Story #108 - Courtney, Idaho (USA) - Pregnancy Preeclampsia, Cesarean Section, Traumatic Hospital Birth, Postpartum Depression & Mental Health Care

I became pregnant with my first child when I was 22. At 32 weeks, my pressure read high during one of my doctor appointments, so they told me to start checking it at home. They didn’t tell me why and, being so young, I didn’t ask. All they said was, “If it ever goes above 140/90, head to the ER.” They did not prescribe a blood pressure cuff so I had to go to the grocery store every morning before work, until my grandpa gave me his.

One week later, I hit the 140/90 number. I tried to calm down, and did the test again. Same result. I called my husband letting him know that I was heading to my doctor’s office. When I got there, I didn’t have any appointment so I had to wait four hours before seeing someone. The doctor I met with was new, and he ended up being a maternal fetal medicine resident, which was wonderful. He checked my BP manually, told me to relax, think about my favorite vacation… But I was continuously hitting the number. They kept asking for blurry vision and headaches because they were trying to figure out if it was preeclampsia. When my husband finally got there, they told him to keep an eye on me, and sent me home, ordering me to come back three times a week until the end of my pregnancy.

I didn’t have to wait that long.

One week later, they found protein in my urine during another routine appointment and sent me straight to the hospital to be monitored for 24 hours. They didn’t allow me to drive and since we only had one car, my husband had to run a couple of miles from work to get me.

Once I got to the ER, I didn’t really understand what was going on. There were talks about preeclampsia, HBP, and proteins, but no one explained. I did have a mild headache, but I was so stressed out, so didn’t think too much of it! The following 72 hours were hell. You think to yourself, “I’m 22 and healthy, this isn’t supposed to happen!” My BP and the protein wouldn’t settle. I had to be monitored every three hours and pee in a bucket. Everything was calculated. Doctors would come in and out, they’d have discussions about meds and no one would let me get up to take a shower. I just needed to process what was going on! I lost it so many times, bawling like a baby.

My sister and mom came to visit, which meant so much to me. They also went to our home, cleaned, did groceries. My husband also stayed with me the whole time and refused to leave my side.

On the third day, I was allowed to go home but on strict bedrest. The only thing I was allowed to do is to go to the bathroom. It was a waiting game.

During the following week, I had a prescription to take for my blood pressure. I also had horrible acne. I never had acne before in my life, but once my BP started rising, my zits got horrible along with my face swelling. It took over a year and heavy medication to get it under control.

I never even had blurry vision or headaches, which are clear indications of preeclampsia, so I think this is why the staff at the hospital never acted on it. But one evening, I missed a dose and the following morning, I had overwhelming hot flashes and started puking everywhere. Knowing what I know now, I should have gone to the hospital asap.

On my following appointment, I had to have an outpatient visit at the hospital instead of my clinic because it was Memorial Day weekend. They did an ultrasound and picked up contractions 3 minutes apart, but to me, they just felt like the baby was moving. The heart rate was also decelerating, but not enough to freak them out. They did a biophysical ultrasound and checked every little thing. The doctor let me go, because I didn’t feel any contractions, but made me promise to come back as soon as I felt something.

After reading my records, I saw that they also had discovered that the umbilical cord was really thin and the blood flow was not as strong as it’s supposed to be. The baby also measured small. But no one said anything about this. In a way, I’m grateful because I would have been even more traumatized, but I also feel like they hid something from me

On the Tuesday after Memorial Day weekend, I went back because I was having contractions. I was 35 weeks and already 3-4 cm dilated. The doctor looked me in the eyes and said, “You’re having this baby today.” By then, my husband and I had already processed that we could have this baby at any time, and all the nurses recognized me when I checked in. One even told me, “We knew you wouldn’t last very long…”

Inserting the IV brought me to my knees. I have very small veins and it was so incredibly painful. They also didn’t have my GBS result back so I had to have antibiotics per their protocol. They also put pads on the hospital bed in case I had a seizure due to the preeclampsia and because my BP was incredibly high despite the meds.  

I got settled and the doctor broke my water. At that point, all we could do was wait and see. 

A couple of hours later, I had failed to dilate so they started me on Pitocin. Gave me an epidural quickly to prevent my BP to get any higher. I wanted one anyway so it was fine by me. But I felt really sick. Like the worst case of flu you’ve ever had.

I don’t think I realized the severity of the situation. My husband was so stressed out, and I think I was just going through the motion. About six hours after they induced, the doctor came in because the baby’s heart rate was decelerating with each contraction. He said, “We have two choices: try vaginally for another hour and ‘who knows what happens,’ or do a C-section.”

I knew his C-section rates were low and I believed that he would not have suggested that if it was not necessary. So, I trusted him.

They got me all setup, but I never had surgery before. I was really nervous about being cut open and was shaking uncontrollably. I learned after that magnesium also does that. I kept asking what would happen to my baby, but no one ever gave me a direct answer. They rolled me out quickly – running, really – and the anesthesiologist gave me a spinal tap on top of the epidural, I’m still not sure why.

During the procedure, I kept asking questions, describing what I felt. They were all very nice and responded.

Luckily, she was born quickly and cried right away. They had a window in the OR where I could see her being transferred to the NICU because she was premature. She was so long and skinny! She passed her APGAR with flying colors and was breathing on her own since they had given her steroids in-utero.

Afterward, the world became blurry.

I later read in my records that the placenta was incredibly small and the cord, tiny—half a pinky finger. They sent the cord for testing, but it was too thin and fragile and disintegrated before they were able to. I have to say that none of these things were explained to me. The only reason I know is because I requested my medical records a year after the fact.

I remember the world spinning after surgery. I was still hooked up on magnesium and oxygen and felt incredibly hungry. The nurse gave me a small piece of toast with jam but I felt like I was going to puke. I asked for something else and she apologized saying she shouldn’t have given me anything, since I was not allowed to eat solid because I was on magnesium.

I didn’t understand what was happening. All I wanted was to take an hours-long nap. I eventually went into another L&D room and asked to see my baby. They said, “No. You’re not allowed to get out of bed and she’s not allowed to leave the NICU.” No one consulted me or told me what was going on. By then, they had started feeding her formula with an NG tube in the NICU. The only reason I knew that was because my husband was going back and forth between my room and hers.

My time in the mother-baby unit was really hard. When they cut you open, you can’t really move. Yet they made me scoot over to get to another “normal” bed because they didn’t have enough hospital beds at the small county hospital I was in. Luckily, there was a nice nurse there with me during the day, who used to be a NICU nurse. She explained what my baby would need being premature. I could still hear other babies cry in the rooms around me. It was so difficult not to have mine with me, especially at night when the nurses would rotate and asked over and over again why I was alone in my room; I mean, can’t they read the chart?

On my second day, I was still on magnesium, with no sign the preeclampsia would go away. I’d facetime with my husband when he was in the NICU, but I had no idea what she looked or smelled like beside what I saw through the phone.

Being by myself all day, I’d scroll through social media and watch TV. I ate Jell-O and chicken broth. At the end of my second day, they got me off the magnesium and I was allowed to eat real food. These fries were amazing! I also got to hop into a wheelchair to meet her! 

The NICU nurses already knew my husband and showed me everything: how to wash my hands, get to the incubator, etc. I knew what an incubator was because I got my degree in healthcare, but it looks different when it’s your own child hooked on monitors! When I saw her, I lost it.

There was a nurse there who was really sweet. She told me that she was small and fragile, but strong! She had lost a lot of weight because she could not feed on her own. I could not believe this was my baby! I kept crying because I felt bad: it was my fault if she was so small. What kind of mother would do this to her baby?

Rationally, I knew it wasn’t, but emotionally, I was crushed. If she died, it would be on me.

Meeting her daugther for the first time.

I went back to my hospital room and sobbed all evening. I eventually fell asleep but woke up unable to open my eyes. I mean eight rounds with Rocky Balboa shut and swollen. I called my husband and told him I couldn’t see anything. He was freaking out and called the nurse. When she arrived, she said, “It’s fine. Swelling is normal after birth.” I was stunned. How this was normal is beyond me. She dismissed everything. Told me she wouldn’t call the doctor and I’d have to wait until the morning.

 I started crying, which made my swelling even worse. My husband crawled in bed with me and held me for the rest of the night.

When the doctor finally saw me the next morning, he told me he’d never seen something like that. They put ice on it, told me to drink some water. There was not much they could do. We ended up wetting diapers and freezing them. I was miserable.

I couldn’t stop crying, wondering why this was happening to me. More than once, nurses and lactation consultants would come in on me crying. It was so awkward. I gave birth in a small college town where people had babies vaginally and then left. My case was so severe they did not know how to behave around me, and no one was truly helpful. I’d mentioned to the lactation consultant that I wanted to breastfeed, but because I was on magnesium and high blood pressure, she said she couldn’t help.

From day 3 to 6, my hospital stay consisted of my blood pressure spiking, me crying, and visiting my baby in the NICU once in a while. They tested my heart and lungs, although no one explained why. My lungs had a lot of water in them so I had to do exercises to remove it. I was in pain—so much pain.

They eventually released me with tons of medications: pain killers, blood pressure meds, etc. My daughter was still in the NICU, so after I was released, I only went home to shower and then drove back to the hospital to see her. I couldn’t fathom staying home when she was there. Her stay was pretty uneventful and we got to do all of her care. Eating was difficult, but she got the hang of it. We’d visit her during the day, stay until midnight, then head home and cry ourselves to sleep until we got to see her again the next day.

My husband helped me with everything: to shower, put on my compression socks, change my bloody pads. I was so weak. We lived in a two-stories apartment with no elevator, so walking up and down the stairs was an event.

Some days, we’d just watch her grow into the incubator. The nurses wouldn’t let us hold her often, for whatever reasons. And when they did, I’d tell my husband to hold her.

My excuse was that I’d have time after he’d go back to work, but in retrospect, that should have been a huge red flag that I was beginning to suffer from postpartum depression.

I didn’t want to have anything to do with my child and felt incredibly disconnected.

I knew she was my baby, but it didn’t feel like it. I felt guilty about what had happened and had the overwhelming sense that it was my fault if her life was so hard. This will sound awful, but I also experienced a lot of anger: she was the direct cause of what had happened to my body. Hadn’t I been pregnant, I wouldn’t be suffering so much. It didn’t help that I didn’t get to hold her for 72+ hours. I was always excited to see her, but I didn’t feel any bond once I got there. Unless you’ve been there, you can’t understand that.

She was released 15 days after being born. They put her on high calories formula and diagnosed her with IUGR [intrauterine growth restriction]. I ended up pumping for only three weeks, then I dried up. I was so sick, so depressed, and so stressed about feeding her. The lactation consultant also didn’t get me the right flanges and seemed so timid seeing my breasts. I’m still confused about that.

Still, I wanted to pump because I thought this was the “least” I could do. I couldn’t grow her until 40 weeks, but I could help a little… until I couldn’t.

Luckily, our health insurance paid for the formula since it was $600 a month. Thank god because otherwise, we wouldn’t have been able to afford to feed her.

Formula feeding was a blessing because we could do shifts. Every 3 or 4 hours on the dot, we’d give her a bottle. It ended up paying off because, at her one-month visit, she had gained two pounds! She remained in newborn diapers until she was four months old, but overall, she thrived.

My health, on the other hand, went downhill. I kept thinking that none of this should have happened this way. On the day of her due date, I was crushed: instead of being a healthy and big baby, she was tiny and small. I didn’t know how to express these feelings. Friends would come over and tell me that baby blues was normal. I thought, “I don’t want to kill myself so this can’t be depression.” In a way, I believed that because it wasn’t that bad, I was not allowed to say I was suffering.

No one in my life had ever had gone through this, at least not publicly. My friends slowly disappeared, and I felt like I was the only person in the world to have gone through this experience.

We were poor college students living in a tiny apartment, and my husband had to go back to work on the day she got out of the NICU. Parental leave would have helped, but it is what it is. Ultimately, I didn’t want anything fancy: just someone to sit with her while I showered. My family lived far away so I couldn’t get that support. I also don’t think they truly understood why I was so sad after we were all home: I was alive and she was alive. My trauma was not logical to them.

What bothers me the most is that, for two months after her birth, I met with doctors and health care professionals every week and no one asked me how I was feeling. No one.

I got lucky because I was young and my body was able to heal quickly, and I got off my blood pressure meds at only eight weeks postpartum.

In my head, since the preeclampsia was “done,” I’d be okay. My doctor wanted me to get tested for autoimmune just in case, but my insurance wouldn’t pay for it since I had no family history. We didn’t have two grants to pay out of pocket so we didn’t do it.

After this, I felt even more depressed. I didn’t want to kill myself, but I wanted to disappear. I convinced myself that my husband and baby were better off without me. Since I was not able to do, let alone enjoy, what a woman is supposed to do, what was the point?

At my nine-week appointment, the doctor who put my IUD in was also a nurse-midwife. She asked questions about baby blues—at last. I told her everything: that I was afraid my baby was going to die, that I’d lay awake at night making sure she was breathing and had severe nightmares about what had happened. But instead of referring me to a therapist, she told me to work on goals: 10 minutes of alone time every day, walking outside… I’m the one who eventually had to convince her to give me a referral for therapy.

The one I saw was nice but not a birth trauma specialist. We did CBT, which is not great at first for what I had gone through. The validation was nice, though. I thought things were going to be okay.

 Unfortunately, I had a horrible experience with a family member soon after, who judged me about not breastfeeding. It caused my depression to spiral down once again. I tried to explain to that person that I had been powerless, that it’s the doctors who gave her formula—not me!—and that I’d tried everything I could. But it was so triggering.

Not long after, we moved out from the college town and I quit therapy. Around that time, COVID hit. I convinced myself I was doing okay, and in a way, things were indeed better. I’d learned some coping skills and felt closer to my baby.

But at seven months old postpartum, my husband’s mental health began to deteriorate. After all, he had almost lost his wife and baby. A lot of his struggles had to do with the people in our lives who didn’t understand why the “she could have died” part was so traumatizing. “But she’s alive and well!” they’d respond. We never had the space to process the event as a whole, and were only focused on getting me better; so much that we forgot about him.

It took a while to convince him to go to therapy. He finally accepted when our daughter turned 14 months old. A lot of it had to do with COVID and his job. On top of it, we were also struggling financially and couldn’t do it out of pocket. But at some point, I knew it wasn’t going to get better on its own, so I made an appointment and ordered him to go. As he began to feel better, his therapist suggested family sessions. We brought our daughter with us and we really got to dive into our trauma and struggles.

I myself began to see a new primary care doctor because I couldn’t lose the weight from the pregnancy and I wanted to make sure my body was ok. My OB was not an option anymore since I wasn’t pregnant and my insurance wouldn’t cover it. I brought all my medical records and labs with me. Everything looked good, but I had developed insulin resistance due to preeclampsia. I was not diabetic, but he prescribed metformin and SSRI. He explained that depression has a metabolic effect which could explain my physical symptoms as well as the psychological ones. I was on them for a couple of months and I couldn’t believe the difference: I finally felt like myself again.

I slowly was able to wean off after a while. I would have been okay staying on it my whole life, but I was already taking a lot of pills and I felt triggered by the amount, so it was positive to stop. I’m still seeing our family therapist, sometimes alone, sometimes with my husband. As therapy gave us a safe place to talk freely about what happened without feeling judged, he also got better. And since you don’t always want to talk about “the day I almost died” on date night, it offered us a separate space in our marriage to process everything.

Finding the hashtag #birthtrauma on Instagram was also a revelation. The fact that my doctors and the first therapist didn’t diagnose me with PTSD is beyond me. There were so many red flags, so many occasions when someone could have stepped in.

Most of my anger is gone now, but I feel an overall sadness over the event. I can’t shake the feeling of “how it should have happened” vs “what actually happened.” There’s a lot of grief to unpack.

It wasn’t until the beginning of 2020 that I was able to put words on my emotions, almost two years after the fact.

About one year after my daughter was born, I started writing a blog. I no longer wanted to feel ashamed about my experience, and it helped people in my life understand how difficult and traumatic it had been. I wanted to free myself and help the girl I used to be. It’s crazy to think that there was not much out there about birth trauma and preeclampsia back then. Now there’s way more, which is amazing. Maybe it’s because I’m myself into these circles, but I find the birth and maternal mental health community online to be so wonderful and healing.

I also found the 140/90 community and I got to meet with other survivors. It helps you feel less isolated. To know that others went through the same trauma and depressive state is empowering. I don’t know if I would still be around if I hadn’t met them.

I used to think that people who committed suicide or were depressed were just being selfish. Then you go through a life-changing event like this and you understand that these people—including myself—truly believed that the world would have been a better place without them. I got to learn that we are not a burden: we simply do not want to suffer anymore.