On The Inability to Feel Happy at Childbirth

Our son was born prematurely in December 2009 after an emergency c-section. At the time, my (then partner, now) wife suffered from HELLP syndrome, which had been overlooked by her GP, her midwife, and her gynecologist. They missed it, in part, for the statistically interesting reason that they were working with average parameters while ignoring that my wife had been extremely fit before she became pregnant (and most of her increased values fell, it was thought, within the acceptable margins). But the bigger reason they missed it was that they refused to listen to her, deciding both that she has low tolerance for pain and that she was a difficult/demanding patient (this was even noted in her medical file).* This was especially galling/infuriating because (a) my wife is incredibly resilient (a mountain climber) and (b) because she is a surgeon and -- unwilling to take advantage of her insider status in the system -- she tried very hard to be undemanding. 

And, in fact, one of the most bewildering features of my wife's situation at the time was that many of her circle (a lot of them prominent physicians) also refused to recognize her (and the baby's) situation for the life-threatening situation it was; this was so for, I think, two reasons: first, they were all self-consciously unwilling to become that difficult colleague who would tell the attending physicians what to do; second, and more, general, a birth is meant to be celebration. (I return to this below.) By the time HELLP syndrome was adequately diagnosed my wife's and our baby's lives were in acute danger. And, in particular, my wife nearly did not survive the surgery. 

This generated a further complication: when people visited us in the hospital they came for a celebration. But it is extremely difficult to be happy when one is terribly weakened, experiencing shock or post traumatic stress and, simultaneously, others, including people one would like to be close to, are incapable to acknowledge this fact in the moment.**

This post was prompted by the ninth birthday of our son earlier this week. But as I look over the previous three paragraphs, I  ask myself why write this now? (For example, I started blogging for NewAPPS in the first year of my son's life; but while I increasingly wrote about fatherhood, I did not discuss this at all.) I suspect it's because I am mourning my dad's death earlier this year. Let me explain. 

The first year of our son's life was difficult for our relationship not just because of ordinary fatigue and stress, but because after a while, and in various ways, I wanted to move on and be happy, join in the socially encouraged celebration of parenthood, whereas my wife wanted, I think, acknowledgment of what had happened to her and our child; rightly so! (She reads this blog sometimes, so I may adjust this!) Crucially, this included not just the near death experiences, pain (etc.), and the lack of recognition described above, but she was also mourning missing out on the childbirth she had imagined.   

One striking feature of the current approach to post natal depression is that it is rarely acknowledged that it can be caused by the kind of experiences I have described above and lack of recognition for them. If one reads the public utterances of medical systems about post natal/partum depression (see here and here), one finds that while it is now treated with utmost seriousness, they treat the cause(s) of post natal depression as a general mystery or they kind of suggests the patients involved may have a history of mental health problems or live unhealthy lifestyles. What one never reads is that it may be induced by the lack of recognition during or after trauma (for parents like us who have just experienced near deaths).

 I was about to share with you my joy about my son's development since. But today I won't give in to the temptation of giving you a happy ending to this story. For, the fact is that we (the parents) missed out on a lot of joy at the start of our son's life; we were simply incapable of it. This incapacity at joy reminds me of my war-traumatized dad. And I am left with the strange consciousness of having understood my father better after my son's birth without understanding why, until now.    

 

*So, the relatively cheap tests that could have been performed to be alerted to the presence of HELLP syndrome were not done until very late in the pregnancy. Because Holland has a non-litigious culture there is no over-testing. The down side is that sometimes necessary tests are not performed. 

**This is not a complaint; it's quite possible folks expressed concern/sympathy that I missed (because too absorbed in my own fears). 

Comments

[Catarina Dutilh Novaes]

This is terrifying and beautiful at the same time. I knew the circumstances of your son's birth had been traumatic, but I never knew the details. I think the fact that your wife is a medical doctor definitely contributed to this outcome (as you noticed); doctors are often confused as to what to do when a patient is 'one of them' (speaking as the daughter of two medical doctors who have each been through all kinds of medical complications).
I don't know if I ever told you, but the birth of my second daughter was also a bit of a scare (though not nearly as bad as your story). It could have easily ended in my death. My then-husband never understood the trauma of that experience, and that's when things started going wrong between us (eventually leading to him now being an ex). So your story here touches a very sensitive nerve in me. I'm glad that you all made it through: your son, your wife, and your relationship.