Almost two years ago, I experienced a very traumatic birth experience that upended my entire world. At 19 weeks of pregnancy, I suffered a placental abruption (when a placenta separates from the wall of the uterus before birth) and eventually ended up giving birth at 28 weeks gestation. My son was in the NICU for 88 days and was hospitalized again for another month shortly after coming home.
The only mental health help that I initially received was a recommendation to go to a support group at the hospital and a prescription for SSRIs. The hospital support group was primarily for postpartum depression; I was the only preemie mom in the group, and was dealing with some very unique issues. I stopped attending after my son came home from the hospital because I had new things to deal with, like his oxygen tanks and his monitors that falsely alarmed every few minutes, sending my husband and me into a panic.
Eventually, I sought comfort the best way that I knew how: I returned to using drugs and alcohol to self-medicate what felt like a seemingly hopeless situation. When I returned to recovery fellowships after having not attended for close to five years, I realized that my situation was not unique. Mother after mother who I spoke with recounted similar experiences — many of the traumatic births were directly related to their substance use, though some were not. However, a disproportionate number of women who I spoke with had suffered some sort of a traumatic birth.
Having a traumatic birth is a complex issue, without factoring in also having a mental health disorder and a history of substance abuse disorder (SUD).
Unfortunately, this isn’t something that we normally talk about. Sure, sometimes you hear stories around the rooms of recovery fellowships about mothers whose baby suffered some sort of complications and mothers who have lost their children, often due to many of these complications. But I wanted to learn more about women’s experiences with birth trauma and the impact that had on their recovery, as well as their overall wellbeing.
Raquel was heavily using at the time that she got pregnant. “I wasn’t getting a period, so I had literally no idea that I was pregnant, or that I could get pregnant. I hadn’t gotten my period in like a year, year and a half. When I was getting high, I was just very nauseous and sick all the time, and then my belly started growing. I was like, okay, I might be pregnant.” Soon after, she checked herself into rehab, and they did a pregnancy test. She was pregnant.
After about 60 days of treatment, Raquel went into preterm labor. She told her counselor, and an ambulance was called. “The thing that bothered me the most was that the nurse and the doctor had treated me as less than human. The doctor — because I was a heroin abuser as well — made comments like ‘oh, you know I’m not going to be able to get an IV in you.’ She made other comments about addicts, too. They weren’t treating me well.”
It was too late for a steroid shot to speed up lung development in the baby (a common procedure for preterm labor) because the baby was almost out and was breach, so Raquel had to have an emergency c-section. She didn’t get to see her baby for three days. “They didn’t try to get me in a wheelchair and bring me down to see her or anything like that. It was my first birth and I wasn’t ready to get out of the bed to walk. Everyone got to see her before me. She was on a feeding tube and a ventilator, and she was really, really tiny. I was afraid for her life and I thought she was for sure going to die. I didn’t find out until years later that cocaine abuse causes premature rupture of membranes.” (What is commonly known as your “water breaking.”)
“When the baby was in the hospital, I remember feeling very afraid, very alone, super paranoid. Couldn’t sleep at night. They brought me a picture book of success stories of babies who had been preemies and showed them at three or four years old being happy and healthy. That’s what got me through.”
She didn’t get to see her baby for three days. “They didn’t try to get me in a wheelchair and bring me down to see her or anything like that.”
When I asked Raquel if that was when she got sober, she said, “No, so what happened was after I had her, it was such a crazy thing because no matter how bad that experience was for me, I was traumatized by it and I didn’t want to go back. I fell into a deep postpartum depression and I had no friends. I was trying to be in recovery, and I felt miserable. I loved her, but I couldn’t stay away from the drugs. I ended up using again from the depression.”
Raquel used again about three and a half months after she had her daughter, and she got sober six months after her daughter was born. “My last bottom was when she was a little, little baby. She had breathing problems where she couldn’t catch her breath. Here I was getting high, and she had an episode and my significant other came banging on the door, and said that she could have died.”
This was when Raquel got sober. “I have definitely forgiven myself through the amends process. I have learned that I have been making amends to my daughter for what she went through and the harm that I caused by not being a good mother to her. I am responsible for my recovery and for being a good mother today. And that’s what I’m doing.”
Raquel has been sober for six and a half years now. “I’ve heard in recovery, you have to get clean for yourself. That’s not my story. I didn’t originally get clean for myself. I got clean for her, but then I ended up sticking around.”
Jessica ended up in Huntington Beach, California, in a very luxurious rehab. “I got there, and it was nothing like I expected. I told my family I was going on a road trip and I ended up in rehab. When I was nine months sober, I ended up pregnant, but I didn’t know I was pregnant. I found out that I was potentially pregnant three days before my birth.”
After setting an appointment for a dilation and curettage for what was a suspected ectopic pregnancy (when a fertilized egg implants outside of the uterus), Jessica ended up going into labor. “I was so uncomfortable, and I was in so much pain on the way there and they had to break my water — I call it skewered. They ended up taking my daughter to the NICU before I even got to see her. About 24 hours after giving birth, I was finally able to go and see her and, at that point, I had no idea if I was going to keep her or look at alternatives like adoption. I wasn’t sure if where I was at that point in life was suitable to take care of a child.”
At the time she gave birth, Jessica was a little bit over a year sober and the manager of a sober living house that was affiliated with the treatment center she went to. “My recovery was more fun — I wasn’t in a very strict sober living or rehab at that point and I had the freedom to do whatever I wanted. At one point I was like, okay, I’m done. My addiction was my past. Obviously, there’s another plan for me than to live in sober living forever.”
Jessica ended up keeping the baby. The doctor’s estimate was that the baby was born at 24 ½ weeks, a micro-preemie. Her daughter ended up coming home from the hospital at 8 weeks old. Shortly after coming home from the hospital, she had a respiratory infection and was admitted to the PICU, “My recovery was not my priority, but once my daughter was a little bigger, if I had a meeting, she had a meeting.” Jessica moved back home.
“My recovery was not my priority, but once my daughter was a little bigger, if I had a meeting, she had a meeting.”
When I asked Jessica if she had any PTSD around her experience, she said: “I think I still do to this day. I think I’m overly cautious because she had so many issues in the beginning. At any time, anything comes up, I’m afraid it’s because she was so little and I didn’t take the proper care of myself when I was pregnant. I put the blame on myself for not knowing that I was pregnant. I’m really good at masking how I handle things. I’m really good at pushing them back and not realizing at that point that’s not okay. I definitely latch onto unhealthy relationships because I still so badly wanted to have connections with people. Being a mom, not knowing I was pregnant, and a drug addiction isn’t a good rap sheet. I submerged myself into unhealthy relationships with men and maybe not the best friendships either because I so badly wanted to be a part of life again.”
Jessica ended up going to therapy after having her daughter, “I still talk with my therapist every now and then — it’s not nearly as often as it was. For the first year, I had a weekly or every other week appointment. At first, I was only venting, because I wasn’t comfortable talking to a lot of the people I was around. The therapist said, ‘hey, it’s okay. You’re learning as much as she’s learning’.”
Jessica’s daughter is four years old now, and healthy and strong. Although Jessica no longer attends recovery fellowships, she is still sober and has thrown herself into being a mom, but she takes time for self-care, too. She says that taking time to herself allows her to be a better mom, so she often goes hiking or out with friends.
“Motherhood is the greatest, as well as the most difficult; it’s not about me anymore and it’s taken me a long time to find that balance between my wellbeing and my daughter’s wellbeing.”
Rachel says that her birth was not traumatic due to physical trauma but because of Child Protective Services (CPS) involvement. Her daughter was born with neonatal abstinence syndrome (NAS) and was admitted to the Neonatal Intensive Care Unit (NICU) at birth. Rachel had been using opioids throughout her pregnancy, which can cause NAS, “I remember feeling betrayed because I was open with my doctor about what I was doing. It started out that I had back pain and my daughter’s father gave me Vicodin. I told her, and she asked if it helped, and she would mark something down. She once made the offhand comment that I should think about quitting before the baby was born. Obviously, I knew that it was wrong, but I didn’t think about how the end result might be that she would be taken from me.”
A social worker came in three hours after the birth and told Rachel that her daughter wouldn’t be going home with her, even though her doctor had never mentioned to her that it was a possibility. “I was curled up and I was crying. The social worker reminded me of a bulldog in her stature, and she was so cold.”
Rachel’s daughter ended up going home with her mother, who stepped in and got licensed to be a foster parent. Rachel went straight to treatment after discharge from the hospital, “Aside from the situation itself, I also had some postpartum depression going on and was very suicidal.” She stayed in treatment for about a month.
“I was curled up and I was crying. The social worker reminded me of a bulldog in her stature, and she was so cold.”
Although Rachel doesn’t recall her actual birth to be traumatic, she did have some issues with the birth that weren’t addressed until she was in treatment. “When I was giving birth to her, there was some kind of issue where she was stuck, she wasn’t coming out and they ended up having to use a vacuum. I tore. I didn’t realize for weeks after, I was in so much pain, and I was in rehab at the time. I thought it was normal. Three weeks into rehab, they started thinking there was something wrong. I was running a fever and I had to go to the hospital.” At the hospital, they discovered that the doctor had left a sponge inside of Rachel, and that she had an infection. Her mom, who has had multiple home births, said after the fact that she had never seen so much blood at a birth, it was everywhere, and she was sure she was going to hemorrhage to death.
Rachel’s recovery was also hindered by her relationship, “It was made harder because my daughter’s father was still using, and we had to take parenting classes and check-in with the court.” She said that every time she came home, he would be high. “You can tell when looking at someone when they’re in it. It was a lot of work, it was a lot of classes, and meetings, and fighting with her father.”
At six months, Rachel’s daughter was able to come home, “It was supposed to be a lot longer, they anticipated a year or two. We went in for court on the last court date and wanted to ask for unsupervised visitation. The judge said she could come home with [me] today.”
Rachel isn’t with her daughter’s father, and she says that her daughter has a strange relationship with him. Rachel is also still sober. “Once she came home, I kind of closed that whole chapter. I haven’t used again since then and I’ve just kind of devoted all my time to being a mom, and I haven’t looked back on it. Even just bringing it up now, it’s still emotional. I wouldn’t think after twelve years I would be emotional about it, but all those feelings come back.”
When we talk about birth trauma and addiction, we tend to mostly focus on the babies. Babies born with abstinence syndrome. Babies with lasting complications from pregnancy. Babies whose mothers are using at home. How often does it occur to us that in order to help the babies, that we also need to help the mother?
When I did the interviews for this piece, what really stood out to me is how alone we all felt navigating this experience. Every single woman that I interviewed reported to me that she felt very alone, and very frightened. I felt the same way.
A 2010 study of NICU parents found that 32% of parents studied met the diagnostic criteria of acute stress disorder, and 15% of mothers and 8% of fathers met the diagnostic criteria for PTSD. Also, 39% of mothers met the diagnostic criteria for postpartum depression. Another, 2009 study found that women who have substance use disorder have higher rates of postpartum depression.
One thing that I can attest to is that my return to recovery has allowed me to connect to other women who feel the same way, and who have been through the same thing as I have. Talking about our traumas is very healing, and part of the pathway to self-forgiveness. It’s only through our shared experiences that we can heal.