I have already written extensively about the birth of my son. The short version is, I struggled profoundly to adjust to life as a new mom. Three months postpartum, I had started to feel overwhelmed by thoughts of guilt, anxiety, anger, fear, hopelessness, numbness, and negativity. I acknowledged that my son felt like another kid I was babysitting. I felt no connection to him. I took care of him and provided for his every need around the clock, but I felt nothing. I figured I better bring this up with my midwife as soon as possible. I made an appointment and was seen urgently by a midwife I’d never met before. I figured I’d get a pelvic exam and some antidepressants until I could find a therapist. As a counselor, I recognized that I was most likely depressed, and possibly had PTSD from the NICU and my birth. I dutifully told the nurse everything I was experiencing as she checked me into an exam room. She nodded and exited quietly after taking my vitals. And then I was alone for almost an hour.
I was furious by the time the midwife came in. I deal with depressed people for a living and knew it was not appropriate to leave someone depressed unsupervised as long as I was. I let her know this and she apologized mechanically. She asked me about my symptoms and I repeated them to her. She listened with wide eyes and no facial expression. When I was done explaining the thoughts of guilt and anger and overwhelm, she looked me in the eye with wide, vacant eyes. She told me that she thought I had postpartum depression and needed to be checked into an emergency mental health facility immediately. Her tip-off? I said I had “wanted to go sleep and not wake up”.
I’d just like to state from the professional counselor side of things, that this kind of a statement indicates passive suicide ideation. Typically, suicide ideation is considered urgent if the client has frequent thoughts about ending his/her life. Other risk factors evaluated are past suicide attempts, past self-harm, and past history with depression/other mental health diagnoses. The situation turns more emergent when the client expresses a specific plan and/or writes a note indicating intent to end his/her life. When I interview teenagers for suicide ideation and they make a statement such as “I want to go to sleep and not wake up”, I ask them to clarify if this means they want to die. Many say yes, indicating the need for an evaluation for their safety. Then, I ask clarifying questions about specific desire to end his/her life, suicide plans, past suicide attempts, and history of depression. In my visit with this midwife, none of these clarifying questions were asked.
I was in disbelief. Surely she was mistaken. I told her that I didn’t need an emergency room because I had never expressed any intent to harm myself or my baby. I was not suicidal. She was either scared, did not believe me, or both. She persisted that I needed a psychiatric evaluation and she would walk me down to the emergency room. I told her she would make everything worse by doing this. I told her I would be retraumatized. She persisted that she would not let me leave without knowing I was going to the emergency room. I told her I thought medication were more appropriate in the short term as I sorted out a therapist. She persisted and said I would receive medication from the emergency room. By now, I could feel my anger rise to a boiling point. But then I got scared at the thought of my baby being taken from me. I was not about to be escorted out of the office by the cops or lose my son. I went numb. I told her I needed a breast pump and to know what to do about the severe bleeding I had been experiencing. She told me on her way out the door that my bleeding was due to stress and would go away. I called my mother-in-law to come pick me up. I called my sister to let her know why my doctor’s visit was lasting abnormally long and to sort out care for my baby. And I was driven silently to the emergency mental health hospital across town.
I knew from my professional experience that this mental health hospital was no supportive environment for a new mom. My most acutely suicidal students came here to be evaluated under lock and key. People were evaluated here for severe mental illness and drug addiction. The people who were seen here could be classified as “a danger to self and others”. All I had wanted was a low dose of Zoloft and some therapy referrals.
Normally, I am very good at diffusing awkward situations with a joke or small talk. But on my way to the emergency room, I didn’t know what to say. I had never felt so angry or betrayed in my entire life. I asked for help and it felt like I was put in adult timeout for it. I was so confused, too. I dealt with suicidal students for my job all the time. I made the same hard calls requiring them to get a risk assessment whether they liked it or not. And now it was happening to me and it felt the opposite of helpful. Was my whole job a lie? Was I actually going crazy? My whole sense of self would come into question for the next 24 hours after checking in to the ER.
The triage nurse called me back almost immediately when we arrived. I was hopeful—maybe I could go home in time for dinner and to pick my husband up from work. I thought about lying to her when she asked why I was there. But the thought of law enforcement loomed in the back of my mind so I told her the truth. I said that I had told a midwife that “I couldn’t handle it and wanted to go to sleep”. She told me with an offensive lack of emotion that I’d have to undergo constant supervision until I got a psychiatric evaluation. I asked her how long it would take. She told me it would be a long process, maybe reaching into the early morning of the following day. My whole body sank in a feeling of complete doom. I was stuck.
I was taken to a waiting room where my mother-in-law sat with me. She tried to make small talk with me, I’m guessing to calm me down. I was still fuming. I hesitantly called my parents who were out of town on vacation. I felt so guilty for interrupting them. They were in utter shock and told me what I already knew: just go along with it and cooperate. I hung up with them and felt alone. I had let my husband know what had happened and he was angry. Normally I hate when my husband is angry, but it felt good that someone else was furious instead of concerned or full of pity. I was told that my belongings would be confiscated and that I’d have to change into hospital scrubs. I was reminded to take off my shoes because I had left them on hoping I wouldn’t have to step on the disgusting floor of the ER. Once I changed, I looked in the mirror and felt like a prison inmate. I still cannot fathom my capacity to feel the anger that I did. I continued waiting and began to panic at the commotion that escalated around me.
I saw two state policemen escort a woman dressed just like me to the chair right next to me. We were soon joined by a teenage girl. All of us waited in silence. I was shocked at how normal they seemed. They weren’t angry at all. And then, I heard a loud, raspy scream. A woman was sitting in a wheelchair at the other end of the triage area, filthy and thrashing around. She began screaming that she was in pain. I was worried. And then, my mother-in-law said, “Probably wants pain meds”. It was as if this woman heard us, as she began cursing at the nurses and demanding pain meds. She repeated how she was hit in the face and needed pain meds. For almost an hour, I sat in stunned silence listening to this woman continue to scream and slur for pain meds. I was suddenly worried when I saw her walk towards me. She eventually settled in a triage bed across the hall. She continued to throw a tantrum while the calm nurses tended to her. What patience (or callousness) they had. I remember the stench that filled the room as she passed by. I got up to use the restroom and recoiled when I saw another woman, equally as filthy, slumped over in a wheelchair and unconscious. My eyes were ripped open to the closest reality of drug addiction I’d ever experienced. And we were all waiting together. A new mom among drug addicts and criminals.
My mother-in-law told the hospital orderly that I was a nursing mother and needed a breast pump. The orderly looked confused and panicked as if he’d never gotten such a request before. He told me he’d have to ask what to do in this situation. I found out my only option was to wait for someone to bring my breast pump to me from home. A flash of anger raged in my mind. To force new moms to the hospital for postpartum mood disorders with not so much as a breast pump?! I already felt dehumanized and humiliated in this process. I now felt even less like a new mother and more like a criminal.
I was led to a tiny room with a bed, a tray table, and a chair. The room was only made private by a shower curtain. A flashback of the shower curtains in the NICU invaded my mind and overwhelmed me with sadness. I used to joke about padded cells, but after spending the night in mine, I never will again. My husband eventually arrived with my breast pump and the two of us sat silently in my room. We were both overwhelmed by the shock of this whole process. We prayed and I cried. I kept feeling the need to apologize to everyone for this inconvenience. I silently made an angry vow to NEVER tell anyone when I was suffering again. A couple hours later a nurse came and made me take off my wedding band. I hadn’t taken it off in almost 2 years.
Once my husband got me settled and brought me Taco Bell, he went home to tend to our son and go to bed. I was now truly alone. I was visited by nurses, hospital admin, and a physician. The physician told me I’d need to wait for an unknown amount of time for a psych evaluation. There was only 3 “clinical liasons” for the entire hospital system that performed these. No one had any idea how long I’d be there. There was no clock, nothing to occupy my time other than my need to pump and clean my supplies in the shared, co-ed public bathroom. I settled in for the night and noticed that the other rooms started to fill with a strange assortment of homeless people, young people, profoundly mentally ill people. I was about to go to sleep for the night when I heard a blood-curdling scream from the room across from mine. It sounded 5 feet away from me because it was and there was no door. I don’t know who it was, but the scream kicked off a sleepless night where I could do nothing but listen to this poor soul curse to himself and the air and the wall and the voices in his head. I’ve never heard such anguish. I was sad for him and so angry at the same time. This was a human being who needed the help of this mental health facility. I did not. I prayed for him until the morning when I saw two state policemen escort him somewhere else. This poor man, dressed just like me, walked slowly in front of me, staring vacantly straight ahead with his arms held out by the two policemen. I heard the nurse walk in and call for maintenance to come mop the urine off the floor of his room.
The morning came and strangely felt safer. I listened for every single footfall outside my door to see if I was any closer to my psych eval. Any closer to leaving. I inhaled the bland breakfast brought to me and listened as a thin woman walked through the doors and past my room. I stuck my head out of my curtain and heard her asking psych-related questions to a homeless man cross the hall from me. He cursed at her and she left. Maybe I’d be next. I kept asking the nurses how long it would be and they finally told me that I was next in the queue. I think they felt sorry for me and knew that I clearly wasn’t an imminent threat. I asked them if there was a fridge to store my pumped breastmilk and, again, I got confused looks. My husband had brought a cooler with an ice pack but it had been 12 hours and the ice pack was warm. Questions were asked and doctors were paged and the best compromise I got was being able to store my milk in the employee refrigerator. I forgot the milk when I left. My sister arrived to pick me up and, soon after, I was finally visited by a “clinical liason”. She asked me questions and I downplayed everything intentionally. I wanted to get back to my baby and my life. She tried to be funny and make small talk. Then, she finally discharged me with referrals for counseling and no medication. I received a paper saying I had “adjustment disorder” and that it would go away in 3-6 months. I didn’t care that this didn’t seem accurate but my sister and I left the hospital. Once I got outside, the hot July sun had never felt so good. It was noon and almost 100 degrees.
I ended up calling the referrals from the “clinical liason” and all of them were full. None of them were even allowing waiting lists for new clients. And so, I was out hundreds of dollars for an emergency room visit with no follow-up, no medication, and no treatment whatsoever.
There were no words for the magnitude of these experiences until recently. I would tell those who knew about the situation beforehand. I am just now seeing its damaging effect in my life as I attempt to find some sort of normalcy. The first thing I noticed was a deep sense of isolation. I went to a breastfeeding support group in an attempt to integrate in to the “mom” community. As we shared stories, it was made clear very quickly that one of us was not like the others. None of the other moms got approached by the facilitators with a business card for an on-call counselor—just me. Same thing happened when I started going to a mom’s group with some of my friends. They would focus on things like the strollers they’d bought or the outings they took with their babies. One of my friends in the group would encourage me to get out with Simon despite a growing sense of pure dread about taking him in public. I had told her about my experience at the mental health hospital and she had the other moms pray for me. Again, one of us was not like the others. As the months wore on, I noticed that I would try to change the subject or hide my brokenness when someone would mention a healthy birth.
I dutifully responded to my son’s every need and took care of him to the best of my ability. But I continued to feel like he was more like a child I was temporarily babysitting, rather than my own flesh and blood. I heard other moms share about their struggles to leave their babies. I had no problem doing this. In fact, there were a couple months where I felt nothing but relief when someone would offer to hold or watch my baby. I thought this was normal. I loved when I could leave him with someone and feel like myself again. I thought I’d feel disconnected like this forever. I never felt hostile towards Simon, but always felt distant. I would see my husband be affectionate with him and wondered why I couldn’t do the same. I’d do my best to hold and talk to him and tell him how much I loved him, but I was partly doing this to convince myself of it. I went on this way for awhile partly because I knew no different, and partly because I was terrified of medical professionals. I already had a fractured trust in the medical profession due to their general unwillingness to support me in natural family planning. Now, the trust was unrepairable. I’ve never fully gotten over that fear and don’t know how long it will take until I do. I gave up trying to find help and prepared to return to work.
Most moms dread returning to work after maternity leave, but I couldn’t wait. I couldn’t wait to return to the familiar comfort of work. Work made me feel more like myself. It also helped me avoid the unresolved chaos in my head. I was able to arrange a semester of working part-time, so either my husband or I would always be home with the baby. I shared a few things about my experience with my co-counselor and explained that I would try and find a therapist one day but wasn’t too hopeful because they were all full. She explained to me that there was a therapist at our Employee Assistance Program who did the kind of therapy I needed. I was so thrilled; this would be a free solution to my mental health issues!! I began seeing this therapist and realized that I was more in need than I originally thought. She was kind and listened and even let me bring my baby to our sessions. Together we worked through my most acute mental health symptoms until she let me know that I was stable enough for trauma therapy whenever I was ready.
Quirks 