Like everything else in her life, Jess had many plans for motherhood. As planned, she fell pregnant after completing her psychologist registration. But from the moment Jess saw the positive result on the pregnancy test, she was surprised that her once positive outlook was overshadowed by an all-consuming sense of dread and anxiety. Despite sharing this openly with her care providers, her severe anxiety remained undiagnosed.

To her relief, that relentless anxiety ended the moment her daughter, Charlotte, was born - 3 months early! Jess found that she coped better with the unexpected preeclampsia diagnosis, the emergency c-section at 28 weeks gestation, and the subsequent 51-day NICU stay in a hospital over an hour away from home, than she did with pregnancy.

Unfortunately, it was finally bringing her little girl home - a moment she’d waited so long for - that saw the return of her anxiety. But this time, it was crippling.

With the support of an incredible care team, featuring her GP, the hospital-appointed psychologist, and her family and friends, Jess’s anxiety started to ease and she could finally enjoy those moments of motherhood she dreamed about - like sitting on the couch with her daughter in their pyjamas - just as planned.

From the moment Jess received a positive pregnancy test - a wanted pregnancy, a planned pregnancy - she was immediately overwhelmed by anxiety and panic, “I was just a wreck, and literally from that moment the anxiety just spiralled.”

Despite experiencing anxiety in the past, Jess always felt it was managed because it didn’t interfere with her life. This all changed with pregnancy. “I’m quite a positive person, which is why I struggled with pregnancy… I just lost all optimism.”

“I’m not a crier, but I cried every day.”

“Instantly, I started to think what if I miscarry, what if something goes wrong?” This was exacerbated by occasional spotting. “I kept spiralling, I kept thinking what could happen, I was obviously googling.”

“My original plan, pre-pregnancy, was that I wanted to tell people quite early… but I couldn’t. I didn’t want to tell anybody because in my brain, if we told people it made it real, and if it made it real and something happened, it would be worse. Which is illogical because even if we told people and something happened, it would still be horrific. But I just couldn’t.”

After the first trimester, Jess and her husband finally began sharing the news with their family and friends - “they were so excited, but I felt like I was just faking it… there was just this disconnect.”

“I didn’t feel optimistic. I just felt heavy, like I had something on my chest the whole time.”

In an attempt to ease her anxiety, she constantly sought reassurance - from going to the GP to recheck her HCG levels, to holding her breath at the bedside scans with her OB every appointment. She was constantly consumed by ‘what ifs?’ and waited anxiously to pass every ‘safety check point’ - 12 weeks, 20 weeks, 24 weeks gestation. “At the time, I knew it was illogical, but it was what I needed to do.”

“Things got a bit better once I started to feel her move a little bit because I think it meant she was real, I had something to tell me I was still pregnant.”

There were several opportunities when Jess confided to her care providers about her anxiety, although these admissions were never acknowledged. “I was very open, at no point did I go into my appointments going things are wonderful, things are great. I often did say I am anxious…”

“I guess I wasn’t fully open because I wasn’t going I’m anxious, I’m worried my baby’s going to die, I’m worried that I’m gonna miscarry, I’m worried I’m gonna have a stillbirth. I was just spiralling but I wasn’t saying that. I just said I’m anxious, but no one questioned me any further.”

There was a particular interaction with a midwife during her hospital admission appointment that Jess remembers with frustration.

“I said to her as well, I am quite anxious, I definitely am struggling with the anxiety. But she didn’t question me any further. And if she had have, I think I would have been open… I was like if no one is questioning me, then it must be fine.”

“It just really frustrated me as a mental health professional - how many women are slipping through the cracks, and at the risk of just having a conversation? Asking someone to expand on their anxiety could have made a difference.”

Despite a series of tumultuous events that Jess thought would tip her over the edge - an unexpected preeclampsia diagnosis resulting in an emergency c-section at 28 weeks gestation, followed by her daughter’s 51-day NICU stay in a hospital over an hour away from home - Jess found that she coped.

“How wild that my mental health in pregnancy was worse than how my mental health was when I had a baby three months early. I actually coped better after she was here, because the second they pulled the placenta out I felt like myself again. It was absolutely insane, I just remember laying in recovery and I just felt like myself, it was like the weight had been lifted off my chest, I felt like I could be optimistic. I went through the whole pregnancy so low, so anxious, and just so not optimistic, and I’m such an optimistic person.”

“That relief! It was just insane! I’ve had a baby almost three months early - that’s the time I should be falling apart! That’s the time I should have been an anxious mess! But because I felt like myself again, I could be optimistic, my brain was logical again, and I felt ok about it all!”

However, being discharged from the hospital less than 72 hours after the birth of Charlotte was one of the most challenging parts of the experience, “leaving the hospital without your baby is just horrific, it just felt so unnatural.”

“It got easier to a degree because we got used to it, but that first time was just shit.”

To make things more complicated, Jess lived an hour away from the hospital where her baby was admitted into the NICU, meaning Jess and her husband had to drive back and forth every day. “We had a potential three-month hospital stay ahead of us with her, three months of driving back and forth, I really tried to not think of it as a whole, I tried to really focus day-by-day, which really helped.”

“The NICU journey is ironic, because that’s probably the time I should have been falling apart and should have been highly anxious but I actually coped really well. I think because it was structured, I do well with structure. I knew she was safe, she was with nurses and doctors keeping us informed, we visited everyday, we just got into a routine… I coped remarkably well.”

However, the closer it got to bringing Charlotte home, the more Jess felt her anxiety bubble under the surface.

“Overall, we had a 51-day stay in the NICU. A majority of the time was in the main hospital in Perth, and then we got transferred semi-closer to home, but it was still 40-50 minutes away in the last two weeks which was really helpful… but that was when things started to bubble a little bit.”

Finally, Jess found out her daughter was being discharged - that very morning after the doctors did their rounds.

“We knew it was coming… but I was a wreck. We were excited but I was dying inside. I was so anxious, I felt sick, and I was sick because of the [breast] abscess, so I was in pain. And my anxiety was just running riot, we’re taking her home, I have to go to the doctor’s this afternoon, how are we doing this?… Is Troy coming to the doctor’s with me? With her? Because I can’t go on my own, I can’t take her on my own! She’s just come home! But if I take her to the doctor’s what if she gets sick and has to go back to the hospital.”

Health anxiety was a big feature of Jess’s postpartum journey because of both her daughter’s small size and her own medical complications and pain. The very afternoon of Charlotte’s discharge from the NICU, Jess was at an appointment for her breast abscess, and was told she would have been admitted to hospital herself had her daughter not been brought home that morning. The doctor sent Jess home with a list of symptoms to look out for and with an order to go to the emergency department should these appear.

“First night, at home, with our baby, was just an absolute recipe for disaster. I barely slept. I was up pretty much the whole night over-analysing every single thing I felt. I was so anxious I made myself sick, I remember I threw up a few times, but then I thought I’ve vomited, this is it… I’m going into sepsis!“

“I was like, I’m gonna have to go to the hospital, I’m gonna get sick. I’m gonna have to go back, we just brought our baby home.” She rang her mum to come over and drive her to the emergency department, although the relief she felt when her mum arrived made her realise that it wasn’t sickness, but anxiety.

While having her breast abscess drained helped some of her anxiety, Jess couldn’t shake the anxiety that consumed her about Charlotte’s health. Furthermore, leaving Charlotte at home daily to attend more medical appointments only contributed to the deterioration of Jess’s mental health. “That was where it started, where I felt a bit more of that disconnect and the depression really started to come in. It was just easier - I think I probably shut myself off in a sense - because I had to go to these appointments. But I thought, it’s better if they look after her anyway, because if I don’t have to look after her then I can’t do anything wrong.”

“Poor Troy, he was doing everything at this point, because I wasn’t functioning and that was just within three days, it was just so fast! I wasn’t eating. I was barely sleeping. I felt sick - just that all-consuming anxiety.”

“I could not function. I managed to express and I’m so grateful I was able to do that, but I think that really came back to that structure [of the NICU] because I’d been doing that for so long already - this is the routine so we’re sticking to the routine!”

“By Thursday, I was already like this is not normal, this is not me. And I knew that I was just sinking, I felt that weight on my chest was back, but it wasn’t just the anxiety anymore, it was that depression of the constant crying. I didn’t want to be around my baby, I just wanted to lock myself in the bedroom, because if I locked myself in the bedroom and wasn’t near her then I didn’t have to think about all the things that could go wrong.”

“It just got worse and worse. My doctor rang me Thursday afternoon to check in about the abscess - it was actually her day off - so I’m just so grateful to her that she’d even rung because that really kick started that conversation about how I was really struggling.”

The next morning, Jess knew she couldn’t keep going like this. “It was such a quick timeline, like Monday to Friday. It went from that anxiety to full-blown paralysis.”

Despite being fully booked, her GP squeezed her in for an appointment the next morning. “I remember I wrote down everything - I wrote a list of what I was feeling - because I know if I have to say it, I’ll cry, and then I won’t be able to speak. So I wrote it all down and I literally got to her room and said here, read this!”

The GP prescribed Jess with medication, as requested, and discussed other options too, including admission to an MBU (mother-and-baby psychiatric unit). “At the time I was like no, there’s no way I need that! Looking back, I probably could have been there… But the idea of leaving home again? We just got home!”

Thankfully, Jess was able to stay home with her daughter because the medication helped her get through it. “I started the medication Saturday morning… I knew it was going to take a little bit of time to kick in, so I just had to show up in some regard and live life to the best I could… By the following Friday - not even a week on full meds, it was probably somewhat of a placebo effect - I felt better. It was slow, it wasn’t amazing overnight, but within a week I felt some relief to those symptoms and was really able to start enjoying having my baby home.”

In addition to the medication, Jess credits the support of her care providers, her family, and her friends for helping her through this time. “We were very lucky, we were very wrapped in support.”

Jess also had access to the hospital psychologist, who she saw until Charlotte was 12 months old. “We got so many services… what we got was really what everyone should be offered.”

“I’m just so eternally grateful that [my GP] listened and she understood that I needed that. She continued to be incredible and she’s still our GP… And I’m just grateful because I know not everybody has that experience.”

“I definitely have moments where it does become overwhelming and I do spiral, but I can bring myself back.”

Jess’ piece of advice to everyone having a baby is to “Talk to your family, your friends, your partner, about what to look for. Because I think for me, if I wasn’t self-aware, it would have taken a lot longer for someone to notice I wasn’t ok.”

“I hate to think what would have happened if I had left it longer, I think it would have gotten quite bad - it was already bad, but it would have got much worse!”

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