For months now I have been crafting the posts to describe the experience of pregnancy after losing Kaitlyn. I tried writing them when I was in the thick of pregnancy and found I couldn’t summon the words. Now, eight weeks after the birth of my son, none of the words I have found seem adequate to describe the terrifying experience of pregnancy after stillbirth. I want you to know why I’ve written openly and honestly about this period. It is not to wallow, complain or over dramatise. It is not to be negative or stay “stuck” in grief or trauma. It’s for two reasons; firstly, to process what I’ve been through and secondly, to share it in the hopes of increasing understanding about what these sorts of pregnancies are like. Perhaps then we can start to offer better support to people in these situations. In a later post I will also talk about some of the things that did help me, and if that information helps just one other pregnant woman then it is absolutely worth the struggle to find the words. Because there is so much to say, I abandoned trying to tell a chronological story and fit everything into one enormous post; instead I have tried to cover different aspects of my experience in separate posts. This first one focuses on how trauma re-presented during this pregnancy.
Two words summarise the second half of my pregnancy – trauma and fear. To understand this, I ask you to focus on the word ‘fear.’ Take a moment to really absorb that word, let it roll around your mind and think about what fear truly feels like. Talking about ‘anxiety’ doesn’t come close; it was pure, visceral fear, a full mind and body response, like the kind you would feel if you came face to face with a sabre-toothed tiger. Imagine surviving a high-speed car crash and then being asked to spend 8 solid months strapped into a car travelling at 100mph with a drunk driver in control. It was 8 months of living in survival mode, pure adrenaline coursing through my veins even in my sleep, my body reacting to things that my mind couldn’t compute. Waking up in a cold sweat multiple times a night because I had been catastrophising in my sleep. Thoughts running away with themselves until I had forgotten where I was or what I was doing. From 28 weeks pregnant this was my life all the time, literally all the time. There was no relief. No amount of breathing, anchoring, mindfulness, talking to people, nothing worked to calm the raging, ever-present fear. And yet even these words don’t come close. I don’t know if I will ever truly be able to describe how it felt.
The first trimester was characterised by anxiety, which stemmed from having had a miscarriage at 8 weeks. I had scans at 6, 8, 10 and 12 weeks with a consultant that I trusted completely and had agreed to take on my care for the whole pregnancy. At 7 weeks I experienced bleeding, exactly as I had with Little Bubba, which was terrifying. Time passed in a fog of Kaitlyn’s first birthday and fundraising concert, followed closely by M’s birthday and Christmas. All this time I was taking a ridiculous number of pregnancy tests, checking for blood on every toilet trip, constantly searching for the faintest signs that we were going to go through another loss. I was convinced someone would ask me if I was pregnant and the idea of that made me panic; I desperately wanted to keep it a secret and was terrified of jinxing things by sharing our news. I found out about the pregnancies of several friends and was completely taken aback at my reaction; I had assumed that being pregnant would change the way I reacted to pregnancy news, but I was so wrong. I put this down to several things: firstly, in my world a pregnancy does not equal a baby, so being pregnant myself did not reassure me that I would get to bring home a living baby. Secondly, I feel panicky for people, because to me pregnancy is not automatically safe, it’s not Hollywood-esque and I worry that a good friend could end up living the same awful devastation that we have. Thirdly, I will admit that I feel jealous of other people’s normality. I wouldn’t wish my experiences on anyone, but I can’t help wishing that I was still normal too. And finally, I realised that I couldn’t handle the idea of being pregnant “with” other people again. When I was pregnant with Kaitlyn I walked my pregnancy journey alongside some very close friends but I came home holding a memory box where a baby should be. There was something extremely triggering about the idea of being pregnant alongside others; it sparked a deeply rooted fear that I would have to come home alone and once again watch others live the life I wanted so much.
There are key terms that have become part of my new trauma-related lexicon. A “trigger” is a reminder of the previous trauma that sparks a mental and physical reaction. At its mildest, which I came to call “Level 1”, this reaction was inside my head, I could cover up what it was doing to me but I probably came across as stand-offish and withdrawn as I tried to manage what was happening inside my head whilst holding a conversation. A “Level 2” response had me in tears, struggling to breathe and/or snapping in anger or frustration. And a full on, “Level 3” response was full dissociation, memories of Kaitlyn’s death overlaid on top of my present reality until it was impossible to tell whether I was sat in a room in 2020 or back in November 2018. Pregnancy announcements saw me swing between a Level 1 and Level 2 response. Level 3 was usually caused by a combination of things, for example having a blood test in a noisy environment.
Which brings me on to “overwhelm.” In the context of trauma, feeling overwhelmed means that my whole nervous system floods, my mind and body are unable to cope with the sheer amount it is trying to process, everything from sensory experiences (such as noise, which was a key trigger in my case) to imagined futures, memories of the past and the amount of adrenaline flowing around my body. In those times, everything becomes a trigger and sensory overload is a serious issue – the radio playing too loudly, too many people talking at once. These seemingly minor disturbances would have me in tears running from the Day Assessment Unit or snapping at my family to turn the damn TV down. Towards the end of my pregnancy I was seen by a newly established Maternity Psychology team and my excellent new therapist helped me to finally understand that what I was experiencing was genuinely as a result of PTSD. I wasn’t just an angry, snappy, person that could no longer be there for my friends or control my responses. It was a result of the trauma memories still sitting in the wrong part of brain. This was a real revelation to me and allowed me to let go of the guilt that was eating away at me. I had thought that I had PTSD under control because of the therapy work I had done previously and in my normal day to day life this was true. But being pregnant again had sent me right back to the start, like falling back down to the bottom of a well I had managed to climb halfway out of.
I think most people are familiar with the “fight, flight or freeze” responses. I found I was doing all three. My flight response was to completely withdraw from the world. As the weeks dragged on I stopped talking to people altogether. I hid away, covered by the Covid pandemic and height of lockdown. I stopped blogging, limited social media access and changed my privacy settings on WhatsApp. Most of all I refused to think about the future, living instead from one hour to the next. While this can be an effective way to manage anxiety, I find it restrictive and stressful as I am someone that needs to plan for the future. The future stopped stretching any further than seven days ahead. I didn’t buy any baby items, didn’t decorate a nursery. Didn’t think about what I might need postnatally, what recovery from a c-section might look like. In the final fortnight I bought one baby grow, one hat, one blanket and one teddy. My reasoning was that if my son died, I wanted him to have some special items that I had picked out for him just as Kaitlyn had. I couldn’t make this baby real to the world, in case the universe punished my audacity by taking him away.
My fight response was anger. It wasn’t always expressed but it flared up easily inside me, and when it was visible this was usually in the form of panicky tears or visibly shutting down. It was triggered most, I’m sad to say, by interactions with others, which is so often the way for people dealing with grief and trauma. When a midwife that didn’t know me suggested that I might not be able to come to hospital for checks during the early weeks of lockdown. Whenever anyone told me to relax or told me I had to enjoy my pregnancy. I struggled to describe my new world and therefore others couldn’t understand it; this was incredibly isolating and once again I felt trapped inside my own glass box, just like in the immediate weeks following Kaitlyn’s death. Some of this was about the way we view pregnancy in our culture. The conversation is slowly changing but for the most part we still struggle to acknowledge that babies die, especially later in pregnancy. Pregnant women are put under pressure to not feel anxious or low but to be glowing and happy all the time. I hope that one day we can acknowledge that being positive all the time isn’t natural for humans. Not being able to constantly look on the bright side doesn’t make someone a failure or a negative person; some battles are just too deep and too complex to be washed away in a blaze of rainbows. Having said all of this, I did enjoy being pregnant, in my own way; there was a golden nugget of hope wrapped inside the swirling fog of panic and trauma and grief. I had fought and struggled for this and I was grateful for every single day that passed safely. I bonded with my baby from the start, despite the constant fear of his death. But this tiny hope felt precarious and terrifying, and so the enjoyment I felt didn’t fit the normal paradigm, it wasn’t visible to others and I repeatedly tripped over my own tongue when I tried to explain how it felt.
My freeze response was a complete inability to make decisions. Some of these decisions were complex and came with significant consequences. I will ask myself for the rest of my life whether I did the right thing by delivering at 37+2, whether it was too early, was a c-section the right thing, should I have allowed him to arrive spontaneously? All my previous experiences crashed into each other in my mind – my NCT poster birth with M, spontaneous labour at 39+6, 9 hours at home, no drugs and a water birth. Kaitlyn’s death. How the hell could I know which path we would go down this time? There was no safe milestone in my pregnancy; however far I got, the riskiest and most terrifying time still lay ahead. Weighed against these worries was the huge looming risk that I allowed my pregnancy to continue and my baby died as a result. At 36+2 I went to hospital in such a panic that it was recommended I spend my final week in hospital. I froze in a haze of indecision, with my baby’s survival on one side of the scale and M’s mental health, already impacted by 3 months of lockdown, on the other. I was caught like a rabbit in headlights and in the end my midwife made the decision for me (gently and with my permission). In my life before I was a competent and decisive person. Now I felt the weight of every single decision sitting too heavily on my shoulders. This was made so much worse by Covid and having to go to everything alone, make decisions alone and M not being able to visit while I was an inpatient. S did his absolute best, but relaying everything to your partner on the phone or back at home is definitely not the same as having them there next to you.
The hospital was a minefield of triggers setting off the fight, flight and freeze responses. We had carefully considered attending a different hospital this time but everywhere else was so far away and I was worried about having to drive for an hour every time I needed a check up. Every physical space was a tangible reminder of all that had gone before. For antenatal clinic and the Day Assessment Unit I would be sitting in the very same waiting room that I sat in just before finding out Kaitlyn died; she may even have died while I had been sitting there. I began to feel not only that it was a terrible reminder of the past but also that it was a cursed space. One time I distractedly sat down in the very same chair I had sat in when I was having contractions with Kaitlyn; when I realised, I leapt out of it again as if it were on fire. For some reason in that part of the hospital the radio is always blaring, and it is full of advertising from photographers in the form of cute little newborns plastered all over the walls. These things are dreadful and unnecessary trauma triggers. Due to Covid the clinics temporarily moved to a different floor of the building…right into the area where we heard we had lost Little Bubba and then gone for surgery the next day. Out of hours care was the worst – up to the second floor, walk past the entrance to the bereavement suite, through the postnatal ward full of beaming parents and noisy newborns, through the delivery unit full of labouring women and into antenatal, where you might end up opposite a woman going through an induction of labour. It felt like running the gauntlet and I was emotionally drained by it. No part of the hospital was safe and the constant triggers were completely overwhelming.
These survival responses of fight, flight and freeze serve an important purpose; when faced with the sabre-toothed tiger, they initiate helpful behaviours designed to keep us alive. But we are only designed to live in survival mode for short bursts at a time, not day in day out for 8 months. By the day of the birth I was exhausted and depleted in every possible way and I had become so triggered by a simple blood test or injection that I had no idea how I was going to get through surgery. In the final weeks leading up to the birth, my fantastic new therapist worked with me to put strategies in place to prevent further trauma occurring during surgery. We focussed on management of symptoms, rather than treating the root cause of the trauma. We put breathing and grounding techniques in place that I spent weeks practising and, with the help of two amazing midwives that cared for me throughout, used during the c-section. We made a trauma birth plan, detailing the most common triggers, what people might see when I was triggered and how they could best help me. Every time I felt the panic rise during the c-section I managed to keep it under control using the techniques my therapist had helped me with.
Looking back on the surgery I am so relieved that no further trauma occurred, partly because the outcome was a happy one, of course, and partly as a result of the preparation work we had done in therapy. This experience highlights once again the importance of skilled and effective mental health support in recovering from birth trauma; so many women go through subsequent pregnancies without any decent support in place. I was very lucky that the new psychology service opened when it did, but protecting people’s mental health shouldn’t come down to luck. When we think of PTSD we think about soldiers at war or survivors of major disasters; PTSD as a result of pregnancy loss or birth trauma is still poorly understood, though thankfully this is slowly changing. The effects of trauma reside within your body and physically inside your brain, therefore cannot simply be thought or medicated away. My therapist explained that in trauma, memories become stuck in the wrong part of the brain. There is a malfunction in the way the brain processes emotional memory, which literally changes the neuro-circuitry of the brain. This is what causes symptoms such as being triggered (or “hyper-arousal”) and avoidance of everything, from physical reminders to your own thoughts and emotions. Now that I’m no longer pregnant these symptoms have calmed down significantly but they are still there, so there will be ongoing therapy to start finally addressing the way the memories of Kaitlyn’s death and birth have been filed in my brain. It will be hard, upsetting work, but necessary if I want to really reclaim my life. After almost two years of heartbreaking grief and an extremely traumatic pregnancy, I am ready to regain some normality, joy and stability – in fact I crave it. I will never, ever leave Kaitlyn behind, grief will always be part of my life and Kaitlyn will always be present and never consigned to my past. I will always speak her name with pride and love. But I finally believe that I do deserve to feel happiness again, and all three of my children deserve that too. After all, I cannot best serve Kaitlyn’s memory and legacy when I’m ruled by PTSD.
Despite everything I’ve written here, I look at my perfect boy sleeping peacefully on my chest and know that every second was worth it. Every panic attack, every tearful night, every rushed drive to hospital. Deciding to try again for a baby after losing both Kaitlyn and Little Bubba felt like stepping off a cliff and praying I would fly, and with our darling boy here I can now say that I am glad we were able to step over that cliff edge. This feeling of gladness doesn’t negate the trauma, doesn’t make it ok that pregnancy had to be that way this time. Trauma and grief and gratitude all exist alongside each other, and once this next lot of therapy is complete I really hope to add true joy to that list too. Thankfully for us it was worth the battle to get here and I would do it all again to bring home the baby we so desperately wanted and now have the privilege of cherishing.
A Keepsake for Kaitlyn 