Is this PPD?

I've been medicated for depression since 2001. I was taken off them before I got pregnant with Alex, and stayed off them until she was weaned at 27 months. I was taking them until I got the stomach flu at 10 weeks pregnant with Atticus and couldn't keep anything down. Knowing I have a history of depression, I have been seeing a brain care specialist for months now and everyone is monitoring me for Postpartum Depression (PPD).

I'm not sure, but I think I'm coming down with it.

Everyone, medical, thought I was doing really well. I haven't had an appointment to see anyone in nearly 2 weeks. This week, I feel like I'm falling apart. I'm not sure what happened...

I'm still doing the good mommy stuff. He's got clean diapers, no diaper rash. Feed on demand - started feeling guilty about the pacifier, so we're nursing more (An author I read recently described nursing as being nibbled to death by caterpillars. I enjoy it more than that, but I can see the comparison). Feeling guilty about not pumping, so I haven't put it away. It's still here in the living room. Staring at me.

My nipple actually split the last time I used it, so I have to get my guts up to put it to my breast again. The split has healed; but there's nothing like watching blood and milk getting sucked out of your body, threatening to contaminate the precious half ounce you did manage to pump over the last 40 minutes... Yeah. Pumping and me still aren't buddies. Alex was well fed. She was 90th percentile for length and weight, she was constantly nursing, and I could get maybe half an ounce after pumping for 30 minutes. Atticus... our nursing relationship is weird - I'll blog it later, but I'm sure it's feeding into this PPD thing. And the pumping is even harder this time.

Without a supply of milk for him, I have to take him everywhere. That includes class. My professor is really sweet about it. When Atticus was really wee, he'd sleep and nurse through class. As he's getting bigger, he's less quiet and our nursing relationship is more fraught, so I take him out of the room to nurse. I'm missing class. I'm so embarrassed. I know my course grade is suffering. But at least my professor let me stick it out.

Since Atticus was late and I got mastitis the second week, I missed the first two weeks of class. The other course I was enrolled in, I was told to withdraw. I had already missed too much. Since I was no longer on track to get all my coursework done, I am no longer graduating in May. I'm taking two courses in the spring and another two in the fall. Because I am no longer enrolled in the correct number of courses, some of my financial aid has been withdrawn. I can't make rent in December.

The financial aid thing is a bummer. Since Bryn and I got married (I kind of waited to marry him because of this), I'm not sure how eligible I am for financial aid anymore. I filled out my last FAFSA before we got married, and now it's not my last FAFSA. Keep your fingers crossed for us, folks.

Money shouldn't be that big an issue. Bryn is working darn near full time now. The hourly rate isn't awesome, but it's more than $10/hour and more than 30 hours per week. It's not much, but we can make it through - we get food stamps. We get more food stamps than I think is ethical, but we manage to spend every cent every month. On top of that I get WIC. But money is an issue. Alex's child support isn't getting paid, so I have absolutely no money in the bank. I haven't for months. If I need money, I have to ask Bryn. I can't so much as treat myself to a cup of coffee in a nice cafe. I can't get Alex new shoes. I can't get the oil changed in the car. I can't pay the gas bill or the electric. I can't do anything without asking Bryn for money. And the first thing he asks is if I've spent all of the money he transferred last time. I haven't had more than $10 in my account for more than a few days (waiting for autopay on my phone) since July. Bryn's birthday is next week. His first since we got married. Am I really going to spend his money buying him a present? Last year, without the child support, this wasn't an issue - I had my financial aid. This year? I just want to know that my bills are getting paid. Is it cold in here?

So, my thesis fell through, for a lot of reasons. I knew what I wanted to do; everyone on my committee tweaked it until I didn't really recognize it. I did the reading that they wanted and discovered that what they wanted was stupid (like I thought) and I couldn't make a five page paper, let alone sixty-five, about how stupid my thesis was. I still think my original idea would work, but now I can't prove it. No one wanted to read it. Thesis option has been scratched. Since I'm not writing a thesis anymore, I need to take more courses and take broader comprehensive exams. So we're here in Burlington for another semester, at least.

I hate Burlington. Everything is more expensive than it needs to be. I have so few friends up here that I am surrounded by people and completely isolated at the same time. I am tethered to the house by my homework and the baby. Housework needs to get done increasingly by me now that Bryn is working so much. And no one just drops in. I miss having friends who would just drop by. I miss having friends I could drop in on. I don't know where a single one of my friends lives up here. Doesn't matter. They all have jobs too.

Family.
My mother moved up here! That was cool. She just finally got a job. Second day? She wakes up from a dead sleep with a sore throat. She gets to try again next week. I'm really worried. She has a history of absenteeism, and I don't want it following her to the new job. I worry about her health, but what is the English major going to tell the Registered Nurse?
My father still hasn't seen Atticus. He lives two hours away and hasn't made the trip. But he did write a check for his lifetime hunting and fishing license, so there's that. I haven't called him in months. Not even for his birthday. Daughter of the freaking year... I just hate the guilt-trips.
Bryn's mom... She came (from freaking Florida, Dad) to see Atticus; but she's gone home now.
Alex is awesome. Until she makes me want to throw her outside. The morning clothes argument. The afternoon homework struggle. The nightly bedtime battle. Thank God Nana lives nearby now.

Bryn. He's not a mind reader. He's a good man trying to make the best out of a bad situation. He works hard and he comes home tired and sore. I just want to curl up with him and let everything else go to hell. But he needs some alone time and time with his friends, and the baby and Alex need tending to...

I just wish I felt necessary. Bryn could handle the mornings without me if he got up earlier. And he could go to bed earlier if he weren't waiting up for me. I stress him out and make him worry; that's not contributing. I feed the baby. That's all I can do that Bryn can't do better on his own.

He knows that I'm not right. We just talked about it. He's been worried for three weeks now. I don't eat much. I don't hydrate. I shower on Wednesday and sometime during the weekend. I'm still going to class and getting all my homework done, but that's about it. The kitchen is gross. Mom being around has been helpful - she does dishes and laundry. She also holds the baby so I can do some stuff. But she isn't always here. And sometimes I need to go out.

Yesterday, I found myself running errands in three day old jeans and my hair was still in the ratty ponytail I'd put up the night before. I cleaned up a bit and took Al to caramel apple dipping, then ran home to start supper. Bryn got home, Al got home, and supper was still cooking. Then we had to leave for bowling with our resident advisors. Alex really wanted to go. We had promised... I took supper out of the oven and we went bowling.

It was nice getting out with everyone. And we weren't sitting in the dark ignoring each other. I didn't even score a 50... Bryn did really well. Alex did really well. I want to go again and prove that I can do better. I used to average between 150 and 175... But that was years ago.

I dropped Bryn and Al at home and went to a party. It was nice being out with people from the program (I guess I do know where one person lives...) and beyond. English people and queer folk were invited for board game night. I had to bring Atticus. I was dehydrated so I was confined to water. I was lousy at the board game and I was working on a headache, but I had fun. I think I talked too much. It's been a while since I talked to grown ups other than Bryn or Mom.

Today at a child's birthday party I think I was obviously not with it. The mom kept trying to include me in conversation and she smiled at me a lot. Alex's present was the smallest (and cheapest) and she specifically came over to compliment the game and thank me. I mean, I thought it was neat, but it wasn't that cool. And in hindsight, not a birthday party present. Too small, not showy enough. Al wasn't having much fun, which didn't help my mood. Store cake frosting gives Al a stomach ache, so she hates cake time. She's only ice skated once before, so falling down hurt but she was a trooper. I also failed to get her properly prepared. No hat, no gloves, no helmet. She got a loaner helmet. Remind me to check her for lice tomorrow. At the end of the party the mom thanked me for coming and hugged me. I nearly started crying. I was done. I'd nursed the baby twice, tended to Al's needs and whims, and comforted her poor feet, knees, and hands, stroked her ego and pointed out that no one finished their piece of cake. Al would not shut up most of the way home. I was so done. I just wanted to be done. I fell into Bryn's arms when we got home.

I wanted a nap. I hate that all I want to do is curl up in bed and watch Monsters Inc.

I have an appointment with my brain care specialist on Tuesday. Bryn and I think I need to go back on medication. I've been worse, but we need to get this now. Two or three weeks ago would have been better, but you work with what you've got.

If it were just the situational stuff, I'd be perfectly entitled to being down. Having just had a baby... why does that make me feel guilty about being down? I've always advocated for PPD selfcare, awareness, acceptance and love. It's hard to do it for myself.

New Purpose

Atticus is no longer a belly-dweller. I want to keep writing, for what it's worth. I have even less free-time...

Alex's baby book is embarrassing. I filed out two pages and failed to tape her bracelet in, so it falls out when anyone moves it. In my defense, I was in a bad place when I had Alex and I never took the time to amend it. I'd like to use this blog to redeem myself.

I was thinking that I could keep you all posted on the doings of the kids (she's at school, he's nurse-napping in my lap), and take some time to examine a specific topic (diapers and nursing are composing themselves as I type this).

As always, thrilled to get comments or prompts for posts.

Thanks for reading thus far, I appreciate it.

August 27, 2012 1:07am

Less than 20 hours after my water broke my baby boy came into the world.

I woke up at 5:30 thinking I had wet the bed. It wasn't wet, but I went to the bathroom just in case. I uncleanched my Kegel and there was a gush of fluid. I made no mess! I woke up Bryn and despite not having contractions to speak of and Martha's advice to rest, we were both awake and making sure we had everything we needed all packed up.

Boo woke up easily and we got her dressed and ready. My contractions got harder and regular at about 5 minutes apart. We called the midwife again and headed to the hospital.

En route I called and texted everyone who needed to know. My mom would meet us there. Bryn's mom was concerned for me but wanted to know how Bryn was holding up. Bryn's sister was MIA. This was not good. She was on Boo Duty. Turned out she was in class and would meet us at the hospital ASAP after class was done.

As it was a Sunday morning, there was no one at registration or information. I'm glad we had toured the hospital recently; we found the Birth Center without a problem.

I wasn't much more dilated than I had been on Friday, but I was 75% effaced. I walked. I sat. I watched TV with Boo. I played Uno. Bryn took me for a walk in the hospital proper. We looked at the art on the walls. We looked at the pretty garden. I didn't want to go out; it was too hot. We walked down the ramp towards the cafeteria and took the stairs back up. And we did it again. I tried to squat, but it just didn't feel right and I couldn't get back up. I wasn't getting anywhere. We talked about Pitocin.

I let the Pitocin conversation marinate for four hours.

I was at 2 cm at 11 am
I was at 2 cm at 3 pm
I agreed to the Pitocin at 7 pm

I resisted the Pitocin because it felt like failure. It felt like I was conceding. I was agreeing that I could not birth a child without medical intervention. My body, as rounded and feminine as it was, could not, on its own, give birth to a baby. I was also agreeing to a needle in my arm, a monitor on my ample waist, and a monitor for the baby. Instead of the happy-hippy ideal I had envisioned, I was getting a medicalized, monitored, machine-that-goes-ping birth. I'm not sure which I found more demoralizing, the failure of my body or the loss of my dream.

If I had been happy with Alex's birth, I may not have fought so long. As it was, I felt anger every time I thought about her birth. Artificially ruptured membranes, Pitocin, machine-that-goes-ping, IV fluids, episiotomy, and not seeing her for an hour after her birth all equaled me hating the birthing process - which was why I went with a midwife this time. To avoid all of that. The midwife nudged in the early afternoon, and then we flat out talked about it. Then I cried to Bryn about it.

Then I saw the worry and pain in his eyes during my contractions and when he saw the disappointment in my eyes every few hours when I was given the news that I hadn't dilated any further. I saw the worry and pain I was feeling reflected in his eyes and I knew that I needed the drug.

At 7:30 pm my drip was started.

This is when it was suggested that I labor in the tub. Hooked up to an IV stand, two elastic belts, hand itchy, contractions every three minutes is not when I would consider it to be the perfect time for a bath. Midwives are weird that way.

I was in the tub for less than an hour, shifting positions every few contractions, when I was told I had to get out of the tub. ...first you want me in the tub, now you want me out of the tub... I resisted just about everything the midwife asked me to do. Every position change was delayed by a couple of contractions. My main fear was that I would be mid-shift and a contraction would hit. I was afraid of being in an awkward position and being that much more uncomfortable if I was caught off guard like that.

At about 11:30 pm I was finally dilated to 9 cm.
At 12:30 am I had my midwife up to her elbow pushing my cervix out of the way while I was blowing instead of pushing. I really wanted to push. I mean, if you have never been in labor you will never know the difference between wanting to do something and needing to do something. There is a difference between wanting to push and needing to push. That line is filament thin and once broached, being told you can't makes one slightly homicidal.


At one point my midwife told me to try being on my knees. Suddenly, I felt really good about where everything was going. This was the position of my dream! I wound up (after dodging my IV line and threading around the fetal monitor line) on my knees leaning over the back of the raised head of the bed. I still wasn't allowed to push with every contraction - I wasn't fully dilated - but I was closer to my ideal birth position.

While I was on my knees I was alternately pushing and blowing through contractions. Martha wanted me to motorboat with my mouth. If your mouth is relaxed, the rest of your muscles tend to follow that cue. She wanted my cervix to relax so she could push it out of the way. I can't motorboat when I'm not stressed out. I just can't. I wound up just saying, "Bubububububububub..." and making Bryn and Martha giggle. It became a weird mantra for me to focus on instead of pushing. Om never meant anything to me; apparently, Bububub does.

I was Bububub-ing a lot, and not doing much pushing. I was getting pretty ticked off. Then I heard it! A baby crying! The woman next door had stopped screaming and I could hear her baby crying. If I listen to Martha and keep my focus, I'll have a baby too! Baby! There is a baby at the end of all this pain! Focus!

I needed to change position again. I was so focused on the baby, I didn't mind, much. I did have a contraction while rolling and navigating the lines and leads connecting me to the machines. It was just as miserable as I'd imagined.

I wound up on my back, slightly propped up. Not what I'd thought ideal, but everyone seemed to like it better. Martha, not the contractions, nor the cervix, was making me uncomfortable. She was trying to widen my pelvis and was sitting on the bed, with her hand in my foreshortened vagina and smack up against my bent right leg. I fought very hard against my desire to straighten that leg and send her onto the floor. I hated her hand. I was hating her. It was all her fault. It was her fault I had the Pitocin, it was her fault I was on my back, it was her fault I couldn't push, and it was her fault I was so uncomfortable. And then, I was allowed to push!

I don't remember how many times I pushed, but I ignored a lot of directions to push again. Sometimes I could only push once in a contraction, I was just too tired. I remember watching my mom. She was standing at the far side of the room, against the wall, with her hands at the small of her back. That is her pose when she's uncomfortable or unhappy. Something was wrong. I asked her if she was alright. She said she was fine and I had another contraction.

I pushed and pushed and eventually there was a baby on the bed with me. I was not really with it. I saw Bryn smiling and crying and cutting the umbilical cord. I thought we were going to wait for it to stop pulsing. Had it stopped pulsing already? You're restarting the Pitocin to help me deliver the placenta? I didn't speak. I was too foggy. Baby! Where is he? I can hear him! Martha was checking my placenta. It was whole. Here's the baby. Huh?

He was awake and alert, but with no desire to latch and nurse. That's okay, we'd get to that later.

Apparently, the Pitocin had been stopped at 10:30. I'd done the last 5 cm on my own. But the baby's heart rate had been dipping with every contraction at about the same time, that was why a lead had been put on his little head at that time. I was so concerned about the lead in his head that I hadn't noticed that my medicine had been stopped. The lead in his head was what was making everyone so anxious. Well, it was the numbers the lead was providing. His heart rate would dip to nearly 40 during contractions at the end. It would bounce back up, but it was really concerning everyone who could see the monitor. The rate didn't fall so much while I was on my back. Yes, I felt less productive, but it put less stress on the baby. Fair trade off.

Bryn cut the cord while it was still pulsing because the baby had to go to the warming table and be checked by the pediatrician who had swooped in with a pediatrics nurse at the last minute. He was wearing a t-shirt and jeans. He hadn't even time to throw on a white coat. The baby's initial APGAR was a 3. They gave him a little oxygen and his second APGAR was a 9. The pediatrician looked just as happy as Bryn when he handed over my baby boy.

My perfectly healthy, beautiful baby boy.