May 2023 Womens Health Awareness and Mental Health Awareness Month
May is women’s health awareness month, as well as, mental health awareness month. These are two subjects that are near and dear to my heart. I’ve spent more than two decades focusing on bringing whole person wellness to my primarily female clientele. This May, I found it timely to share part of my own life experience.
It’s taken me nearly 17 years to come to terms with the birth story of my first child and to realize it is important that I speak openly about it. I had a traumatic birth experience. Yes, you can have a traumatic birth and a natural birth at the same time. At the end of that experience, there was a beautiful baby boy who I fell in love with instantly. I tried to put everything that had happened in the past and move forward. What I understand now is it simply doesn’t work that way. It is important for me to tell my story. In the U.S., we have 50% more women dying in childbirth than we did 30 years ago in the US. Unacceptable.
I’m not going to recount the timeline of exactly when I went into labor and every moment of the process. That is because my labor was 64 hours and by the end of it , I was very depleted. In fact, I found out later by comparing my 1st birth to my 2nd that I qualified for a blood transfusion and was never offered one. I was told it was ok to go home the same day I birthed. Desiring to have a natural birth, does not mean that I shouldn’t have been offered necessary medical care in a hospital.
My labor was initiated by contractions five minutes apart. For 56 hours my contractions remained 5 min and remained an 8 on the pain scale. At that stage, I recall crying out in pain. Instead of going to high alert, the staff, none of which seemed to have knowledge of how long my labor had been (there had been several staff changes by then ) told me to hush. My husband at the time still mentions to me, remember when you screamed during labor? Yes, indeed, I do remember that. I have medical trauma, and therefore it’s very difficult for me to not recount that. I understand now that the pain levels were due to undiagnosed endometriosis. Now it infuriates me that even in the moment of a medical crisis, it was considered unseemly for a woman to raise her voice. It’s taking me 16 years to allow myself to feel that anger.
For most of my labor, my Midwife had been sleeping. She told us later that when she saw we were good birth partners, she felt that we we’re fine since we had done it before. That was not the case! This was my first child. After my labor was not progressing, she was called back in. My baby's heart rate began to drop, and my midwife administered Pitocin. The Pitocin should’ve been administered hours and hours before . My son was finally born, both of our bodies awash with adrenaline and cortisol. It would take almost 2 years for my body and my brain to recover. Honestly, I’m not sure how this type of experience effects children, I've not been able to find any long-term studies.
From labor, I had higher than normal blood loss. Blood loss of that magnitude does not replenish itself on its own .This was never addressed. Lab work was not done at my first postpartum visit. I was very much in survival mode, now I would’ve demanded that my iron levels were checked. At that first visit, I was sent home and told it was OK to have sex even though the pain from my episiotomy was excruciating. Being okayed for sex, not my health, seemed the whole point of my postpartum visit. So, I went back to work at six weeks and continued to breast-feed my son until he was 18 months. I felt winded when I walked down the hall. I thought that was how new moms were supposed to feel.
I knew prior to birth , that woman‘s symptoms and pain are discounted by the medical system. But I didn’t expect it to happen to me as a confident, privileged medical provider myself. I am able to communicate my needs to professionals but when a patient is vulnerable and unwell she can’t always advocate for herself. None of my privilege prevented me from having my needs dismissed. I hear stories all the time from women that bring a man to their doctor's appointment, or other important meetings, such as legal appointments, because they legitimately get more concern than if they went on their own. Unfortunately, this is still the reality.
The mythology around birth was fully at play for myself and those around me during my labor and postpartum experience. The story goes something like this. A woman’s body is just supposed to ‘know what to do’ during labor. Everything and anything she goes through is ‘natural’. Just as she’s supposed to know what to do during labor, her body will just ‘go back to normal’ after 6 weeks without any care or intervention. All of her symptoms are minimized, because of this, health needs go completely unaddressed. Serious issues are so common they’re deemed normal.
Has the situation gotten better since 2007? I think the only thing that has changed is awareness around postpartum conditions. Also, I think due to the ‘me too ‘ movement , I’d hope people are more aware of the fact that painful sex for women, no matter how common, is not normal or acceptable. One should never feel pressured to have painful sex to ‘ help the relationship’ whether that pressure comes from medical staff, family or a partner . Despite awareness, sadly, neither incidents nor severity of birth related conditions have not decreased.
*The reality is, every year at least 40 million women are likely to experience a long-term health problems caused by childbirth. The impact of birth trauma creates PTSD in around 17% of postpartum mothers. Like myself, those with a history of Depression and Anxiety , and a history of PTSD, are much more likely to suffer. Most fatal complications related to pregnancy occurred in the year AFTER baby is born. Because postpartum depression or postpartum anxiety can appear anywhere from a couple of weeks to 12 months after birth there’s no average length of time it lasts. If you’ve had postpartum depression before, your risk increases to 30% each pregnancy.
If you have a history of abuse, because of self worth issues you doubt your own reality, This definitely may get in the way of women seeking intervention. It took me a full two years to heal physically, 2 years to be able to sleep more than two hours at one time, and much, much longer to heal emotionally.
Research shows that women who have had postpartum depression, had increased rate years later for physical illnesses and increased rate of chronic diseases, acute diseases, other mental health problems, and an increased use of daily medication. (Effect of postpartum depression on women’s mental and physical health four years after childbirth.Abdollahi, Eastern Mediterranean health, journal, 1995.) Please note the date of this prior research article. There’s not enough research currently being done on matters of women’s healthcare.
Looking back, I know that family members noticed that I was not at all right. At one point a family member told me that I should go out and buy myself a new dress. Another one would politely offer ( more like insist) wine at family dinners. I would not have been offended if someone asked if I was OK, or suggested or even insisted that I should seek care. I think common convention got in the way of anyone checking in with me about my physical or mental well-being. Again the mythology of motherhood, and birth prevented good, well-meaning people, from listening to their instincts . This is why, whenever I see a woman postpartum in my clinic or personally, I ask her all the questions, regardless of how she looks.
I understand this is a heavy topic, but there IS hope. I think there is a movement of women, my age and younger, who are refusing to accept the mstatus quo, when it comes to their healthcare, along with other aspects of their lives. Women are becoming much more educated about all aspects of their health, we are making empowering decisions that reflect our own beliefs.
One really big bright spot has been the White House Executive Order on Advancing Womens Health Research , and Innovation. This is a big deal. First of all , $100 million is more than a symbolic gesture. The initiative is a reaction to, and an acknowledgment of the huge flaw in the medical system which is gender bias. Most research starts with mice and those mice are males. The females mice in labs are only used to breed more male mice. The more the public is informed the less acceptable these conventions become.
The first step is always awareness, and that starts with people sharing their stories. I’m not someone who likes to be seen as self-indulgent or self pitying. That’s not what my share is about. I just want women to feel safe enough to describe the authentic experiences, they’ve had in the healthcare system. We are not victims, we are survivors. Once enough of the stories are shared, I believe that reasonable person will become outraged and momentum will only increase.
Women are the caretakers of their families. Our physical and mental well-being extends to the health of our entire society. We shouldn’t need reasons to make women’s health count as much as men’s. However, some research shows the largest predictor of a child success is the rate of their mothers happiness. A child's success is less correlated with household income, school district, access to technology than it is with his mothers life satisfaction and well being. I believe positive change is on the horizon in the realm of women’s physical and mental health in all stages of their lives, and that women themselves will be the initiators.