By Christina Livas L.Ac.
As an acupuncturist working in the fertility field, I am frequently asked if Acupuncture is safe during pregnancy. I am here to answer that question! Acupuncture is a completely safe and effective treatment for minor to moderate pregnancy symptoms. It is important to know that there are many medications that are considered unsafe to take during pregnancy and while breastfeeding. That is why many patients turn to acupuncture (as I did during my own pregnancy) to treat even common symptoms unrelated to pregnancy to avoid taking medication unless it was deemed necessary.
Here is a list of symptoms Acupuncture can treat during your pregnancy journey.
- Nausea and vomiting
- Constipation and/or hemorrhoids
- Urinary discomfort or chronic UTIs
- Headaches and migraines
- Anxiety and depression
- Carpal tunnel/arthritis
- Threatened miscarriage
- Lingering first trimester symptoms
- Sinus congestion
- Emotional Imbalance
- GERD/acid reflux/heartburn
- Neck pain
- Back pain
- Rib pain
- Leg cramps
- Headaches and migraines
- General discomfort
- Sinus congestion
- Preparing the body for labor
- After pains
- Perineal pain
- Incision pain
- Breast discomfort
- Insufficient Lactation
- Baby blues/postnatal depression
While acupuncture can treat a variety of symptoms during your pregnancy there are still areas of the body that should not be needled while you are pregnant. This makes it very important that you choose an acupuncturist that specializes in fertility and/or pregnancy. Pregnancy is an amazing and exciting time in your life and you should make sure your body feels amazing too!!
Book your appointment with Christina in Highland Park or Buffalo Grove! Acupuncture support for fertility, pregnancy, postpartum care, and general wellness is available in Chicago seven days a week, too! Book an Initial Acupuncture Consultation with the October BOO-GO Special and get an Acupuncture Follow-up for FREE ($95 value)!
pubmed/31392990 – low back pain and pelvic painhttps://www.ncbi.nlm.nih.gov/ pubmed/30423471 – anxiety and depression pre/postnatalhttps://www.ncbi.nlm.nih.gov/ pubmed/30261764 – treating nausea and vomitinghttps://www.ncbi.nlm.nih.gov/ pubmed/31483927 – safety of acupuncture during pregnancy
by Kellie Stryker MSW LCSW
According to reproductivefacts.org, “Infertility often creates one of the most distressing life crises that a couple has ever experienced together. The long term inability to conceive a child can evoke significant feelings of loss. Coping with the multitude of medical decisions and the uncertainties that infertility brings can create great emotional upheaval for most couples.”
Kristin L. Rooney, BA and Alice D. Domar, PhD with Boston IVF wrote: “Infertility is often a silent struggle. Patients who are struggling to conceive report feelings of depression, anxiety, isolation, and loss of control. Depression levels in patients with infertility have been compared with patients who have been diagnosed with cancer.1 It is estimated that 1 in 8 couples (or 12% of married women) have trouble getting pregnant or sustaining a pregnancy. Despite the prevalence of infertility, the majority of infertile women do not share their story with family or friends, thus increasing their psychological vulnerability. The inability to reproduce naturally can cause feelings of shame, guilt, and low self-esteem. These negative feelings may lead to varying degrees of depression, anxiety, distress, and a poor quality of life.”
It’s normal to experience times of stress throughout the infertility process. However, it becomes a cause of concern when the feelings become persistent or prolonged.
According to reproductivefacts.org, if you experience the following symptoms for a prolonged of time, you may benefit from meeting with a mental health professional.
- Loss of interest in usual activities
- Depression that doesn’t lift
- Strained relationships
- Social isolation
- Thoughts that are consumed by infertility
- High levels of anxiety
- Diminished ability to concentrate or accomplish tasks
- Change in your sleep patterns, appetite or weight
- Increased use of drugs or alcohol
- Persistent feelings of pessimism, guilt, bitterness, anger or worthlessness
- Thoughts about death or suicide
Help Is Out There
The following resources are dedicated to helping you improve your Reproductive Mental Health:
- RESOLVE: The National Infertility Association – RESOLVE provides free support groups in more than 200 communities; is the leading patient advocacy voice; and serves as the go-to organization for anyone challenged in their family building.
- ASRM : American Society for Reproductive Medicine – ASRM is a multidisciplinary organization dedicated to the advancement of the science and practice of reproductive medicine. The Society accomplishes its mission through the pursuit of excellence in education and research and through advocacy on behalf of patients, physicians, and affiliated health care providers. The Society is committed to facilitating and sponsoring educational activities for the lay public and continuing medical education activities for professionals who are engaged in the practice of and research in reproductive medicine.
- Pulling Down The Moon – Holistic care for family health and fertility should be highly personal, compassionate, and customized to meet the unique needs and complex challenges of each patient. Founded in 2002, Pulling Down the Moon recognizes the stress and emotional turmoil and fatigue that can come with infertility as well as your day to day health.
- Shine Fertility – Shine supports women through mentorship, community and education. We empower women by encouraging a proactive approach to fertility health and fertility preservation.
Taking Care of You
It’s ok to be sad, frustrated, angry, resentful, bitter and whatever emotions you may be feeling at this very moment. You are allowed to feel all of the above and more. Sit with it. Don’t force yourself to put on a brave face when you are going through unimaginable pain. However, when you are ready, allow yourself to work through the emotions you are experiencing.
Georgia Witkin, Ph.D with Progyny wrote: “You may not have control over the physical effects of fertility treatment, but you can take control over many of the psychological effects. What you think and what you do shapes what you feel, so choose thoughts and behaviors that reinforce your sense of control.”
Kellie Stryker is a Licensed Clinical Social Worker and owner of Rain to Rainbow Counseling. Kellie has over 10 years of experience in the mental health field. Kellie currently lives in Crystal Lake, IL with her husband and 1 yr old daughter who was conceived through infertility treatments. Kellie’s mission as a Reproductive Mental Health Counselor is to provide support to others as they navigate through their infertility journey.
Rain to Rainbow Counseling offers supportive services which are focused on all aspects of Reproductive Mental Health which include infertility, grief, loss, miscarriage, stress management, adoption and pregnancy counseling. Rain to Rainbow Counseling is currently in network with Blue Cross Blue Shield of IL and Optum United Health Care. In Person and Online Telehealth Sessions are available.
Benefits of Online Telehealth:
- Confidential: Rain to Rainbow Counseling uses Simple Practice, a secure and HIPAA compliant program.
- Online Client Portal: No software to download. Private login and password for each client.
- Same benefits and techniques: Only difference is we see each other on screen instead of in person.
- Convenience: Can literally be done from when and wherever you are comfortable.
The anticipation, anxiety, the loss of control and not knowing what to expect can be especially difficult during the “two-week wait.” The two-week wait – between ovulation and when your next cycle is due to start – can feel as if you are in limbo as there is no way to tell if you’re pregnant.
You may find yourself watching for signs and symptoms of pregnancy. Each twinge in your belly, tenderness in your breasts and feeling of fatigue, asking yourself, “Does this mean I’m pregnant? Or am I getting my period?”
The questions, the “what if’s,” the TIME all feels endless and one seems to build upon the other until what you’re left with is a gigantic ball of anxiety and feeling a loss of control.
What if instead of “getting through” the two-week wait, we were intentional and mindful of nurturing ourselves by creating a plan? This holistic guide to self-care will provide you with a plan for nurturing yourself in four areas: physical, social, emotional and spiritual.
Sleep is not only necessary and restorative for our bodies, it also allows us to cope with our feelings of anxiety and overwhelm in a more manageable way. If you find yourself having difficulty falling asleep, here are a few helpful tips:
- Keep a journal or notepad next to your bed and write down the thoughts, worries or items on your ‘to-do’ list. Say to yourself, “This will be here for me if/when I need it.” Sometimes the act of writing something down allows for a cathartic release of whatever we’re feeling preoccupied with.
- Listen to a guided meditation app before bed to relax into sleep and take your mind off of the two-week wait. Bonus: the more you practice, the more this cues your body and mind that it’s time to sleep.
Gentle exercise such as planning a walk to a scenic place, a lake or forest preserve. Getting outside can have a calming, centering effect while you are present in nature. Try Yoga for Fertility poses on your own or building community through practice with others. Schedule an Unwind the Mind Massage, “This session was created to be a safe oasis from post-ovulation stress, boosting immune and endocrine function, while supporting a potential pregnancy.” (Pulling Down the Moon, Fertility Enhancing Massage (FEM)
- Plan a social outing with your partner or friends. Socializing provides an outlet for connection as well as a distraction from the thoughts and feelings you maybe preoccupied with. And, it’s fun! What activities do you enjoy doing? Want to try something new? Try being intentional about planning enjoyable activities, especially during the two-week wait.
- Create a list of friends, family members or supports you can reach out to check in with during the two-week wait. Is there a fellow member of your support group, a friend or family member who has an understanding of what you’re going through? Who acts as a sounding board, offers encouragement or provides a fun distraction? Write these supports down so that when you’re feeling especially alone or overwhelmed during your journey you have a few go-to people you feel safe reaching out to.
- Mantras can have a powerful and empowering impact. Choose a word or short phrase you would like to be the focus during your two-week wait. How would you like to feel and respond to yourself and others? Write the mantra on a post-it note or schedule it as a daily event on your phone to be reminded of your intention.
Nurture ~ Empower ~ Peace ~ Joy ~ Warrior
- Practicing meditation & mindfulness “Mindfulness is the energy of being aware and awake to the present moment… Being present is the most powerful place to be.” Thich Nhat Hanh. Bringing your attention back to the present moment can help decrease feelings of anxiety and increase self-awareness. New to meditation? Try a guided meditation app. There are guided meditations specific to fertility, sleep, anxiety and grief that you may find especially helpful in starting or ending your day.
In summary, while creating a plan doesn’t take away the uncertainty, it may allow you to feel a sense of control with how you choose to meet this part of your fertility journey. Creating a plan for the two-week can be a nurturing way to care for yourself during a time when your thoughts and feelings may be overwhelming. Take this time to connect with yourself, your partner and those you enjoy spending time with who play a supportive role in your journey.
- Yoga for Fertility – https://www.pullingdownthemoon.com/services/yoga-classes/
- Fertility Enhancing Massage (FEM) – https://www.pullingdownthemoon.com/services/therapeutic-massage/
- Meditation Apps:
- Calm – https://apps.apple.com/us/app/calm-com/id571800810?ls=1
- Insight Timer – https://apps.apple.com/us/app/zen-timer-meditation-timer/id337472899
- Meditation Studio: Fertility Collection – https://www.meditationstudioapp.com/fertility
- Fertility Mantras & Positive Affirmations – https://fertility-news.rmact.com/path-to-fertility-blog/infertility-mantras-fertility-mantras-your-choice
Emily Heilman is the founder of Flourish Counseling & Wellness. As a Licensed Clinical Social Worker (LCSW) and Certified Perinatal Mental Health specialist (PMH-C), she specializes in perinatal mental health and wellness, supporting women and their families navigate their fertility journey, the pregnancy and postpartum period, and throughout motherhood. Her experience in the field of women’s and perinatal mental health spans the past 13 years where she has worked in community mental health, hospital settings and private practice. Emily offices are located in the Chicago Loop & Oak Park. To learn more, visit: https://flourishcounselingltd.com/
by Rickie Kostiner RYT, Clinical Intern
I took a good hard look one morning at the piles of stuff that had accumulated between my jeans and sweaters. It was a misshapen pile that had peculiar characteristics including big dark spots and glimpses of shimmer, it was hard and jagged around the edges but soft and mushy inside. No, it wasn’t loose socks, empty boxes, or unopened mail, it was me. I wasn’t dreaming, but I swore that I could see myself in physical and metaphysical form in my closet that day. My heart sank and slouched to the ground. Knees to chin I rocked back and forth for what seemed like an entire day wondering how I got there. How did I end up on that shelf and how could I find my way back into my own body. My body, I shrieked. What. Is. A. Body and why can’t I feel any part of mine? I touched my toes, not painted calloused soles. I licked my lips, cracked, and broken. I ran my fingers through my hair, rough and thin. I closed my eyes and tried to breathe but every breath stopped short in my chest. What was happening? How did I get this way? I somehow managed to pull myself off the dirty carpet that day and I continued to move through the rest of my day. That’s all I did, I moved through places, interactions, workouts, meals. There were no feelings, because I wasn’t there. I was still on that shelf.
How do I get off the shelf? Am I ever going to feel anything ever again. I walked past a yoga studio everyday to get on the train. One day a sign out front of the studio read, “come inside and feel your body! Baby, it’s cold outside.” Okay, I thought, this is it, I’ll try it. That first yoga class was weird, I couldn’t explain how it made me feel but I went back. I went back three more times and then five more times after that and pretty soon I was practicing six times a week, but I still couldn’t tell you why. I practiced for two years, completed my first 200 hour teacher training, and had started teaching and I still couldn’t tell you why.
It was a Sunday, I had been teaching yoga for about four months. A dear friend and fellow yoga instructor told me she was going to take my class. Immediately, I felt shocks of nerves zooming through my body. “I’m nervous!” I said to her. She replied, “Rickie, I am here for whatever you have to give.” Wow. Right? Think about it, I am here for whatever you have to give. That level of flexibility is something I could only dream about achieving. For the first time since I started practicing yoga I felt something other than those adjectives that I was “supposed” to be feeling (tired, strong, healthy etc.) I felt safe. I went home that day and opened my closet to see that the pile of stuff was smaller. The parts that were black began to fade and the parts that were shimmering glistened a little more. As I continued to take in what my friend had said, ideas began to click in my head. In teacher training our leaders told us that yoga was much more than the physical practice, it is a much deeper and broader philosophy that encourages and encompasses a way to live, a way to treat one another, and most importantly, a way to treat the self.
I started to listen, and I started to observe. I took a step back from the rigid expectations I had of myself as a teacher and student and allowed the philosophy to manifest within. The true intention behind the practice and philosophy of yoga is to find stillness, both in the mind and body. The physical, asana, practice of yoga is done in order to help the body sit still. Handstand means nothing if the body cannot rest. Slowly, yoga finally began to make sense. The reason I came to yoga each day was because I was allowed simply to be.
Everyone has their unique reasons for finding and pursuing yoga. If you approach your practice with intention that is truth and that is real. Yoga changed my life by giving me a safe space to uncover layers of myself and were buried beneath many years of neglect. Today, as I continue my studies and research further into the dimensions of counseling and psychology, I am reminded every time I step on my mat that I have everything I already need within to heal. A perspective that took me a long time to actualize, but once I did, other pieces of my life fell into place. The piles of stuff in my closet slowly transformed into significant pieces of my life that I began to recognize as relationship, family, self. I was there all along, buried beneath the layers of stuff, patiently waiting to be uncovered. As you begin to uncover layers of self that have been buried remember to trust in the process that the practice of yoga can bring. Now, I practice both on and off my mat with the intention of, I am just a voice, the yoga does the work.
During Mental Health Awareness, we encourage finding support in whatever format works best for you-whether yoga, acupuncture, visiting a support group specific to your needs for infertility support, trying again after loss, or single parenthood), meditation, and/or speaking with your doctor. Resources, such as, Resolve (866-NOT-ALONE), Star Legacy Foundation, and the Women’s Professional Health Networking Group of clinicians supporting patients going through fertility treatments, pregnancy after loss, struggling in their relationships on the journey, perinatal anxiety, depression, and more (consult with your practitioner at PDtM for more information about these trusted contacts including Alison Lautz below).
Join Pulling Down the Moon for the FREE Webinar Hope & Healing: Simple, Practical Techniques for Coping with Disappointment & Loss on June 3rd at 6pm CST.
Author: Rickie Kostiner RYT, Clinical Intern Supervisor: Alison Lautz, LCSW Therapist & Life Coach www.alisonlautz.com 815-341-9244 email@example.com
By Brooke Laufer, Psy.D.
Motherhood, Not What You Thought
Mental health issues are among the most common complications related to childbearing, and yet it is still a topic that is largely misunderstood. A conversation I had with my dentist recently reminded me how little the general public knows about perinatal mental health issues. “Oh,” she said, “I just thought women cried a little bit, but you know, they’re usually just so happy to be mothers, right?!” We want to believe becoming a mother is an absolute joy. Motherhood is expected to be a fulfilling time for a woman, when a woman is in her most natural role–the role she was meant to play as suggested by film and other media–when her true purpose is determined. In reality, having a child is a profound, frightening, and exhilarating experience at the boundary of life, from which one comes back a transformed person. Most women bear this monumental transition to motherhood with some hardship. Experiences range from tearfulness, exasperation, and nervousness to more extreme feelings of obsessiveness, helplessness, and even murderous fantasies. While many women will have what is labeled the Baby Blues, 20% of women will have a Perinatal Mood and Anxiety Disorder, a debilitating psychological experience that interrupts their lives. With a growing amount of research and education, we begin to clearly see what distinguishes a true Perinatal Mood and Anxiety Disorder from the non-clinical experience of the Baby Blues.
10 years ago I was as unaware as my dentist of what could happen to a woman’s state of mind when she was faced with childrearing, so after my daughter was born I learned in a shocking and destabilizing way–the way most women learn–what a Perinatal Anxiety Disorder was. For me, it started with anxiety attacks while in my third trimester. I shook uncontrollably in the evenings and experienced an overwhelming sensation of claustrophobia during the day. I found a good psychiatrist who helped me understand that taking an SSRI (the one I’d gone off when I got pregnant) would relieve my anxiety and would not hurt my baby. Then after a fairly uncomplicated birth, I was supposed to be thrilled, but I had a new baby who didn’t sleep well. I loved her, but I wasn’t completely attached to her; I was also ragged and jumpy. When she was 4 months old, I started having intrusive thoughts that deeply disturbed me. At first they were like small blips on a radar, like thoughts from the periphery of my mind that I could barely hear. But then the blips grew larger and included images. I could clearly hear thoughts telling me that harm would come to the baby. I could see my baby being sexually violated. I had thoughts that my husband and I would be the ones to sexually harm our baby daughter. I could barely tolerate these thoughts as they began popping in with greater frequency. Luckily, my psychiatrist answered his phone the day I called beside myself in tears. He calmly told me that what I was experiencing was Postpartum OCD, he told me about Karen Kleiman’s book This Isn’t What I Expected, and he raised the dosage of my Sertraline. I was a therapist, a clinical psychologist, and I was learning for the first time what a Perinatal Mood and Anxiety Disorder was; this was not the Baby Blues. I recovered from my Postpartum OCD, but my life was changed forever. Since that time I have done what I can to research perinatal mental health, to immerse myself in the literature and new information we have on this condition, and to talk about it. Talk to women, to friends, to family, and especially to my clients, letting them know they are not alone, they are not crazy, and they can still be the mothers they want to be.
The term ‘Baby Blues,’ first used in Nicholson J. Eastman’s 1940 best-selling baby care book Expectant Motherhood, is an umbrella term referring to any emotional experience a woman has in the period after bringing home the baby. It is no surprise this massive life transition, along with sleep disturbance, disruption of routine, and emotions from the childbirth experience itself will contribute to how a mom feels. Her experience is also affected by the hormone changes that occur first during pregnancy, and again after a baby is born. The levels of progesterone and allopregnanolone rise during pregnancy and plummet after childbirth, and this drop is thought to contribute to emotional dysregulation. These short-term postpartum symptoms include weepiness or crying for no apparent reason, impatience, irritability, restlessness, anxiety, fatigue, sadness, mood changes, and poor concentration.The informal diagnosis of Baby Blues requires that these symptoms last no more than 2-4 weeks, occurring for a few minutes up to a few hours each day, and typically going away with rest, support, and time. Baby Blues rarely get in the way of daily life or need intervention from a medical provider.
“A baby opens you up, is the problem. No way around it unless you want to pay someone else to have it for you. There’s before and there’s after. To live in your body before is one thing. To live in your body after is another. Some deal by attempting to micromanage; some go crazy; some zone right the hell on out. Or all of the above. A blessed few resist any of these, and when you meet her, you’ll know her immediately by the look in her eyes: weary, humbled, wobbly but still standing. Present, if faintly.” Elisa Albert, After Birth (2015)
Perinatal Mood and Anxiety Disorders
When a disturbing emotional state lasts beyond 2-4 weeks, clinicians should start to assess for a perinatal mood and anxiety disorder (PMAD). Formerly referred to as Postpartum Depression, or simply “postpartum,” we now use the term “Perinatal” because the symptoms can occur not only one year postpartum, but also during pregnancy, or after a pregnancy loss. We say “Mood and Anxiety Disorders” instead of “depression” because it more accurately covers the range of experiences women have. These include major depression, generalized anxiety, OCD, PTSD, and postpartum psychosis.
Although there is no clear indicator of who will experience a PMAD, previous mental health issues, trauma, and lack of resources are some of the risk factors. Important to note: PMADs do not affect just biological mothers. Growing research shows us that men experience postpartum anxiety and depression. In fact a client of mine came in a few weeks after her baby was born and reported that her husband was acting strangely: yelling a lot, throwing pillows at the wall when the baby cried, uncontrollably crying, and openly fantasizing about leaving the baby out in the snow. We were able to get him in for a session with her and help him understand that he needed help. The couple was surprised that he was having postpartum rage, while she was adapting well. He actively resented his child for destroying their former life, while she’d become protective of the child. Eventually, with months of treatment, he was able to love and attach to his daughter.
Similarly, adoptive parents may report symptoms of PMADs: it can be particularly confusing to resent or feel disconnected to an adopted baby whom you wanted and planned for and possibly spent much or most of your savings on. Likewise, LGBTQ families who may have worked for years on fertility treatments or with a surrogate to finally bring home a baby are also vulnerable to PMADs and should not be ignored as a population worth assessing.
Perinatal depression mimics that of a major depressive disorder but with certain symptoms specific to mothering. A woman may be withdrawn from the baby and her family, not want to hold the baby or have difficulty bonding, have a flatness of facial expression and voice, exhibit excessive tearfulness, or severe self loathing. She may have a belief that she can’t handle motherhood or be a good mother, she may be unable to enjoy most of her life, or she may believe her family would be better off without her.
A client of mine described feeling like she couldn’t see herself in the family picture. She vacillated between dissociation and depression. This mom had twin baby girls with whom she was not bonding. She felt like a machine part going through the mechanical motions of caretaking. After her first session of unburdening herself of the sadness and shame she carried, she was able to start to locate herself. Her experience points to the invisibility some women feel as mothers. The erasure of self to motherhood is well noted by the poet Alice Notley:
“For two years, there’s no me here….
Two years later I obliterate myself again
having another child” (1972)
Perinatal Anxiety and PTSD
Perinatal anxiety, or anxiety during and after pregnancy, has received little attention compared to its well-known cousin, postpartum depression, yet anxiety symptoms are more frequently reported. Worrying, of course, is a normal part of new motherhood–checking that the car seat is secure or that the baby is still breathing, for example–but if it interferes with a woman’s life so that she cannot think about other things or take care of herself or her baby, then it verges on mental illness.
For women who are prone to anxiety, the information-saturated era we live in is loaded with potential stressors about conceiving, being pregnant, and parenting, requiring women to be vigilant about what information she is exposed to. An anxiety disorder can be spotted in the repetitive fears and questions moms have, in extreme over-protectiveness such as not letting anyone hold the new baby, or in the too well put-together mask some moms wear, hiding an internal world out of control.
Post-Traumatic Stress Disorder (PTSD) in the perinatal period refers to past trauma resurfacing during the perinatal period, including flashbacks and nervous system responses (freeze, flee, fight) that can interrupt caring for a new baby. What many doctors do not realize is that women who have experienced sexual trauma may have fear of a baby coming out of the vaginal canal, a fear of male providers, and/or a fear of being alone with baby.
Perinatal Obsessive-Compulsive Disorder
Obsessive compulsive disorders are possibly the most insidious of the postpartum conditions because they include the intrusive thoughts that haunt many mothers. Intrusive thoughts are thoughts that happen frequently and randomly, feel uncontrollable, and are often disturbing. These disturbing thoughts, or obsessions, can lead moms to engage in repetitive behaviors, or compulsions, to try to ease their anxiety. Many moms with OCD are plagued by repetitive fears of harm coming to their babies, possibly due to the extreme helplessness of a newborn baby. It is horrifying for mothers to have uncontrollable thoughts and images of their baby tumbling down the stairs or falling out a window, or images of themselves smothering the baby or sexually abusing their own child. Because of the disturbing nature of these thoughts, it can be the most difficult disorder to admit, yet, as was my experience, by breaking the silence women can find tremendous relief in the normalization of Perinatal OCD.
Postpartum Psychosis is the most rare of perinatal conditions, occurring in .1% of moms, but it is the most dangerous. Psychosis is a break from reality that can happen over time but can also become a medical emergency very quickly. As with Postpartum OCD, a mom may experience intrusive and paranoid thoughts, but instead of being disturbed by them, she may begin to identify with them. For example, a new mother may have the thought that someone is going to steal her baby, so she acts on it by hiding the baby or running away with the baby. Unfortunately, it is typically after a postpartum psychotic episode has ended badly that the media gives it attention. Just a few years ago a woman who I know from my hometown was arrested for the death of her 14 month old boy. After months of working full time, bad day care experiences for her baby, an unstable partner, and increasing symptoms of OCD and paranoia, she came to believe she and her son would be better off dead. After she suffocated her baby she attempted to overdose on medications, but she survived. Even though the she had an expert forensic psychiatrist diagnosed her with Altruistic Filicide, deeming her Not Guilty By Mental Defect, she was sentenced to 25 years in prison. Unfortunately, there is still little understanding or mitigation done for mothers convicted of infanticide, resulting in excruciating treatment and excessive sentencing.
Women may find it difficult to reach out for help, as it is taboo to admit you are unhappy or unnatural at motherhood. To the extent that women in our society are still seen as playing their most natural role as mothers, to acknowledge unhappiness or discomfort may have high stakes relating to women’s own identities and how others may see them. A mom may fear being seen as a “bad mother,” which would ostracize her from mainstream society. With more education and awareness around the frequency and epidemiology of perinatal mental health issues, much of this silencing can be alleviated. What is essential to understand is that a woman herself should not be blamed–not by her providers, her family, or herself–for a perinatal condition. We often have little control over the occurrence of a Perinatal Mood and Anxiety Disorder, but we can do much about its treatment.
Psychotherapy and Medication
With a proper diagnosis of a Perinatal Mood and Anxiety Disorder, good treatment can support a full recovery. The best form of treatment is individual psychotherapy that reduces stigma and shame and normalizes the client’s experience. Besides reassuring women that it’s normal to feel ambivalent during pregnancy and motherhood, I also educate each woman about her particular diagnosis. Women often feel desperately alone and deeply ashamed when they experience PMAD symptoms, especially ones that are less talked about like rage or intrusive thoughts. I reassure my clients that these inner experiences don’t indicate their worthiness as mothers but are instead treatable symptoms of common disorders. Women express tremendous relief when they realize that their scariest and most shameful symptom is something others also experience–and something we know how to treat. Helping women accept all the parts of themselves will reduce symptoms of anxiety and depression. One important goal I look to when working with PMADs is helping women regain a sense of self. It may not be the self they knew before the baby but a new self that emerges in the transformation. Questions we consider: How does having a baby disrupt a mother’s sense of who she is, of her body, her understanding of life and death, her relation to the world and to her sense of independence, her experience of fear and hope and time, and the structure of her experience altogether?
Therapy may include the new baby, so that I can support a secure attachment and help the mom experience the infant’s behavior without insecure projection and negative interpretation. I may recommend infant massage or, inversely, setting the baby down for an extended period. Therapy may also include the partner or other family members. Marital disharmony is the most commonly cited non-biological cause and consequence of PMADs, so by bringing in and educating the partner on PMADs, a mom is more able to be understood and get her needs met at home. Group therapy, such as a moms support group, can be an excellent way to reduce shame and isolation, as it can provide universality, catharsis, socialization, and good information.
Additionally, psychopharmacology is an effective form of treatment for Perinatal Mood and Anxiety Disorders. Current research and an updated classification system (no longer the A, B, C labels for medications that were often misleading) suggest many medications are safe during pregnancy and breastfeeding. There is still damaging stigma around medication and pregnancy that needs to be fought with accurate information. Reducing a previously prescribed medication for pregnancy or changing a medication during breastfeeding are potentially misguided recommendations that can put a women at risk of relapse. The American College of Obstetricians and Gynecologists and the American Medical Association agree that treating the mother’s health is the priority; the trace amounts of medication that a fetus or nursing baby will receive should not keep a mother from the medical treatment she needs.
Although public awareness of postpartum depression has increased in recent years thanks to celebrities like Brooke Shields and Serena Williams, many people–including therapists–are still learning that PMADs are serious and pervasive experiences. When I started talking about my Postpartum OCD experience one of my aunts told me the story of my grandmother, who had three children in four years. The day after they brought home the third baby my grandfather got in his car to go to work, as he started to pull out of the driveway my grandmother came running outside and threw herself on the hood of his car. She spent the next 7 months in a sanitarium, a nicer version of an asylum in a neighboring state, and came home to her children who were being cared for by a strict German nanny. It’s possible my grandmother was experiencing depression or anxiety or even psychosis, they sent her away and no one discussed it. Although awareness and treatment have improved since the harsh days of my dear grandmother, perinatal mental health is still overdue for the attention it deserves, considering women are doing some of the most laborious and important work of our world.
Brooke Laufer is a Clinical Psychologist who has been practicing psychotherapy since 2005. Brooke began her clinical work in psychiatric wards and then in schools with adolescents and their families. After having her first child Brooke had a disturbing Postpartum OCD experience, which inspired her to begin researching, understanding, and specializing in the treatment of perinatal mental illness. She has a private practice in Evanston, where she continues to treat adolescents and adults, specializing in perinatal mental health issues.Brooke Laufer, Psy.D.
by Marie Davidson, Ph.D.
As I write this it is actually the Feast of the Epiphany, celebrated in Christian tradition as the day the Wise Men arrived from the East after the birth of Christ, led to their destination by a star. The Merriam Webster Dictionary also offers these definitions of epiphany: “A sudden perception of the essential meaning of something;” an intuitive grasp of reality through something simple or striking;” and “an illuminating realization.”
Many years ago, as measured in ordinary time, but not all that long ago as measured in emotional impact, I experienced an epiphany that made all the difference to me as a suffering fertility patient. I dwelled in distress much of the time, my thoughts haunted by the many challenges of treatment, the succession of disappointments, and, worst of all, the complete absence of any certainty about how this fertility drama would turn out.
One morning, my moment of epiphany arrived quite suddenly. No wise men or wise women arrived, and no guiding star appeared, just a swiftly dawning realization of what I was really going through—right now—in my life. To this day I cannot say for sure what brought on this intuitive grasp of reality at that particular moment. I suppose it was the result of many, many months of efforts to not embrace my situation. My distress had served to only highlight my sadness and anger and to keep me from moving past that. It was just no longer a reasonable option to keep this exhausting process going. So, I had a serious, mildly humorous chat with myself.
This is what I said:
“OK, Marie, this is what’s going on in your life right now—you and your husband have been in a battle against infertility (and against each other, truthfully.) Infertility sucks, but it’s what you’ve got. You didn’t cause it, and you may or may not overcome it in the way you hope. You don’t know the end of this drama you are in because the screenplay isn’t finished. But there is something you can do, and that is to accept the role you’ve been assigned and act it out as skillfully and graciously as you can. Inhabit the script! Be the star in your own drama, dammit!”
Or something like that, it’s pretty close to the internal conversation I had. I definitely know I made a conscious decision to star in my own story. I would be the guiding star leading me to my unknown destination.
My life improved after that. Far from wonderful and still plenty of stress and anxiety, but I had a peace of mind that had eluded me for a long time. I rather think I excelled in playing myself—the woman who happened to be an infertility patient; the woman who accepted her inability to control the next act in the play I was starring in; the woman who was now able to experience the other parts of her life without the dark film of infertility blocking the view.
I did not know then that my life’s work would be a career counseling fertility patients. What a privilege it has been. A number of years ago, I met a woman who had come to talk about family-building options. She’d been through a lot of treatment with no success. I noticed how even-keeled she was as she spoke of her history and I commented, “You seem to be handling all of this pretty well.” She said, “Well, you should have seen me a year ago, when I was a complete basket-case.” I asked, “So, what happened?” Her answer was, “One day I decided to accept the basic background reality of my life.” I smiled. “You had an epiphany.”
Over the years, I have found it very useful to apply the same kind of epiphany to other life situations—the ones you can’t control but must live in and through. Whatever it is I struggle with, I try my best to be as skilled and gracious as I can be, even if I won’t win any Golden Globes. Strangely, the experience of an infertility journey can give you a valuable perspective on how to deal with the inevitable brick-bats of life.
Marie Davidson, Ph.D.
Fertility Centers of Illinois
Dr. Marie Davidson is a licensed clinical psychologist and patient educator. She specializes in counseling individuals and couples who are coping with infertility, and has provided counseling services to patients, donors, and surrogates since 1992. Dr. Davidson earned her doctoral degree at the University of Illinois in 1988. She facilitates patient education seminars on numerous topics such as considering egg donation and cracking the door to adoption, leads several women and couples support groups, and is widely published in the fertility field. She has been an invited speaker at many professional meetings.
Her personalized care and detailed understanding of the treatment process have been a welcome and supportive resource to many couples and individuals as they seek to grow a family.
by Melissa Hinshaw LMTIt’s that time of year when everyone is moving and shaking and buying and baking and trying to make all the parties and give families equal time. Whether you are single, married, divorced, or in between, you know what I am referring to. During this festive, yet chaotic time of year, how do we hold on to ourselves and what we deem important? What do each of us hope for the holidays and what traditions do we want to hold fast to our hearts when the pace is so fast and we are trying to please so many?The pressure of the holiday season can be both exhilarating and stressful. In my younger years, two small children at my hip, one with Autism and not interested at all in Christmas, presents, Santa, or family gatherings, by the end of the season I used to feel completely wiped out, angry, resentful, and grateful that it was all over with. I realized I had no boundaries during this time of year and I went with the flow and did what was expected socially and and within my own family even though it was, at times, not good for me or my family at all. I wanted my younger son, who was ecstatic about Christmas, and presents, and Santa to experience the magic that I had growing up. My childhood home was a wonderland of smells, and tastes, and decorations and presents and nervous excitement while my four brothers and sisters and I awaited Santa’s visit. Looking back, we rarely traveled around from this house to that house or attended gatherings that my parents felt pressured to attend or did much anything stressful except for getting the lights on the damn Christmas tree. My mom was a pro…I think because she loved this time of year and you knew it when you were at my house. I longed for this feeling again. The feeling of holiday joy and giving and singing and snow. I wanted it to be simple. I wanted to love Christmas again and I wanted my children to love it too.After many stressful and disappointing holidays with depression looming each and every year beginning with Thanksgiving. After many tearful conversations on the phone with my mom, having a glass of wine when the whole thing was finally over, and asking her, “How do I do this mom? I used to love this time of year. How do I make it special like you did, for my boys, one who could care a less and often falls apart over the holiday break, and one who couldn’t get enough?” “Melissa my dear, create your own traditions. Do what works for your family. Say, No, when you need to.” She was right. I needed to create Melissa traditions, Melissa style, and engage both of my children at their individual levels yet do holiday things we could enjoy as a family. I took her advice. I created a few simple traditions that we have stuck with over the years. My youngest loves it while my older son complains and requires lots of cheerleading, but we do our activities together and it makes us feel like we are a part of the holidays. We have pictures to remind us that we have done this before and we will do it again this year. This is a big deal for me and I cannot completely explain my reasons. I just know that being swallowed up by others’ rituals and rules and schedules doesn’t bring me joy. It brings me sadness and stress. Of course I enjoy celebrating with other people and sharing what makes the holidays special for them, but that is reserved for a very few. It is ok to have quiet during this time of year. It is ok to find peace and joy in the simple.I encourage everyone to find one special thing to do with your partner, your kid or kids, or your best friend that brings you to a special place. Something that you can do each and every year…something to look forward to. Something that you decide feels good and brings joy. Something you can share a photo of to remind you what you’ve done and to remind you that you you will do it again.If you need to break that is okay, too. We are here for you, take time for a massage before or after the holidays or start the New Year off with a cleanse!
Pulling Down the Moon, Guest Blog
by Lindsay Housner
This is a picture of my family; it’s one of my favorites. On more than one occasion people who don’t know me well see this and say things like, “Oh my gosh, Lindsay, your life is so perfect that even your dog is perfect?!” The comment on our dog would be the first thing they were wrong about. Adorable, yes. Perfect? Not even close. I think our veterinarian has classified him as neurotic… Nevertheless we couldn’t love him more!
The truth is there’s so much behind the surface of this beautiful photo (which is likely true for many of the picture perfect moments we see daily). It could never reveal all the heartache, struggle and excoriating pain it took us to get to that moment, captured in time.
You would never know from looking at it that on February 20, 2016 (the day before I turned 33 years old), our world came crashing down harder than I knew possible when our first son, Aidan James, was born still at nearly 37 weeks and 5 days. Or that as I sat in the hospital waiting to induce labor, I was sure I was the only woman in the world that had lost her baby this late in pregnancy. Or that after experiencing the devastating loss of our beloved baby boy, with little to no answers why, we would struggle to conceive again. You could also never know the crippling anxiety I experienced for the 37 weeks and 5 days in my next pregnancy. Or the insane emotional rollercoaster I rode the entire time because while I was finally pregnant again after struggling for so long, it was near impossible for me to be happy about it. No, that wouldn’t happen until I held my sweet baby girl and light of my life, safely in my arms.
To say our road to parenthood has been tough would be the understatement of the century. It’s tested me beyond measure to the point of breaking. Each time I broke (and it happened a lot), I found new ways and things that helped me start to pick up the pieces again.
First, I found my “people.” My people are the women that I was connected with shortly after losing my son that had a similar story. These women were my lifeline, the only people that I felt fully understood by and endlessly supported. I wrote novels to them via email and they always responded with words of encouragement, understanding and compassion. They have become some of my closest lifelong friends whom I owe the world to. Each new person I met introduced me to new things that I grasped on to for dear life to help me through the day.
In the early days it was books. Anything and everything I could read, I did. Elizabeth McCraken’s memoir, “An Exact Replica of a Figment of My Imagination” resonated with me best. It was heart wrenching but beautiful all at the same time. I recall highlighting sentences and then entire pages, and rereading them over and over because she had taken the exact words right out of my head. Feeling so understood when nothing else made any sense was very therapeutic for me.
Then, once I built up the strength to leave my house, it was acupuncture, herbal supplements and yoga that were my savior. Which is what led me to walk through Pulling Down the Moon’s (PDtM) doors. From there my world as it exists today kept expanding when I was introduced to Beth Heller, one of PDTM’s founders, whose first daughter was also born still 16 years ago. Through an event Beth hosted one evening, I met a psychiatrist that quite literally brought me back to life. PDtM became a tranquil safe haven for me. Somewhere I always knew I would walk in feeling overwhelmed, defeated or just plain sad–and walk out with some sense of relief and hope.
As the days, weeks and months passed, I continued looking for answers to big questions. Why/how could this happen and what are we as a country doing to prevent it from happening to more families? What I found was disheartening but who I found through the process was encouraging. The Star Legacy Foundation is one of the very few organizations I found that focuses its efforts on research and ultimately prevention of stillbirth, when possible. They are doing amazing work and have made great strides, but there is still a long ways to go. In the spring of 2018, we officially launched our Chicago Chapter of Star Legacy all thanks to one of the amazing women I’ve met on this journey, Lindsey Schmitz. When I didn’t have the strength to get things off the ground, she did and she’s been an amazing and inspiring leader for our team here in Chicago.
On October 15th, everything came full circle when Pulling Down the Moon hosted a beautiful yoga session in partnership with our Star Legacy Chapter in honor of Pregnancy and Infant Loss Remembrance Day. I looked around the room and was comforted to see many of the same faces that helped get me to the family photo I shared (literally, my friend Jacqui even introduced me to the talented photographer who took it). But I was quickly reminded that there is still progress to be made and people to support as I saw many new faces.
There are so many women and families, that while they may not have the same story as me, their journey has been anything but easy. If you’re reading this, you are probably one of them. Wherever you are on your road, I hope you know you are not alone. Whether you’re struggling to conceive, searching for answers or just looking to connect with someone who understands your pain, I am confident you can find something or someone helpful through PDTM or Star Legacy.
There’s not a single day that goes by I don’t think about and miss Aidan. He led me to meet so many amazing people and I’ll spend the rest of my time trying my best to honor his short but beautiful life.
To read more about my story and Aidan, please visit his memorial page.
The night before you were born, there was so much lightning. It wasn’t raining though, just hot– the hottest night of the year. Sitting on the big blue birth ball, rocking from side to side, I’d rest my head on the hospital bed during the in-between. When a contraction came, I’d sit up, open my eyes and watch the jagged stabs of light through the window as they punctuated the clear, distinct pain in my body.
Later, the white haze of high noon would blur the edges of the clouds. By then, nothing would be clear for me. The pain and the urge to push or not push and the exhaustion and the panic would all run into and over each other, a hot, foggy murk, and I would not know when or if or how you were coming, or what my body was doing, or if both or either of us would survive.
Everyone said it would be a snap. A breeze. A walk in the park. There will be nothing to it, they said. They said, he’ll slide right out. Nothing is like the first one, after that, it’s all downhill. Your body is ready, they said. Your body knows what to do. Your body will take over. You’ve been through it all already.
Everything they said should have been true; but nothing could have prepared me for birthing you.
I cannot say your birth tore me open. My body did not literally tear. Somehow, I managed to expand beyond my own capacity to accommodate not only your body, but also the hands and wrists and forearms of the midwife who reached inside to turn you and free your shoulder from the umbilical cord that had wrapped and twisted its way around you.
And yet, later, I needed to mend.
It’s hard to know what happened to me afterwards, where I went. I thought I knew how to have a baby – how to birth a baby and then how to mother an infant back at home. I’d done it before – I knew how.
But I didn’t know anything. I didn’t know how to handle you, the colic. Who could blame you for being so fussy! You had swallowed so much amniotic fluid, having descended into the birth canal, then waiting there for much longer than you should have. The fluid was in your ears and eyes and belly. You needed to recover from your own birth. You needed to be held all the time, and of course I wanted to hold you, but you have a brother too, and he also needed my love and attention.
It’s not like things ever got That Bad, really. I was not incapable of joy, because I did laugh and love with you. I could never not get out of bed. I did not want to harm myself or others. I never fantasized about abandoning you or dropping you out of the upstairs window. I said “no” to many of the criteria on the doctor’s checklist when I finally went, nine months later, to get some medication.
It was hard to describe, other than to say that I didn’t quite feel like myself. But then again, it was hard to know who my “self” was anymore. There was a dark heaviness, an anger and sadness and loneliness. There was a feeling that nothing was wrong, but everything was wrong.
I slept upstairs for months, on the guest futon in my office. I did not know how to be married. I had no space. I felt so empty and hollow and heavy, there was no way anyone could meet me where I was.
It was, and still is, vague and blurry and hard to understand.
Maybe I just needed time to breathe, to mend my overstretched ligaments and allow the holes in my psyche to close back up again, after experiencing what was beyond my comprehension, to replenish the reserves of energy and fortitude that had been used up in birthing you.
Maybe if I had been allowed to stay in the hospital for another day or so I would have been okay. Just some time to collect myself before heading back out into the world where so much would be asked of me.
Maybe it’s because I felt so inept.
Maybe it’s because the only ways I knew to love were suddenly limited by time, attention, and energy.
Maybe it’s because your birth was so difficult but maybe it’s because that type of difficulty is not recognized as trauma.
Maybe it’s because I wanted to tell my story – the story of your birth – over and over and over to make sense of it, to find a context, but once everyone knew the basic details – 20 hours of active labor, the cord around your shoulder, no c-section, nine pounds, two ounces, everyone’s fine – they had heard enough.
Maybe I had post-partum depression. Maybe I had a chemical imbalance.
Maybe I just needed help. Everyone had told me – 2 kids is more like 10 kids, the workload increase is exponential, etc. etc. But no one ever said, you will not know how to handle it. You will not know how to love so much, so separately, at the same time, and this not knowing will tear you apart.
Maybe it was simply that I was an almost-40 year old woman who spent many long days alone with a toddler and an infant, and I could have used some time to myself.
Maybe it was nothing more than that.
My water broke first. That was a surprise. It hadn’t been that way the first time. Later, I was told that that there is much lore and myth around births where the water breaks before contractions have begun because contrary to common portrayals on TV, this sequence of events is actually rare.
I had just gotten your brother into the bath and I bent down to kneel beside the tub and there it was, as if the bathwater had overflowed onto the floor. Of course I knew, but I still wanted to be sure. I waited. Soon, there were puddles of amniotic fluid all over the house. We called your grandparents to come for your brother. I stood on the front porch, waving until the car disappeared around the corner into the clear evening light. My heart ached, saying goodbye to my “only” son, bursting to welcome you.
Back home again when everything was over, I was nostalgic for the hospital. There was a hippie deli down the street, and I missed the tuna sandwich on thick, soft, grainy bread, with tomato and sprouts brought to me on my one day of convalescence. I would miss the quiet, the solicitude, and that single night, alone with you, in the bed beside me, swaddled, nursing, as we figured out how to be together with you outside of me.
Afterwards, I wanted to do it again right away, which was crazy, given what I’d just been through. I thought it was the post-partum euphoria, the hormones and dizziness. But the feeling lasted. I wanted a third. A girl. I felt myself clinging to the hope that I would go through it all again. I knew that if I was going to do it, it was going to have to be now, that I could not make the transition in and out of this space again. I needed to keep the momentum going. As the months wore on, though, I knew I could not handle more. This was plenty. We were enough.
But first I had to be sad.
I had to be sad that I am not younger. I had to be sad that I didn’t do this sooner. I had to be sad that I’m someone who needs a lot of solitude in order to feel fully whole. I had to be sad that I will never have a daughter, a Violet or Ruby. I had to be sad that your birth marks an ending for me. I had to mourn the loss of possibility, that while it is still technically possible, it is not actually desirable, given our circumstances, our lives, to have more children. I had to actually say the words to myself, No, I can’t handle more. And then I had to be sad that I can’t handle more. I needed to be sad that this will be all, and I had to go through all of that to recognize that this is plenty. That you, I, we are enough.
Last time, I had birthed naturally, as I had wanted, but in a traditional hospital, with an O.B. With you, I was going to have a water birth. We had switched OB practices so that I could employ a midwife and use the Alternative Birthing Center and give birth in the giant bathtub. I could labor in water, which was said to be so relaxing and warm and peaceful. Floating took pressure off the joints and alleviated the affects of gravity and you would not be shocked by the sudden change from water to air and I could catch you myself as you slid out.
But the night you were born was the busiest of the year in the birthing wing. Someone said it was because of the lightning, the way it pierced the pressure of the atmosphere which induced labor. The tub was not available. It’s rare that so many women are laboring at the same time that those who desire the tub suites cannot have them, but as I breathed through my contractions in the triage room, I was told that there was a chance we might not be able to have a water birth.
There was much confusion then, and conferring with various staff members. But I left that to the trusted others to handle, your father and godmother, who were with me in the hospital. I was busy, breathing, focusing, rocking, turning further and further inward in preparation for the work I would do later.
The lightning began to fade as the first signs of daylight appeared in the sky. There was a shift change for the staff, and once my regular midwife showed up, I knew we would be alright. She was taking charge of the situation and said that yes, we could get into the tub room because I had been there longer than the others. I only had to be dilated 5 cm before I could get into the room but that surely that would not be a problem because I had been there all night.
But when she checked, I was only at 2.5 cm, still. I didn’t know why it was taking so long, what was wrong, what I was doing wrong.
Even at this hospital, with all their alternative methods, there were still rules; they followed the standard hospital protocol which allowed no more than 24 hours to elapse between when one’s water breaks and when the baby is delivered. Without amniotic fluid, the theory goes, the baby has no protection from harmful germs and bacteria and is potentially exposed to danger of all kinds.
5 cm to get into the water, 24 hours without water.
5 cm to get into the water, 24 hours without water.
5 cm to get into the water, 24 hours without water.
Later, somehow, in the space between trying to return to normal and recognizing that my notion of normal had vaporized – during the time when I tried to show your brother how much I still loved him and how much attention I still had for him, how much I could still dance and romp and play and be silly, and how much it was okay for him to be mad at me for having a baby, and how it was okay for him to not want me to sit next to him, or tuck him into bed at night, all while trying to figure out what would make you happy, not the car nor the stroller nor the bassinet, only my arms, my breast – somewhere in there a part of myself became dormant, as if stunned into stillness. It felt as if nothing within me was growing, that I had shed all the life I had.
I was already a mother when I had you, so your birth was not the dramatic transformation into something else that had occurred the first time. One birth revealed to me how much I was capable of, was for me about capacity; the other illuminated my limitations, the point where branches can bend no further, the point of breakage. Both showed me to myself. Both were necessary for me to be whole. At the time I did not know that. At the time I did not recognize that anything was growing or alive, that deep underground, my roots were stretching, absorbing nutrients from the rich soil of my life, of our lives together.
By now I’m Tired. I’ve been having steady contractions for 14 hours already. The tub is open. We are moving. We parade down the hall, carrying pillows from home and clothes and bags and cups of coffee and cups of ice. I feel that I’ve earned this and here we are, the large room with the queen sized bed with the flowered spread and oak headboard. The tub. The tub is full of water and waiting for me, for us. Through the window I see the blue sky and white, puffy clouds. Late morning light. I sink into the tub. Getting close to transition now. The contractions are coming quick and hard and I am breathing and the water feels so good, I lay back, rest, so that only my face and the apex of my belly with its protruding navel are not submerged in water. And then I wait. And nothing happens. When a contraction comes, several minutes later, it is weak, and barely a moan escapes my body. I wait some more. It’s afternoon now. We’re close to 20 hours now. I’ve gotten to 8 cm and now my contractions have stopped. I’ve reached transition and now I’m going backwards. I am closing back up.
Out of the tub and into the shower. Out of the shower and on to the bed. A walk down the hall. Nipple stimulation to get contractions going. We’ll try a breast pump. This works; the contractions are back and they are quick and hard and we are ready to go and they are in my back now. There is no water inside me and no cushion. I’m having back labor now and I’m on all fours on the bed and I have never had pain so deep and hot that it pushed me to the edge of consciousness. I do not know who I am. I do not know what I am.
Then back in the tub and do I feel pushy now?
I’m not sure; I can try to push but I don’t know how. I don’t know how to push anymore and it’s not time yet. It should be time, but it’s not time yet. We’re not ready yet. Back into the shower and down the hall and back and nipple stimulation and now I feel pushy. I want to push in the tub but that doesn’t work. We’ll try the bed and now the pain the pain the pain. On my back and I am screaming and I can’t take it. I can’t do it any more I am done. The contractions are too much, it’s too fast now. It’s happening too fast and too slow and it’s not over yet and it should be and out the window is only white haze and my eyes are blurry. The room is flooded with light and I scream into the light it’s too much I’m pushing now. I’m pushing now. My body is on fire and you will be here now.
I am in and out of that place within me that I have never known before, that I will not remember afterwards, that place that allows my body to take over. That place that pushes me out of itself, that is myself. That is fluid. I will need this later. I will want this later. But my moments here are so fleeting I will not know how to come back and this is not a place to return to, only to bring back with me. But there is no time to come back here, like waking from a dream and wanting to remember it before the day begins.
I am pushing now for you to come but you do not come. You move down but then back up and something is wrong. It is not supposed to happen this way. It’s not supposed to be this way. I am to push and you are to emerge but you are not coming out. You have descended. You can’t stay there too long but you stay. Your head is moving now your head is out. Your skull your brain your mouth your eyes are here but now your body is stuck. We’re both stuck. There is nowhere to go because of where you are and where I am and I am done but you’re not out and there is nothing to do but scream and sob and push and breathe and pray and beg to be cut open but they cannot cut because your head is out and the only way out is through me. It’s not supposed to be this way, your body should slide right out now, but there is the cord. The cord is keeping you here, part of my body holding strong to your body, not letting you out and this is when we could die. Like a flash of lightning, I suddenly know, in my bones and skin and fluid and a new kind of scream, that something is very wrong, that you or I or both of us might not survive this. Darkness descends now. But now there are the hands and wrists and forearms, reaching in and turning. I don’t know what is happening, only more pain but there you are now you’ve been turned and you’ll slide out now, and I’m pushing and just like that there you are. You’re out. You’re out now and I’m done. My shaking sobbing body is done. But you’re quiet. There is no sound from you yet, not yet not yet and I am waiting for you still and I don’t know I don’t know if-
Here you are. You’re on me now, blue and slimy and crying too and mine. You’re here and you’re okay and we both made it we’re both alive and you’re out and both our hearts are beating and you’re fine and you’re here.
Oh my God – you’re here.
“Waiting for Elijah” appeared in the Winter 2010 issue of Calyx Literary Journal and is republished here with the author’s (Christine S, Massage Therapist LMT) permission.
Five years ago, after deciding to start a family, I became pregnant for the first time. Although my husband and I were nervous about a miscarriage in the first trimester, once we got to three months, we relaxed and started planning for the arrival of our son. I was staying active, eating healthily, doing everything I was told to do, and so it didn’t occur to us that our son wouldn’t be born in the summer of 2014. Then, in April 2014, our lives changed forever. At 25 weeks, I started having contractions. Within a few hours our son died in utero. I will never forget the look on the doctors faces as they desperately searched for a heartbeat but couldn’t find one.
Later that night I was induced, and Luca Thomas Sturdy was born at 4 am on April 4th, 2014 weighing 1.7 lbs. There was no first cry, Luca was born into silence. Our midwife stayed with us, crying by our side, and encouraging us to hold him, of which I am so grateful to her. Luca was perfect, tiny, but perfect.
The next few weeks and months were the hardest time of my life. I felt like everything I knew to be true was gone and I couldn’t understand how life could continue. It took months for the reality of what had happened to sink in. I would look in the mirror and think ‘thats not me, thats a women whose baby has died. No, it is me, that’s who I am now.” I had become one of the ‘other people’ that terrible things happen to. We got through it with the help of a wonderful counsellor and support from friends and family, but it fundamentally changed us both, and how we looked at life. We realised how unpredictable life can be and how naive we were to this previously.
It also reinforced how much we wanted children, and so we started to try again. We were constantly told what had happened was ‘bad luck’, and that we’d have our ‘rainbow’ baby. We conceived quickly again, but this was the start of a series of loses, four more in total, all apparently unrelated and ‘bad luck’.
After the third loss, we started IVF and begun seriously researching adoption.
IVF bought its own challenges and a great deal of resentment. I resented having to inject myself, and having to deal with daily phone calls to tell me if any of my eggs had survived and fertilised and then if any of the embryos had developed over night. I started to resent the idea of pregnancy – I didn’t want to deal with this anymore, I just wanted a child. IVF was a horrible reminder of how little control we had and it turned becoming parents into a numbers game.
Luckily, we had talked about adoption in the past so looking into it wasn’t a huge leap for us. As we researched it more, we understood it wasn’t a simple ‘plan b’, but came with unique and serious challenges. It added to the isolation I already felt when I compared the decisions we were making to friends around us. We had to let go of all our preconceived ideas of what our children would be like, and what how our lives would unfold.
We tried two rounds of IVF, both unsuccessful. Our lives had turned into a constant battle with fertility and grief. If we weren’t putting all our energy into trying to get pregnant we were recovering from another loss. I was embarrassed to contact friends as the only news I ever had was another loss, and I felt like people were running out of energy to support us. Suggesting we should have hope seemed farcical. I hated that this had taken over our lives so completely and felt so withdrawn from everyone around us who were seemingly breezing through life, now trying for their second or third child.
Through counselling I realised that I was avoiding my biggest fear; that we would never have children, whether through conception or adoption. It was like a monster in my peripheral vision, lurking just out of sight, but close enough that I could feel its presence and it filled me with dread. I decided to face this fear. I thought alot about what our lives could be like if we didn’t have children. I wasn’t ready to chose this path, but in facing it as an option, it helped me to see that there were so many possibilities and I could let go of the fear of any one path not working out.
And then an opportunity arose to move from London to Chicago. We realised how good it would be for us to be in a new place, and have a new focus, so in January 2017 we moved to the mid-west. After another loss, we decided to stop trying to conceive and focus on adoption – we had just been approved to adopt by the state of Illinois and were excited to start the matching process.
Four days after making the decision to stop trying, I had a positive pregnancy test. I cried, not out of joy or happiness, but at the thought of the inevitable loss this represented, I was devastated and petrified of how this one would end. After four and half years I finally, genuinely, did not want to be pregnant. I had accepted that we would start our family a different way, and was excited about this. But we pulled all our energy, and started the process again. I had my first scan at five weeks, surgery at eight weeks for a transabdominal cerclage and began weekly progesterone injections. I had multiple emergency trips to the hospital believing the baby had died. I felt sick going into every scan, which I was having every two weeks. But, despite everything, in between all the anxiety and stress, there were amazing moments – feeling the baby move, my husband singing to him, imagining the moment we would meet him (when I could bring myself to have this fantasy). We decided at 36 weeks we had to tip the scale and focus more on excitement rather than fear and so we bought some baby clothes. Once I got over the initial anxiety I couldn’t stop smiling as I held these tiny clothes and thought about our baby. I used every tool available to me to get through those nine months – acupuncture with Kelly, yoga including Prenatal Yoga After Infertility with Kellie, meditation, massage with Christine S, mantras, group therapy, swimming, walking.
I am writing this on Oct 16th, and our son Adam James Williams-Sturdy is three months old today, having been born on 16th July weighing 6lbs 8. He is an absolute joy and we still cannot believe he is here with us. Despite everything that has happened to us, we feel like the luckiest people in the world when we see his beautiful smile and his big bright eyes. He was born on Luca’s due date, four years on, and looked just like Luca when he was first born. One day we will tell him about his big brother.
I hope that sharing my experience helps others to accept that there is only so much of life that we can plan and predict, and by letting go of the rest, you can find new paths forward and new ways to be happy. This is the legacy that Luca has left us.
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