. I got so used to trauma I forgot what it was like to not be locked into it.
But I am at peace with the less intense thoughts. It’s because I’ve deflated some of the devil, after all. I speak out about patient experience in the taboo areas especially of broken fannies and broken minds. The more women I meet who talk about birth, incontinence, PTSD, PND, and the more women roar into the world around us about our actual bodily experience from periods to the menopause, from babies to breasts, even the worst bits, that are taboo, the more faith I have that the spell might be broken, the smell and the soaken bits might disappear.
I want it to, because I want women to find help and not feel so rank and alone. This is a good sign. It’s not something incontinence or birth trauma gave me though; it isn’t a reward for bad luck. It’s something my voice gave me. It is what speaking does, or can do if you are lucky. Chase away daemons. Deflate nasty jokes. Fill the space. Break the deadlock.
When I muddle through now, knowing birth trauma will always be somewhere, at the back of my mind, and there will always be bad things that happen amongst the good, in the chaos, I realise or at last can see: this just life. And the best bits, the most beautiful bits, are the things we forget as we glide along, that we nearly miss, the bits that are not outstanding or remarkable, or carved into a brain because they are so shocking they give us PTSD. The bits we don’t stop to breathe in as we are too busy living them. The bits that one day we will grieve the most. The guttural echo of a last laugh, the smell of wet wool or burned cakes or fresh washing. The curve of a young child’s back. The white blonde shimmer of baby curls. The slick-mop of a just-for-the-first-time-big-boy-gelled quiff. The pink cheeks and sparkle of the second toughest in the infants. Cracker jokes and height charts, mis-sung carols and car songs. The sound of your name in someone else’s warm mouth as they try it out for the first time. These things are careless, endless, urgent, easy, precious. A beard on your cheek, a tongue running over clean teeth, rain shining on tarmac, the one dress that feels like home. Egg drips on a chin. A good cup of tea. Sleep in your eyes and the sound of snoring, breathing, sighs and cries in the night when everyone is tucked up in exactly the right place. These are the things that love and life are built on. They aren’t seared into your mind like a trauma or humiliation, or regrets. Things that sit like obstructions deep in your gut. Like pain and horror do. Those things don’t go even if they sink all the way down to the bottom of the ocean, to the rifts where fires burns and rocks melt under water.
But we can move beyond them and into the slippy beauty of life outside the drama and upset. Delight in the everyday that runs through our fingers. Find faith in our body, broken or not, and the life-journey it commands. Or at least we can try, especially if we can find the place for our bodies in the world without kneeling at the altar of stigma.
I won’t be here every day in the worst bit of the hospital, but I’ll probably be back. Maybe the staff who I am now on first name terms with will have left, gone, retired, found new areas to command. Perhaps the tests and the screening and the toys will be different and I’ll need to find my way again into treatment. But it doesn’t seem a shame. It’s just time.
The lift doors opened and I saw a mural of a lady doctor looking out from the wall, a welcome for the next woman coming in, someone who I hope knows that there is hope, and good reasons to believe, that with help and time she may be healed.
I walked into the January sun and wondered ‘How the hell did I get here?’
I never thought I would.