19 | Mon
“I felt like my body wasn’t my own and I was in some shell of an existence... We are talking about an organ that’s so primal, that’s so identifying as a woman that basically brought life into this world, and now it’s essentially falling out... When you just have this part of you that feels so broken, it feels like the whole of you is broken.”
Monique’s birth may have been quick, but its complications and long-term impacts were anything but. From a 3rd degree tear, prolapse, severe postpartum haemorrhage, a full levator avulsion on the right and a partial levator avulsion on the left, a near death experience, and a stay in the ICU, she paints a picture of the pain from her birth trauma and postpartum PTSD as a ‘storm’ - one that she is still weathering.
But thanks to talk therapy with her long-time psychologist, self-compassion, group therapy through the Australasian Birth Trauma Association (ABTA), and the support of her husband, it’s no longer a storm that she is weathering alone.
Join me in this episode to hold space for Monique’s incredibly moving story that shines a gut-wrenching light on birth trauma and why it matters. Please note, this episode vividly describes the experience and impact of physical and psychological trauma - go gently.
“My husband and I were trying to conceive for one and a half years in total. We did a laparoscopy and found I had stage one endometriosis, which was interesting because I don't have any of the typical symptoms.”
“We were given three months to try, and on the third month, we fell pregnant - it was a very uneventful pregnancy.”
“I'm a very - and probably a lot of your listeners can relate to this - I'm a perfectionist type A. Unfortunately, I think we're more prone to mental illness because we favour control and all that. I really wanted to make it a point that I trust the medical professionals, and I trust that they're going to tell me if anything was wrong or if anything was going to happen. That was a big thing for me to do.”
“I've had a history of anxiety and depression in the past, so I did seek out my therapist during pregnancy.”
“I went and saw a physiotherapist and began, I guess, preparing my body down that sense. I felt that I was pretty prepared. I felt like that I surrounded myself with a really good team. I felt really prepared and really safe going into it.”
This all changed at a sizing scan when Mon found out her son was showing full term at 35 weeks gestation. "No more dialogue really happened of my options.”
“As a bit of pretext, we were quite open to Caesarean. My husband has erb’s palsy, he became stuck when he was in the birth canal and has now permanent nerve damage in his arm. We were quite aware of the risks associated with having a big baby.”
“We then went, ‘Okay, well, they would tell us if we couldn't do this, so everything must be okay’.”
“I ended up going to the hospital quite early on because my contractions came on quite quickly. It was one-minute rest, one-minute contraction, one-minute rest.”
”I laboured away, eventually opted for an epidural. That worked for about an hour and then I regained full feeling, except not full enough that I could actually move around, but I could feel everything.”
“My physio taught me a different way of how to push. Basically, it was just almost like, I guess they say ‘breathing your baby out’. It's just instead of holding your breath, which will make you quite fatigued quite quickly, it's just breathing through your contractions while pushing. I started doing that, and the midwife next to me just went, ‘Stop doing that. What are you doing? Hold your breath and push.’”
“Like a scalded schoolgirl, I just did as I was told.”
Unfortunately, by the time their son was crowning, Mon and her husband were told he was stuck and needed to come out. “We both just went, ‘do what you need to do. Just do what you need to do to get him out and get him safe.’”
“That's a moment I relive quite regularly because this is where you start to put the self-blame on yourself. You think, if only I told them, No, do something different, roll me on my side, or tell that midwife to get out of the room. But when you're in that moment, you just want it to be over and you just want everyone to be okay. You trust the medical professionals to know what they're doing and to help you.”
“They ended up using forceps and pulled him out. That's where that one action pretty much turned my world upside down.”
Mon experienced a 3C tear and developed a partial levator avulsion on her right side. “What that means is my pelvic floor has been ripped from the bone on the right-hand side. I also suffered a massive postpartum haemorrhage of 3.3 liters. To put that in context, the human body has about five litres, maybe six litres if you're pregnant.”
“It all happened very quickly. Before I knew all that though, they lifted him up and we saw he was a boy, and I gave him his name.”
“I'm just holding him but I started to get very cold… I knew she was stitching me up and I said, ‘Oh, is it going to be much longer?’ She's like, ‘Oh, we've got a bit to go’. I went, ‘Okay, because I'm getting really cold. I'm getting really cold’. At that moment, Code Blue was called.”
“Levi was ripped off my chest and thrown in my husband's arms. He was told to sit in the corner, sign these documents, which, of course, he didn't read. It was just sign whatever was put in front of him.”
“It was just the whole floor was red. It was just a river… the nurses just came in and started just mopping up the blood. That's how they measure the blood. They mop it up and then put it in a bucket and they weigh the bucket in the end.”
“I was wheeled away. The way I describe it is if you've seen in TV shows or the where you have the lights passing overhead as someone is wheeled down a corridor. I looked up and that's what I saw. It's these lights, just one, two, three, just passing overhead. I couldn't speak at this point. My body was essentially numb.”
“I looked at the midwives and they looked scared. When the people looking after you look scared, you know that it's not going to be okay. They're screaming at me saying, ‘Monique, wake up. Wake up. Monique, stay with me. Stay with me, Monique’. And holding my hand and getting me the squeeze it, and I couldn't.”
“At that point, I went, ‘Oh, I'm going to die.’”
“I had a moment of clarity and I went, ‘Right. I got to hold my son. I got to give him his name. Mitch is going to be a really good dad without me. It's going to be fine if I die.’”
“I basically was just surrendering to that fact and accepting my doom.”
“I got down to theatre and the anaesthetist just grabbed my hand and he squeezed it really hard and he said, ‘Monique, my name is... (I forgot his name now, but he goes), We're going to save you. We're going to save you’. To hear that as a last thing before you get passed out, it was the most comforting thing because I just went, ‘Okay, I'm going to be okay.’”
It was several hours before Monique’s husband knew if she was okay. “I gave birth at around 7:30, and he didn't know I was okay until about 10 o'clock. So for him to be alone with doing all those without me and not knowing if I was okay or not, he was terrified.”
After surgery, Monique spent the night in ICU. “I woke up a couple of times, unfortunately, being ventilated. If that's ever happened to anyone else, it's quite terrifying because you feel like you can't breathe.”
“When I fully awoke the next morning or afternoon, I don't know, it was quite surreal... I was just drowsy and couldn't really understand what was going on. I had five units of blood transferred at that point.”
The doctors came in were basically like, ‘Yes, this is what's happened to you. You've had a 3C tear, you've lost this much blood, blah, blah, blah.’ All I could say is, ‘Where's my baby? I understand you have to tell me this, but where's my son? Is he okay?’”
“My husband came down and told me he was okay, and we just cried.”
“That next day I spent in ICU and I couldn't feed myself, couldn't really do anything. They ended up bringing Levi down in the afternoon and I held him my arms and tried to breastfeed. Mitch and Levi stayed with me until eleven o'clock at night, where they told him he had to go back up to the maternity ward, which is I'm very thankful for that they allowed him to stay as long as he did. I don't think that was actually allowed, but I think I don't know if they just gave it allowance at that point. I'm so thankful for that.”
“The next morning, I still couldn't feed myself when I was waiting for Mitch to come down, but he didn't come down.”
“The nurses helped me to the chair and they told me I shouldn't be sitting in the chair for longer than half an hour. They ended up leaving me there for two and a bit hours. I don't fault them for that because if you saw what it's like in ICU, they didn't have enough staff on. They were obviously caring for someone that needed their urgent care. But still, I had sit there with my catheter overflowing, trying to hold a spoon.”
“I couldn't get out of the bed for a couple of days. I just didn't have the strength. Everything was done for me when Levi was brought over. When I did need to go to the bathroom, I basically had a nurse on either side of me and had to use them for full support to go to the bathroom, which was scary.”
“That broke me because I'm a doer. I like to help. I like to be productive. Basically to the point where I started to internalise this thought process of ‘I couldn't even deliver my baby properly. I can't even help him now’. The only thing I could do, I threw everything I put into breastfeeding because I felt that that was the only thing I could do to help anyone. There was nothing else I can do.”
“I went numb. Anyone that would do anything for me, I would profusely thank them and go, ‘Thank you. Thank you so much. I'm so blessed to have you with me. Thank you’. I would freeze. I made myself go numb just to survive where it was like, ‘Okay, my job is to feed him, and I'm going to do that to the best of my ability. I'm going to feed him.’”
“I didn't understand the damage that had been done. At the time, they just told me numbers like 3.3 litres and I went, ‘Oh, okay’. I didn't compute what that even meant. I just went, ‘it's a lot of blood.’”
“On my day of discharge, which was six days postpartum, I was determined and it took me about half an hour to walk out of the maternity ward because I was hanging onto the wall by myself as Mitch held Levi, and I was shuffling down the hallway, but I was determined, I'm going to leave this hospital on my own.”
“The second week, I could walk maybe five minutes at a time. The third week, 10 minutes. Fourth week, 20 minutes, and so on. I made that my goal... I think that's what kept me going in those first days because I felt like I didn't really understand the full scope and long-term impact of my injuries.”
“I think the first three months postpartum was really just processing and the shock of the birth itself... it was not just mourning what had happened and saying ‘Oh, we didn't get the birth that we want’. For us, it was the shock of, I guess it's a shock that we almost died, like I almost died, and that our family unit that we were so excited for almost didn't exist.”
“It's that shock of and the fear of how delicate life is.”
“At that point, my therapist basically stepped in and began intensive therapy with me twice a week just to help me process what happened and admit things that happened because I tried to explain things away quite easily and minimise things. She really put a mirror up to me and went, ‘No, this is what happened. You're showing all the symptoms. You're doing everything that's a case book of PTSD. You've got PTSD.’”
“It wasn't really until closer to the three-month mark that I admitted that I almost died. Then that was a processing part of that as well.”
“I guess for me, it was a pretty much total despair where I couldn't comprehend what would happen the next let alone the next hour, and I was essentially living minute by minute, constant fear.”
“I was living day to day, minute by minute. What I presented to the world really depended on what I was feeling in that exact moment. My therapist actually had a hard time diagnosing me in the beginning because if I had a good morning and then I went to therapy, I was really optimistic and overly bubbly and almost erratic. But then there would be a trigger and I would spiral so deep where I would have suicidal thoughts and contemplate and daydream about if I just died, perhaps on that table, all this pain wouldn't be here.”
“It was very erratic behaviour.”
“I often would just fall on the floor crying, begging Mitch to just explain to me what happened, how am I going to get through this, and what am I to do now.”
“I had really vivid flashbacks, which was really hard because obviously when you've got a newborn, every time he woke up and I'd feed him and pop him back down, I'd lay back down and just relive the whole moments of laying on that bed - because that was such a pinnacle part of my experience and that accepting death for me, it's just changed my soul. Reliving that moment was quite common.”
“Nightmares were very common. When I did finally get to sleep, there was nightmares.”
“What came later on for me, especially after that three-month point where I had my diagnosis of prolapse, is my trauma became really closely associated with my physical body. I think trauma is something that changes you physically, emotionally, and mentally. It's just everything about you changes.”
“Physically, I would have a slight twinge in my body, and it would send me spiraling. There was one time I remember I wouldn't go to sleep at all because I had a slight pain in my chest, and it was the same pain I experienced when I felt myself bleeding out. I thought, ‘If I go to sleep, I'm not going to wake up’. I pretty much stayed awake that whole night until I basically passed out from exhaustion at about 5:00 or 6:00 AM.”
“I guess my GP thought I was having more postnatal anxiety and depression because I would have anxiety attacks and I would have the symptoms of nausea or trembling or sweating, because I'm basically reliving a nightmare.”
“It was constantly being vigilant. I guess that's the fight response coming out. But then I would freeze.”
“When I really first understood what happened to me with the three C tear, I had gone out for a walk that day. If you remember June, July last year was still in the La Niña - torrential, forever rain - but I was determined to go walking every single day. I went out and it started to rain and of course, I couldn't walk that fast to get out of the rain. I had to find shelter in a park and I was waiting for the rain to pass and I was watching a video and it explained what a 3C tear was. When I finally realised what had happened to me physically and what that meant for my long-term recovery, I shut down and I just remember sitting in the park raining and crying and shaking and essentially just having a panic attack meltdown in middle of public and I couldn't control it.”
“That lack of control pretty much defined my period of life at that time.”
“I found that I was fearful of everyone. I didn't trust medical professionals, but I was also just desperate for someone to look after me.”
“For me, it just felt like my life was over because everything that I knew, my whole identity, where I used to love doing Pilates and yoga and even that didn't feel good anymore. I felt like my body wasn't my own and I was in some shell of an existence now. I felt I didn't feel like me and I still don't feel like me today. I know that when we have children that it changes us forever. But how profound that the life I knew I'm never going to get back. Maybe I'll get to do some things again that I love, but it was this overwhelming sense of grief that I had, and that just sent me down.”
“Within a day, I would have so many emotions where sometimes I would just be crying on the floor. I'll put my bub to bed. I'd crumple onto the floor in the corner and just cry and cry and cry until he woke up, and then I would stand up, dry my tears and go back to being that again. It was just survival. Every day was just survival.”
“I would have friends or family that would reach out and say, ‘We're here to support you. If there’s anything you need, if you need to go to appointments, let me know’… I don't expect them to drop everything for me. I think I had to remind myself that quickly, but I rarely ask for help. If I'm asking for help, I really need it. I think it's a hard pill to swallow that a lot of people offer their services and help in a tokenistic way of making themselves feel good. This is a bit of a pessimistic note, but I find it very self-serving, a lot of people offering help, but when you actually ask for and accept it, it's rarely followed through with.”
“I think that that really contributed to the loneliness that I felt. I was so desperate just to feel part of a community that understood what happened, the intensity of what I was currently feeling in that I wasn't alone.”
“There's a couple of times where my therapist was ready to admit me to a mum-and-bub centre (MBU). I believe there's a new one that just got opened up at Westmead… but my parents had come down and they stayed with me during both those periods. They essentially became my nurses.”
“That was at my low point.”
“I mentioned before that it was really heavily tied to my prolapse and my symptoms of prolapse… I think I do need to focus on this because we are talking about an organ that's so primal, that's so identifying as a woman that basically brought life into this world, and now it's essentially falling out.”
“I'm quite lucky where I have stage one prolapse, but it's quite mobile. So what that means is if I do any excessive activity, there's a chance that it will get a lot worse. And because I have a partial levator avulsion, the chances are that when I go into menopause that it's going to get significantly worse. That's just the reality of it. It's just impending idea that I'm basically never going to get better. I can manage it, but I'm never going to go back to where it was before because there's no muscle on the bone. It's gone. I was coming terms with that.”
“I was trying to get the correct pessary fitted, I would go for a walk and it would just be this heavy, stinging sensation that it's going to fall out. It was so painful and I would bleed and it would ache.”
“When you just have this part of you that feels so broken, it feels like the whole of you is broken.”
“Because of my 3C tear, I was basically incontinent fecally and urinary as well. I couldn't leave the house until I had basically done my business, otherwise I might not make it.”
“Then my son started daycare and I get the daycare illnesses.” Within a month, Mon experienced RSV, gastro twice, and potentially tonsillitis. “When that hit, that basically brought on all my symptoms again because I was out of control of my body.”
“I had to go in nappies, essentially, and I just didn't feel human anymore. It was to that point where I just didn't know how I could continue if this was what the rest of my life was going to look like.”
It was following the realisation about the extent of her injuries and during the bout of daycare illnesses, that Monique went to her GP to discuss starting medication. “She had been encouraging me for a while that she wanted me to start Zoloft, and I was very hesitant.”
“I did start, and then I had all GI issues. I was still breastfeeding at the time, and I couldn't drink, I couldn't eat. Everything just made me sick. Then I got even sicker. I was recovering from a previous bout of gastro, so I was even sick from that. Then I pretty much took myself to hospital to just go into IV drip because I was so dehydrated and I couldn't physically recover. I couldn't drink enough fluids to really function. I almost passed out that morning.”
“I only was on that [Zoloft] for a few days, and that pretty much triggered me even more. Since then, I've basically just gripped my teeth and bear it. I stopped taking Zoloft. But I think if I was able to, I definitely would have, because it hasn't been an easy journey trying to come out of that without any help whatsoever except talk therapy.”
In terms of Mon’s recovery, there was five key things that helped her: talk therapy, journaling, self-compassion and acceptance, group therapy, and her supportive husband, Mitch.
Talk therapy
“I was really thankful that my psychologist I've got a pretty good relationship with. I've been seeing her for about seven years, and we mainly do CBT therapy. Through this PTSD experience, we mainly relied on talk therapy and exposure because it had worked for me in the past.”
“One task my therapist told me is she's like, You're not going to remember a lot of this. A lot of people don't remember much anyway, but just because your body just naturally tries to forget as much as possible. She told me to take as many photos as possible, so I've just been spamming. My phone is full. But it's nice because I look back and go, ‘I actually don't remember that day. I don't remember anything of what happened then.’ To look back and know that it happened, I can relive some of those happy times and some of the happy memories that are recorded. That's comforting.”
Admittedly, Monique struggled with talk therapy at times. “I felt like I had to show her the depth of what I was feeling, so I had to take it upon myself to do a lot of things to show her. For example, I ended up taking a two-week journal of just writing down a sentence every single day of what was happening, and it was erratic… It was helpful in a way where I could really make sense of what happened… But when it came to then at the end of the hour, when you understood what happened, then you have to go away and do the work. That's where the loneliness started because I didn't feel strong enough to do it on my own.”
Journaling
“I've had a love-hate relationship with journaling. Even pre-pregnancy, it was my thing to sit down, do my makeup, and then write a one-page journal entry every single morning… When you have trauma, that's impossible because the pressure of trying to justify how you feel and put what you're feeling into words, it was so hard and I gave it up, essentially, and I was like, ‘I can't journal. This is impossible.’“
“I found that the only way I could really do it is just do a sentence a day. It was really just before I was going to sleep or trying to go to sleep, and I'll open up just Apple notes and just put in a sentence saying, ‘Okay, what was happening today? And what was I feeling today?’ That was the answer. I didn't try to justify it. I didn't try to put meaning to it. I just would basically state it is what it is. Once I took the expectation away that I had to justify how I was feeling, it became a lot easier, and then I could just present it to my therapist.”
“I did that initially for two weeks, and after that, I basically pick it up when I'm going through a hard period or if I know I'm going through a hard period. For example, leading up to the one year [anniversary], I picked it up again and just made sure that I was really proactive about it. But I try not to give myself another job to do when you're trying to do 100 million things as you do as a new parent.”
Self-compassion and acceptance
“I was really focusing on just being compassionate with myself and forgiving myself for everything I felt that I had, in quotation marks, done wrong.”
”It's one thing to say the words and it's a lot of work to believe them because that's one thing when I was learning self-compassion… I don't feel it. I still feel like it's my fault. I still feel like if I perhaps did a little bit more research or if I told them to go away, or I said, ‘No, I don't want forceps,’ or ‘I would like a caesarean,’ or all these other options and I was empowered, maybe none of this would have happened.”
“This is where self-compassion comes in because I feel like I did everything that I could. It's very easy for when you go through these stages of grief, which is essentially what it is, that you start blaming people. I was blaming health care professionals for a while and saying, ‘They're not doing enough for me.’ Then that got to redirected on myself again, saying, ‘I'm not doing enough for me. I wish I could have done more.’”
“I'm not sure if I can say if I've forgiven myself because I've pretty much learnt that there's nothing to forgive. I think what has really happened over time is slowly I've actually accepted that there really is nothing to forgive… Yes, I still self-blame. Yes, I still spiral, and I cry, and I cry thinking, What has happened to me? Why did this happen to me? Of all the people like I thought I did everything right. What did I do wrong? But then I come out, the storm passes and I go, It's okay. There's nothing to forgive. It's okay. This is the way it is now.”
Visualisations with her therapist, where she imagined herself as a blameless child, helped Monique too “Just to be saying you're still worthy of everything in your life. You don't need to justify your worth. You're worth it because you are here. That's it.”
“I feel like a year on, self-development-wise, is I've really learnt that I can't control anything… I don't want to say, ‘Oh, I'm so thankful this happened.’ I don't want to say that, but I don't think I would have been able to relinquish control like I can now if something like this profound event didn't happen to me.”
“There's a saying - I've got a bracelet made up of it - This storm will pass - and it reminds me that in the darkest moment and it's pelting with rain like it was in the park that day and how horrible everything was, the storm will pass, the sun's going to come out again. And then the storm is going to come again. It's just the way of the world. That's really what I've come to realise. That's really settled my soul where in those really dark moments, because they're going to come and I know they're probably going to keep coming for a very long time and maybe for the rest of my life, hopefully not as bad, but that's what I'm preparing for. But I know that it's a wave, it's a storm, and it will pass and the sun will come out again.”
Group therapy
“I was so desperate to not feel alone that I contacted everyone possible. You know how you get that book of brochures when you come out of hospital and it has all these health care lines, I think I rang every single one.”
After calling several services, Monique enlisted the support of the Australasian Birth Trauma Association (ABTA).
“They have a Facebook group that I've been a part of. But even just going back through the search history and reading other people's experiences, for me, who, like I said before, I didn't know what tomorrow looked like, and I found a person there who had a very similar experience to me, and I just messaged them and I just went, ‘It's been two years. Can you tell me how you are? Are you okay?’ And the support that outpoured from her, and she just told me where she was two years down the track, it gave me hope. And that's what I really just needed.”
“So I used one of their services where they did online group therapy. It was really insightful. So we all had a moment to share what happened to you. But then every week they presented some a resource of some kind about the process of processing birth trauma and things that you can do to actually help through the cycle of, like we're saying, the ups and downs of what happens during recovery. The resources they provided from people presenting who are volunteers, who have actually been through trauma themselves, it was a really amazing community… It was a really good place to be. Usually it's very hard to find that online community, especially during Zoom.”
“My mother's group I was assigned is amazing, but to be part of another group that's actually all living and processing trauma, it just helps us not feel so alone.”
Mitch
“He basically said, ‘I'm not going anywhere. I'm always here.’”
“Just to show an example of what he’s like, it was really common for me, especially when I was in some of my darkest days where I would be on my hands and knees at his feet, begging him, because you're not really begging a person, you're just begging anyone to like, ‘Can you just help me? Can you just help me? Tell me what's wrong. Tell me how I can get better. Tell me there's hope.’ He had no idea, but he just got down, gave me a hug and goes, ‘There's hope. It's going to be okay’. Didn't try to fix it, didn't try to justify it... It's just like, ‘There's hope. It's going to be okay.’”
“My heart goes out to anyone who doesn't have that support. It's a scary thing. I think, ‘How could I have done this without my team around me?’ I don't think I could have. I think I probably wouldn't be sitting here if it wasn't for that.”
Mon only had one thing left to say: “It was hard, as raw as I can be, it was the most fucking hardest time I've ever had, and I'm still going through it. It's embarrassing, it's humiliating, it's horrible. So find your people. Definitely find your people and keep them close.”
