The Tangled Web of Postpartum Revelations

*Warning: this essay contains descriptions of medical trauma and obstetric violence

Two nights after my son was born, I had a nightmare. In my dream, I had just given birth. I inexplicably found myself in an unknown body of water, bobbing along gentle waves on a surfboard. My baby and my husband were nowhere in sight. The night sky was dotted with bright, glittering stars, and the lights in the buildings beyond the harbor shone brightly. There were people all around me, also on surf boards, and despite their friendly chatter, I felt a deep sense of dread.

A massive tidal wave appeared in the distance. Everyone started to panic. The dark blue wave gained height and speed, and all I could do was paddle to shore as it advanced on us all. I managed to grip onto a small boat that was pushed towards me, as the tsunami crashed all around us.

I was swept ashore, which wasn’t a sandy beach, but the linoleum floor of a shopping mall. The building was partially ruined by the tsunami. The lights were flickering, and chunks of rubble lay strewn about haphazardly. As I made my way through the mall, there were groups of people huddled everywhere. Some were injured and everyone seemed angry. I recognized no one. Panic-stricken, I frantically looked for my family.

“I just gave birth!” I screamed. “Please help me! I can’t find my baby. I need my baby!”

I also begged for medical assistance. But no one would speak to me or even look at me. The mall became a labyrinth. I wound around stairwells, and trudged up and down pathways, pleading with passersby. No one seemed to care. They ignored my cries and refused to make eye contact with me. The longer I looked, the more distraught I became.

I felt crazed. Why wouldn’t anyone respond to me? I kept wandering through the mall, desperate to find my family. Streams of dark blood trickled down my thighs, as I kept searching. I looked behind me to see a trail of bloody footprints in my wake.

I woke up with tears rolling down my cheeks. My tiny newborn slept soundly on my chest. I could feel his hot breath on my skin. I held him closely, still panicked and befuddled from my nightmare. It was the first time I had slept for a long stretch since my son’s birth, and the dream disturbed me. I couldn’t get over the feeling of helplessness, and the image of my bloody footprints staining the floor burned into my brain.

Scenes from the aftermath of my son’s birth flashed through my mind: dark blood clots the size of soft balls, streaks of dried blood on my toilet seat, my midwife’s furrowed brow, a paramedic’s black boots, the bright gleam of an exam light over the hospital bed, a pile of bloody water wipes, and my nurse’s kind face as she wiped blood off of my feet. The phrases “severe postpartum hemorrhage” and “uterine atony” echoed through my mind. I looked down at my hands that cradled my son, and I noticed that there was still dried blood underneath every fingernail.

The sun peeked through the blinds of my bedroom window, as I watched my son’s chest rise and fall. I couldn’t stop the steady stream of tears that leaked down my face. My mind was sluggish from lack of sleep and blood loss. Fighting disorientation, I knew I needed to compartmentalize what had happened until I was ready to fully address it. I wanted to be strong for my son, and I didn’t want my joy to be overshadowed by a fluke medical event.

I made myself a promise that morning: I would sort everything out eventually. But I needed to be present and take new motherhood one day at a time. If I focused on the bad moments for too long, I was afraid they’d devour me. “I’ll come back to you,” I promised those dark memories, as I mentally put them in a box and shut the lid. I closed my eyes and conjured the triumphant and peaceful scene when my son was born. I held those feelings of love and empowerment close, and I rode that high for the first few weeks of motherhood.

The first flashback came barreling into my mind like a repulsive specter when I was three months postpartum. I was watching an action movie with my husband. Our son lay on the floor on his activity mat, cooing and kicking. I watched in horror as the lead villain sifted through a chunk of bloody brain. Nausea rolled through, and I quickly turned away from the tv. The dark red mass of brain looked exactly like the blood clots that had come out of me in the hours following my son’s birth. We turned off the movie, but I couldn’t stop the flashbacks from coming. The lid I had put on the bad memory box had shifted open, and there was nothing I could do to close it.

In the months that followed, despite my ability to function day to day and my happiness in new motherhood, dark memories and unpleasant feelings would sneak up on me. The thought of getting blood drawn at an upcoming doctor’s appointment made me break out in a cold sweat. This led to putting it off indefinitely. The sight of blood in a movie or tv show made me feel nauseous and unsettled.

The worst feelings struck when I thought of scheduling a well women’s OBGYN appointment. I would tense up just thinking about anyone touching me in that area. Anything remotely having to do with doctors or medical experiences made me spiral. Scenes of the bright lights and exam table at the hospital would flash into my mind and would leave me feeling violated and angry.

Rage rose up inside me like the tidal wave from my dream, and I knew I had to track the source. I was at peace with my son’s birth, and as the months passed by, I came to terms with the hemorrhage that followed. However, there was a lingering dark presence in my mind that needled me, stirring up my revulsion. I kept going over the events of my son’s birth, the hemorrhage, and my postpartum hospital stay, but besides seeing a lot of blood, nothing felt like it justified the sense of disgust I kept feeling. I finally realized the trauma that kept bubbling up predated that entire sequence of events. After months of flashbacks and intrusive thoughts, I found the source: a routine doctor’s appointment fifteen years earlier.

I was 20 years old, and I was very nervous. I had never been to a gynecologist before. My very kind pediatrician, who I had known for years and trusted greatly, had always done my pap smears. But I was a junior in college, and I needed to establish care with an actual gynecologist.

This new doctor was brusque and rude. She glanced at my chart, firing off questions. She barely looked up at me. She didn’t walk me through what she was doing or explain what would come next- she just went through the motions like an automaton. I felt uncomfortable but I was glad that she was moving quickly. I just wanted the appointment to be over. I remember thinking that I would book my next appointment with the kind nurse practitioner who my mom preferred, instead of this curt doctor.

Toward the end of the exam, I asked her a deeply personal question about something I was experiencing during intimate moments with my boyfriend at the time. I felt embarrassed, but I still summoned the courage to talk to her about it. Despite her rude bedside manner, she was a doctor, so naturally I thought she was the best person to ask since my question was about sexual disfunction.

In response to my question, without warning or explanation, she proceeded to touch me in a very sensitive area. I froze and my heart started racing. She kept touching me and asked me a follow up question related to what I had told her, but I couldn’t even hear what she said. I could not believe what was happening. I stammered out an answer, and she stopped. I was shocked. She never asked for permission or even told me what she was doing. She seemed frustrated with my response and left my question unanswered. The appointment wrapped up quickly after that, and I left feeling very confused.

I never saw that doctor again. Disturbed by what transpired, I switched practices and put the event out of my mind. Looking back now, I can see how that terrible moment changed the entire course of my pregnancy, birth experience, and postpartum recovery over a decade later. The memory of that unsettling situation lay dormant inside of me, and the minute I found out I was pregnant, this fierce anger coupled with an extreme will to protect myself came to the forefront of my psyche.

It's been freeing to realize that being assaulted by a doctor fifteen years ago was at the root of my post-traumatic stress flashbacks and lingering dark feelings. Going through a postpartum hemorrhage was harrowing, but that pain and stress had a purpose: becoming a mother to my precious son. And I would endure that a thousand times over if it meant bringing my beautiful child into this world. But it’s taken me much longer to let go of those feelings of helplessness as I was demoralized in a cold exam room by a woman who was supposed to be a trustworthy figure.

My son’s peaceful birth buoyed me in the wake of my postpartum hemorrhage, and now I view his entrance into the world as the ultimate taking back of my power. If that doctor from fifteen years ago hadn’t acted in such a manner, I would have never walked away from the patriarchal hospital obstetrics system.

The doctor at my confirmation of pregnancy appointment echoed the same shades of contempt and belittlement. I opted not to get an internal ultrasound, because I wasn’t comfortable with it. The doctor argued with me and didn’t take any of my concerns or blatant discomfort into consideration. He was so condescending, and I could see that women in his care rarely pushed back or said no to him. Or if they did, he intimidated them into doing what he wanted. After that appointment, I looked at my husband and said, “I’m never going back there.” And I didn’t.

I found a highly skilled, certified homebirth nurse midwife, who gave me the beautiful gift of informed consent. She never touched me without asking. She gave me all my options and never once swayed me in any direction. It was true, collaborative care. We were a team, but I had autonomy over my own decisions. There was no practice policy I had to abide by, there were no strict protocols I had to follow. Every single appointment was like a birth class that was taught by a warm, caring individual. She and her team took time with me to make sure I felt informed and empowered.

The day my son was born, I was calm and focused. I let the contractions come in waves, and I rode them instead of fighting them. I closed my eyes as I labored and went to a peaceful place deep inside of myself. Time passed so quickly, and before I knew it, my body was pushing for me. My midwife helped me into the birthing pool, and I surrendered to the rhythm of the end of my labor. I breathed into each pushing contraction positioned on my hands and knees, while my birth team quietly observed me. There was no poking or prodding, there was no doctor with an ego or a God complex. It was just me, my husband holding my hand, and three of the wisest women I’ve ever met gently watching my son’s birth unfold.

When the final push occurred and my son gently surged into the water, I lifted him up quickly and put him on my chest. He was pink and crying and perfect. I sat back against the soft edge of the pool, and I smiled wide as tears came to my eyes. The moment felt alive with triumph. I pushed without coaching or without someone telling me how dilated I was. I pulled my own child out of the water to meet the world. I delivered my own baby. As a woman, I have never felt more empowered than I did in that moment.

Six hours after my son was born, I slowly hemorrhaged. I watched my midwife work with such skill- assessing my bleeding and swiftly administering medications, all the while explaining everything that was going on and giving me all my options. My body responded very slowly to those lifesaving medications, so my midwife advised me to transfer to the hospital for some extra care. Not only was she with me every step of the way, but I watched as she became the most senior medical staff member in the room when we entered a hospital setting. The doctor and nurses were knowledgeable, but my experienced midwife quietly outshone them all.

Now that I’ve navigated my way out of the tangled dark thoughts and gory flashbacks from the assault and my postpartum hemorrhage, I feel very grateful. I believe everything that happened led me to become a strong and empowered mother. It’s liberating to know that there are wise and respectful birth workers out there who can help you transition from maiden to mother- unlike the obstetricians who would keep you a maiden forever. To me, becoming a mother means living my life with a confidence that I never had before. And it’s that confidence, coupled with vulnerability and courage, that will bolster me to speak out about obstetric violence and the rights of laboring mothers.