Illustrations by Ashley Goodall
When your baby finally arrives, exhaustion follows—that's a given. But some women have it far worse, tumbling into a nightmare of their mind's own making.
When I opened my eyes, there was something on my chest. It was making a loud noise, like a high-pitched shriek, and had little arms and legs. Wait—was that a BABY?
I catapulted from the bed, still clutching the tiny thing. It was hot and its face was red. My husband's face swam up from the shadows. "What's happening?" I yelled at him, and thrust the child into his arms. "I can't hold this baby."
I looked wildly around. Where were we, and how to escape? Maybe through that window, if my abdomen didn't hurt so much. "Sit down," my husband said, leading me back to the bed where I was, I soon learned, recovering from an emergency cesarean section after 24 hours of trying to give birth.
Once your baby turns into an old lady, it's a bit weird.
The short version: my uterus hadn't been able to push the baby out; I had a temperature; the baby was distressed, so they performed the surgery to save both our lives.
But all I knew was the walls were too close, the air too thin, and I definitely needed to get the hell out of that room. It took ten minutes of deep breathing before reality came flooding back: I was in hospital, and that baby was my son.
About an hour later, the walls stopped shimmering.
Was my post-birth delirium normal, and what had caused it? The most obvious answer was the drugs. After the c-section, I was on a cocktail of 12 substances, including a morphine drip—and, after that was removed, morphine tablets.
I'd downed one of the tablets right before I fell asleep, and woken to a nightmare of my mind's own making.
Dr Aidan O'Donnell, the lead obstetric anaesthetist at New Zealand's Waikato hospital, says hallucinations and delirium caused by hospital-administered drugs after childbirth are rare, but can happen. They are less likely on a drip, also known as patient-controlled analgesia (you push the button for another hit).
"But you had stepped down to tablets, and it sounds like they gave you an over-generous dose. Hospitals would be trying to get the recipe right, but that doesn't always happen", says O'Donnell, who is also a member of the Obstetric Anaesthetists Association.
Women who have taken hallucinogenic drugs before, like magic mushrooms or LSD, could be more likely to experience delirium from post-birth opiates, he adds. But by far the most common side-effects are itching, nausea, sedation and constipation.
Project manager Allie, 34, wishes that was all she had experienced in hospital after her emergency c-section. The next day, sleep-deprived and on a bunch of drugs including synthetic opioid oxycodone, she picked up her baby to find her unrecognizable.
"Her face morphed into an old woman's face. It turned all wrinkly. Then there were bugs sort of scattering over the walls, like little flecks of color, and I looked out the window and could see a big screen with people dancing around it, like a big party. I was just like, woah, I'm tripping out," she says.
"After that, I said to them, 'Whatever's in this drip, I don't want it. Take it out.' I mean, you don't want to be in pain, but once your baby turns into an old lady it's a bit weird. I could handle it because I knew I was wasted, but for a new mum with no experience with drugs, it could be a quite scary.
"And I just remember thinking, what is my baby seeing, if I'm seeing this? Is she high, too? I think they need to warn people that these side-effects can happen."
Allie's experience sounds terrifying, says Dr O'Donnell.
"In cases of delirium, the causes are almost always physical [for example, caused by drugs or infection], but patients can get very worried, because they think they're going mad. Again, this is unusual, and we get it right more often than not."
Some experts, however, believe dissociative experiences after childbirth—including hallucinations—aren't always substance-related, and can be attributed to shock.
Researcher Elizabeth Mary Skinner knows what this looks like, as a veteran midwife and intensive care nurse. For her PhD she delved into maternal injuries, speaking to 40 women about their traumatic births and the aftermath.
Skinner found the majority of these women suffer from post-traumatic stress disorder (PTSD), the condition most commonly associated with war veterans, or car crash victims.
Journalist Sophie, 36, thinks this could explain why, when she first met her newborn baby boy, she thought she was cuddling a tiny horse. "I thought that in my arms was this perfectly-formed, sleek little black horse," she recalls. "I had this little horse in my lap, and I thought it was the nicest thing in the whole world."
Sophie had been huffing on gas and air, or entonox (also known as laughing gas) for three hours while pushing out her baby. She was light-headed, exhausted, and thinks she just couldn't mentally cope with seeing her child. Her excruciating 30-hour labor was mostly endured without an epidural,and there were instances where the baby's heartbeat couldn't be found.
I just really couldn't deal with it.
"You think you're going to die and you think your baby is going to die," says Sophie. "I didn't really want to know about that baby when he came out, you know? It was like, fuck, I'd just had 30 hours of hell, and half my body was falling out of me, and they hand this baby to you, and you're expected to love it?
"I just really couldn't deal with it. But when it was just a perfect little black horse, it was just everything I'd dreamed of. God it was weird. I remember it so clearly, that horse..."
Sophie's theory that seeing a horse instead of her baby was a coping mechanism is likely, Skinner says. The dissociation and numbness Sophie and I both felt is what happens when people process trauma.
Of my personal experience, Skinner says: "Nobody warned you, nobody explained [the birth process] to you. You were worried and you were sleep-deprived and you pushed and pushed, and I bet your husband was confused, too."
Women don't expect dramatic births, or that they will need emergency c-sections or pain-relief medication, because the likelihood of this is downplayed, she says. But according to the most recent maternity data in New Zealand (from 2014) only one in three women have a "normal" vaginal birth. The rest have interventions such as induction, c-sections, and/or episiotomy—a surgical cut to enlarge the vaginal opening.
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Skinner is part of a growing group of medical experts pushing for women to be informed of all the risks of vaginal birth—as well as the possibility and complications of a c-section—well before they go into labor. This movement for the stark truth over fluffy antenatal classes teaching women about nappies and birthing music is gathering steam worldwide.
If something doesn't go according to plan, a woman's confusion simply adds to the trauma, says Skinner. As does the pressure to have a "natural" birth.
"We need to treat women as adults," she says. "It's not the 19th century; they can handle it. We need to inform women when they're in their right mind that things can go wrong, not once they are already in hospital. If you understand the complications that can occur, then you're prepared."
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