Like many mothers, Sarah from The Pesky Placenta Society struggled to decipher whether her pregnancy symptoms were ‘normal’ or something more sinister. But with a pre-existing chronic illness, Sarah also had to confront her complicated relationship with health anxiety.

Unfortunately, the concerns she raised were proven to be more than ‘just anxiety’ when at 35 weeks pregnant, Sarah nearly died from pre-eclampsia - or what she refers to as “her pesky placenta”.

This is a story about the challenges of navigating both mental ill health and physical ill health in pregnancy; about fighting to be believed and to believe yourself; about the trauma that comes with nearly dying during what is supposed to be the happiest time of your life; about the struggles of bonding with your baby when your brain tells you that mothering is a barrier to your healing; and about the power of pre-emptive planning to protect your mental health.

Most importantly, it is a story about hope that with the right support, things will get better.

This is Sarah’s story.

“Even in my wildest dreams, I could not have imagined it going as bad as it did.”

When Sarah thinks about her mental health journey, she reflects on how her experience as a social worker shaped her pregnancy and postpartum. “I was working in child protection and I was actually specialising in the prenatal role for a few years. So my understanding of perinatal mental health is pretty good - professionally! Personally, it still hit me like a truck.”

“I think my work experience meant that I had a lot of resources that I already knew about… and I think I can confidently say that if I didn't have access to that immediately when I needed it, I would have definitely spiralled even further than I did.”

Sarah’s complicated relationship with anxiety began a decade before her pregnancy, following her experience with chronic ill health. “I ended up being diagnosed with Lyme disease, which is not unheard of in Australia, but it's certainly not common. It's a tick borne illness that our government and medical world doesn't like to recognise as present in Australia. And even though I was in the States - I was in the homeland of Lyme disease! - I still, even with that, couldn't get anyone to take me seriously.”

“I had about 18 months of just being really, really sick and not knowing what was wrong.”

“I'd got to that point where I'd had the head immunologist of a hospital tell me that he'd seen many a young woman who just needed a ‘little bit more attention’ and in the state I was in, I just shut down… I think I'd started to believe that I was making this up for some reason, because no one could find anything.”

While Sarah did eventually receive a diagnosis from a Lyme disease specialist, it was the struggle to be taken seriously that resulted in health anxiety and later, significantly shaped her pregnancy.

”I think then, when you get pregnant, for me anyway, any mental health stuff is just exacerbated times ten because your body is changing in such a big way… I spent the pregnancy trying really hard not to panic.”

“It's difficult to differentiate between what's just uncomfortable pregnancy stuff and what's actually a health problem.”

“I feel like everything can be explained away as a ‘pregnancy thing’. You'd be like, ‘oh, this happened’. And someone goes, ‘oh, yeah, that happens when you get pregnant’.”

“I was trying really hard not to just Google everything [and] I did quite well with my boundaries when I was pregnant, I would actively stop people if they started telling me their horror stories, because… I can't hear it right now because I'm going to take that and just run with it.”

“So I did quite well, but then when I started feeling sick, like properly sick, it just felt like exactly how I felt ten years ago.”

“I was going in to see the OB and going, ‘look, I've got all these things happening that seem not normal’. And I think preeclampsia in particular is tricky… often it just is silent.”

“Everyone seemed so worried about my blood pressure, but still didn't suspect preeclampsia until it was a bit too late… I was diagnosed at 34 weeks, but I was symptomatic well, really from the beginning of pregnancy.”

“So eventually, when I finally was diagnosed with that, I was upset because I knew that I had, on paper, all of these concerns and I kept getting told I was fine. So that really brought up my previous journey. So then I started convincing myself I was crazy.”

“By the time I was diagnosed, it was that kind of relief and worry at the same time. I finally was, like, a bit vindicated…. But then I immediately go into ‘this is actually serious’. Now I have to formally worry about it instead of hypothetically worry about it!”

Sarah was immediately hospitalised. “I think being in a hospital was so helpful as much as hospitals kind of suck to be stuck in. It meant that even though I was still catastrophising stuff, the staff were right there, and they're checking my blood pressure every hour or whatever… even if it gets bad, I'm in the right place.”

A week into her hospital stay, Sarah’s blood pressure reading returned a result of 230 over 30. “They thought that every blood pressure machine was somehow not working.”

“I’m still yet to find a medical professional who can explain that to me. They all just tell me that it's not possible - sure, but it happened!”

“The pulse pressure is what that gap is called, and when you have more than 60 in between your top and your bottom numbers, they consider that abnormal. I had 200 by the end!”

“No one can explain to me why that happened, which also doesn't help my anxiety, because it's this unanswered question, and I think just understanding the mechanics of how things work can help you kind of ground yourself a little bit, because even if it's bad, you can understand it… but I have no idea if my blood pressure has the capacity to do that again.”

“I think having that big question mark for me, even though it might not necessarily change anything, it's just a jigsaw piece that's not there, and trauma really fragments everything, and you have to try and put it back together. So when there's a piece missing, even if it's not necessarily relevant to you right now, it takes you back to that space of not having control. And I think that was the biggest thing for me.”

Between the alarming blood pressure reading and the birth of her son via emergency c-section at 35 weeks gestation, Sarah says it all happened within half an hour. “And that's not a lot like when you think about it! You have to get down to the OR. They have to do all the prep. They started the procedure before my anaesthetic had set in, so I was very full of fentanyl, which is a pretty heavy duty opioid.”

“I'd been seizing until the anaesthetic set in. I don't know if that's a thing. It seemed like everything settled a little bit once the spinal block took effect, but the staff around me were still panicking. I could hear them talking to each other. They were worried that I was going to die there on their watch.”

“In an average c-section, babies are born quite quickly… but usually they take a lot of time stitching you back up. But I didn't have time because I was going straight to the ICU, so I had maybe seven or eight minutes.”

“It was a rough job, necessarily, but it's a bit dehumanising. You’re kind of just roughly put back together. I didn't get cleaned and then I spent three days in the ICU not able to move. So by the time I had a shower, I still had surgery on me. It takes away a lot of your dignity, I think.”

The rush to the ICU meant that Sarah was separated from her son who was taken to the Special Care Nursery (SCN). “I think that's one of the things that I still - and I can feel myself getting emotional now - is, like, I cannot picture him being born. I know it happened, obviously, and I know what it looked like because there was a nurse who took a photo, and so I'm very grateful for that. But there was something very surreal about not even being able to picture what my baby looked like.”

“I was just lying there. It felt like hours… just like flicking between ‘I don't know what he looks like, I can't picture him at all’ and then ‘I might not ever see him again because I was dying’.”

“I didn't know if he was okay, like I assumed he was because no one mentioned anything when he was born. But I didn't know if I was going to survive. It was just a really full on mental time and I was just on my own in my delirious preeclampsia fentanyl brain, like not able to understand what was happening - in and out of consciousness.”

Later on, Sarah’s husband was able to come and show her photos of their son. “It just felt weird, like I'm sitting there zooming in on this baby that apparently just came out of me, and this isn't how you meet your baby, this isn't how it's supposed to go!”

“The trouble with the ICU is it's very busy because everyone's dying. And so the staff are understandably rushing to and fro. And I logically understood that me meeting my son was not anyone's priority. But I wish that it had been someone's, because I still look back on that and I think, how different could my postnatal experience have been if I was able to see him sooner and maybe even stay closer?”

“I'd be told, like, ‘yep, we're going to go soon’ and I'd message my husband, ‘yes, we're coming up’ - because obviously they're not going to bring a little premmie baby into the ICU - but then the shift would change and the next person wouldn't know that that was the plan.”

“I didn't actually meet him until the following night… It was almost exactly 24 hours after he was born.”

Unfortunately, Sarah was quickly returned to the ICU. “I think I had five minutes with him, maybe.”

“I just stayed sort of in and out of consciousness for another day and night and then went back on the postnatal ward. And that was also weird because everyone else got to have their babies with them and I didn't.”

“He was on a different floor and unless I had someone to help me get up to where he was, I just couldn't do it on my own. So there were so many times where it just wasn't worth it - And to people who've never had bonding issues with their baby, that must just sound insane.”

”I think I was in a pretty vulnerable state when I got pregnant… physically, I wasn't in the best health. Mentally and emotionally, I was definitely not!” After having experienced a few miscarriages, Sarah spent her first trimester of pregnancy convinced she would experience another loss. “So I think just the fact that the pregnancy progressed at all was something I had to wrap my head around.”

“So I wasn't super connected from the beginning, which, when I look at the full spectrum, I think I was preparing myself to lose him from day one, and then it sort of switched to, I thought I was going to die, and so then that was my reason for not wanting to get too close.”

“I spent a very vulnerable pregnancy with diagnosed depression and anxiety, but not medicated… looking back, I'm still annoyed that I let myself get bullied into this, but I went off my antidepressants when I got pregnant because I think my GP was quite heavy on the risk side of things, and I get that from their point of view. But I think looking back, I wish I had stayed on it throughout my pregnancy because it was safe.”

“I think when it's your first pregnancy and when you have my kind of health history, it's very difficult in the moment to just kind of take a step back and go, do I need to advocate for myself here? Or do I need to just do what I'm told?”

“It is hard, I think, mental health in pregnancy, because your hormones get blamed for everything too…. often when you're pregnant, they just become the front runner and everything is like ‘you're just hormonal’ and same thing when you've had the baby, like the baby blues. Yes, it's very hormonal and it's very real, but it sort of gets minimised because it's hormones.”

”I was convinced that my world was ending every day for a few weeks after my son was born. Every afternoon, I would have a panic attack…. It was debilitating. Every single day, my husband would have to sit with me and remind me it's done. Obviously, not all of it was over because I still had health problems, but we're home, we're safe. We had to do that chat every single day. And even though on paper, medically, my birth was traumatic, nobody can argue with that... But even with all of that, I had people like, ‘oh, this will get better, it's just baby blues’. Yes, the hormones are definitely exacerbating this. I noticed a shift after about a fortnight. Once your hormones start to settle, it got a little bit easier, but it didn't go away.”

“And even if you have the birth of your dreams, you've got this tiny human that you've got to keep alive and you're trying to heal and rest, and all of it is overwhelming and exhausting… And I'm very mindful that a lot of the advice people give is well meant. Like, I don't doubt the intention. However, the advice I kept getting was like, ‘just focus on the baby!’”

“I was still sitting in a space of going, ‘I don't like him’. And that still feels really weird to say out loud, but it's true. I'm very committed to being as honest about it as I can, because I know that if I felt it, somebody else has or is.”

“I didn't know who he was, I didn't know who I was. I spent every day just, like, waiting for death to find me. And so I didn't want to cause him any more issue by loving him and then going away.”

”And it wasn't just 24 hours that we were separated. That's how long it was until I met him. But mentally, we were separated for a very long time.”

“And when you're in that space of, ‘I don't know who I am after this, I don't even know what happened’, how am I supposed to then be a parent to this baby that everyone's telling me that I'm so in love with? But I'm not feeling that. That's just so many things to be trying to process in a postpartum brain. Like, trauma aside, there's a lot to try and figure out in terms of who you are when you become a mum. And I think when you add trauma on top of that, it's just the crappiest sundae you've ever seen with this trauma cherry sitting right on the top. And I just didn't want to spend time with him.”

“All his needs were met. I changed his nappies. I made sure he was warm. I made sure he was fed. I put him to sleep. And I think that's where we have this gap, I think, in our understanding of postpartum mental health, where it's defined by whether your baby is cared for or not. And he was. He wanted for nothing. But I wasn't okay.”

“And then I had all these appointments. Like, I had an appointment a day for two weeks after he was born, because when preeclampsia gets quite bad, as it did with me, it just takes down every part of your body, so you have to go and get checked. So I couldn't actually spend time focusing on those lovely newborn warm, fuzzy cuddles that you're supposed to have, because I'd have to go to an appointment, and then I'd have to be reliving everything, and then I'd come home in a state of just exhaustion and worry.”

“I've never blamed him for what happened, but I definitely blamed him that I couldn't focus on myself after he was born. I think I resented the responsibility of this little baby who relentlessly needed me.”

“I still don't remember many large chunks of it, so I started writing it out as best I could just to piece together what had happened. But I kind of had a few weeks where I just thought of it as, ‘oh yeah, that sucked. That wasn't what I wanted, but we're okay’. And so then when it hit me that actually I should be dead, that's a lot to try and process.”

”There was just so many things happening and then I still had all the health anxiety, like for weeks after. But the one that really got me and still happens is I still have, to an extent, the exaggerated reflexes, so I still have random little jerks, but those were really exaggerated in those first couple of weeks. And because I'd had convulsions and the seizing, whenever that happened, I would instantly panic that I was having a seizure… And because preeclampsia, you can actually develop up to six weeks postpartum… I was still in that danger zone… And that in and of itself is exhausting enough without all the parenting - just sort of trying to figure out, am I still going to die?”

”I think preeclampsia really validated my health anxiety in a very unhelpful way, because I'm now left with a lifelong problem that puts me at high risk of just about everything, and so knowing the possibilities of what could happen in the future plays on my mind a fair bit.”

”I'm very mindful that my access to resources is not the average person’s. So I don't want this to seem like I just assume everyone should be able to do the same thing, but I think because of my social work background and trauma being such an intimate friend of mine on a professional level, it did give me a bit of a heads up like, at some stage soon, this is all going to hit you, and then there's no planning, nothing's going to be able to happen once you're feeling the weight of everything.”

“So I used those few days to try and put some stuff in place, knowing what was coming, I knew that it was inevitable that I would end up requiring pretty intensive support… I don't feel it yet, but I need to organise this now, because when it hits me, I'm not going to think of it… So I managed to see just my regular psychologist the week after I got out of hospital. And she was great because she'd been helping me through so much anyway.”

“But because of my connections in child protection, I worked with a lot of people in health as well. So there was a few lovely midwives who knew of this therapist and they were like, ‘we've called her, she's ready, like she's got a spot, you just got to go to your GP and do this referral’ and so everything was kind of handed to me on a silver platter. And she has a midwifery background but she specialises in birth trauma and perinatal trauma so I just felt really at home with her. I think the combination of mental health and physical health knowledge was really helpful for me because I didn't have to over explain… it was refreshing to be able to talk to someone who just knew what I was talking about and she just let me get it all out.”

“And she brought up doing EMDR straight away and I knew a lot about it because of my work background but as many social workers are, we're great at telling people what to do with their feelings, we're not the best at dealing with our own! And so I was really sceptical… I don't know how it works, it just works and your eyes move back and forth. I describe it as it takes the sting out of it. I can remember what happened, but it's not like I'm stuck there anymore. So I was very lucky. Like I started doing EMDR a fortnight after he was born, and that's not common.”

“I felt like I got to a better space quicker, and I think most of that is just because I have the right people there at the right time to get things moving really quickly. And I knew that I needed to do that. There's like the calm before the storm with trauma where you're just kind of floating along and I knew that I needed to make the most of that time and so I'm glad that I did. And I think I also had people that I knew were looking after my son. Like, I am very lucky in the support system that I had.”

”I'm just very grateful that I was able to prioritise that because I don't think I would be as okay as I am now so quickly without having the space to just go and do what I need to do.”

”I think it's hard to try and put yourself first, but yeah, I think when you do, you can only be a better parent for it.”

”I also went back on medication… I think I needed the therapy as well, but [the medication] helped me be in a space to be able to talk about it. I think for me, it's a bit of a stepping stone.”

In addition to medication, talk therapy, and EMDR, Sarah also undertook IFS (Internal Family Systems). ”It's again, one of those things that when I was trying to explain it to my husband, I was like, ‘it's not as weird as it sounds. It makes sense when a professional is explaining it!’… it's a set of cards that you kind of go through that have different images and stuff on them, and the idea is you kind of just pull out the ones that make you feel something and you don't necessarily have to know what that is. It's just if it's kind of triggered a feeling in you, set it aside and all of those cards have different meanings to them… And I've actually been looking forward to getting back into it because it is that kind of deep work that I've not done before.”

“Having the opportunity to do that now, it's very raw and it's exhausting, but it's so necessary… I need to work through it. But doing it in a structured way with IFS is really helpful, because it's not like you're not sort of just pulling out threads, like there's a purpose to it and things get kind of pulled apart in a very structured way so you're not just left, like, floundering in all of these thoughts.”

“And I think that's where my writing really helped me because not only did it help me process, but it just helped me put together like, this happened and this happened kind of helped me stay sane a little bit.”

“When I first started writing things out after my son was born, it was just dot points. Like, I was just, at first trying to make sense of what had happened and trying to remember as much as I could. And then after a few weeks, when I started turning that into a bit of a narrative, it just felt more natural, I think, to write it to him… I was able to connect with him through my writing more than I could in real life. And so I knew that if I could try and write it to him, I still had hope that maybe one day I could feel what I was writing. Yeah. So I think for me, that's how I got it out in the most real way that I could.”

”I remember the first time I envisioned somebody harming him, and I was like, I would rip their head off… I spent so long, just being like, how do women supposedly lift cars off their children? Like, I don't understand this feeling that I'm supposed to have. So I think then when I first had that real defensive mama bear thing and it wasn't like a real threat, I was just, like, picturing what I would do. But that was like, a weird, trauma milestone for me. So I got there in the end. I think healing is slow, slower than we probably want it to be, but it meant that I could be whole enough to have some left for him.”

”And I value that. While I wish things were different, I think I appreciate those feelings potentially more than I would have, because I'd never thought I would have them. And to be able to just want to smoosh his little face or sniff his head, that was stuff that I didn't do for a really long time.”

“I feel a lot of hope for good things, particularly like in my relationship with my son. We got there in the end and I'm just enjoying liking him… I often have little moments where I just kind of reflect on how close we came to not having what we have now. Even on the hard days, I'm always very grateful to be a mum and to be here and yeah, I hope I can hold on to that feeling.”

“And then finding the online community around birth and perinatal trauma was like 100% my salvation. As sad as it is that so many people can understand what it feels like to have perinatal trauma, I think I needed that. No one in my own life could say to me, I know how you feel, and still I don't know anyone who had a birth experience like mine in my personal life. So finding people who get it, even if they're on the other side of the world, has been really helpful for healing. And I think it showed me you can be okay. Like, you're not yet, but you can be because these people are.”

”When we can be vulnerable in writing, it just has so much potential to change someone else. And that's why I started the Instagram space that I did, because I was like, if there's just one person that I can be that for, it's worth it. Because I am so grateful to the people who have gone before me and been really vulnerable in sharing their stories. Because without them, even with all the wonderful specific perinatal therapy that I had, it's not the same as being able to see somebody a few years ahead of you go, like, ‘I've been where you are and look where I am now. You can do it because I did it and I didn't think I could do it!’”

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