Multiple Stressors: Lauren’s Postpartum Story

Before Lauren put all of her focus on her children, Lauren was focused on her body. She participated in national figure competitions; her strenuous workouts and diet were her main concerns. Her body was a masterpiece that she had carefully and painstakingly crafted. However, after trying to conceive for 18 months, a doctor at a fertility clinic told Lauren her rigorous workout regime might be affecting her fertility. Her body fat was so low that she’d stopped having a period.

Lauren

Even after stopping her fitness routine, Lauren and her husband of ten years still needed to try an intrauterine insemination (IUI) and fertility drugs to get pregnant. The couple purposely did not use Clomid, which often results in multiples. “I didn’t necessarily want twins,” Lauren said with a good-hearted laugh. They got pregnant on the first IUI try, with twins. “We were floored since they told us we only had a 5% chance of conceiving twins.”

Lauren’s journey began, and looking back on it, she realizes she had anxiety throughout her pregnancy, but at the time, she had no idea. “When I think about my whole pregnancy journey, it was the perfect storm. My husband and I had been married for ten years and been able to do our own thing, and we had no clue what we were headed for. Our life totally turned upside down.” Lauren is a NICU nurse, so she is surrounded by babies with challenges at birth, and those worries prompted a lot of anxiety. Also, at the 18-week anatomy scan, they were unable to identify a nasal bone on one twin, which is a hard marker for Down Syndrome. “They couldn’t find the nasal bone at 20 weeks, 27 weeks, and they kept on telling me every time what it would mean.” It meant having a child with special needs. Lauren worried from 18 weeks until delivery about this twin’s health. “I remember lying in bed at night, scrolling through Google, looking for stories of women in similar situations and I would grasp on to those stories.”

At 32 weeks pregnant, Lauren developed preeclampsia and went on bed rest. Then at 34 weeks, she had an emergency C-section due to her blood pressure spiking. The babies were a month early. However, the C-section went smoothly and Lauren remembers being “relaxed and calm.” In her mind, “all my problems would be solved” once the twins made it safely into the world.

lauren 3

Looks can be deceiving. No one would know underneath this beautiful woman’s smile were all those worries.

However, an onslaught of physical and mental symptoms were about to begin. For most women, delivery is the cure for preeclampsia, but Lauren’s blood pressure spiked three days postpartum, right before she was to go home from the hospital. She ended up in the hospital for seven more days. She’d also needed two different spinal taps, which caused her back spasms and the inability to sleep. “I’m thinking the girls are in the nursery, so I’ll be able to sleep. Oh my gosh, no.” Lauren took medication to sleep in the hospital, but whenever the nurses came to check her blood pressure, “I would be so nervous about what it was going to be that I couldn’t sleep.” Insomnia was already beginning for Lauren, and it would be one of the most difficult hurdles in her recovery.

Lauren’s anxiety began to intensify. However, she was very good at covering it up. “I was in denial.” At all of her postpartum blood pressure checks, “I was in such deep denial that I’m not sure anybody could have picked up on it. I put a smile on my face. When I was out and about with my girls, I put on a show.” Once she was home alone, she became a very different, very anxious new mom. She answered the PPD screening questions dishonestly at her doctor’s office, as many women do. She didn’t want to admit to herself or anyone else that there was a problem, not after all she’d been through to get pregnant and get her daughters home from the hospital. Lauren is a woman of extreme self-discipline, a woman who could squat with 135 pounds and chest press 80 pounds. She should be able to handle this, control this, is what she told herself.

Lauren had “all the support in the world” between her parents and in-laws. However, at about four weeks postpartum one of the twins became colicky, and no matter who helped Lauren, she could hear the baby screaming: “I was upstairs with the door closed and the fan going and I could hear her wailing.” The inability to rest turned into the inability to sleep at all. The combination of colic and insomnia sent Lauren over the edge.

At her worst, Lauren went four days without any sleep, and she felt hopeless and “like she was dying.” Many of Lauren’s panic attacks would happen during restless sleep, and she would wake up short of breath, thinking she’s slept a few hours, but it would have only been fifteen minutes. Racing heart, vision changes, and pressure on her chest were some of the symptoms she would wake to, which caused her to be “incapacitated.” Her husband had to take on all of the feedings and care of their daughters, and Lauren still feels guilty about this time and struggles with feeling like she has to “make up for it because I was not present when they were so little.” The effects of postpartum mood disorders stay with women long after the acute symptoms are gone.

Eventually, Lauren ended up in the Emergency Room (ER). When she got to the ER, Lauren was in the depths of a panic attack. At this point, her OB had already prescribed her Zoloft and Xanax, prior to a 60- hour stretch of no sleep, but nothing helped Lauren to sleep or slow down her panic. “I think that was part of my panic, thinking ‘If this can’t help me, nothing can.’ I’m taking all this Xanax, and I still can’t sleep.”

The ER changed all of her medicine and they gave her Klonopin. Lauren still couldn’t sleep, but she was finally calm enough to have a conversation, and the psychiatrist asked her the hardest question: “Do you feel like you need to be in the hospital?” Yes, she needed help, but she also needed to be home with her girls. This was at just eight weeks postpartum. Lauren said she didn’t want to stay at the hospital, and they couldn’t involuntarily commit her because she wasn’t having suicidal thoughts. Her instructions were to try the meds through the weekend and then she had the appointment with the outpatient clinic on Monday.

Lauren remembers thinking if I can just make it to the next thing (appointment, support group, medication), that’s going to fix everything. And she had to think this way. She had to think someone or something was going to work, or she would just stop trying. But the wait, just a few days, from her ER visit to the perinatal clinic was hell. Lauren cried hysterically through her entire appointment at the outpatient clinic. However, there weren’t any beds available, so instead of being admitted, the psychiatrist made yet another medication change. Lauren then faced another two days of hell, insomnia and panic attacks, until the psychiatrist called to check in with her. After just speaking with Lauren for a few minutes, the doctor knew Lauren had to be admitted to the inpatient clinic. The doctor made some calls to the clinic and secured Lauren a room. At this point, Lauren had lost the ability to think rationally, to hold a conversation, to eat, or function at all.

During these weeks when anxiety and insomnia hijacked Lauren’s brain and body, she felt like she’d made the biggest mistake of her life–having kids. She’d lost all confidence in her ability to mother. She remembers telling the doctors, “If I don’t sleep, I’ll die, and that would be best for my girls.” But the doctors and nurses at the UNC Clinic worked tirelessly to help Lauren. They had to observe her closely and tweak her medication many times before she began feeling better. But she did. She left the clinic knowing she wanted to be present in her girls’ lives and that she was on her way to recovering. Yet even after the medicine began to work, and Lauren began to understand those thoughts were just her anxiety talking, she still had to work for a long time to gain back her confidence as a mother. It was a long road.

Lauren’s girls are almost a year old now, and she is in a place where she can enjoy them. Life isn’t perfect, but if she has a bad day, she can bounce back. And resilience is the touchstone of motherhood, and Lauren’s story.

Lauren 2

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