In celebration of The Hills: New Beginnings returning to MTV, I wanted to share a special story from one of my longest and dearest friends, Dr. Jennifer Dunphy. You may have heard of her back in her heyday when she was formerly known as "Jen Bunney from The Hills." Despite what you see on the reboot of The Hills today, much has changed for Jen since then. Not only has she successfully completed her PhD making her a doctor, but even bigger, she recently became a mother. But the road to having a baby and recovering from childbirth wasn't easy. In fact, Jen would agree that her work on her doctorate and as a top executive at a major healthcare firm seemed like a walk in the park compared to her initial introduction to motherhood.
Today, I wanted to share her birth story that reflects both the beauty of childbirth but also the difficulty that sometimes follows labor and delivery. Her story is here to elucidate the things that often go untalked about. But not today.
Similar to Jen, as you will read in her story, I suffered from postpartum depression and anxiety. A story that you can read here. While both of our stories are entirely unique in their own right, we hope to make it clear that postpartum trauma is real, happens more often than you think and comes in a multitude of forms. Not only that, but it is something we hope can be discussed openly - both individually by mothers and collectively by healthcare organizations. Personally, I had very few tools to deal with my postpartum situation that ensued six months post delivery, which included a loss of vision, panic attacks, insomnia, migraine headaches, depression and anxiety, all wrapped up in an inability to care for my two young children. Partner that with doctors without answers, and it can leave a new mother feeling very vulnerable when she is already in one of her most vulnerable states.
Coming from two women who had relatively uncomplicated, low risk pregnancies, and then to be faced with life-threatening symptoms and zero answers, we hope more stories can be shared. Not to place more fear around labor and delivery and the aftermath that may follow, but to educate women for preparedness in hopes of achieving more answers, and also so that women no longer feel alone. Again today, I share Jen's story. In her words. Buckle in!
Jen's Story: In Her Words
I just texted my best friend, “Wow. How intense having a child is should be a PSA”. Spoiler alert on my labor story… I had a hard time. I always knew about post partum depression and what signs to look out for, but no one ever, not once, mentioned anything about post partum anxiety. Nor, did they mention that there is a difference between normal anxiety that you may suffer from in everyday life, even bad anxiety, and what I like to call the post partum apocalypse. I have grown into a fairly private person, but because of the severity of what I perceived my experience to be I decided to share it.
The first thing you should know about post partum anxiety is that the symptoms closely mimic life threatening symptoms. So, when you experience a “panic attack”, you generally are experiencing symptoms, which if you have after delivery, probably do warrant a trip to the emergency room just to make sure. It also makes having post partum anxiety TERRIFYING, because it could ALSO be heart failure or some other very serious condition during a very high risk period for moms. Thus, you basically have your anxiety and then anxiety about your anxiety.
I had to be induced as I was quickly approaching 42 weeks without a lot of progress in dilation , I had no major complications during my pregnancy other than some very bothersome nausea/migraines. But, at the end of the day although it was uncomfortable I was healthy and the baby was healthy as I was going into labor. I felt very lucky to have gotten through my ~ten months of pregnancy with a healthy baby and with none of the scary conditions some of my friends have had like pre-eclampsia. I didn’t want to be induced as I felt GREAT in my third trimester (much better than the first or the second), but it was time because studies show that the risks go up (for both mom and baby) if the baby doesn’t come before 42 weeks and so I was 41 and 3 days scheduled for my induction.
On my way into the hospital I started to get really nervous not knowing what to expect and I remember the thought flashed through my mind, what if I don’t come back out. We checked in and they made us wait an hour and then go back home because someone had taken our room who was 7 cm dilated (I was zero). Fine with me! Finally, they called us back in at 11 pm on February 28th 2019. We were admitted to L&D and my goal was to remain relaxed as much as possible. Still, I started trembling uncontrollably once we were back at the hospital and wouldn’t stop full body shaking for the next 30 hours.
When we arrived they checked out the baby in the first room to make sure he was good and he was doing GREAT, they said they rarely see a baby heart rate and ultrasound look so good at almost 42 weeks. This gave me a lot of (false) confidence. They transferred me to the delivery room and hooked me up to the IV’s, they also started my antibiotics because I was GBS positive. This was no big deal for me, I don’t love needles but I also am not a scaredy cat and have a high pain tolerance. After that they gave me the pill to start labor called cytotec--the nurse told me its a very common first step for inductions, and hardly has any side effects….she said it would take 4-12 hours to work and start dilation by instigating mild contractions. They gave me the pill and told me to relax. I took the medication--down the hatch--and told my husband to start a movie for us so I could calm down and relax and get into this experience which seemed like it would be a long haul since I was 0 cm dilated. I was feeling good and ready to get the show on the road. This whole induction thing wasn’t so bad so far….
Within about 5 five minutes I started feeling sharp pains, I told my hubs, I feel something weird it actually really hurts. Since I have a pretty high pain tolerance I thought this was odd, but maybe my body was just adjusting. The pains continued and I tried to distract myself with the movie. All of a sudden the nurse rushed into the room and called for help. They tried to act calm but I could tell something was wrong. I couldn’t IMAGINE what, my baby and I had been healthy together for 10 months what could go wrong NOW?! She said the baby is in distress (heart rate was too low for too long a period of time) and is not tolerating the medication you took. I started very frantically asking questions about why, and she basically told me to shut up because we need to concentrate and fix the problem. She asked me to lay on my left side and take deep breaths. It wasn’t working. I was starting to hyper contract (very fast and hard contractions)--this was a very odd reaction to a medication supposed to cause only mild contractions and dilation over the course of 12 hours. Then, I was told to get on all fours and they gave me oxygen. At that point, facing the wall on all fours in my hospital bed breathing in oxygen from a mask I figured I was just seconds away from getting rushed into an emergency c-section to save the baby. I told myself that the only thing that mattered was getting the baby out in time and to do whatever was humanly possible to make that happen. Then they told me they had to give me a shot to reverse the effect of the pill and stop the contractions. They gave me the shot in my butt while I was still on all fours--within what seemed like seconds the baby stabilized with normal heart rate. Thank god. However, the shot made my heart go very fast and I started throwing up and got really sick (a small price to pay my baby was okay) I was shaking so badly it was like I was convulsing. To put this in context, this was only about fifteen minutes into my labor experience. Needless to say, I was off to a rocky start. I believe this experience was the start of my anxiety and I never really was able to relax after that--for months.
The rest of the labor went by pretty seamlessly, but I will give a quick summary. I wasn’t dilated at all, so I had a doctor attempt to thread a foley balloon--which actually WORKED. They also started low dose pitocin and within 12 hours I was dilated to 5 cm. At that point, they decided it was time to progress the labor and break my water (which I was not looking forward too). I haven’t mentioned pain because I wasn’t in any (really, it was weird). I know I have a high pain tolerance but I did not expect zero pain. Sure, I was a bit uncomfortable, but I expected pain like in the movies and I was ready for it but it just didn’t come.
When they came in to give me epidural the anesthesiologist asked me to rate my pain level 1-10, I told him 1 and he asked why I wanted it. I had heard things really pick up after getting the water broken so I decided to go ahead and get it since I was afraid of how bad it would become after the water was broken. The epidural was truly painless and the drugs made me numb legs down as expected. The OB came in not five minutes later and broke my water, which was also completely painless, and then they inserted a catheter and an internal contraction monitor so that they would know how high to put my Pitocin dosage. From there they upped my pitocin so that my contractions were exactly the interval apart that they wanted. After a few hours of this, post water breaking I started to feel some pain and had to push the button to up my epidural a few times but it was honestly no big deal and I could have been fine without more meds I was just getting more uncomfortable and my discomfort seemed to be coming with less time of relief in between. The nurse told me to press the button because she said when the pain starts and people want relief the meds often “can’t catch up” to the pain. I didn’t want that to happen and had no idea how bad it was going to get it, so I PUSHED THAT BUTTON! At this point about 27 hours in I was STILL shaking uncontrollably and all they would give me to calm down and rest was a low dose of benedryl. Even so, I did not sleep the entire labor, not for a minute.
The nurse said if you start to feel pressure call me, so when I did she came and checked and I was 10 cm dilated! I pushed for about 30 minutes and a beautiful healthy baby boy was delivered on March 1st 2019! I was SO relieved to be done, I couldn’t believe the baby was here and I wasn’t pregnant anymore. I was actually feeling good, my nerves finally, finally calmed, I was so tired I could hardly see, I just wanted to relax and when the baby came I was in shock/completely sleep deprived and just sort of stared at him. As the doctor was finishing up and the cord was cut the next ball dropped…
My OB told me I had started hemorrhaging. To stop the bleeding they had to give me yet another shot, they said it was different than the last shot. I remember telling the doctor I felt fine and ask if I really needed the shot, he said yes. I didn’t want it, especially after what happened last time. I obviously wasn’t tolerating these shots very well. This one was called methergen. About 5 minutes after I got it ,my heart started going very fast and I became to experience chest pain and overall I just didn’t feel right. Shortly after that I started throwing up, which doesn’t really happen to me personally unless I am very sick. It felt like my heart was going to beat out of my chest. I had never experienced anything like this before and to top that off, I was 29 hours sleep deprived. My blood pressure started going up and my heart starting skipping beats and I felt like I had just run a marathon (which maybe I had). I was scared I was potentially having serious cardiac complications. I kept asking them to check me out, and they kept telling me I just had anxiety and maybe they should call in a social worker. (WTF) Finally, at my husband’s request they did some blood tests to check for a heart attack including measuring troponins, and performed an EKG. (they also checked me for anemia) I asked for something to calm me down to see if that would help relax my heart rate and they gave me a little ativan in my IV which did seem to help. My values were elevated but not abnormal, and since everything checked out and baby was fine, they moved me into the post-delivery room where we stayed for two days. Everything was fine whenever they checked me out, the bleeding slowed, and I was cleared for discharge two days later. I was extremely tired and had trouble moving around easily, getting out of breath, but I figured that was normal considering I just had a baby. I was discharged on a Sunday and by Monday I definitely felt like something was wrong.
Back At Home
At home, I was having trouble doing simple things like going to the bathroom and going upstairs without feeling very out of breath and feeling the urgent need to sit down (like you just worked out as hard as you can and if you don’t sit down you will pass out). I would also get dizzy breastfeeding. I had pain when I took a deep breath, my heart rate was pretty high all of the time and I was having some high blood pressure readings (although no swelling). I also felt like I had fluid in my lungs or pressure (like an elephant sitting on my chest) whenever I bent down.
Back to the Hospital
Then in the afternoon the day after I was discharged I was breastfeeding and started seeing black spots and my heart rate accelerated out of nowhere. I took my blood pressure and it was 140/100 and my i-watch told me my heart rate at rest was 135. So I layed down and tried to calm down, lucky my mom was with me and my husband was around the corner running an errand. After about 3 minutes it got better and I sat up and then it started again. I thought I was going to pass out for the first time in my life my heart was beating so fast from no stimulus at all and my body started feeling like something was happening to it. My right side started to feel really weird like it was swelling but on one side only, my vision wasn’t right either. Since I was in such a high risk period and experiencing some pretty scary symptoms of which I had never had anything like before, I ended up calling 911. I thought I could have been having a stroke or a heart attack. The paramedics rushed in my house and all I could think of was, I really hope they save me in time. They told me all my vitals were stabilized and it was safe to get driven to the ER. My husband took me to the ER where they performed a series of tests including a chest x ray, CT scan of my chest, EKG, blood work and an echo cardiogram.
We weren’t actually expecting to find anything so when the ER doctor told us he thinks he found fluid around my heart we were shocked—this is called a pericardial effusion and CAN be life threatening, but not necessarily. It was horrible and my monitors were alarming the whole time because my heart rate and blood pressure were out of control. I had never seen my husband look worried before in his life and he did at that moment. Finally, the cardiologist came in to tell us more. The first thing I remember asking the doctor is I am not going to die right, and he didn’t answer me--just launched into what was going on. That also didn’t help. On top of that I knew that heart failure in pregnancy, of which I had all the symptoms, had a 30% mortality rate. I kept thinking my beautiful baby is only 3 days old, he needs me to survive. I don’t want him to grow up without a mom, I can’t leave him now. I kept thinking what bad luck this all was and I couldn’t believe this was happening to me. I even thought about telling my husband how I wanted to raise him and to bring him to me if I needed to be admitted to the hospital so I could see him one last time. At this point thinking I was going to potentially not make it multiple times in one day, and this all going on only 2 days after giving birth with hormones and sleep deprivation, resulted in me basically losing it. If you imagine a scale of flight or fight adrenaline with 1 being sleeping and 10 being going down on a burning plane, I was a 10.
My husband kept telling me I needed to calm down because we didn’t know what was wrong yet and this extreme anxiety could make it worse--that didn’t help. The next step was finding out how much fluid there was. The doctor said that if the fluid was too large, or there was hemodynamic issues (meaning the heart wasn’t beating right and the ejection fraction is too low) I would need to drain the fluid and have a heart procedure--right away. That next period of time , waiting to see what was going to happen to me, was the scariest of moment of my entire life. They did the chest CT and luckily, it showed the fluid was not causing my heart to function poorly and I could probably go home. Finally they decided I could come home to my baby and didn’t need to be admitted. No one wants to think about dying but I actually thought it could to happen to me that entire afternoon and evening. After that experience, I wasn’t able to calm down.
When I got home I was still on edge, I hadn’t had enough tests to know what was going on yet, and I still felt miserable. To be honest, the next few weeks were all a blur. After I got home, I couldn’t reset my system from extreme panic to normal. I refused to take any medication for 6 weeks because I wanted to breast feed and was scared about transferring any to the milk. The doctors asked me to monitor my blood pressure, which I was doing about 4 times a day. One person mentioned you don’t want blood pressure too high because you can have a stroke. So, every time I would take it I would get extremely anxious it was going to be high. I think it was a lot higher than normal but then it would go even higher whenever I would check it. This would then trigger an extreme panic attack. I was getting readings of 160/110 with HR of 166. This was not a mild panic. Once I was able to calm down the blood pressure would go low to about 95/60, so they never put me on BP meds. My body was more or less just completely freaking out and no one had any answers for me. Inside, I was still constantly scared I was going to die.
My next echocardiogram showed my heart was functioning normally and that the fluid had gone down quite a bit (but was still there). Still, physically it looked like things were okay. And maybe the fluid could cause a few of the symptoms, such as inflammation or chest pain. But, not all of them. After a few weeks, I finally got in to see a specialist who was both an OB and cardiologist well versed in these issues-- who said the fluid around my heart was likely caused by a virus I had at the end of my pregnancy or the fluids/stress/inflammation from labor and wasn’t dangerous to me. My other symptoms they never figured out other than I have a very sensitive system and my autonomic nervous systems was having trouble regulating the changes in fluids and blood pressure and therefore going a little crazy (of course no one tells you this is even possible when you hear what to expect after delivery). Of the six doctors I saw in person, and four others I consulted with over the phone everyone was stumped--no one knew what was causing my symptoms. But, the thing they agreed on was that they thought I was going to be okay--physically (so thankful). I was very relieved I wasn’t on the verge on heart failure, but still felt very off and I was caught in what I call a terror tornado. Every single day, with the sun shining and looking out into my garden on a beautiful day in a safe neighborhood I was feeling extreme terror. I was scared every moment of the day it was almost as if the calming center of my body decided it was going to go on permanent vacation. I was literally in abject terror from the moment I woke up to when I would go to sleep every day for weeks. Although my anxiety had a trigger—this experience I just described-- many with postpartum anxiety have no triggers at all and can have the exact same feelings. More than that it is quite common--much more common than society tells you. I hear so much about postpartum depression but I never even knew postpartum anxiety existed. I thought I was the only one going through this experience. I didn’t want to leave the house and did not want to be left alone with the baby in case I had another attack. I always felt scared and couldn’t relax no matter what I tried. This went out for about 5 weeks straight, day in and day out. My husband and mom did their best to take care of me but no one could understand how I could be doing so badly when the scary part was over--I was going to live, I might even be healthy. So, what was WRONG with me? I couldn’t really take care of the baby without getting a panic attack, my own baby. I couldn’t get up to change a diaper without feeling super dizzy and out of breath like I had to sit down right away thinking about even getting up to get something made me anxious. There was definitely a component of the physical recovery in all of this in that I was physically not myself, but the anxiety on top of it made everything unbearable. As the days and weeks went on and I kept expecting to feel better and when I didn’t I would get increasingly frustrated. I wasn’t bonding enough with my baby because I just felt horrible all of the time and spending time with him would peak my anxiety. Breastfeeding made my anxiety worse and the cycle would repeat itself with triggers everywhere. There would be glimmers of feeling back to normal and then something would trigger panic. It felt like getting caught in a rip tide and just when you were able to bring your head above the water to take a breath of air you were just as quickly pulled back under again. This cycle continued for quite some time and no one really knew what to do with me. I had people tell me to take medication, to stop breast feeding. But, I was stubborn and didn’t want to do either. So, I just let time pass. Finally, starting at around week 5 I started to notice that things were beginning to improve VERY slightly both physically and mentally. I could get up and not be out of breath and my blood pressure seemed to be slowly stabilizing. It didn’t hurt as much when I took a deep breath and I was getting my appetite back some. I also decided it was time to go on a little bit of medication and I started taking anti-anxiety medication at a very low dose which helped me sleep better and allowed my body to recover and my mind to gain the strength it needed. But, it wasn’t until ten weeks that I really felt any semblance of normality again and I still have anxious/bad days to this day. There is no clean ending to this story, I still have good days followed by bad days but I am significantly better than in those first six weeks. I really wish postpartum anxiety would have been discussed with me as a possibility. In fact, I didn’t even know it existed and when I did find out more about it the dialogue didn’t really expand beyond you may be prone to anxiety after labor. The resources say things like, you may feel irritable toward your partner, or nervous when going out to shop…not you may feel like you going to die every waking hour for approximately 42+ days…and not just kind of feel like you are going to die but actually fully believe you will not live (I didn’t see that anywhere!!!!). The extreme nature of postpartum conditions is played down. Further, there is hardly any differentiation from postpartum depression within any major information resources --but the symptoms are completely different. Postpartum anxiety can be severe and can affect you physiologically including dramatic swings in blood pressure, and heart rate. With more awareness we can get to a more rapid diagnosis and treatment. My baby is doing great, gaining weight and getting good reports from the pediatrician and the better I feel the more we are able to bond and the happier I think that he is. Looking back I would have started on medication sooner, but I know what would have really helped is knowing this exists at this level and talking to someone that had been through this experience to tell me that this isn’t completely crazy and it has happened to them, which is the reason I wanted to share my story.