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Friday, December 16, 2011

Bi-polar and pregnant: One woman's story, part 3

As a birth advocate, I am a moderate - I don't feel that birth is a 'one size fits all' experience; neither do I think that every epidural, every cesarean, every induction is a horrible very bad thing. We can whine and complain and write about how maternal-choice inductions and cesareans are a bad thing that put mothers and babies at risk, but in reality, sometimes they're the best option at the time - for a variety of reasons.

In talking to Em about her birth experiences, I realized that sometimes, there are those unseen reasons that no mother likes to talk about - things that really, are no one's business even though they are not visible on the outside. And your choice may tick some people off - especially those who don't know the full truth - but that's just too bad. In short, she and her experiences have taught me a lot about my birth advocacy and how I can use it to help other women.
After losing our daughter, I had my breakdown, I had my meds back, and I was armed with research. I found that my meds were a C class drug. No definitive danger to my baby and they would help me tremendously with the turmoil ahead. My psych told me flat out -NO. I had pages of research, he said NO again. He told me I had to drop this, as it was making me upset to talk about it. No, asshole you flat out patronizing me is what was aggravating me. I left. I called my insurance asking for a new psych referral. I was referred to the head doctor of the hospital’s loony bin. He couldn’t take me on but referred me to another psych that did specialize in women during their reproductive years. Hallelujah.  She agreed with all my research, was pleased to have an informed patient and we decided on a direction for treatment of my bipolar disorder. Team member #2 was on board. My talk therapist has been with me since before my pregnancy with our second child. 
I asked my M/F doc for a referral to a new OB. My previous one left me less than impressed, we shall say. They didn’t see me till I was being discharged after our loss and then patronized me about psych drugs during my follow up. I was seriously given the speech about post-partum depression and to call when I needed drugs. They knew I was bipolar and had a doctor to cover that area of my health. Plus after they basically called me crazy for saying something was off, I couldn’t trust them. My M/F gave me the name of my new OB. We met and I liked her immediately. She knew my history and was willing to take on a mentally ill woman with a single-minded need to have a child. Team member #3 was on board.  
Shortly after we conceived again. I had this driving urge to be pregnant again and wasn’t in the mood to wait. I did wait long enough to have the autopsy confirm it was an infection, as we wanted to make sure what risks we faced in the future. I could tell you details, but really they don’t help. I felt by having a team in place I could get on with conception. So we did. From the moment I peed on the stick I knew everything was going to be ok, I knew it in my heart and soul. My pregnancy was less than ideal - I gained so much weight (55+ lbs total), I slept, and I ate like a teenager. I was moody and had emotional outbursts but refused extra meds. The less I took the safer my baby was. I was in Hell but as long as the baby was ok I could cope.
I again consented to the Nuchal fold test (I wanted to see my baby), but not the AFP. My OB agreed and didn’t push. After all I had the history of a false positive. I then had my 20-week ultrasound, which confirmed a very healthy baby boy was nestled in my womb. The tech was so cool and gave us a free 3-D scan. He slept just like his sister. I fell in love. My M/F doc came in and confirmed the healthy happy news. He had some residents and let them get a feel for the U/S on my belly - hey, it was more face time with Almond. He then tried the instruction of placing an amniotic needle and promptly got punched. He knew why and then explained that I was that patient, the 1 in 500. I can’t win the lottery but I got that one.
At my 34 wk appointment I looked at my OB and asked for a C-Section. After my previous two experiences it couldn’t be worse. I was huge and swollen and flat out miserable. She calmly looked at me and promised my next birth will go much easier and all will be ok. It is a testament to her diligence with me that I trusted her and let it go. The magic 37 weeks hit and I am 90% effaced, 3 cm dilated. We are feeling that by week 38 I will be holding my son. Week 38 hits and I am 95% effaced and 4 cm. No baby. 38 wks 4 days I headed into L&D - our son had been asleep for hours with no movement. I panicked and headed to the hospital. I get to L&D and it started - the breakdown. They were originally going to place me in the room we were informed of our daughter’s passing - nope that wasn’t happening. So into another room I go, get hooked up and bam - heartbeat blasting through to everyone but me. I began begging and crying to be induced, I was so scared my son would die in my womb. I was hearing his strong beautiful heartbeat and was crying. 
It was at this point in the conversation that I asked Em, given her need for medication as her due date approached, if she was suicidal. She responded, "Yes." Unfortunately, this is one "medical reason" that many women don't wear on their sleeves, or in their swollen ankles and discomfort: one that is often met with disapproving glances and harsh comments from people who have no idea what's going on on the inside. I felt badly and thought to myself, Have I ever questioned someone's decision like this? Have I ever rushed to judgment like this before? Probably.
My OB was called and stood by her guns; she wouldn’t budge - no induction till 39 weeks. Then the Bitch Nurse, as I can call her nothing else, said to me that I should thank God my child died in my womb where I could offer her the most comfort. She continued to go on and on, saying I needed to come to peace with her death, accept God into my life, and basically listen to her. She’d been in my shoes and knew better. No, she didn’t know better. Until you are in the exact place (which let’s face it, doesn’t happen) you can’t tell someone that you know better. I began crumbling fast. 
I continued to try all the tips to go into labor - membrane sweeps, spicy foods, labor cookies, sex, walking, you name it I tried it. My son was not moving; he was comfortable and stubborn. I (headed) to my psych who noticed I was in a bad place and started Prozac to help bring me out. The problem is that Prozac isn’t that safe for pregnant women. She asked how much longer I would be pregnant, to which I replied he would be born within 10 days, even if I needed an induction.  
Christmas passed and so did the next week. I checked into the hospital to have my induction. They were crowded with women wanting babies before the end of the year; I wasn’t there because of that but, because I desperately needed strong psychiatric drugs that might harm my child.
Em said that once the Pitocin started and the epi was placed, she progressed quickly. She requested to sit upright - which she said surprised them - and within a few minutes her son was born.
We could see the crown of our son’s head. I decided to take a look. They brought down the mirror so I could push and watch my son enter the world. (By the) third contraction and each push brought him closer to my arms. After the third contraction and the ninth push, he was born. I couldn’t make out his face for all the tears in my eyes. I pushed for all of 10 minutes. He was immediately placed on my chest to warm and nurse. He was perfect and he was here. 
My third time at the rodeo and I finally got it right. His birth cleansed me. Healed me. Made me whole again. Every moment I look at my son he heals me. His mere existence is amazing to me, as is my daughter’s. Yet when I think back on his birth is it with great joy and happiness, not the fear and apprehension I had at my daughter’s birth. I could go through the experience of birthing my son a million times over and it wouldn’t be enough for how amazing it was. My medically controlled birth, with the most interventions - and it was the best one. Not because of the medical interventions but due to the OB and her ability to do what was right for me and our son. 
To see him born was a singular moment for me. Is this birth for everyone? No. Was it right for us, given the circumstances? Yes. I cannot put into words how amazing I felt after my son was born. I stood up after his birth and felt as I did at 14 weeks post partum with his sister. Everything about our son’s birth was joyous and healing. 
So now you’re asking what was the point of my posts?  I don’t know. Maybe it’s to shed light onto how the same woman can have vastly different experiences. Maybe it’s to tell women that even if one birth scars you, the next one could heal you. And maybe it’s just to share. Maybe it’s so that there is a positive out of all of the dark. I know most birth advocates don’t get behind inductions, but mine was needed. Not because I was physically miserable - which I was, but for the fact my mental health was slipping fast and I needed stronger drugs. I wasn’t going to risk his exposure to my meds any longer than he had to be. I feel it’s important to say this - I was perfectly poised for an induction. My cervix was ripe, I was 39 weeks 6 days, and I was on medication that could prove harmful to my child if fully exposed. I had heard enough about possible complications and c-sections during the induction prep. Mine wasn’t one of these. I have an amazing OB who listened to me in the beginning and followed through with what we decided on in the face of my bipolar rage. I learned through all this that open honest communication with your health care provider is a must. If you fear a reaction from your doctor- you need a new doctor. There is no place for silence and fear in your relationship to your health care provider. 
Thanks for reading and sharing my experience. - Em.  
If you or someone you know is pregnant and experiencing symptoms bipolar disorder, depression or other mental health problems, there is support and help available.

Managing Pregnancy and Bipolar Disorder - NAMI
My Bipolar Pregnancy blog - drug database for pregnant or nursing mothers
Infant Risk center - website of pharmacologist Dr. Tom Hale at Texas Tech University Health Sciences Center

Read part one and two here.


K said...

I had a 100% completely elective mental health induction. And I don't apologize for it. My mother was diagnosed with breast cancer on Dec 28. The tumor was huge and the cancer was possibly/probably very advanced. The first phone call I made was to my midwife, in tears, "I need this baby out." I was due Jan 12. On Jan 8 my mother was due to start chemo. I wanted her to be able to see this baby before then, we lived 3 hours apart. We induced Jan 4. My daughter was just under 7 lbs and did great, as did I. I took a LOT of flack, a TON, from all my more birth-y minded friends and aquaintances. I was called a bad mother, selfish, you name it. I felt then it was the best decision and do now. I hardly see how being awash in those stress hormones was good for my baby any more than her early entrance. Thankfully (kind of) my midwife was the daughter of a breast cancer survivor and 'got' it. My daughter spent her first months in OR waiting rooms, chemo rooms and gramma's house while I nursed her through her mastectomy recovery. It is almost 11 years later now. My mom is now Stage IV, I wouldn't change a thing about how we've walked this journey together including inducing that birth. It is really easy to bash women for their decisions until you walk in their shoes.

This is my mom and my dd, age 3 days. I love the juxtraposition of the newborn smile and my mom's very sad eyes. It pretty much says it all.

The Deranged Housewife said...

What a beautiful photo...thank you for sharing your story! How is your mom doing?

Quantmlife said...

I'm so glad you, Em, and K shared because it's an awesome reminder that we shouldn't judge people for these type of choices... we have no idea what it's like inside their bodies or their brains. Having a very different pregnancy this time from the first and definitely have already felt the pinch of judgment for choices I felt I must necessarily make for my sanity, my baby (inside me), and my physical health/healing.

I would never have imagined the amount of pain I've been faced with in this pregnancy (related to pregnancy or otherwise)... I generally have an extremely high tolerance for pain... delivered my first who was very large with absolutely no drugs... have had teeth drilled with no Novocaine but sciatica is literally kicking my butt.

Again thanks for sharing.

MamaOnABudget said...

Thank you for sharing this - I think it's really important that we (generally) have our natural birth on baby's time is the only good option bubble popped now and then. Birth isn't math - it's isn't a 1+1=2 kinda thing. Sometimes 1+1=yellow or panda (or life or death), and we just can't know that particular answer until we are in those particular shoes.