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Episode 423

Leonie – perinatal anxiety and depression (PAD), episiotomy, postpartum depression

In today’s episode Leonie shares her experience with perinatal anxiety and depression which manifested as a profound sense of defeat in pregnancy and visceral rage in postpartum. She opted for talking therapy with a psychologist and managed her symptoms but she was still overwhelmed at birth when the love for her baby wasn’t immediate. It’s so important to talk about these experiences because studies show that up to 40 percent of mothers don’t feel love for their baby at birth (instead, it grows and develops over time). Leonie had two positive vaginal births with a private obstetrician who encouraged her despite her requests for planned caesareans.

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“I’m a type-A personality – love a plan and a schedule – and I planned to get off the pill for a year before I ideally wanted to conceive. I fell pregnant soon after so it was an unexpected pregnancy. I think it definitely contributed to an antenatal depression diagnosis.

“I went to the GP after I returned from overseas and presumed I was low in iron because I felt so tired. The GP wanted me to do a pregnancy test to rule it out and sure enough I was pregnant which really threw me.

“I didn’t know about antenatal depression. The shock of the pregnancy turned into a lot of not-knowing and doubt and that’s not how I live or act generally. I really didn’t know if I could do pregnancy and parenthood. I got quite overwhelmed and by 20 weeks when we knew the baby was all okay, I felt like my emotions shut down. I’d lie in bed with tears streaming down my face and I just couldn’t pinpoint what was going on. All I wanted to do was to be in bed all day which is a complete 180 on my personality.

“My obstetrician advised medication but I felt scared taking it so I decided to reach out to the Gidget Foundation and I did online therapy throughout the pregnancy. It was either free or very heavily subsidised and it was an absolute lifesaver for me. I did a birth course but that scared me even more and I have a family history of severe perineal tearing and that was a huge concern for me. I wanted a planned caesarean but my obstetrician encouraged me to have a vaginal birth.

“I felt as though I was trying to get through pregnancy and then as I got closer to birth I was overly anxious about birth. It wasn’t until I had the baby in my arms that I felt a bit of relief; there wasn’t anymore thinking about it, I knew I just had to get on with it.

“I ended up going into spontaneous labour. I was so edgy and grouchy all day, nothing made it easier. By 10pm I was having period-pain cramps and they were pretty consistent. Jules started timing them and all I wanted to do was go to hospital for the drugs. We ended up going into hospital at midnight because I couldn’t stop vomiting and the midwives really encouraged me to go in as soon as possible. The staff got me straight into a bed and gave me an anti-nausea shot and put a drip in my arm but I was nauseous the whole labour, it was pretty awful.

“They ended up breaking my waters and then I was given the gas and air and that helped with the vomiting; it felt like a bit of a holiday. I’d been asked if I wanted an epidural and Jules and I had discussed that I’d get it if I was in severe, uncontrollable pain and really felt like I needed it…at that stage I didn’t feel like I needed it, I was in control. I eventually decided I wanted it and that was when they told me it was too late and I was devastated. They gave me a morphine shot and it took the edge off but only slightly.

“I got the urge to push and that’s when my obstetrician arrived. I was trying to stay focussed on their direction but I don’t think I was listening and I was scared about tearing. I started panicking and there was a very firm midwife who asked me to stop and focus on her which allowed me to recalibrate. All of a sudden there was all this beeping, the baby’s heart rate had dropped and so had mine so they did an episiotomy and Noah was born crying.

“The first thought I had was: how did that baby fit in my belly? It dawned on me that the pregnancy, all the big emotions, the big belly, that was all to get to this moment where this baby is placed on me. I thought: Oh my goodness, this is a real human. For so long I felt like he was a mythical creature that had taken over my body and I just wanted to get through the birth and I hadn’t really thought about what it means when the baby comes and is a real person. That was quite beautiful but secondly, I remember thinking that I didn’t feel anything towards this little creature. It felt like someone had gone to the room next door, grabbed a baby and put him on me. Jules was crying and I was in shock. I didn’t even feel like I needed to hold the baby. As time went on the love grew but in those initial moments I was very vacant.

“For the first month after birth I was quite euphoric because everyone was coming to visit and see the baby and I didn’t have much anxiety during that period. My obstetrician called every two weeks to check in on me and the child health nurses provided me with resources if I started to feel depressed again. As soon as the visitors eased and Jules went back to work, I could feel it building. It wasn’t a feeling of defeat, it was a feeling of anger. I was so angry and the people closest to me copped it. I was angry that Jules went to work and I was at home 24/7, there was so much resentment building and it lasted for a year. I felt rattled and anxious/angry in a way that I’d never been before and I was even annoyed at Jules for suggesting a psychologist because I didn’t think it was depression.

“I went to a psychologist that I’d seen in the past and having that third-party to talk through things with where I talked about all the things that were making me angry – the fact that my husband was going to work and my friends were eating dinner in a restaurant and had shared a photo on instagram. It was actually a relief to be diagnosed with postpartum depression; sometimes putting a label on something enables you to feel like you’ve got a bit more control. The strategies were to remember the things I enjoyed before having a baby, Jules made sure I had time on my own, we went out for dinner even if we planned it weeks in advance.

“I fell pregnant again and I felt much more capable but I did end up with perinatal depression again because I started to worry about how I was going to juggle two kids. I returned to the Gidget Foundation again to stay on top of it because I didn’t want to fall in a hole again. I felt the anxiety simmering away but my toddler was a good distraction, I knew I had to prioritise what I needed to do – all the little things that gave me energy.

“I went with the same obstetrician but went to a different private hospital. The uncertainty of the pandemic really rattled me and I was nervous about the birth and who would look after Noah. My obstetrician suggested an induction because then it was scheduled and that really helped me with my mental health.

“It was a relatively quick labour. I was contracting and feeling a bit off and then I realised the baby was coming. I lay on the bed and within minutes he was here. I felt less detached this time and I also felt more attached and confident. I was very emotional in the days afterward because Noah couldn’t come to the hospital and I didn’t have any visitors. I had postpartum depression again and I started talk therapy immediately – I had the tools and knew what to do.”

Topics Discussed

Episiotomy, mother rage, perinatal anxiety and depression (PAD), Postpartum depression (PPD), Private obstetrician, psychology, Two Babies

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